Alcohol consumption and ischemic heart disease mortality in Russia.

PubMed

Razvodovsky, Yury E

2012-01-01

It has been repeatedly emphasized that alcohol provides the most plausible explanation for both the high rate of cardiovascular mortality rate and its dramatic fluctuations in Russia over recent decades, while other traditional risk factors identified in epidemiological studies have little predictive value. The aim of this study was to examine the relation between alcohol consumption and ischemic heart disease (IHD) mortality rates in Russia. A ge-standardized sex-specific male and female IHD mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means of ARIMA time series analysis. The results of the analysis showed that alcohol consumption was significantly associated with both male and female IHD mortality rates: a 1-liter increase in overall alcohol consumption would result in a 3.9% increase in the male IHD mortality rate and a 2.7% increase in the female IHD mortality rate. As a conclusion, the results of this study provide indirect support for the hypothesis that the drastic fluctuations in IHD mortality in Russia over recent decades are related to alcohol, as indicated by the close temporal association between number of deaths from IHD and overall alcohol consumption per capita.

Alcohol and Drug-Related Mortality among Enrollees in the World Trade Center Health Registry (WTCHR), 2004-12.

PubMed

Welch, Alice E; Zweig, Kimberly Caramanica; Liao, Tim; Yip, Jennifer; Davidson, Alexander; Jordan, Hannah; Brackbill, Robert; Cone, James

2018-06-13

Have World Trade Center Health Registry (WTCHR) enrollees experienced increased alcohol and drug-related mortality associated with exposures to the events of 9/11/01? Cases involving death due to alcohol or drugs between 2003 and 2012 in New York City (NYC) were obtained through a match of the Registry with NYC Vital Records. We compared ICD-10-coded deaths where alcohol and/or drug use was the underlying cause of death to deaths from all other causes. Of 1,193 deaths, 66 (5.5%) were alcohol/drug-related. Adjusted odds ratios for dying from alcohol/drug-related causes were significantly elevated for enrollees who were male, age 18-44 years, smoked at enrollment, had 9/11-related probable PTSD, were rescue/recovery workers, or sustained an injury on 9/11/01. Following a major disaster, alcohol and drug-related mortality may be increased.

Alcohol consumption and pancreatitis mortality in Russia.

PubMed

Razvodovsky, Yury E

2014-07-28

Pancreatitis is a major public health problem with high associated economic costs. The incidence of pancreatitis has increased in many European countries in recent decade. Accumulated research and empirical evidence suggests that excessive alcohol consumption is a major risk factor for both acute and chronic pancreatitis. The aim of this study was to examine the aggregate-level relation between the alcohol consumption and pancreatitis mortality rates in Russia. Age-standardized sex-specific male and female pancreatitis mortality data for the period 1970-2005 and data on overall alcohol consumption were analyzed by means ARIMA (autoregressive integrated moving average) time series analysis. Alcohol consumption was significantly associated with both male and female pancreatitis mortality rates: a 1 liter increase in overall alcohol consumption would result in a 7.0% increase in the male pancreatitis mortality rate and in 2.3% increase in the female mortality rate. The results of the analysis suggest that 63.1% of all male pancreatitis deaths and 26.8% female deaths in Russia could be attributed to alcohol. Conclusions The outcomes of this study provide indirect support for the hypothesis that unfavorable mixture of higher overall level of alcohol consumption and binge drinking pattern is an important contributor to the pancreatitis mortality rate in Russian Federation.

[Associations between mortality and alcohol consumption in Lithuanian population].

PubMed

Grabauskas, Vilius; Prochorskas, Remigijus; Veryga, Aurelijus

2009-01-01

The objective of the study was to assess alcohol-related mortality that potentially might explain an increasing trend in overall mortality of Lithuanian population, which started after 2000 and peaked in 2005. An empiric analysis of national mortality and other statistical data as well as their international comparisons. An analysis of available data clearly indicates that a decline in mortality in 1998-2000, i.e. during the beginning of the National Programme of Health, as well as its increase in 2001 and 2005 were predominantly determined by cause-specific deaths of two groups: deaths from diseases of the circulatory system (mainly ischemic heart disease) and alcohol consumption-related deaths (liver cirrhosis, accidental poisoning by alcohol, accidents, etc.). A certain proportion of deaths, which were caused by alcohol, were wrongly assigned to the deaths from diseases of the circulatory system due to uncertainties in filling-in death certificates. By approximate estimates, at least one-quarter of increase in all-cause mortality between 2002-2004 and 2005-2007 could be explained by an increase in alcohol consumption, accounting for additional 880 deaths on average per year. In the year 2007, 12.6% (n=5760) of all deaths were somehow related to alcohol consumption. A comparative analysis demonstrated that mortality and alcohol consumption trends were going in parallel over the last decade. The systemic decline in mortality observed in Lithuania from 1995 stopped in 2000 after a decrease in alcohol taxes, which resulted in an increase in alcohol accessibility and consumption. An average annual increase in alcohol consumption over the period of 2001-2004 was 7%; it increased up to 17% in 2005 and accounted for 12% annual increase on average within 2005-2007. Negative trends in alcohol-related morbidity and mortality in Lithuanian population most notably registered in 2001 and 2005 were largely influenced by uncontrollable increase in alcohol consumption over the

An evaluation of the impact of a large reduction in alcohol prices on alcohol-related and all-cause mortality: time series analysis of a population-based natural experiment

PubMed Central

Herttua, Kimmo; Mäkelä, Pia; Martikainen, Pekka

2011-01-01

Background We examined the effect of a large reduction in the price of alcohol that occurred in Finland in 2004 on alcohol-related and all-cause mortality, and mortality due to cardiovascular diseases (CVDs) from which alcohol-attributable cases were excluded. Methods Time series intervention analysis modelling was applied to the monthly aggregations of deaths in Finland for the period 1996–2006 to assess the impact of the reduction in alcohol prices. Alcohol-related mortality was defined using information on both underlying and contributory causes of death. Analyses were carried out for men and women aged 15–39, 40–49, 50–69 and >69 years. Results Alcohol-related deaths increased in men aged 40–49 years, and in men and women aged 50–69 years, after the price reduction when trends and seasonal variation were taken into account: the mean rate of alcohol-related mortality increased by 17% [95% confidence interval (CI) 1.5, 33.7], 14% (95% CI 1.1, 28.0) and 40% (95% CI) 7.1, 81.7), respectively, which implies 2.5, 2.9 and 1.6 additional monthly deaths per 100 000 person-years following the price reduction. In contrast to alcohol-related mortality, CVD and all-cause mortality decreased: among men and women aged >69 years a decrease of 7 and 10%, respectively, in CVD mortality implied 19 and 25 fewer monthly deaths per 100 000 person-years, and a decrease of 7 and 14%, respectively, in all-cause mortality similarly implied 42 and 69 fewer monthly deaths. Conclusion These results obtained from the time series analyses suggest that the reduction in alcohol prices led to an increase in alcohol-related mortality, except in persons <40 years of age. However, it appears that beneficial effects in older age, when CVD deaths are prevalent, counter-balance these adverse effects, at least to some extent. PMID:19995860

Coffee, alcohol and other beverages in relation to cirrhosis mortality: the Singapore Chinese Health Study

PubMed Central

Goh, George Boon-Bee; Chow, Wan-Cheng; Renwei-Wang; Yuan, Jian-Min; Koh, Woon-Puay

2014-01-01

Limited experimental and epidemiologic data suggest that coffee may reduce hepatic damage in chronic liver disease. The association between consumption of coffee and other beverages, and risk of cirrhosis mortality was evaluated in The Singapore Chinese Health Study. This is a prospective population-based cohort of 63,275 middle-aged and older Chinese subjects who provided data on diet, lifestyle and medical histories through in-person interviews using structured questionnaire at enrollment between 1993 and 1998. Mortality from cirrhosis in the cohort was ascertained through linkage analysis with nationwide death registry. After a mean follow-up of 14.7 years, 114 subjects died from cirrhosis; 33 of them from viral hepatitis B (29%), two from hepatitis C (2%), and 14 from alcohol-related cirrhosis (12%). Compared to non-drinkers, daily alcohol drinkers had a strong dose-dependent positive association between amount of alcohol and risk of cirrhosis mortality. Conversely, there was a strong dose-dependent inverse association between coffee intake and risk of non-viral hepatitis related cirrhosis mortality (p for trend=0.014). Compared to non-daily coffee drinkers, those who drank two or more cups per day had 66% reduction in mortality risk (HR=0.34, 95% CI=0.14–0.81). However, coffee intake was not associated with hepatitis B related cirrhosis mortality. The inverse relationship between caffeine intake and nonviral hepatitis-related cirrhosis mortality became null after adjustment for coffee drinking. The consumption of black tea, green tea, fruit juices or soft drinks was not associated with risk of cirrhosis death. Conclusion This study demonstrates the protective effect of coffee on non-viral hepatitis related cirrhosis mortality, and provides further impetus to evaluate coffee as a potential therapeutic agent in patients with cirrhosis. PMID:24753005

Coffee, alcohol and other beverages in relation to cirrhosis mortality: the Singapore Chinese Health Study.

PubMed

Goh, George Boon-Bee; Chow, Wan-Cheng; Wang, Renwei; Yuan, Jian-Min; Koh, Woon-Puay

2014-08-01

Limited experimental and epidemiologic data suggest that coffee may reduce hepatic damage in chronic liver disease. The association between consumption of coffee and other beverages and risk of cirrhosis mortality was evaluated in the Singapore Chinese Health Study. This is a prospective population-based cohort of 63,275 middle-aged and older Chinese subjects who provided data on diet, lifestyle, and medical histories through in-person interviews using a structured questionnaire at enrollment between 1993 and 1998. Mortality from cirrhosis in the cohort was ascertained through linkage analysis with nationwide death registry. After a mean follow-up of 14.7 years, 114 subjects died from cirrhosis; 33 of them from viral hepatitis B (29%), two from hepatitis C (2%), and 14 from alcohol-related cirrhosis (12%). Compared to nondrinkers, daily alcohol drinkers had a strong dose-dependent positive association between amount of alcohol and risk of cirrhosis mortality. Conversely, there was a strong dose-dependent inverse association between coffee intake and risk of nonviral hepatitis-related cirrhosis mortality (P for trend = 0.014). Compared to non-daily coffee drinkers, those who drank two or more cups per day had a 66% reduction in mortality risk (hazard ratio [HR] = 0.34, 95% confidence interval [CI] = 0.14-0.81). However, coffee intake was not associated with hepatitis B-related cirrhosis mortality. The inverse relationship between caffeine intake and nonviral hepatitis-related cirrhosis mortality became null after adjustment for coffee drinking. The consumption of black tea, green tea, fruit juices, or soft drinks was not associated with risk of cirrhosis death. This study demonstrates the protective effect of coffee on nonviral hepatitis-related cirrhosis mortality, and provides further impetus to evaluate coffee as a potential therapeutic agent in patients with cirrhosis. © 2014 by the American Association for the Study of Liver Diseases.

Projections of alcohol- and tobacco-related cancer mortality in Central Europe.

PubMed

Bray, I; Brennan, P; Boffetta, P

2000-07-01

Central European mortality rates for cancer sites related to tobacco and alcohol have increased rapidly in recent decades. From a public health point of view, it is of considerable interest to know whether these past increases in cancer mortality will continue into the future. Cancer mortality rates for the period 1965-1994 in Bulgaria, Czech Republic and Slovakia (analysed together), Hungary, Poland, and Romania were analysed for cancers of the larynx, oral cavity and pharynx, oesophagus, bladder, kidney, and pancreas. Using a Bayesian age-period-cohort approach, we have calculated smoothed observed rates. The effects of period and cohort were extrapolated to estimate mortality projections for 1995-99, 2004-09, and 2005-09. Mortality rates for all sites are projected to increase in most countries. Hungary has the highest projected rates for most sites, and particularly rapid increases are expected for cancers of the oral cavity and pharynx and of the larynx in Hungarian men. The smoothed 1990-94 male mortality rates for these two sites of 16. 32/100,000 and 8.70/100,000, respectively, are projected to reach 35. 17/100,000 for cancer of the oral cavity and pharynx and 14.12/100, 000 for cancer of the larynx by the period 2000-04. For kidney cancer, former Czechoslovakia has the highest observed and projected mortality rates. The smoothed 1990-94 rate of 8.37/100,000 is expected to increase 24% to 10.38/100,000 by 2000-04. Our results indicate that further increases may be expected on top of the already high cancer mortality levels in Central Europe. Policies to reduce alcohol consumption and prevent smoking in younger generations are necessary to reduce mortality as these cohorts age. Copyright 2000 Wiley-Liss, Inc.

The Association between Alcohol Availability and Mortality: Its Significance to the Prevention of Alcohol Problems.

ERIC Educational Resources Information Center

Beshai, Nabila

1988-01-01

Examined alcohol availability and mortality data from Los Angeles (California) County in 1981 and 1982. Found association between alcohol availability and mortality, evident for death from heart disease, cancer, alcohol-related death, and death from all causes. Findings provide support for public health approach focused on limiting alcohol…

Trends in alcohol-related mortality in East and West Germany, 1980-2014: age, period and cohort variations.

PubMed

Piontek, Daniela; Kraus, Ludwig

2018-05-01

Several indicators suggest that the extent and trends of alcohol-related mortality differ between East and West Germany. Regional drinking patterns and differences in health-care systems are assumed to affect the risk of dying from an alcohol-induced disease. The study addresses two questions: (1) what are the unbiased and independent age, period and cohort effects on alcohol-related mortality trends in Germany; and (2) do these trends differ between East and West Germany? Data on alcohol-related mortality for East and West Germany came from the national causes of death register for the years 1980-2014. Analyses included all deaths fully attributable to alcohol based on the International Classification of Diseases (ICD-9 and ICD-10). Gender-stratified age-period-cohort analyses were conducted using the intrinsic estimator model. Age effects showed a concave pattern with a peak at ages 55-64 years in both regions. Incidence rate ratios (IRR) in East Germany were highest in the years 1990-1994 (men and women: IRR = 1.52) and declined thereafter. In West Germany, IRR were lowest in 1980-1984 (men: IRR = 0.81, women: IRR = 0.75) and stabilized at approximately 1.10 since 1995-1999. Cohort effects showed continuously lower IRR for those born after 1955-1959 in the East and those born after 1945-1949 in the West. Patterns for males and females were comparable. The results suggest that alcohol-related mortality showed different trends in East and West Germany, which can be explained partly by different drinking patterns before and changes in the health-care system after the reunification. © 2018 Society for the Study of Addiction.

Alcohol in Greenland 1951-2010: consumption, mortality, prices.

PubMed

Aage, Hans

2012-01-01

Fluctuations in alcohol consumption in Greenland have been extreme since alcohol became available to the Greenland Inuit in the 1950s, increasing from low levels in the 1950s to very high levels in the 1980s - about twice as high as alcohol consumption in Denmark. Since then, consumption has declined, and current consumption is slightly below alcohol consumption in Denmark, while alcohol prices are far above Danish prices. Description of historical trends and possible causal connections of alcohol prices, alcohol consumption and alcohol-related mortality in Greenland 1951-2010 as a background for the evaluation of the impact of various types of policy. Time series for Greenland 1951-2010 for alcohol prices, consumption and mortality are compiled, and variation and correlations are discussed in relation to various policies aimed at limiting alcohol consumption. Corresponding time series for Denmark 1906-2010 are presented for comparison. The trends in alcohol prices and consumption followed each other rather closely until the 1990s in Greenland and the 1980s in Denmark. At this time, consumption stabilised while prices decreased further, but the effect of prices upon consumption is strong, also in recent years. A trend in Greenlandic mortality similar to consumption is discernible, but not significant. Among alcohol-related deaths cirrhosis of the liver is less prevalent whilst accidents are more prevalent than in Denmark. The effect of alcohol excise taxes and rationing upon consumption is evident. The stabilisation and subsequent decline in consumption since the mid-1990s, while alcohol prices decreased persistently, does not preclude continued effects of prices. On the contrary, price effects have been neutralised by other stronger causes. Whether these are government anti-alcohol campaigns or a cultural change is not clear.

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

Relative Mortality among Criminals in Norway and the Relation to Drug and Alcohol Related Offenses

PubMed Central

Skardhamar, Torbjørn; Skirbekk, Vegard

2013-01-01

Background Registered offenders are known to have a higher mortality rate, but given the high proportion of offenders with drug-addiction, particularly among offenders with a custodial sentence, higher mortality is expected. While the level of overall mortality compared to the non-criminal population is of interest in itself, we also estimate the risk of death by criminal records related to substance abuse and other types of criminal acts, and separate between those who receive a prison sentence or not. Methods Age-adjusted relative risks of death for 2000–2008 were studied in a population based dataset. Our dataset comprise the total Norwegian population of 2.9 million individuals aged 15–69 years old in 1999, of whom 10% had a criminal record in the 1992–1999 period. Results Individuals with a criminal record have twice the relative risk (RR) of death of the control group (non-offenders). Males with a record of use/possession of drugs and a prison record have an 11.9 RR (females, 15.6); males with a drug record but no prison record have a 6.9 RR (females 10.5). Males imprisoned for driving under the influence of substances have a 4.4 RR (females 5.6); males with a record of driving under the influence but no prison sentence have a 3.2 RR (females 6.5). Other male offenders with a prison record have a 2.8 RR (females 3.7); other male offenders with no prison record have a 1.7 RR (females 2.3). Conclusion Significantly higher mortality was found for people with a criminal record, also for those without any record of drug use. Mortality is much higher for those convicted of substance-related crimes: more so for drug- than for alcohol-related crimes and for women. PMID:24223171

A population-based study of premature mortality in relation to neighbourhood density of alcohol sales and cheque cashing outlets in Toronto, Canada

PubMed Central

Matheson, Flora I; Creatore, Maria Isabella; Gozdyra, Piotr; Park, Alison L; Ray, Joel G

2014-01-01

Objective Alcohol overuse and poverty, each associated with premature death, often exist within disadvantaged neighbourhoods. Cheque cashing places (CCPs) may be opportunistically placed in disadvantaged neighbourhoods, where customers abound. We explored whether neighbourhood density of CCPs and alcohol outlets are each related to premature mortality among adults. Design Retrospective population-based study. Setting 140 neighbourhoods in Toronto, Ontario, 2005–2009. Participants Adults aged 20–59 years. Measures Our primary outcome was premature all-cause mortality among adults aged 20–59 years. Across neighbourhoods we explored neighbourhood density, in km2, of CCPs and alcohol outlets, and the relation of each to premature mortality. Poisson regression provided adjusted relative risks (aRRs) and 95% CIs, adjusting for material deprivation quintile (Q), crime Q and number of banks. Results Intentional self-harm, accidental poisoning and liver disease were among the top five causes of premature death among males aged 20–59 years. The overall premature mortality rate was 96.3/10 000 males and 55.9/10 000 females. Comparing the highest versus lowest CCP density Q, the aRR for death was 1.25 (95% CI 1.15 to 1.36) among males and 1.11 (95% CI 0.99 to 1.24) among females. The corresponding aRR comparing the highest Q versus lowest Q alcohol outlet density in relation to premature mortality was 1.36 (95% CI 1.25 to 1.48) for males and 1.11 (95% CI 1.00 to 1.24) for females. The pattern of the relation between either CCPs or alcohol outlet density and premature mortality was typically J shaped. Conclusions There is a J-shaped relation between CCP or alcohol outlet density and premature mortality, even on controlling for conventional measures of poverty. Formal banking and alcohol reduction strategies might be added to health promotion policies aimed at reducing premature mortality in highly affected neighbourhoods. PMID:25518874

A population-based study of premature mortality in relation to neighbourhood density of alcohol sales and cheque cashing outlets in Toronto, Canada.

PubMed

Matheson, Flora I; Creatore, Maria Isabella; Gozdyra, Piotr; Park, Alison L; Ray, Joel G

2014-12-17

Alcohol overuse and poverty, each associated with premature death, often exist within disadvantaged neighbourhoods. Cheque cashing places (CCPs) may be opportunistically placed in disadvantaged neighbourhoods, where customers abound. We explored whether neighbourhood density of CCPs and alcohol outlets are each related to premature mortality among adults. Retrospective population-based study. 140 neighbourhoods in Toronto, Ontario, 2005-2009. Adults aged 20-59 years. Our primary outcome was premature all-cause mortality among adults aged 20-59 years. Across neighbourhoods we explored neighbourhood density, in km(2), of CCPs and alcohol outlets, and the relation of each to premature mortality. Poisson regression provided adjusted relative risks (aRRs) and 95% CIs, adjusting for material deprivation quintile (Q), crime Q and number of banks. Intentional self-harm, accidental poisoning and liver disease were among the top five causes of premature death among males aged 20-59 years. The overall premature mortality rate was 96.3/10,000 males and 55.9/10,000 females. Comparing the highest versus lowest CCP density Q, the aRR for death was 1.25 (95% CI 1.15 to 1.36) among males and 1.11 (95% CI 0.99 to 1.24) among females. The corresponding aRR comparing the highest Q versus lowest Q alcohol outlet density in relation to premature mortality was 1.36 (95% CI 1.25 to 1.48) for males and 1.11 (95% CI 1.00 to 1.24) for females. The pattern of the relation between either CCPs or alcohol outlet density and premature mortality was typically J shaped. There is a J-shaped relation between CCP or alcohol outlet density and premature mortality, even on controlling for conventional measures of poverty. Formal banking and alcohol reduction strategies might be added to health promotion policies aimed at reducing premature mortality in highly affected neighbourhoods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

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.

Individual- and area-level characteristics associated with alcohol-related mortality among adult Lithuanian males: A multilevel analysis based on census-linked data.

PubMed

Grigoriev, Pavel; Jasilionis, Domantas; Stumbrys, Daumantas; Stankūnienė, Vladislava; Shkolnikov, Vladimir M

2017-01-01

Although excessive alcohol-related mortality in the post-Soviet countries remains the major public health threat, determinants of this phenomenon are still poorly understood. We assess simultaneously individual- and area-level factors associated with an elevated risk of alcohol-related mortality among Lithuanian males aged 30-64. Our analysis is based on a census-linked dataset containing information on individual- and area-level characteristics and death events which occurred between March 1st, 2011 and December 31st, 2013. We limit the analysis to a few causes of death which are directly linked to excessive alcohol consumption: accidental poisonings by alcohol (X45) and liver cirrhosis (K70 and K74). Multilevel Poisson regression models with random intercepts are applied to estimate mortality rate ratios (MRR). The selected individual-level characteristics are important predictors of alcohol-related mortality, whereas area-level variables show much less pronounced or insignificant effects. Compared to married men, never married (MRR = 1.9, CI:1.6-2.2), divorced (MRR = 2.6, CI:2.3-2.9), and widowed (MRR = 2.4, CI: 1.8-3.1) men are disadvantaged groups. Men who have the lowest level of educational attainment have the highest mortality risk (MRR = 1.7 CI:1.4-2.1). Being unemployed is associated with a five-fold risk of alcohol-related death (MRR = 5.1, CI: 4.4-5.9), even after adjusting for all other individual variables. Lithuanian males have an advantage over Russian (MRR = 1.3, CI:1.1-1.6) and Polish (MRR = 1.8, CI: 1.5-2.2) males. After adjusting for all individual characteristics, only two out of seven area-level variables-i.e., the share of ethnic minorities in the population and the election turnout-have statistically significant direct associations. These variables contribute to a higher risk of alcohol-related mortality at the individual level. The huge and increasing socio-economic disparities in alcohol-related mortality indicate that recently implemented

Alcohol in Greenland 1951–2010: consumption, mortality, prices

PubMed Central

Aage, Hans

2012-01-01

Background Fluctuations in alcohol consumption in Greenland have been extreme since alcohol became available to the Greenland Inuit in the 1950s, increasing from low levels in the 1950s to very high levels in the 1980s – about twice as high as alcohol consumption in Denmark. Since then, consumption has declined, and current consumption is slightly below alcohol consumption in Denmark, while alcohol prices are far above Danish prices. Objective Description of historical trends and possible causal connections of alcohol prices, alcohol consumption and alcohol-related mortality in Greenland 1951–2010 as a background for the evaluation of the impact of various types of policy. Design Time series for Greenland 1951–2010 for alcohol prices, consumption and mortality are compiled, and variation and correlations are discussed in relation to various policies aimed at limiting alcohol consumption. Corresponding time series for Denmark 1906–2010 are presented for comparison. Results The trends in alcohol prices and consumption followed each other rather closely until the 1990s in Greenland and the 1980s in Denmark. At this time, consumption stabilised while prices decreased further, but the effect of prices upon consumption is strong, also in recent years. A trend in Greenlandic mortality similar to consumption is discernible, but not significant. Among alcohol-related deaths cirrhosis of the liver is less prevalent whilst accidents are more prevalent than in Denmark. Conclusions The effect of alcohol excise taxes and rationing upon consumption is evident. The stabilisation and subsequent decline in consumption since the mid-1990s, while alcohol prices decreased persistently, does not preclude continued effects of prices. On the contrary, price effects have been neutralised by other stronger causes. Whether these are government anti-alcohol campaigns or a cultural change is not clear. PMID:23256091

Long-Term Mortality of Patients with an Alcohol-Related Wernicke-Korsakoff Syndrome.

PubMed

Sanvisens, Arantza; Zuluaga, Paola; Fuster, Daniel; Rivas, Inmaculada; Tor, Jordi; Marcos, Miguel; Chamorro, Antonio J; Muga, Roberto

2017-07-01

To characterize a series of contemporary patients with alcohol-related Wernicke's encephalopathy (WE) or Korsakoff's syndrome (KS) and to update the current prognosis of disease. Retrospective and prospective study of patients diagnosed with an alcohol-related WE or KS between 2002 and 2011 in a tertiary hospital. Socio-demographic, alcohol use characteristics, signs and symptoms, co-morbidity and blood parameters were obtained at admission. Patients were followed up until 2013 and causes of death were ascertained through the review of charts. Sixty-one patients were included (51 with WE and 10 with KS). Among patients with WE, 78% were men and age at diagnosis was 57 years (interquartile range (IQR): 49-66). Twenty-three percent fulfilled the classic WE triad. Regarding Caine's criteria for WE, 70.6% presented with at least two out of four signs or symptoms. Median follow-up of patients with WE syndrome was 5.3 years (IQR: 2.6-8.8), the cumulated mortality was 45% and death rate of 7.4 × 100 person-years (95% confidence interval (CI): 4.8-10.9). Overall, 50% of patients would be expected to die within 8 years of WE episode and main causes of death included serious bacterial infections (44.5%) and cancer (33.3%). Survival of patients with an alcohol-related Wernicke-Korsakoff syndrome is poor; pursuing treatment of alcohol use disorder and early diagnosis of thiamine deficiency is a priority for improving clinical outcomes. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Mortality risks in alcoholism and effects of abstinence and addiction treatment.

PubMed

Miller, N S

1999-06-01

The mortality rate from alcoholism and related comorbidities is high. Studies show multiple causes of premature death from alcoholism. Several studies showed that abstinence had a positive effective on the overall survival of alcoholics. Alcoholics who abstained from alcohol, particularly continuously, showed reduced mortality rates and increased years of longevity than alcoholics who relapsed to alcohol consumption. The sources of the findings tend to be derived from treatment populations, in which abstinence is expected to occur in higher rates than in the general population.

Socioeconomic differences in alcohol-attributable mortality compared with all-cause mortality: a systematic review and meta-analysis.

PubMed

Probst, Charlotte; Roerecke, Michael; Behrendt, Silke; Rehm, Jürgen

2014-08-01

Factors underlying socioeconomic inequalities in mortality are not well understood. This study contributes to our understanding of potential pathways to result in socioeconomic inequalities, by examining alcohol consumption as one potential explanation via comparing socioeconomic inequalities in alcohol-attributable mortality and all-cause mortality. Web of Science, MEDLINE, PsycINFO and ETOH were searched systematically from their inception to second week of February 2013 for articles reporting alcohol-attributable mortality by socioeconomic status, operationalized by using information on education, occupation, employment status or income. The sex-specific ratios of relative risks (RRRs) of alcohol-attributable mortality to all-cause mortality were pooled for different operationalizations of socioeconomic status using inverse-variance weighted random effects models. These RRRs were then combined to a single estimate. We identified 15 unique papers suitable for a meta-analysis; capturing about 133 million people, 3 741 334 deaths from all causes and 167 652 alcohol-attributable deaths. The overall RRRs amounted to RRR = 1.78 (95% confidence interval (CI) 1.43 to 2.22) and RRR = 1.66 (95% CI 1.20 to 2.31), for women and men, respectively. In other words: lower socioeconomic status leads to 1.5-2-fold higher mortality for alcohol-attributable causes compared with all causes. Alcohol was identified as a factor underlying higher mortality risks in more disadvantaged populations. All alcohol-attributable mortality is in principle avoidable, and future alcohol policies must take into consideration any differential effect on socioeconomic groups. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

The effect of alcoholic beverage excise tax on alcohol-attributable injury mortalities.

PubMed

Son, Chong Hwan; Topyan, Kudret

2011-04-01

This study examines the effect of state excise taxes on different types of alcoholic beverages (spirits, wine, and beer) on alcohol-attributable injury mortalities--deaths caused by motor vehicle accidents, suicides, homicides, and falls--in the United States between 1995 and 2004, using state-level panel data. There is evidence that injury deaths attributable to alcohol respond differently to changes in state excise taxes on alcohol-specific beverages. This study examines the direct relationship between injury deaths and excise taxes without testing the degree of the association between excise taxes and alcohol consumption. The study finds that beer taxes are negatively related to motor vehicle accident mortality, while wine taxes are negatively associated with suicides and falls. The positive coefficient of the spirit taxes on falls implies a substitution effect between spirits and wine, suggesting that an increase in spirit tax will cause spirit buyers to purchase more wine. This study finds no evidence of a relationship between homicides and state excise taxes on alcohol. Thus, the study concludes that injury deaths attributable to alcohol respond differently to the excise taxes on different types of alcoholic beverages.

Fraction of stroke mortality attributable to alcohol consumption in Russia.

PubMed

Y E, Razvodovsky

2014-01-01

Stroke is an international health problem with high associated human and economic costs. The mortality rate from stroke in Russia is one of the highest in the world. Risk factors identification is therefore a high priority from the public health perspective. Epidemiological evidence suggests that binge drinking is an important determinant of high stroke mortality rate in Russia. The aim of the present study was to estimate the premature stroke mortality attributable to alcohol abuse in Russia on the basis of aggregate-level data of stroke mortality and alcohol consumption. Age-standardized sex-specific male and female stroke mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means ARIMA time series analysis. The results of the analysis suggest that 26.8% of all male stroke deaths and 18.4% female stroke deaths in Russia could be attributed to alcohol. The estimated alcohol-attributable fraction for men ranged from 16.2% (75+ age group) to 57,5% (30-44 age group) and for women from 21.7% (60-74 age group) and 43.5% (30- 44 age group). The outcomes of this study provide support for the hypothesis that alcohol is an important contributor to the high stroke mortality rate in Russian Federation. Therefore prevention of alcohol-attributable harm should be a major public health priority in Russia. Given the distribution of alcohol-related stroke deaths, interventions should be focused on the young and middle-aged men and women.

Alcohol consumption and all-cause mortality.

PubMed

Duffy, J C

1995-02-01

Prospective studies of alcohol and mortality in middle-aged men almost universally find a U-shaped relationship between alcohol consumption and risk of mortality. This review demonstrates the extent to which different studies lead to different risk estimates, analyses the putative influence of abstention as a risk factor and uses available data to produce point and interval estimates of the consumption level apparently associated with minimum risk from two studies in the UK. Data from a number of studies are analysed by means of logistic-linear modelling, taking account of the possible influence of abstention as a special risk factor. Separate analysis of British data is performed. Logistic-linear modelling demonstrates large and highly significant differences between the studies considered in the relationship between alcohol consumption and all-cause mortality. The results support the identification of abstention as a special risk factor for mortality, but do not indicate that this alone explains the apparent U-shaped relationship. Separate analysis of two British studies indicates minimum risk of mortality in this population at a consumption level of about 26 (8.5 g) units of alcohol per week. The analysis supports the view that abstention may be a specific risk factor for all-cause mortality, but is not an adequate explanation of the apparent protective effect of alcohol consumption against all-cause mortality. Future analyses might better be performed on a case-by-case basis, using a change-point model to estimate the parameters of the relationship. The current misinterpretation of the sensible drinking level of 21 units per week for men in the UK as a limit is not justified, and the data suggest that alcohol consumption is a net preventive factor against premature death in this population.

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.

The Gorbachev Anti-Alcohol Campaign and Russia's Mortality Crisis.

PubMed

Bhattacharya, Jay; Gathmann, Christina; Miller, Grant

2013-01-01

Political and economic transition is often blamed for Russia's 40% surge in deaths between 1990 and 1994. Highlighting that increases in mortality occurred primarily among alcohol-related causes and among working-age men (the heaviest drinkers), this paper investigates an alternative explanation: the demise of the 1985-1988 Gorbachev Anti-Alcohol Campaign. Using archival sources to build a new oblast-year data set spanning 1978-2000, we find a variety of evidence suggesting that the campaign's end explains a large share of the mortality crisis - implying that Russia's transition to capitalism and democracy was not as lethal as commonly suggested.

The Relationship of Alcoholism and Alcohol Consumption to All-Cause Mortality in Forty-One-Year Follow-up of the Swedish REBUS Sample.

PubMed

Lundin, Andreas; Mortensen, Laust Hvas; Halldin, Jan; Theobald, Holger

2015-07-01

The purpose of this study was to examine the effects of alcoholism, alcohol consumption amount, and alcohol consumption pattern on mortality in a general population sample. This study used a 1970 prospective population sample (double-phase random sample) of 2,300 individuals ages 18-65 years in Stockholm County, which was also linked to mortality registers. A total of 1,895 individuals participated in a semi-structured, baseline psychiatric interview with a psychiatrist and social worker. Alcoholism and other mental disorders were recorded according to the eighth revision of the International Classification of Diseases (ICD-8). Information on the usual amount and frequency of alcohol consumption was collected at the psychiatric interview. Mortality up to year 2011 was assessed with Cox proportional hazard regression models. At baseline, there were 65 men and 21 women diagnosed with alcoholism. During followup, there were 873 deaths in the study population of 1,895. Alcoholism was associated with increased mortality rate. Former drinkers, but not never-drinkers, also had increased risk for mortality compared with moderate drinkers. We found no associations between heavy consumption and mortality. Frequent heavy episodic drinking was uncommon but related to mortality before, but not after, adjusting for an alcoholism diagnosis. Our results demonstrated that alcoholism—but not a reported high consumption of alcohol or frequent heavy episodic drinking—predicted a long-term risk of death.

Ethnic Variations in Liver- and Alcohol-Related Disease Hospitalisations and Mortality: The Scottish Health and Ethnicity Linkage Study.

PubMed

Bhala, Neeraj; Cézard, Genevieve; Ward, Hester J T; Bansal, Narinder; Bhopal, Raj

2016-09-01

Preventing alcohol-related harms, including those causing liver disease, is a public health priority in the UK, especially in Scotland, but the effects of ethnicity are not known. We assessed liver- and alcohol-related events (hospitalisations and deaths) in Scotland using self-reported measures of ethnicity. Linking Scottish NHS hospital admissions and mortality to the Scottish Census 2001, we explored ethnic differences in hospitalisations and mortality (2001-2010) of all liver diseases, alcoholic liver disease (ALD) and specific alcohol-related diseases (ARD). Risk ratios (RR) were calculated using Poisson regression with robust variance, by sex, adjusted for age, country of birth and the Scottish Index of Multiple Deprivation (SIMD) presented below. The White Scottish population was the standard reference population with 95% confidence intervals (CI) calculated to enable comparison (multiplied by 100 for results). For all liver diseases, Chinese had around 50% higher risks for men (RR 162; 95% CI 127-207) and women (141; 109-184), as did Other South Asian men (144; 104-201) and Pakistani women (140; 116-168). Lower risks for all liver diseases occurred in African origin men (42; 24-74), other White British men (72; 63-82) and women (80; 70-90) and other White women (80; 67-94). For ALD, White Irish had a 75% higher risk for men (175; 107-287). Other White British men had about a third lower risk of ALD (63; 50-78), as did Pakistani men (65; 42-99). For ARD, almost 2-fold higher risks existed for White Irish men (182; 161-206) and Any Mixed Background women (199; 152-261). Lower risks of ARD existed in Pakistani men (67; 55-80) and women (48; 33-70), and Chinese men (55; 41-73) and women (54; 32-90). Substantial variations by ethnicity exist for both alcohol-related and liver disease hospitalisations and deaths in Scotland: these exist in subgroups of both White and non-White populations and practical actions are required to ameliorate these differences. © The

The Gorbachev Anti-Alcohol Campaign and Russia’s Mortality Crisis

PubMed Central

Bhattacharya, Jay; Gathmann, Christina

2013-01-01

Political and economic transition is often blamed for Russia’s 40% surge in deaths between 1990 and 1994. Highlighting that increases in mortality occurred primarily among alcohol-related causes and among working-age men (the heaviest drinkers), this paper investigates an alternative explanation: the demise of the 1985–1988 Gorbachev Anti-Alcohol Campaign. Using archival sources to build a new oblast-year data set spanning 1978–2000, we find a variety of evidence suggesting that the campaign’s end explains a large share of the mortality crisis – implying that Russia’s transition to capitalism and democracy was not as lethal as commonly suggested. PMID:24224067

Income disparity and mortality among patients with alcohol use disorder in South Korea.

PubMed

Woon Kwak, Chae; Han, Kyu-Tae; Mo Nam, Chung; Tae Moon, Ki; Yoon, Ho-Soon; Park, Eun-Cheol

2017-12-01

Problems related to alcohol consumption, particularly alcohol disorders, occur frequently in South Korea and are gradually increasing due to the drinking culture and social atmosphere. We analyzed the relationship between mortality and income among patients with alcohol disorders. We used data from the National Sampling Claim Data 2003-2013, which included medical claims filed for 10,593 patients newly diagnosed with alcohol disorders. We performed survival analyses using a Cox proportional hazards model. 12.79% died during the study period. Patients with lower incomes were more positively associated with the risk of mortality than those with higher incomes (0-30 percentile: hazard ratio [HR] = 1.432, 95% confidence interval [CI] = 1.155-1.777; 31-60 percentile: HR = 1.318, 95% CI = 1.065-1.633; 61-90 percentile: HR = 1.352, 95% CI = 1.097-1.665; 91-100 percentile: ref). Such associations were significant in males, patients with mild conditions, or those who lived in metropolitan areas. In conclusion, we found that income disparity was related to mortality among patients diagnosed with disorders due to alcohol use. Thus, healthcare professionals need to provide active intervention in the early phase of alcohol disorders, and consider policy that would improve healthcare accessibility for low-income populations in order to reduce income disparity. Copyright © 2017 Elsevier B.V. All rights reserved.

Aggregate level beverage specific effect of alcohol sale on myocardial infarction mortality rate.

PubMed

Razvodovsky, Yury Evgeny

2009-01-01

The pronounced fluctuations in cardiovascular mortality in the countries of the former Soviet Union over the past decades have attracted considerable interest. The mounting evidence suggests that binge drinking pattern is a potentially important contributor to higher cardiovascular mortality rate in the former Soviet republics. There is assumption that if occasional heavy drinking of strong spirits increases the risk of cardiovascular mortality, countries where this is predominant drinking pattern should display positive association between spirits consumption and cardiovascular mortality at the aggregate level. To estimate the aggregate level beverage specific effect of alcohol sale on myocardial infarction mortality rate in drinking culture, which combine a higher level of spirits consumption per capita with the explosive drinking pattern. Trends in beverage specific alcohol sale per capita and myocardial infarction mortality rate from 1970 to 2005 in Belarus were analyzed employing ARIMA time series analysis. The results of time series analysis suggest positive relation between strong spirits (vodka) sale per capita and myocardial infarction mortality rate. The analysis suggests that a 1 liter increase in vodka sale per capita would result in a 7.2% increase in myocardial infarction mortality rate (8.2% increase in male mortality and 6.8% increase in female mortality). the results of the present study suggest a positive relation between vodka sale and myocardial infarction mortality rate at aggregate level and support the hypothesis that binge drinking of strong spirits is a risk factor of myocardial infarction at the individual level. Thus, from a public policy point of view, the outcome of this study suggests that cardiovascularrelated mortality prevention programs should put more focus on addressing alcohol consumption structure.

Iron loading, alcohol and mortality: A prospective study.

PubMed

Schutte, Rudolph; Huisman, Hugo; Mels, Catharina M C; Botha, Shani; Kruger, Ruan; Smith, Wayne; Kruger, Iolanthé M; Hawkins, Michelle; Smith, Lee; Breet, Yolandi; Schutte, Aletta E

2018-05-16

The relationship between total body iron and cardiovascular disease remains controversial and information absent in black sub-Saharan Africans in whom alcohol consumption tends to be high. The level of total body iron is tightly regulated, however this regulation is compromised by high alcohol intake causing iron loading. The aim of this study is to investigate total body iron, as represented by serum ferritin, and its interaction with measures of alcohol intake in predicting all-cause and cardiovascular mortality. We followed health outcomes for a median of 9.22 years in 877 randomly selected HIV negative African women (mean age: 50.4 years). One hundred and five deaths occurred of which 40 were cardiovascular related. Ferritin averaged 84.0 (5th to 95th percentile interval, 7.5-533.3) ng/ml and due to the augmenting effect of inflammation, lowered to 75.3 (6.9-523.2) ng/ml after excluding 271 participants with high-sensitivity C-reactive protein (CRP) levels (above 8 mg/l). CRP increased by quartiles of ferritin in the total group (P trend = 0.002), but this relationship was absent after excluding the 271 participants with high CRP values (P trend = 0.10). Ferritin, gamma-glutamyl transferase and carbohydrate deficient transferrin (all P < 0.0001) were higher in drinkers compared to non-drinkers, but CRP was similar (P = 0.77). In multivariable-adjusted analyses, ferritin predicted both all-cause (hazard ratio, 2.08; 95% confidence interval, 1.62-2.68; P < 0.0001) and cardiovascular (1.94; 1.29-2.92; P = 0.002) mortality. In participants with CRP levels below or equal to 8 mg/l, the significant relationship remained between ferritin and all-cause (2.51; 1.81-3.49; P < 0.0001) and cardiovascular mortality (2.34; 1.45-3.76; P = 0.0005). In fully adjusted models, interactions existed between ferritin and gamma-glutamyl transferase, self-reported alcohol use and carbohydrate deficient transferrin in predicting all-cause (P ≤ 0.012) and

Beverage-specific alcohol sales and violent mortality in Russia.

PubMed

Razvodovsky, Yury Evgeny

2010-01-01

High violent mortality rate in Russia and its profound fluctuation over recent decades have attracted considerable interest. A mounting body of evidence points to the binge drinking pattern as a potentially important contributor to the violent mortality crisis in Russia. In line with this evidence, we assume that higher level of vodka consumption in conjunction with binge drinking pattern results in close aggregate-level association between vodka sales and violent mortality rates in Russia. To test this hypothesis, trends in beverage-specific alcohol sales per capita and mortality rates from external causes in Russia between 1980 and 2005 were analyzed by means of ARIMA time-series analysis. Results of the analysis indicate that violent mortality rates tend to be more responsive to change in vodka sales per capita than to change in total level of alcohol sales. The analysis suggests that a 1-litre increase in vodka sales per capita would result in a 5% increase in violent mortality rate, an 11.3% increase in accidents and injuries mortality rate, a 9.2% increase in suicide rate, a 12.5% increase in homicide rate, and a 21.9% increase in fatal alcohol poisoning rate. The outcomes of this study provide support for the hypothesis that alcohol played a crucial role in the fluctuation in violent mortality rate in Russia in recent decades. Assuming that drinking vodka is usually associated with intoxication episodes, these findings provide additional evidence that the binge drinking pattern is an important determinant of the violent mortality crisis in Russia.

The cost of lost productivity due to fetal alcohol spectrum disorder-related premature mortality.

PubMed

Easton, Brian; Burd, Larry; Sarnocinska-Hart, Anna; Rehm, Jürgem; Popova, Svetlana

2015-01-01

Individuals with Fetal Alcohol Spectrum Disorder (FASD) have increased mortality as compared to the general population. To estimate the productivity losses due to premature mortality of individuals with FASD in Canada in 2011. A demographic approach with a counterfactual scenario in which nobody in Canada is born with FASD was used. Population estimates were calculated using data on the labour force, unemployment rate, and average weekly wage obtained from Statistics Canada. The number of FASD-related deaths, coded in the International Classification of Diseases, version 10, was estimated based on data from Statistics Canada and pooled prevalence estimates of the major disease conditions associated with FASD were obtained from a meta-analysis. The estimates of FASD-related mortality rates served as a basis for the length of working life span estimation. Once the number of working years lost to premature deaths was derived, productivity losses were computed. It was estimated that in total 327 individuals with FASD aged 20 to 69 (almost twice as many men as women) died in Canada in 2011. As a result, there were 2,877 years of potential employment lost, which translated to a loss ranging from $88 million to $126 million. This amount represents the increase in national income, had there been no premature mortality from FASD and the workers with FASD had been typical members of the labour force (without compromised productivity due to FASD). The estimates of productivity losses further reinforce the value of FASD prevention as a primary strategy.

The impact of alcohol taxation on liver cirrhosis mortality.

PubMed

Ponicki, William R; Gruenewald, Paul J

2006-11-01

The objective of this study is to investigate the impact of distilled spirits, wine, and beer taxes on cirrhosis mortality using a large-panel data set and statistical models that control for various other factors that may affect that mortality. The analyses were performed on a panel of 30 U.S. license states during the period 1971-1998 (N = 840 state-by-year observations). Exogenous measures included current and lagged versions of beverage taxes and income, as well as controls for states' age distribution, religion, race, health care availability, urbanity, tourism, and local bans on alcohol sales. Regression analyses were performed using random-effects models with corrections for serial autocorrelation and heteroscedasticity among states. Cirrhosis rates were found to be significantly related to taxes on distilled spirits but not to taxation of wine and beer. Consistent results were found using different statistical models and model specifications. Consistent with prior research, cirrhosis mortality in the United States appears more closely linked to consumption of distilled spirits than to that of other alcoholic beverages.

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

Influence of unrecorded alcohol consumption on liver cirrhosis mortality

PubMed Central

Lachenmeier, Dirk W; Monakhova, Yulia B; Rehm, Jürgen

2014-01-01

Unrecorded alcohol includes illegally distributed alcohol as well as homemade or surrogate alcohol which is unintended for consumption by humans (e.g., cosmetics containing alcohol). The highest unrecorded alcohol consumption occurs in Eastern Europe and some of these countries have an over proportional liver cirrhosis mortality. Compounds besides ethanol have been hypothesized as being responsible for this observation. On the other hand, chemical investigations were unable to prove that unrecorded alcohol regularly contains contaminants above toxicological thresholds. However, illegally produced spirits regularly contain higher percentages of alcohol (above 45% by volume), but for considerably less costs compared with licit beverages, potentially causing more problematic patterns of drinking. In this review, it is investigated whether patterns of drinking rather than product composition can explain the liver cirrhosis mortality rates. Statistical examination of World Health Organization country data shows that the originally detected correlation of the percentage of unrecorded alcohol consumption and liver cirrhosis mortality rates disappears when the data is adjusted for the prevalence of heavy episodic drinking. It may be concluded that there is currently a lack of data to demonstrate causality between the composition of illicit spirits (e.g., higher levels of certain contaminants in home-produced products) and liver toxicity on a population scale. Exceptions may be cases of poisoning with antiseptic liquids containing compounds such as polyhexamethyleneguanidine, which were reported to be consumed as surrogate alcohol in Russia, leading to an outbreak of acute cholestatic liver injury, histologically different from conventional alcoholic liver disease. PMID:24966592

The Huge Reduction in Adult Male Mortality in Belarus and Russia: Is It Attributable to Anti-Alcohol Measures?

PubMed Central

2015-01-01

Background and Aim Harmful alcohol consumption has long been recognized as being the major determinant of male premature mortality in the European countries of the former USSR. Our focus here is on Belarus and Russia, two Slavic countries which continue to suffer enormously from the burden of the harmful consumption of alcohol. However, after a long period of deterioration, mortality trends in these countries have been improving over the past decade. We aim to investigate to what extent the recent declines in adult mortality in Belarus and Russia are attributable to the anti-alcohol measures introduced in these two countries in the 2000s. Data and Methods We rely on the detailed cause-specific mortality series for the period 1980–2013. Our analysis focuses on the male population, and considers only a limited number of causes of death which we label as being alcohol-related: accidental poisoning by alcohol, liver cirrhosis, ischemic heart diseases, stroke, transportation accidents, and other external causes. For each of these causes we computed age-standardized death rates. The life table decomposition method was used to determine the age groups and the causes of death responsible for changes in life expectancy over time. Conclusion Our results do not lead us to conclude that the schedule of anti-alcohol measures corresponds to the schedule of mortality changes. The continuous reduction in adult male mortality seen in Belarus and Russia cannot be fully explained by the anti-alcohol policies implemented in these countries, although these policies likely contributed to the large mortality reductions observed in Belarus and Russia in 2005–2006 and in Belarus in 2012. Thus, the effects of these policies appear to have been modest. We argue that the anti-alcohol measures implemented in Belarus and Russia simply coincided with fluctuations in alcohol-related mortality which originated in the past. If these trends had not been underway already, these huge mortality

The Huge Reduction in Adult Male Mortality in Belarus and Russia: Is It Attributable to Anti-Alcohol Measures?

PubMed

Grigoriev, Pavel; Andreev, Evgeny M

2015-01-01

Harmful alcohol consumption has long been recognized as being the major determinant of male premature mortality in the European countries of the former USSR. Our focus here is on Belarus and Russia, two Slavic countries which continue to suffer enormously from the burden of the harmful consumption of alcohol. However, after a long period of deterioration, mortality trends in these countries have been improving over the past decade. We aim to investigate to what extent the recent declines in adult mortality in Belarus and Russia are attributable to the anti-alcohol measures introduced in these two countries in the 2000s. We rely on the detailed cause-specific mortality series for the period 1980-2013. Our analysis focuses on the male population, and considers only a limited number of causes of death which we label as being alcohol-related: accidental poisoning by alcohol, liver cirrhosis, ischemic heart diseases, stroke, transportation accidents, and other external causes. For each of these causes we computed age-standardized death rates. The life table decomposition method was used to determine the age groups and the causes of death responsible for changes in life expectancy over time. Our results do not lead us to conclude that the schedule of anti-alcohol measures corresponds to the schedule of mortality changes. The continuous reduction in adult male mortality seen in Belarus and Russia cannot be fully explained by the anti-alcohol policies implemented in these countries, although these policies likely contributed to the large mortality reductions observed in Belarus and Russia in 2005-2006 and in Belarus in 2012. Thus, the effects of these policies appear to have been modest. We argue that the anti-alcohol measures implemented in Belarus and Russia simply coincided with fluctuations in alcohol-related mortality which originated in the past. If these trends had not been underway already, these huge mortality effects would not have occurred.

Serum high density lipoprotein cholesterol, alcohol, and coronary mortality in male smokers.

PubMed Central

Paunio, M.; Virtamo, J.; Gref, C. G.; Heinonen, O. P.

1996-01-01

OBJECTIVE--To determine whether the increase in mortality from coronary heart disease with high concentration (> 1.75 mmol/l) of high density lipoprotein cholesterol could be due to alcohol intake. DESIGN--Cohort study. SETTING--Placebo group of the alpha tocopherol, beta carotene cancer prevention (ATBC) study of south western population in Finland. PARTICIPANTS--7052 male smokers aged 50-69 years enrolled to the ATBC study in the 1980s. MAIN OUTCOME MEASURES--The relative and absolute rates adjusted for risk factors for clinically or pathologically verified deaths from coronary heart disease for different concentrations of high density lipoprotein cholesterol with and without stratification for alcohol intake. Similar rates were also calculated for different alcohol consumption groups. RESULTS--During the average follow up period of 6.7 years 258 men died from verified coronary heart disease. Coronary death rate steadily decreased with increasing concentration of high density lipoprotein cholesterol until a high concentration. An increase in the rate was observed above 1.75 mmol/l. This increase occurred among those who reported alcohol intake. Mortality was associated with alcohol intake in a J shaped dose response, and those who reported consuming more than five drinks a day (heavy drinkers) had the highest death rate. Mortality was higher in heavy drinkers than in non-drinkers or light or moderate drinkers in all high density lipoprotein categories from 0.91 mmol/l upward. CONCLUSIONS--Mortality from coronary heart disease increases at concentrations of high density lipoprotein cholesterol over 1.75 mmol/l. The mortality was highest among heavy drinkers, but an increase was found among light drinkers also. PMID:8634563

Impact of alcohol consumption and body mass index on mortality from nonneoplastic liver diseases, upper aerodigestive tract cancers, and alcohol use disorders in Korean older middle-aged men: Prospective cohort study.

PubMed

Yi, Sang-Wook; Hong, Jae-Seok; Yi, Jee-Jeon; Ohrr, Heechoul

2016-09-01

Alcohol use is a leading risk factor for the global disease burden including liver diseases. However, the combined effect of alcohol use and body mass index (BMI) on alcohol-related diseases has seldom been examined. We examined whether alcohol consumption and BMI could act together to increase mortality from nonneoplastic liver diseases, upper aero-digestive tract (UADT) cancers, and alcohol use disorders (AUD) in middle-aged Korean men.107,735 men (mean age, 58.8 years) participated in a postal survey in 2004 and were followed until 2010, by linkage to national death records. Hazard ratios (HRs) of cause-specific death were calculated after adjustment for confounders.Each 5-drink (approximately 45 g alcohol) higher weekly alcohol consumption was associated with increased mortality, by approximately 70% for nonneoplastic liver disease mortality (HR = 1.70, P < 0.001), approximately 60% for UADT cancer mortality (HR = 1.64, P < 0.001), and approximately 70% for AUD mortality (HR = 1.71, P < 0.001). Generally, BMI was inversely associated with these alcohol-related diseases (HR per each 5 kg/m higher BMI = 0.18-0.46, P < 0.001 for each cause), while, in participants with BMI ≥25 kg/m, each 5 kg/m higher BMI was also associated with an elevated mortality from nonneoplastic liver diseases of approximately 150% (HR = 2.52, P = 0.001). Men with BMI < 21 kg/m and weekly alcohol consumption ≥14 drinks showed markedly higher mortality from nonneoplastic liver diseases (HR = 5.7), alcoholic liver diseases (HR = 9.3), UADT cancers (HR = 10.5), and esophageal cancer (HR = 15.5), compared to men drinking less than 1 drink/wk with BMI ≥25 kg/m. The combined effect of low BMI and high weekly alcohol consumption was 2.25- to 3.29-fold greater than the additive effect of each factor for these alcohol-related diseases (P < 0.05 for each cause).Alcohol consumption and low BMI were related to deaths from nonneoplastic liver diseases, UADT

Examining Alcohol's Contribution to the US African-American/White Cirrhosis Mortality Differential from 1950 to 2002

PubMed Central

Kerr, William C.; Karriker-Jaffe, Katherine J.; Ye, Yu

2013-01-01

Aims: The aim of this study was to estimate the overall impact of alcohol on US race- and sex-specific age-adjusted cirrhosis mortality rates and to consider beverage-specific effects that represent changes in drinking patterns over time, comparing states with large and small African-American/White cirrhosis mortality differentials. Methods: Using series data from 1950 to 2002, the effects of per capita alcohol consumption on cirrhosis mortality for African American and White men and women were estimated using generalized least squares panel models on first-differenced data. Granger causality tests explored geographic patterning of racial differences in cirrhosis mortality. Results: Cirrhosis mortality was significantly positively related to apparent consumption of alcohol, with an overall impact of 8–14%/l of ethanol. This effect was driven by spirits which were more strongly associated with mortality for African-American women and for African-American men in states with larger mortality differentials. This disparity first emerged in New York and spread through the Northeast and into Midwestern states. Conclusion: Differences in the contribution of alcohol to cirrhosis mortality rates suggest variation by race and gender in life-course patterns of heavy consumption, illicit liquor and spirits use, as well as birth cohort effects. PMID:23558110

Contribution of alcohol in accident related mortality in Belarus: a time series approach

PubMed Central

Razvodovsky, Yury Evgeny

2012-01-01

Abstract: Background: High accidental death rates in the former Soviet republics (FSR) and its profound fluctuation over the past decades have attracted considerable interest. The research evidences emphasize binge drinking pattern as a potentially important contributor to accident mortality crisis in FSR. In line with this evidence we assume that higher level of alcohol consumption in conjunction with binge drinking pattern results in close aggregate-level association between alcohol psychoses and accidental death rates in the former Soviet Slavic republic Belarus. Methods: Trends in alcohol psychoses rate (as a proxy for alcohol consumption) from 1979 to 2007 were analyzed employing a distributed lag analysis in order to asses bivariate relationship between the two time series. Results: According to the Bureau of Forensic Medicine autopsy reports the number of deaths due to accidents and injuries increased by 52.5% (from 62.3 to 95.0 per 100.000 of residents), and fatal alcohol poisoning rate increased by 108.6% (from 12.8 to 26.7 per 100.000 of residents) in Belarus between 1979 and 2007. Alcohol in blood was found in 50.1% victims of deaths from accidents and injuries for the whole period, with the minimum figure 40% in 1986 and maximum 58.2% in 2005. The outcome of distributed lags analysis indicated statistically significant association between the number of alcohol psychoses cases and the number BAC-positive deaths from accidents at zero lag. Conclusion: The outcome of this study supports previous findings suggesting that alcohol and deaths from accidents are closely connected in a culture with prevailing intoxication-oriented drinking pattern, and add to growing body of evidence that a substantial proportion of accidental deaths in Belarus are due to effects of binge drinking. PMID:21502784

Alcohol intake and mortality among survivors of colorectal cancer: The Cancer Prevention Study II Nutrition Cohort.

PubMed

Yang, Baiyu; Gapstur, Susan M; Newton, Christina C; Jacobs, Eric J; Campbell, Peter T

2017-06-01

Alcohol consumption is associated with a higher risk of colorectal cancer, but to the authors' knowledge its influence on survival after a diagnosis of colorectal cancer is unclear. The authors investigated associations between prediagnosis and postdiagnosis alcohol intake with mortality among survivors of colorectal cancer. The authors identified 2458 men and women who were diagnosed with invasive, nonmetastatic colorectal cancer between 1992 (enrollment into the Cancer Prevention Study II Nutrition Cohort) and 2011. Alcohol consumption was self-reported at baseline and updated in 1997, 1999, 2003, and 2007. Postdiagnosis alcohol data were available for 1599 participants. Of the 2458 participants diagnosed with colorectal cancer, 1156 died during follow-up through 2012. Prediagnosis and postdiagnosis alcohol consumption were not found to be associated with all-cause mortality, except for an association between prediagnosis consumption of <2 drinks per day and a slightly lower risk of all-cause mortality (relative risk [RR], 0.86; 95% confidence interval [95% CI], 0.74-1.00) compared with never drinking. Alcohol use was generally not associated with colorectal cancer-specific mortality, although there was some suggestion of increased colorectal cancer-specific mortality with postdiagnosis drinking (RR, 1.27 [95% CI, 0.87-1.86] for current drinking of <2 drinks/day and RR, 1.44 [95% CI, 0.80-2.60] for current drinking of ≥2 drinks/day). The results of the current study do not support an association between alcohol consumption and all-cause mortality among individuals with nonmetastatic colorectal cancer. The association between postdiagnosis drinking and colorectal cancer-specific mortality should be examined in larger studies of individuals diagnosed with nonmetastatic colorectal cancer. Cancer 2017;123:2006-2013. © 2017 American Cancer Society. © 2017 American Cancer Society.

Alcohol prices, taxes, and alcohol-related harms: A critical review of natural experiments in alcohol policy for nine countries.

PubMed

Nelson, Jon P; McNall, Amy D

2016-03-01

Evidence for alcohol-price policy relies heavily on aggregate econometric studies for the United States. Prior reviews of prices and alcohol-related harms include only a few studies based on natural experiments. This study provides a comprehensive review of natural experiments for a wide variety of harms from studies published during 2003 to 2015. We examine policy changes that importantly affected alcohol taxes and prices, and related changes in availability. Forty-five studies met inclusion criteria, covering nine countries: Australia, Denmark, Finland, Hong Kong, Iceland, Russia, Sweden, Switzerland, and United States. Some studies cover more than one harm or country, and there are 69 outcomes for review. Summaries are provided for five outcome groups: alcohol-related mortality and hospitalizations; assaults and other crime; drink-driving; intoxication; and survey-indexes for dependency. The review notes both positive/mixed results and negative/null results. Findings indicate that changes in taxes and prices have selective effects on harms. Mortality outcomes are positive for liver disease and older persons, especially in Finland and Russia. Mostly null results for assaults and drink-driving are found for five countries. Intoxication results for Nordic countries are mixed for selective subpopulations. Results for survey indexes are mixed, with no strong pattern of outcomes within or across countries. Prior reviews stress taxes as a comprehensive and cost-effective intervention for addressing alcohol-related harms. A review of natural experiments indicates the confidence placed on this measure is too high, and natural experiments in alcohol policy had selective effects on various subpopulations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Magnitude and Trends in Heavy Episodic Drinking, Alcohol-Impaired Driving, and Alcohol-Related Mortality and Overdose Hospitalizations Among Emerging Adults of College Ages 18-24 in the United States, 1998-2014.

PubMed

Hingson, Ralph; Zha, Wenxing; Smyth, Daniel

2017-07-01

This article estimates percentages of U.S. emerging adults ages 18-24 engaging in past-month heavy episodic drinking and past-year alcohol-impaired driving, and numbers experiencing alcohol-related unintentional injury deaths and overdose hospitalizations between 1998 and 2014. We analyzed national injury mortality data from coroner, census, and college enrollment statistics, the National Survey on Drug Use and Health, and the Nationwide Inpatient Sample. From 1999 to 2005, percentages of emerging adults ages 18-24 reporting past-month heavy episodic drinking rose from 37.1% to 43.1% and then declined to 38.8% in 2014. Alcohol-impaired driving rose from 24% to 25.5% and then declined to 16.0%. Alcohol-related unintentional injury deaths increased from 4,807 in 1998 to 5,531 in 2005 and then declined to 4,105 in 2014, a reduction of 29% per 100,000 since 1998. Alcohol-related traffic deaths increased from 3,783 in 1998 to 4,114 in 2005 and then declined to 2,614 in 2014, down 43% per 100,000 since 1998. Alcohol-related overdose deaths increased from 207 in 1998 to 891 in 2014, a 254% increase per 100,000. Other types of nontraffic unintentional injury deaths declined. Alcohol-overdose hospitalizations rose 26% per 100,000 from 1998 to 2014, especially from increases in alcohol/other drug overdoses, up 61% (alcohol/opioid overdoses up 197%). Among emerging adults, a trend toward increased alcohol-related unintentional injury deaths, heavy episodic drinking, and alcohol-impaired driving between 1998 and 2005 was reversed by 2014. Persistent high levels of heavy episodic drinking and related problems among emerging adults underscore a need to expand individually oriented interventions, college/community collaborative programs, and evidence-supported policies to reduce their drinking and related problems.

Alcohol Dependence, Mortality, and Chronic Health Conditions in a Rural Population in Korea

PubMed Central

Noh, Samuel; Shin, Jongho; Ahn, Joung-Sook; Kim, Tae-Hui

2008-01-01

To determine the effects of excessive drinking and alcohol dependency on mortality and chronic health problems in a rural community in South Korea, this study represents a nested case-control study. In 1998, we conducted the Alcohol Dependence Survey (ADS), a population survey of a village in Korea. To measure the effects of alcohol on chronic health conditions and mortality over time, in 2004, we identified 290 adults from the ADS sample (N=1,058) for follow-up. Of those selected, 145 were adults who had alcohol problems, either alcohol dependence as assessed in the ADS by the Severity of Alcohol Dependence Questionnaire (N=59), or excessive drinking without dependency (N=86). Further 145 nondrinkers were identified, matching those with alcohol problems in age and sex. We revisited the village in 2004 and completed personal interviews with them. In multivariate logistic regressions, the rates of mortality and morbidity of chronic health conditions were three times greater for alcohol dependents compared with the rate for nondrinkers. Importantly, however, excessive drinking without dependency was not associated with the rates of either mortality or morbidity. Future investigations would benefit by attending more specifically to measures for alcohol dependence as well as measures for alcohol consumption. PMID:18303191

National, regional and global mortality due to alcoholic cardiomyopathy in 2015.

PubMed

Manthey, Jakob; Probst, Charlotte; Rylett, Margaret; Rehm, Jürgen

2018-03-13

(1) A comprehensive mortality assessment of alcoholic cardiomyopathy (ACM) and (2) examination of under-reporting using vital statistics data. A modelling study estimated sex-specific mortality rates for each country, which were subsequently aggregated by region and globally. Input data on ACM mortality were obtained from death registries for n=91 countries. For n=99 countries, mortality estimates were predicted using aggregate alcohol data from WHO publications. Descriptive additional analyses illustrated the scope of under-reporting. In 2015, there were an estimated 25 997 (95% CI 17 385 to 49 096) global deaths from ACM. This translates into 6.3% (95% CI 4.2% to 11.9%) of all global deaths from cardiomyopathy being caused by alcohol. There were large regional variations with regard to mortality burden. While the majority of ACM deaths were found in Russia (19 749 deaths, 76.0% of all ACM deaths), for about one-third of countries (n=57) less than one ACM death was found. Under-reporting was identified for nearly every second country with civil registration data. Overall, two out of three global ACM deaths might be misclassified. The variation of ACM mortality burden is greater than for other alcohol-attributable diseases, and partly may be the result of stigma and lack of detection. Misclassification of ACM fatalities is a systematic phenomenon, which may be caused by low resources, lacking standards and stigma associated with alcohol-use disorders. Clinical management may be improved by including routine alcohol assessments. This could contribute to decrease misclassifications and to provide the best available treatment for affected patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Gender differences in socioeconomic inequality of alcohol-attributable mortality: A systematic review and meta-analysis.

PubMed

Probst, Charlotte; Roerecke, Michael; Behrendt, Silke; Rehm, Jürgen

2015-05-01

The present analysis contributes to understanding the societal distribution of alcohol-attributable harm by investigating socioeconomic inequality and related gender differences in alcohol-attributable mortality. A systematic literature search was performed on Web of Science, MEDLINE, PsycINFO and ETOH from their inception until February 2013. Articles were included when they reported data on alcohol-attributable mortality by socioeconomic status (SES), operationalised as education, occupation, employment status or income. Gender-specific relative risks (RR) comparing low with high SES were pooled using random effects meta-analyses. Gender differences were additionally investigated in random effects meta-regressions. Nineteen articles from 14 countries were included. For women, significant RRs across all measures of SES, except employment status, were found, ranging between 1.75 [95% confidence interval (CI) 1.21-2.54; occupation] and 4.78 (95% CI 2.57-8.87; income). For men, all measures of SES showed significant RRs ranging between 2.88 (95% CI 2.45-3.40; income) and 12.25 (95% CI 11.45-13.10; employment status). While RRs for men were in general slightly higher, only for occupation this gender difference was above chance (P = 0.01). Results refer to deaths 100% attributable to alcohol. The results are predominantly based on data from high-income countries, limiting generalisability. Alcohol-attributable mortality is strongly distributed to the disadvantage of persons with a low SES. Marked gender differences in this inequality were found for occupation. Possibly male-dominated occupations of low SES were more strongly related to risky drinking cultures compared with female-dominated occupations of the same SES. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Joint Effect of Alcohol Consumption and Educational Level on Alcohol-related Medical Events: A Danish Register-based Cohort Study.

PubMed

Christensen, Helene Nordahl; Diderichsen, Finn; Hvidtfeldt, Ulla Arthur; Lange, Theis; Andersen, Per Kragh; Osler, Merete; Prescott, Eva; Tjønneland, Anne; Rod, Naja Hulvej; Andersen, Ingelise

2017-11-01

Alcohol-related mortality is more pronounced in lower than in higher socioeconomic groups in Western countries. Part of the explanation is differences in drinking patterns. However, differences in vulnerability to health consequences of alcohol consumption across socioeconomic groups may also play a role. We investigated the joint effect of alcohol consumption and educational level on the rate of alcohol-related medical events. We pooled seven prospective cohorts from Denmark that enrolled 74,278 men and women age 30-70 years (study period, 1981 to 2009). We measured alcohol consumption at baseline using self-administrated questionnaires. Information on highest attained education 1 year before study entry and hospital and mortality data on alcohol-related medical events were obtained through linkage to nationwide registries. We performed analyses using the Aalen additive hazards model. During follow-up (1,085,049 person-years), a total of 1718 alcohol-related events occurred. The joint effect of very high alcohol consumption (>21 [>28] drinks per week in women [men]) and low education on alcohol-related events exceeded the sum of their separate effects. Among men, we observed 289 (95% confidence interval = 123, 457) extra events per 100,000 person-years owing to education-alcohol interaction (P < 0.001). Similarly, among women, we observed 239 (95% confidence interval = 90, 388) extra events per 100,000 person-years owing to this interaction (P < 0.001). High alcohol consumption is associated with a higher risk of alcohol-related medical events among those with low compared with high education. This interaction may be explained by differences in vulnerability and drinking patterns across educational groups.See video abstract at, http://links.lww.com/EDE/B267.

Reduction in Male Suicide Mortality Following the 2006 Russian Alcohol Policy: An Interrupted Time Series Analysis

PubMed Central

Chamlin, Mitchell B.; Andreev, Evgeny

2013-01-01

Objectives. We took advantage of a natural experiment to assess the impact on suicide mortality of a suite of Russian alcohol policies. Methods. We obtained suicide counts from anonymous death records collected by the Russian Federal State Statistics Service. We used autoregressive integrated moving average (ARIMA) interrupted time series techniques to model the effect of the alcohol policy (implemented in January 2006) on monthly male and female suicide counts between January 2000 and December 2010. Results. Monthly male and female suicide counts decreased during the period under study. Although the ARIMA analysis showed no impact of the policy on female suicide mortality, the results revealed an immediate and permanent reduction of about 9% in male suicides (Ln ω0 = −0.096; P = .01). Conclusions. Despite a recent decrease in mortality, rates of alcohol consumption and suicide in Russia remain among the highest in the world. Our analysis revealed that the 2006 alcohol policy in Russia led to a 9% reduction in male suicide mortality, meaning the policy was responsible for saving 4000 male lives annually that would otherwise have been lost to suicide. Together with recent similar findings elsewhere, our results suggest an important role for public health and other population level interventions, including alcohol policy, in reducing alcohol-related harm. PMID:24028249

Surveillance of US Death Rates from Chronic Diseases Related to Excessive Alcohol Use.

PubMed

Polednak, Anthony P

2016-01-01

To assess the utility of multiple-cause (MC) death records for surveillance of US mortality rates from chronic causes related to excessive alcohol use. The Alcohol-Related Disease Impact (ARDI) resource produced estimates of the population 'alcohol attributable fraction' (AAF) due to excessive drinking for each alcohol-related (AAF > 0%) cause of death, and used AAFs to estimate numbers of alcohol-related deaths from alcohol-related underlying causes (UC) in adults age 20-64 and 65+ years in 2006-2010. For surveillance, this study used MC death file to identify individual deaths (2006-2010) with an 'alcohol-induced' cause (AAF = 100%) anywhere on the certificate, and to obtain US rates of premature death (ages 15-64 and 65-74 years) for 1999-2012. Using the selected MC records, numbers of deaths from alcohol-related chronic UC (2006-2010) were 81% of ARDI estimates for age 20-64, but only 40% for 65+ years. The MC records identified substantial numbers of deaths from causes (e.g. certain infectious diseases) not included as alcohol-related in ARDI, but included in surveillance of premature death rates for chronic UC. Also, premature death rates for chronic alcohol-induced causes using only the UC (as in routine mortality statistics) were only about half the rates based on MC; all rates increased in recent years but some reached statistical significance only by using MC. Using MC records underestimated total US deaths from alcohol-related chronic causes as the UC, but enhanced surveillance of rates for premature deaths involving chronic causes that may be related to excessive alcohol use. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Developing a method to derive alcohol-attributable fractions for HIV/AIDS mortality based on alcohol's impact on adherence to antiretroviral medication

PubMed Central

2011-01-01

Background Alcohol consumption is causally linked to nonadherence to antiretroviral treatment that in turn causes an increase in HIV/AIDS mortality. This article presents a method to calculate the percentage of HIV/AIDS deaths attributable to alcohol consumption and the associated uncertainty. Methods By combining information on risk relations from a number of published sources, we estimated alcohol-attributable fractions (AAFs) of HIV/AIDS in a stepwise procedure. First, we estimated the effect of alcohol consumption on adherence to antiretroviral treatment, and then we combined this estimate with the impact of nonadherence on death. The 95% uncertainty intervals were computed by estimating the variance of the AAFs using Taylor series expansions of one and multiple variables. AAFs were determined for each of the five Global Burden of Disease regions of Africa, based on country-specific treatment and alcohol consumption data from 2005. Results The effects of alcohol on HIV/AIDS in the African Global Burden of Disease regions range from 0.03% to 0.34% for men and from 0% to 0.17% for women, depending on region and age category. The detrimental effect of alcohol consumption was statistically significant in every region and age category except for the North Africa/Middle East region. Conclusions Although the method has its limitations, it was shown to be feasible and provided estimates of the impact of alcohol use on the mortality outcome of HIV/AIDS. PMID:21320310

Comparing alcohol mortality in Tsarist and contemporary Russia: is the current situation historically unique?

PubMed

Andreev, Evgeny; Bogoyavlensky, Dmitri; Stickley, Andrew

2013-01-01

This study compared the level of alcohol mortality in tsarist and contemporary Russia. Cross-sectional and annual time-series data from 1870 to 1894, 2008 and 2009 on the mortality rate from deaths due to 'drunkenness' were compared for men in the 50 provinces of tsarist 'European Russia': an area that today corresponds with the territory occupied by the Baltic countries, Belarus, Moldova, Ukraine and the Russian provinces to the west of the Ural Mountains. In 1870-1894, the male death rate from 'drunkenness' in the Russian provinces (15.9 per 100,000) was much higher than in the non-Russian provinces. However, the rate recorded in Russia in the contemporary period was even higher--23.3. Russia has had high levels of alcohol mortality from at least the late 19th century onwards. While a dangerous drinking pattern and spirits consumption may underpin high alcohol mortality across time, the seemingly much higher levels in the contemporary period seem to be also driven by an unprecedented level of consumption, and also possibly, surrogate alcohol use. This study highlights the urgent need to reduce the level of alcohol consumption among the population in order to reduce high levels of alcohol mortality in contemporary Russia.

Early mortality of alcoholic hepatitis: a review of data from placebo-controlled clinical trials.

PubMed

Yu, Chao-Hui; Xu, Cheng-Fu; Ye, Hua; Li, Lan; Li, You-Ming

2010-05-21

To investigate the early mortality of placebo-treated alcoholic hepatitis patients. Mortality data about alcoholic hepatitis patients who participated in randomized placebo-controlled trials were searched from PubMed, EMBASE, and Cochrane Library, extracted and analyzed. A total of 661 placebo-treated patients in 19 trials were included. The overall mortality rate was 34.19% with a median observation time of 160 d (range 21-720 d). Hepatic failure, gastrointestinal bleeding and infection were the three main causes of death, accounting for 55.47%, 21.17% and 7.30% of all deaths, respectively. One-month mortality data about 324 placebo-treated alcoholic hepatitis patients in 10 trials were reported with a pooled mortality rate of 20.37%. The one-month mortality rate of patients with moderate to severe alcoholic hepatitis tended to be higher than that of general patients (22.69% vs 10.93%, P < 0.05), whereas no significant difference was observed between the patients from North America or Europe (22.43% vs 18.45%, P > 0.05), neither any difference was found between the studies published before and after 1990 (18.18% vs 21.88%, P > 0.05). Alcoholic hepatitis is a severe liver disease with a high mortality rate, and hepatic failure, gastrointestinal bleeding and infection are the three main causes of death.

Phenobarbital compared to benzodiazepines in alcohol withdrawal treatment: A register-based cohort study of subsequent benzodiazepine use, alcohol recidivism and mortality.

PubMed

Askgaard, Gro; Hallas, Jesper; Fink-Jensen, Anders; Molander, Anna Camilla; Madsen, Kenneth Grønkjær; Pottegård, Anton

2016-04-01

Long-acting benzodiazepines such as chlordiazepoxide are recommended as first-line treatment for alcohol withdrawal. These drugs are known for their abuse liability and might increase alcohol consumption among problem drinkers. Phenobarbital could be an alternative treatment option, possibly with the drawback of a more pronounced acute toxicity. We evaluated if phenobarbital compared to chlordiazepoxide decreased the risk of subsequent use of benzodiazepines, alcohol recidivism and mortality. The study was a register-based cohort study of patients admitted for alcohol withdrawal 1998-2013 and treated with either phenobarbital or chlordiazepoxide. Patients were followed for one year. We calculated hazard ratios (HR) for benzodiazepine use, alcohol recidivism and mortality associated with alcohol withdrawal treatment, while adjusting for confounders. A total of 1063 patients treated with chlordiazepoxide and 1365 patients treated with phenobarbital were included. After one year, the outcome rates per 100 person-years in the phenobarbital versus the chlordiazepoxide cohort were 9.20 vs. 5.13 for use of benzodiazepine, 37.9 vs. 37.9 for alcohol recidivism and 29 vs. 59 for mortality. Comparing phenobarbital to chlordiazepoxide treated, the HR of subsequent use of benzodiazepines was 1.56 (95%CI 1.05-2.30). Similarly, the HR for alcohol recidivism was 0.99 (95%CI 0.84-1.16). Lastly, the HR for 30-days and 1 year mortality was 0.25 (95%CI 0.08-0.78) and 0.51 (95%CI 0.31-0.86). There was no decreased risk of subsequent benzodiazepine use or alcohol recidivism in patients treated with phenobarbital compared to chlordiazepoxide. Phenobarbital treatment was associated with decreased mortality, which might be confounded by somatic comorbidity among patients receiving chlordiazepoxide. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Alcohol-related mortality in the assessments of hospital unit physicians and pathologists: analysis of accounting medical documents].

PubMed

Solov'ev, A G; Viaz'min, A M; Mordovskiĭ, É A; Krasil'nikov, S V

2014-01-01

To make a comparative analysis of the data available in the accounting medical documents drawn up at a multidisciplinary hospital on the level and structure of alcohol-related mortality (ARM) and to evaluate the efficiency of its accounting. Accounting medical documents, such as 453 inpatient cards (Form 003/y), 453 postmortem protocols (cards) (Form 013/H-80), and 453 death certificates (Form 106/y-08), were chosen as the basis for the study. The data of the final clinical and postmortem diagnoses in the patients who had died at hospital and their primary cause of death were comparatively analyzed. According to Form 003/y, ARM was 5.5%; the detection rate of alcohol-related disease (ARD) was 11% (95% confidence interval (CI), 8.3 to 14.3%); according to Form 013/H-80, ARM was 7.1% (95% CI, 4.9 to 9.8%) and the detection rate of ARD was 12.6% (95% CI, 9.7 to 16%). The consistency of the diagnoses of ARD as a main cause of death, made by hospital unit physicians and pathologists, is estimated as the mean--the Cohen's kappa coefficient (kappa) is 0.570) (p < 0.001). The results of the investigation suggest that there are 3 types of ARM, which differ in its level and structure: ARM in the assessments of hospital unit physicians; that in the assessments of pathologists, and that according to the death certificates drawn up. The consistency index for the diagnosis of ARD as a main cause of death indicates that the hospital unit physicians only determine the etiology of alcohol-related cause of death, without identifying it specifically.

Characterization of acute-on-chronic liver failure and prediction of mortality in Asian patients with active alcoholism.

PubMed

Kim, Hwi Young; Chang, Young; Park, Jae Yong; Ahn, Hongkeun; Cho, Hyeki; Han, Seung Jun; Oh, Sohee; Kim, Donghee; Jung, Yong Jin; Kim, Byeong Gwan; Lee, Kook Lae; Kim, Won

2016-02-01

Alcoholic liver diseases often evolve to acute-on-chronic liver failure (ACLF), which increases the risk of (multi-)organ failure and death. We investigated the development and characteristics of alcohol-related ACLF and evaluated prognostic scores for prediction of mortality in Asian patients with active alcoholism. A total of 205 patients who were hospitalized with severe alcoholic liver disease were included in this retrospective cohort study, after excluding those with serious cardiovascular diseases, malignancy, or co-existing viral hepatitis. The Chronic Liver Failure (CLIF) Consortium Organ Failure score was used in the diagnosis and grading of ACLF, and the CLIF Consortium ACLF score (CLIF-C ACLFs) was used to predict mortality. Patients with ACLF had higher Maddrey discriminant function, model for end-stage liver disease (MELD), and MELD-sodium scores than those without ACLF. Infections were more frequently documented in patients with ACLF (33.3% vs 53.0%; P = 0.004). Predictive factors for ACLF development were systemic inflammatory response syndrome (odds ratio [OR], 2.239; P < 0.001), serum sodium level (OR, 0.939; P = 0.029), and neutrophil count (OR, 1.000; P = 0.021). For prediction of mortality at predefined time points (28-day and 90-day) in patients with ACLF, areas under the receiver-operating characteristic were significantly greater for the CLIF-C ACLFs than for Child-Pugh, MELD, and MELD-sodium scores. Infection and systemic inflammatory response syndrome play an important role in the development of alcohol-related ACLF in Asian patients with active alcoholism. The CLIF-C ACLFs may be more useful for predicting mortality in ACLF cases than liver-specific scoring systems. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Influence of alcohol use on mortality and expenditure during hospital admission: a cross-sectional study

PubMed Central

Peng, Shu-Hui; Hsu, Shiun-Yuan; Kuo, Pao-Jen; Rau, Cheng-Shyuan; Cheng, Ya-Ai; Hsieh, Ching-Hua

2016-01-01

Objectives This study was designed to investigate the effect of alcohol intoxication on clinical presentation of hospitalised adult trauma patients at a Level I trauma centre using propensity score matching. Design Cross-sectional study. Setting Taiwan. Participants Detailed data of 929 hospitalised adult trauma patients with alcohol intoxication, aged 20–65 years, and 10 104 corresponding patients without alcohol intoxication were retrieved from the Trauma Registry System between 1 January 2009 and 31 December 2014. Alcohol intoxication was defined as a blood alcohol concentration (BAC) ≥50 mg/dL. Main outcome measures In-hospital mortality and expenditure. Results Patients with alcohol intoxication presented with significantly higher short-term mortality (OR: 3.0, 95% CI 2.0 to 4.4; p<0.001) than patients without alcohol intoxication. However, on comparison with propensity score-matched patients with respect to sex, age, comorbidity, Glasgow Coma Scale (GCS), injury region based on Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS), alcohol intoxication did not significantly influence mortality (OR: 0.8, 95% CI 0.5 to 1.4; p=0.563). This implied that the higher mortality of alcohol-intoxicated patients was attributable to patient characteristics such as a higher injury severity rather than alcohol intoxication. Even on comparison with sex-matched, age-matched and comorbidity-matched patients without alcohol intoxication, patients with alcohol intoxication still had significantly higher total expenditure (17.4% higher), cost of operation (40.3% higher), cost of examination (52.8% higher) and cost of pharmaceuticals (38.3% higher). Conclusions The associated higher mortality of adult trauma patients with alcohol intoxication was completely attributable to other patient characteristics and associated injury severity rather than the effects of alcohol. However, patients with alcohol intoxication incurred significantly higher expenditure than

Alcohol-Related Problems in High-Risk Groups. EURO Reports and Studies 109. Report on a WHO Study.

ERIC Educational Resources Information Center

Plant, Martin, Ed.

Alcohol consumption has risen dramatically in many countries since the Second World War. Accompanying this rise has been a rise in alcohol-related problems, including liver cirrhosis mortality, alcohol dependence, and alcohol-related crimes and accidents. Alcohol misuse presents huge health, social, and legal problems throughout most of Europe and…

Alcohol and Mortality: Combining Self-Reported (AUDIT-C) and Biomarker Detected (PEth) Alcohol Measures Among HIV Infected and Uninfected.

PubMed

Eyawo, Oghenowede; McGinnis, Kathleen A; Justice, Amy C; Fiellin, David A; Hahn, Judith A; Williams, Emily C; Gordon, Adam J; Marshall, Brandon D L; Kraemer, Kevin L; Crystal, Stephen; Gaither, Julie R; Edelman, E Jennifer; Bryant, Kendall J; Tate, Janet P

2018-02-01

Unhealthy alcohol use may be particularly detrimental among individuals living with HIV and/or hepatitis C virus (HCV), and is often under-reported. Direct biomarkers of alcohol exposure may facilitate improved detection of alcohol use. We evaluated the association of alcohol exposure determined by both self-report [Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)] and a direct biomarker [phosphatidylethanol (PEth)], with mortality among HIV-infected and HIV-uninfected in the Veterans Aging Cohort Study-Biomarker Cohort. We considered PEth <8 ng/mL to represent no alcohol use. Alcohol exposure by AUDIT-C scores [0, 1-3/1-2 (men/women), 4-7/3-7 (men/women), 8-12] and PEth (<8, ≥8) was combined into categories to model the relationship of alcohol with mortality. Participants were followed from blood collection date for 5 years or until death within 5 years. The sample included 2344 (1513 HIV+; 831 uninfected) individuals, 95% men. During a median follow-up of 5 years, 13% died. Overall, 36% were infected with HCV (40% HIV+/HCV+, 27% HIV-/HCV+). Overall, 43% (1015/2344) had AUDIT-C = 0 (abstinence). Of these, 15% (149/1015) had PEth ≥8 suggesting recent alcohol exposure. Among those with AUDIT-C = 0, HCV+ individuals were more likely to have PEth ≥8. After controlling for age, sex, race, HIV, HCV, and HIV viral suppression, those with AUDIT-C = 0 but PEth ≥8 had the highest risk of mortality (adjusted hazard ratio 2.15, 95% confidence interval: 1.40 to 3.29). PEth in addition to self-report may improve detection of alcohol use in clinical settings, particularly among those at increased risk of harm from alcohol use. Individuals infected with HCV were more likely to under-report alcohol use.

Mortality in HIV-Infected Alcohol and Drug Users in St. Petersburg, Russia

PubMed Central

Fairbairn, Nadia S.; Walley, Alexander Y.; Cheng, Debbie M.; Quinn, Emily; Bridden, Carly; Chaisson, Christine; Blokhina, Elena; Lioznov, Dmitry; Krupitsky, Evgeny; Raj, Anita; Samet, Jeffrey H.

2016-01-01

In Russia, up to half of premature deaths are attributed to hazardous drinking. The respective roles of alcohol and drug use in premature death among people with HIV in Russia have not been described. Criminalization and stigmatization of substance use in Russia may also contribute to mortality. We explored whether alcohol, drug use and risk environment factors are associated with short-term mortality in HIV-infected Russians who use substances. Secondary analyses were conducted using prospective data collected at baseline, 6 and 12-months from HIV-infected people who use substances recruited between 2007–2010 from addiction and HIV care settings in a single urban setting of St. Petersburg, Russia. We used Cox proportional hazards models to explore associations between 30-day alcohol hazardous drinking, injection drug use, polysubstance use and environmental risk exposures (i.e. past incarceration, police involvement, selling sex, and HIV stigma) with mortality. Among 700 participants, 59% were male and the mean age was 30 years. There were 40 deaths after a median follow-up of 12 months (crude mortality rate 5.9 per 100 person-years). In adjusted analyses, 30-day NIAAA hazardous drinking was significantly associated with mortality compared to no drinking [adjusted Hazard Ratio (aHR) 2.60, 95% Confidence Interval (CI): 1.24–5.44] but moderate drinking was not (aHR 0.95, 95% CI: 0.35–2.59). No other factors were significantly associated with mortality. The high rates of short-term mortality and the strong association with hazardous drinking suggest a need to integrate evidence-based alcohol interventions into treatment strategies for HIV-infected Russians. PMID:27898683

Mortality in HIV-Infected Alcohol and Drug Users in St. Petersburg, Russia.

PubMed

Fairbairn, Nadia S; Walley, Alexander Y; Cheng, Debbie M; Quinn, Emily; Bridden, Carly; Chaisson, Christine; Blokhina, Elena; Lioznov, Dmitry; Krupitsky, Evgeny; Raj, Anita; Samet, Jeffrey H

2016-01-01

In Russia, up to half of premature deaths are attributed to hazardous drinking. The respective roles of alcohol and drug use in premature death among people with HIV in Russia have not been described. Criminalization and stigmatization of substance use in Russia may also contribute to mortality. We explored whether alcohol, drug use and risk environment factors are associated with short-term mortality in HIV-infected Russians who use substances. Secondary analyses were conducted using prospective data collected at baseline, 6 and 12-months from HIV-infected people who use substances recruited between 2007-2010 from addiction and HIV care settings in a single urban setting of St. Petersburg, Russia. We used Cox proportional hazards models to explore associations between 30-day alcohol hazardous drinking, injection drug use, polysubstance use and environmental risk exposures (i.e. past incarceration, police involvement, selling sex, and HIV stigma) with mortality. Among 700 participants, 59% were male and the mean age was 30 years. There were 40 deaths after a median follow-up of 12 months (crude mortality rate 5.9 per 100 person-years). In adjusted analyses, 30-day NIAAA hazardous drinking was significantly associated with mortality compared to no drinking [adjusted Hazard Ratio (aHR) 2.60, 95% Confidence Interval (CI): 1.24-5.44] but moderate drinking was not (aHR 0.95, 95% CI: 0.35-2.59). No other factors were significantly associated with mortality. The high rates of short-term mortality and the strong association with hazardous drinking suggest a need to integrate evidence-based alcohol interventions into treatment strategies for HIV-infected Russians.

Alcohol Consumption and Chronic Liver Disease Mortality in New Mexico and the United States, 1999-2013.

PubMed

Tomedi, Laura E; Roeber, Jim; Landen, Michael

Current chronic liver disease (CLD) mortality surveillance methods may not adequately capture data on all causes of CLD mortality. The objective of this study was to calculate and compare CLD death rates in New Mexico and the United States by using both an expanded definition of CLD and estimates of the fractional impact of alcohol on CLD deaths. We defined CLD mortality as deaths due to alcoholic liver disease, cirrhosis, viral hepatitis, and other liver conditions. We estimated alcohol-attributable CLD deaths by using national and state alcohol-attributable fractions from the Centers for Disease Control and Prevention's Alcohol-Related Disease Impact application. We classified causes of CLD death as being alcohol-attributable, non-alcohol-attributable, or hepatitis C. We calculated average annual age-adjusted CLD death rates during five 3-year periods from 1999 through 2013, and we stratified those rates by sex, age, and race/ethnicity. By cause of death, CLD death rates were highest for alcohol-attributable CLD. By sex and race/ethnicity, CLD death rates per 100 000 population increased from 1999-2001 to 2011-2013 among American Indian men in New Mexico (67.4-90.6) and the United States (38.9-49.4), American Indian women in New Mexico (48.4-63.0) and the United States (27.5-39.5), Hispanic men in New Mexico (48.6-52.0), Hispanic women in New Mexico (16.9-24.0) and the United States (12.8-13.1), non-Hispanic white men in New Mexico (17.4-21.3) and the United States (15.9-18.4), and non-Hispanic white women in New Mexico (9.7-11.6) and the United States (7.6-9.7). CLD death rates decreased among Hispanic men in the United States (30.5-27.4). An expanded CLD definition and alcohol-attributable fractions can be used to create comprehensive data on CLD mortality. When stratified by CLD cause and demographic characteristics, these data may help states and jurisdictions improve CLD prevention programs.

Alcohol and cause-specific mortality in Russia: a retrospective case-control study of 48,557 adult deaths.

PubMed

Zaridze, David; Brennan, Paul; Boreham, Jillian; Boroda, Alex; Karpov, Rostislav; Lazarev, Alexander; Konobeevskaya, Irina; Igitov, Vladimir; Terechova, Tatiana; Boffetta, Paolo; Peto, Richard

2009-06-27

Alcohol is an important determinant of the high and fluctuating adult mortality rates in Russia, but cause-specific detail is lacking. Our case-control study investigated the effects of alcohol consumption on male and female cause-specific mortality. In three Russian industrial cities with typical 1990s mortality patterns (Tomsk, Barnaul, Biysk), the addresses of 60,416 residents who had died at ages 15-74 years in 1990-2001 were visited in 2001-05. Family members were present for 50,066 decedents; for 48,557 (97%), the family gave proxy information on the decedents' past alcohol use and on potentially confounding factors. Cases (n=43,082) were those certified as dying from causes we judged beforehand might be substantially affected by alcohol or tobacco; controls were the other 5475 decedents. Case versus control relative risks (RRs; calculated as odds ratios by confounder-adjusted logistic regression) were calculated in ever-drinkers, defining the reference category by two criteria: usual weekly consumption always less than 0.5 half-litre bottles of vodka (or equivalent in total alcohol content) and maximum consumption of spirits in 1 day always less than 0.5 half-litre bottles. Other ever-drinkers were classified by usual weekly consumption into three categories: less than one, one to less than three, and three or more (mean 5.4 [SD 1.4]) bottles of vodka or equivalent. In men, the three causes accounting for the most alcohol-associated deaths were accidents and violence (RR 5.94, 95% CI 5.35-6.59, in the highest consumption category), alcohol poisoning (21.68, 17.94-26.20), and acute ischaemic heart disease other than myocardial infarction (3.04, 2.73-3.39), which includes some misclassified alcohol poisoning. There were significant excesses of upper aerodigestive tract cancer (3.48, 2.84-4.27) and liver cancer (2.11, 1.64-2.70). Another five disease groups had RRs of more than 3.00 in the highest alcohol category: tuberculosis (4.14, 3.44-4.98), pneumonia (3

Life-time risk of mortality due to different levels of alcohol consumption in seven European countries: implications for low-risk drinking guidelines.

PubMed

Shield, Kevin D; Gmel, Gerrit; Gmel, Gerhard; Mäkelä, Pia; Probst, Charlotte; Room, Robin; Rehm, Jürgen

2017-09-01

Low-risk alcohol drinking guidelines require a scientific basis that extends beyond individual or group judgements of risk. Life-time mortality risks, judged against established thresholds for acceptable risk, may provide such a basis for guidelines. Therefore, the aim of this study was to estimate alcohol mortality risks for seven European countries based on different average daily alcohol consumption amounts. The maximum acceptable voluntary premature mortality risk was determined to be one in 1000, with sensitivity analyses of one in 100. Life-time mortality risks for different alcohol consumption levels were estimated by combining disease-specific relative risk and mortality data for seven European countries with different drinking patterns (Estonia, Finland, Germany, Hungary, Ireland, Italy and Poland). Alcohol consumption data were obtained from the Global Information System on Alcohol and Health, relative risk data from meta-analyses and mortality information from the World Health Organization. The variation in the life-time mortality risk at drinking levels relevant for setting guidelines was less than that observed at high drinking levels. In Europe, the percentage of adults consuming above a risk threshold of one in 1000 ranged from 20.6 to 32.9% for women and from 35.4 to 54.0% for men. Life-time risk of premature mortality under current guideline maximums ranged from 2.5 to 44.8 deaths per 1000 women in Finland and Estonia, respectively, and from 2.9 to 35.8 deaths per 1000 men in Finland and Estonia, respectively. If based upon an acceptable risk of one in 1000, guideline maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men. If low-risk alcohol guidelines were based on an acceptable risk of one in 1000 premature deaths, then maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men, and some of the current European guidelines would require downward revision. © 2017 Society for the Study of Addiction.

Per capita alcohol consumption and suicide mortality in a panel of US states from 1950 to 2002

PubMed Central

Kerr, William C.; Subbaraman, Meenakshi; Ye, Yu

2011-01-01

Introduction and Aims The relationship between per capita alcohol consumption and suicide rates has been found to vary in significance and magnitude across countries. This study utilizes a panel of time-series measures from the US states to estimate the effects of changes in current and lagged alcohol sales on suicide mortality risk. Design and Methods Generalized least squares estimation utilized 53 years of data from 48 US states or state groups to estimate relationships between total and beverage-specific alcohol consumption measures and age-standardized suicide mortality rates in first-differenced semi-logged models. Results An additional liter of ethanol from total alcohol sales was estimated to increase suicide rates by 2.3% in models utilizing a distributed lag specification while no effect was found in models including only current alcohol consumption. A similar result is found for men, while for women both current and distributed lag measures were found to be significantly related to suicide rates with an effect of about 3.2% per liter from current and 5.8% per liter from the lagged measure. Beverage-specific models indicate that spirits is most closely linked with suicide risk for women while beer and wine are for men. Unemployment rates are consistently positively related to suicide rates. Discussion and Conclusions Results suggest that chronic effects, potentially related to alcohol abuse and dependence, are the main source of alcohol’s impact on suicide rates in the US for men and are responsible for about half of the effect for women. PMID:21896069

Alcohol Policies and Alcohol-Related Motor Vehicle Crash Fatalities Among Young People in the US.

PubMed

Hadland, Scott E; Xuan, Ziming; Sarda, Vishnudas; Blanchette, Jason; Swahn, Monica H; Heeren, Timothy C; Voas, Robert B; Naimi, Timothy S

2017-03-01

Motor vehicle crashes (MVCs) are a leading cause of death among young people in the United States. We examined the relationship between states' alcohol policy environments and alcohol-related MVC fatalities among children, adolescents, and young adults under the minimum legal drinking age of 21 years. We used the Alcohol Policy Scale (APS), an assessment of 29 alcohol policies across 50 states and Washington, DC, developed with the assistance of an interdisciplinary Delphi panel. Using the Fatality Analysis Reporting System, we examined APS scores in relation to fatalities of people ≤20 years old from 2000 to 2013 occurring in crashes in which ≥1 involved driver had a blood alcohol content ≥0.08%. Logistic regression was used with a 1-year lag between policies and MVC fatalities and adjusted for potential confounders. Of 84 756 MVC fatalities of those ≤20 years old during the study period, 23 757 (28.0%) were alcohol related, including deaths of 11 006 (46.3%) drivers, 10 212 (43.0%) passengers, and 2539 (10.7%) pedestrians, cyclists, and others. People killed in alcohol-related MVCs were predominantly male (72.7%) and older (65.5% were 18-20 years old), and 51.2% were non-Hispanic white. Restrictive policy environments were associated with fewer fatalities (adjusted odds ratio, 0.91 per 10-percentage-point increase in APS score; 95% confidence interval, 0.89-0.94). The association was observed for drivers and passengers, male and female decendents, and children, adolescents, and young adults. More restrictive alcohol policies are associated with reduced alcohol-related MVC mortality among young people. Studies should scrutinize the relationship between policies and fatalities to highlight mechanisms. Copyright © 2017 by the American Academy of Pediatrics.

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.

Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study.

PubMed

Ferrari, Pietro; Licaj, Idlir; Muller, David C; Kragh Andersen, Per; Johansson, Mattias; Boeing, Heiner; Weiderpass, Elisabete; Dossus, Laure; Dartois, Laureen; Fagherazzi, Guy; Bradbury, Kathryn E; Khaw, Kay-Tee; Wareham, Nick; Duell, Eric J; Barricarte, Aurelio; Molina-Montes, Esther; Sanchez, Carmen Navarro; Arriola, Larraitz; Wallström, Peter; Tjønneland, Anne; Olsen, Anja; Trichopoulou, Antonia; Benetou, Vasiliki; Trichopoulos, Dimitrios; Tumino, Rosario; Agnoli, Claudia; Sacerdote, Carlotta; Palli, Domenico; Li, Kuanrong; Kaaks, Rudolf; Peeters, Petra; Beulens, Joline Wj; Nunes, Luciana; Gunter, Marc; Norat, Teresa; Overvad, Kim; Brennan, Paul; Riboli, Elio; Romieu, Isabelle

2014-07-03

To investigate the role of factors that modulate the association between alcohol and mortality, and to provide estimates of absolute risk of death. The European Prospective Investigation into Cancer and nutrition (EPIC). 23 centres in 10 countries. 380 395 men and women, free of cancer, diabetes, heart attack or stroke at enrolment, followed up for 12.6 years on average. 20 453 fatal events, of which 2053 alcohol-related cancers (ARC, including cancers of upper aerodigestive tract, liver, colorectal and female breast), 4187 cardiovascular diseases/coronary heart disease (CVD/CHD), 856 violent deaths and injuries. Lifetime alcohol use was assessed at recruitment. HRs comparing extreme drinkers (≥30 g/day in women and ≥60 g/day in men) to moderate drinkers (0.1-4.9 g/day) were 1.27 (95% CI 1.13 to 1.43) in women and 1.53 (1.39 to 1.68) in men. Strong associations were observed for ARC mortality, in men particularly, and for violent deaths and injuries, in men only. No associations were observed for CVD/CHD mortality among drinkers, whereby HRs were higher in never compared to moderate drinkers. Overall mortality seemed to be more strongly related to beer than wine use, particularly in men. The 10-year risks of overall death for women aged 60 years, drinking more than 30 g/day was 5% and 7%, for never and current smokers, respectively. Corresponding figures in men consuming more than 60 g/day were 11% and 18%, in never and current smokers, respectively. In competing risks analyses, mortality due to CVD/CHD was more pronounced than ARC in men, while CVD/CHD and ARC mortality were of similar magnitude in women. In this large European cohort, alcohol use was positively associated with overall mortality, ARC and violent death and injuries, but marginally to CVD/CHD. Absolute risks of death observed in EPIC suggest that alcohol is an important determinant of total mortality. Published by the BMJ Publishing Group Limited. For permission to use (where

Prevalence of alcohol-related pathologies at autopsy: Estonian Forensic Study of Alcohol and Premature Death

PubMed Central

Tuusov, Jana; Lang, Katrin; Väli, Marika; Pärna, Kersti; Tõnisson, Mailis; Ringmets, Inge; McKee, Martin; Helander, Anders; Leon, David A

2014-01-01

Aims Alcohol can induce diverse serious pathologies, yet this complexity may be obscured when alcohol-related deaths are classified according to a single underlying cause. We sought to quantify this issue and its implications for analysing mortality data. Design, Setting and Participants Cross-sectional study included 554 men aged 25–54 in Estonia undergoing forensic autopsy in 2008–09. Measurements Potentially alcohol-related pathologies were identified following macroscopic and histological examination. Alcohol biomarkers levels were determined. For a subset (26%), drinking behaviour was provided by next-of-kin. The Estonian Statistics Office provided underlying cause of death. Findings Most deaths (75%) showed evidence of potentially alcohol-related pathologies, and 32% had pathologies in two or more organs. The liver was most commonly affected [60.5%, 95% confidence interval (CI) = 56.3–64.6] followed by the lungs (18.6%, 95% CI = 15.4–22.1), stomach (17.5%, 95% CI = 14.4–20.9), pancreas (14.1%, 95% CI = 11.3–17.3), heart (4.9%, 95% CI = 3.2–7.0) and oesophagus (1.4%, 95% CI = 0.6–2.8). Only a minority with liver pathology had a second pathology. The number of pathologies correlated with alcohol biomarkers (phosphatidylethanol, gamma-glytamyl transpeptidase in blood, ethylglucuronide, ethylsulphate in urine). Despite the high prevalence of liver pathology, few deaths had alcoholic liver disease specified as the underlying cause. Conclusion The majority of 554 men aged 25–54 undergoing forensic autopsy in Estonia in 2008–09 showed evidence of alcohol-related pathology. However, the recording of deaths by underlying cause failed to capture the scale and nature of alcohol-induced pathologies found. PMID:25066373

The Socioeconomic Differences in Alcohol-Related Harm and the Effects of Alcohol Prices on Them: A Summary of Evidence from Finland.

PubMed

Mäkelä, Pia; Herttua, Kimmo; Martikainen, Pekka

2015-11-01

We make a case study of Finland to study the connections between socioeconomic status, alcohol use, related harm and possibilities for intervention by means of alcohol pricing. A review of Finnish studies on the topic. The socioeconomic differences in severe alcohol-related harm were great, and in the past two decades, these differences have widened. Alcohol-related mortality has also strongly contributed to both the level and widening of socioeconomic differences in life expectancy. Both in 2004, when alcohol prices were abruptly cut, and in the longer term with more gradual changes in lowest prices of alcohol, the lowest socioeconomic groups were most affected in absolute-but not so clearly in relative-terms, particularly among men. However, these effects are sometimes weak, not fully consistent by gender and across different measures of harm. The large and increasing socioeconomic differences in alcohol-related harm in Finland underline the importance of reducing these differences. The finding that particularly among men the impact of reduced alcohol prices on health has often in absolute terms been the greatest in the lower socioeconomic groups suggests that policies aimed at keeping the price of alcoholic beverages high may help to both minimize the overall level of alcohol-related health problems and to reduce absolute inequalities. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

The relationship between alcohol consumption and vascular complications and mortality in individuals with type 2 diabetes.

PubMed

Blomster, Juuso I; Zoungas, Sophia; Chalmers, John; Li, Qiang; Chow, Clara K; Woodward, Mark; Mancia, Giuseppe; Poulter, Neil; Williams, Bryan; Harrap, Stephen; Neal, Bruce; Patel, Anushka; Hillis, Graham S

2014-01-01

Moderate alcohol consumption has been associated with a reduced risk of mortality and coronary artery disease. The relationship between cardiovascular health and alcohol use in type 2 diabetes is less clear. The current study assesses the effects of alcohol use among participants in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation (ADVANCE) trial. The effects of alcohol use were explored using Cox regression models, adjusted for potential confounders. The study end points were cardiovascular events (cardiovascular death, myocardial infarction, and stroke), microvascular complications (new or worsening nephropathy or retinopathy), and all-cause mortality. During a median of 5 years of follow-up, 1,031 (9%) patients died, 1,147 (10%) experienced a cardiovascular event, and 1,136 (10%) experienced a microvascular complication. Compared with patients who reported no alcohol consumption, those who reported moderate consumption had fewer cardiovascular events (adjusted hazard ratio [aHR] 0.83; 95% CI 0.72-0.95; P = 0.008), less microvascular complications (aHR 0.85; 95% CI 0.73-0.99; P = 0.03), and lower all-cause mortality (aHR 0.87; 96% CI 0.75-1.00; P = 0.05). The benefits were particularly evident in participants who drank predominantly wine (cardiovascular events aHR 0.78, 95% CI 0.63-0.95, P = 0.01; all-cause mortality aHR 0.77, 95% CI 0.62-0.95, P = 0.02). Compared with patients who reported no alcohol consumption, those who reported heavy consumption had dose-dependent higher risks of cardiovascular events and all-cause mortality. In patients with type 2 diabetes, moderate alcohol use, particularly wine consumption, is associated with reduced risks of cardiovascular events and all-cause mortality.

Average volume of alcohol consumption and all-cause mortality in African Americans: the NHEFS cohort.

PubMed

Sempos, Christopher T; Rehm, Jürgen; Wu, Tiejian; Crespo, Carlos J; Trevisan, Maurizio

2003-01-01

To analyze the relationship between average volume of alcohol consumption and all-cause mortality in African Americans. Prospective cohort study--the NHANES Epidemiologic Follow-Up Study (NHEFS)--with baseline data collected 1971 through 1975 as part of the first National Health and Nutrition Examination Survey (NHANES I) and follow-up through 1992. The analytic data set consisted of 2054 African American men (n = 768) and women (n = 1,286), 25 to 75 years of age, who were followed for approximately 19 years. Alcohol was measured with a quantity-frequency measure at baseline. All-cause mortality. No J-shaped curve was found in the relationship between average volume of alcohol consumption and mortality for male or female African Americans. Instead, no beneficial effect appeared and mortality increased with increasing average consumption for more than one drink a day. The reason for not finding the J-shape in African Americans may be the result of the more detrimental drinking patterns in this ethnicity and consequently the lack of protective effects of alcohol on coronary heart disease. Taking into account sampling design did not substantially change the results from the models, which assumed a simple random sample. If this result can be confirmed in other samples, alcohol policy, especially prevention, should better incorporate patterns of drinking into programs.

Ethnicity, Russification, and Excess Mortality in Kazakhstan*

PubMed Central

Sharygin, Ethan J.; Guillot, Michel

2014-01-01

Russians experience higher adult mortality than Central Asians despite higher socioeconomic status. This study exploits Kazakhstan’s relatively heterogeneous population and geographic diversity to study ethnic differences in cause-specific mortality. In multivariate regression, all-cause mortality rates for Russian men is 27% higher than for Kazakh men, and alcohol-related death rates among Russian men are 2.5 times higher (15% and 4.1 times higher for females, respectively). Significant mortality differentials exist by ethnicity for external causes and alcohol-related causes of death. Adult mortality among Kazakhs is higher than previously found among Kyrgyz and lower than among Russians. The results suggest that ethnic mortality differentials in Central Asia may be related to the degree of russification, which could be replicating documented patterns of alcohol consumption in non-Russian populations. PMID:26207118

Association of State Alcohol Policies With Alcohol-Related Motor Vehicle Crash Fatalities Among US Adults.

PubMed

Naimi, Timothy S; Xuan, Ziming; Sarda, Vishnudas; Hadland, Scott E; Lira, Marlene C; Swahn, Monica H; Voas, Robert B; Heeren, Timothy C

2018-05-29

Motor vehicle crashes are a leading cause of mortality. However, the association between the restrictiveness of the alcohol policy environment (ie, based on multiple existing policies) and alcohol-related crash fatalities has not been characterized previously to date. To examine the association between the restrictiveness of state alcohol policy environments and the likelihood of alcohol involvement among those dying in motor vehicle crashes in the United States. This investigation was a repeated cross-sectional study in which state alcohol policies (operationalized by the Alcohol Policy Scale [APS]) from 1999 to 2014 were related to motor vehicle crash fatalities from 2000 to 2015 using data from the Fatality Analysis Reporting System (1-year lag). Alternating logistic regression models and generalized estimating equations were used to account for clustering of multiple deaths within a crash and of multiple crashes occurring within states. The study also examined independent associations of mutually exclusive subgroups of policies, including consumption-oriented policies vs driving-oriented policies. The study setting was the 50 US states. Participants were 505 614 decedents aged at least 21 years from motor vehicle crashes from 2000 to 2015. Odds that a crash fatality was alcohol related (fatality stemmed from a crash in which ≥1 driver had a blood alcohol concentration [BAC] ≥0.08%). From 2000 to 2015, there were 505 614 adult motor vehicle crash fatalities in the United States, of which 178 795 (35.4%) were alcohol related. Each 10-percentage point increase in the APS score (corresponding to more restrictive state policies) was associated with reduced individual-level odds of alcohol involvement in a crash fatality (adjusted odds ratio [aOR], 0.90; 95% CI, 0.89-0.91); results were consistent among most demographic and crash-type strata. More restrictive policies also had protective associations with alcohol involvement among crash fatalities

Oral cancer: the association between nation-based alcohol-drinking profiles and oral cancer mortality.

PubMed

Petti, Stefano; Scully, Crispian

2005-09-01

The unclear association between different nation-based alcohol-drinking profiles and oral cancer mortality was investigated using, as observational units, 20 countries from Europe, Northern America, Far Eastern Asia, with cross-nationally comparable data. Stepwise multiple regression analyses were run with male age-standardised, mortality rate (ASMR) as explanatory variable and annual adult alcohol consumption, adult smoking prevalence, life expectancy, as explanatory. Large between-country differences in ASMR (range, 0.88-6.87 per 100,000) were found, but the mean value was similar to the global estimate (3.31 vs. 3.09 per 100,000). Differences in alcohol consumption (2.06-21.03 annual litres per capita) and in distribution between beverages were reported. Wine was the most prevalent alcoholic beverage in 45% of cases. Significant increases in ASMR for every litre of pure ethanol (0.15 per 100,000; 95 CI, 0.01-0.29) and spirits (0.26 per 100,000; 95 CI, 0.03-0.49), non-significant effects for beer and wine were estimated. The impact of alcohol on oral cancer deaths would be higher than expected and the drinking profile could affect cancer mortality, probably because of the different drinking pattern of spirit drinkers, usually consuming huge alcohol quantities on single occasions, and the different concentrations of ethanol and cancer-preventing compounds such as polyphenols, in the various beverages.

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

Alcohol Abuse Increases Rebleeding Risk and Mortality in Patients with Non-variceal Upper Gastrointestinal Bleeding.

PubMed

Kärkkäinen, Jussi M; Miilunpohja, Sami; Rantanen, Tuomo; Koskela, Jenni M; Jyrkkä, Johanna; Hartikainen, Juha; Paajanen, Hannu

2015-12-01

No current data are available on rebleeding and mortality risk in patients who use alcohol excessively and are admitted for non-variceal upper gastrointestinal bleeding (NVUGIB). This information could help in planning interventions and follow-up protocols for these patients. This study provides contemporary data on the long-term outcome after first-time NVUGIB in alcohol abusers (AAs) compared to non-abusers (NAs). Consecutive patients hospitalized for their first acute gastrointestinal bleeding from 2009 through 2011 were retrospectively recorded and categorized as AA or NA. Risk factors for one-year mortality and rebleeding were identified, and patients were further monitored for long-term mortality until 2015. Alcohol abuse was identified in 19.7% of patients with NVUGIB (n = 518). The one-year rebleeding rate was 16.7% in AAs versus 9.1% in NAs (P = 0.027). Alcohol abuse was associated with a twofold increase in rebleeding risk (P = 0.025); the risk especially increased 6 months after the initial bleeding. The study groups did not differ significantly in 30-day (6.0%) or one-year mortality rates (20.5%). However, there was a tendency for higher overall mortality in AAs than NAs after adjustment of comorbidities. AAs with NVUGIB are at high risk of rebleeding, and mortality is increased in AA patients. A close follow-up strategy and long-term proton pump inhibitor therapy are recommended for AA patients with peptic ulcer or esophagitis.

Directly alcohol-attributable mortality by industry and occupation in a Spanish Census cohort of economically active population.

PubMed

Pulido, José; Vallejo, Fernando; Alonso-López, Ignacio; Regidor, Enrique; Villar, Fernando; de la Fuente, Luis; Domingo-Salvany, Antonia; Barrio, Gregorio

2017-11-01

To assess disparities in directly alcohol-attributable (DAA) mortality by industry/occupation in Spain during 2002-2011 and the contribution of different socio-demographic factors, including socioeconomic position, to explain such disparity. Nationwide cohort study covering 16 million economically active people living in Spain in 2001. Deaths at age 25-64 were analyzed. Subjects were classified by employment status, industry and occupation at baseline. Poisson regression models were built, calculating rate ratios (RRs) compared to all employees or those in the education sector. DAA mortality was much higher in the unemployed than in employees (Crude RR: 2.4; 95% CI: 2.3-2.6) and varied widely across industries/occupations. Crude RRs>3.0 (p<0.05) compared to teachers were found in employees in extractive industries/fishing, agriculture/livestock, construction, catering/accommodation and protective services. Socio-demographic factors, especially age, gender and educational attainment contributed more to explain risk disparities than other factors or potential selection bias. However, after exhaustive sociodemographic adjustment, including education attainment and material wealth, a RR>1.33 (p<0.05) remained in unemployed, catering/accommodation employees and unskilled construction workers. RRs were significantly larger in women than men (p<0.05) among mineworkers/fishworkers/sailors (RR=8.6 vs. 1.2) and drivers (RR=3.7 vs. 1.0). The results could be extrapolated to all alcohol-attributable mortality since disparities for other strongly alcohol-related deaths, although smaller, were in the same direction. Given the wide occupational disparities in alcohol-attributable mortality, implementation of special measures to reduce this mortality in the highest risk groups is fully justified. Future research should better characterize the explanatory factors of disparities and their role in the causal chain. Copyright © 2017. Published by Elsevier B.V.

Underestimating the Alcohol Content of a Glass of Wine: The Implications for Estimates of Mortality Risk

PubMed Central

Britton, Annie; O’Neill, Darragh; Bell, Steven

2016-01-01

Aims Increases in glass sizes and wine strength over the last 25 years in the UK are likely to have led to an underestimation of alcohol intake in population studies. We explore whether this probable misclassification affects the association between average alcohol intake and risk of mortality from all causes, cardiovascular disease and cancer. Methods Self-reported alcohol consumption in 1997–1999 among 7010 men and women in the Whitehall II cohort of British civil servants was linked to the risk of mortality until mid-2015. A conversion factor of 8 g of alcohol per wine glass (1 unit) was compared with a conversion of 16 g per wine glass (2 units). Results When applying a higher alcohol content conversion for wine consumption, the proportion of heavy/very heavy drinkers increased from 28% to 41% for men and 15% to 28% for women. There was a significantly increased risk of very heavy drinking compared with moderate drinking for deaths from all causes and cancer before and after change in wine conversion; however, the hazard ratios were reduced when a higher wine conversion was used. Conclusions In this population-based study, assuming higher alcohol content in wine glasses changed the estimates of mortality risk. We propose that investigator-led cohorts need to revisit conversion factors based on more accurate estimates of alcohol content in wine glasses. Prospectively, researchers need to collect more detailed information on alcohol including serving sizes and strength. Short summary The alcohol content in a wine glass is likely to be underestimated in population surveys as wine strength and serving size have increased in recent years. We demonstrate that in a large cohort study, this underestimation affects estimates of mortality risk. Investigator-led cohorts need to revisit conversion factors based on more accurate estimates of alcohol content in wine glasses. PMID:27261472

Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland and Sweden

PubMed Central

Westman, J; Wahlbeck, K; Laursen, T M; Gissler, M; Nordentoft, M; Hällgren, J; Arffman, M; Ösby, U

2015-01-01

Objective To analyse mortality and life expectancy in people with alcohol use disorder in Denmark, Finland and Sweden. Method A population-based register study including all patients admitted to hospital diagnosed with alcohol use disorder (1 158 486 person-years) from 1987 to 2006 in Denmark, Finland and Sweden. Results Life expectancy was 24–28 years shorter in people with alcohol use disorder than in the general population. From 1987 to 2006, the difference in life expectancy between patients with alcohol use disorder and the general population increased in men (Denmark, 1.8 years; Finland, 2.6 years; Sweden, 1.0 years); in women, the difference in life expectancy increased in Denmark (0.3 years) but decreased in Finland (−0.8 years) and Sweden (−1.8 years). People with alcohol use disorder had higher mortality from all causes of death (mortality rate ratio, 3.0–5.2), all diseases and medical conditions (2.3–4.8), and suicide (9.3–35.9). Conclusion People hospitalized with alcohol use disorder have an average life expectancy of 47–53 years (men) and 50–58 years (women) and die 24–28 years earlier than people in the general population. PMID:25243359

Alcohol consumption and mortality from aortic disease among Japanese men: The Japan Collaborative Cohort study.

PubMed

Shirakawa, Toru; Yamagishi, Kazumasa; Yatsuya, Hiroshi; Tanabe, Naohito; Tamakoshi, Akiko; Iso, Hiroyasu

2017-11-01

Only a few population-based prospective studies have examined the association between alcohol consumption and abdominal aortic aneurysm, and the results are inconsistent. Moreover, no evidence exists for aortic dissection. We examined the effect of alcohol consumption on risk of mortality from aortic diseases. A total of 34,720 men from the Japan Collaborative Cohort study, aged 40-79 years, without history of cardiovascular disease and cancer at baseline 1988 and 1990 were followed up until the end of 2009 for their mortality and its underlying cause. Hazard ratios of mortality from aortic diseases were estimated according to alcohol consumption categories of never-drinkers, ex-drinkers, regular drinkers of ≤30 g, and >30 g ethanol per day. During the median 17.9-year follow-up period, 45 men died of aortic dissection and 41 men died of abdominal aortic aneurysm. Light to moderate drinkers of ≤30 g ethanol per day had lower risk of mortality from total aortic disease and aortic dissection compared to never-drinkers. The respective multivariable hazard ratios (95% confidence intervals) were 0.46 (0.28-0.76) for total aortic disease and 0.16 (0.05-0.50) for aortic dissection. Heavy drinkers of >30 g ethanol per day did not have reduced risk of mortality from total aortic disease, albeit had risk variation between aortic dissection and abdominal aortic aneurysm. Light to moderate alcohol consumption was associated with reduced mortality from aortic disease among Japanese men. Copyright © 2017. Published by Elsevier B.V.

ALCOHOL USE BY URBAN BICYCLISTS IS ASSOCIATED WITH MORE SEVERE INJURY, GREATER HOSPITAL RESOURCE USE, AND HIGHER MORTALITY

PubMed Central

Sethi, Monica; Heyer, Jessica; Wall, Stephen; DiMaggio, Charles; Shinseki, Matthew; Slaughter, Dekeya; Frangos, Spiros G

2017-01-01

Alcohol use is a risk factor for severe injury in pedestrians struck by motor vehicles. Our objective was to investigate alcohol use by bicyclists and its effects on riding behaviors, medical management, injury severity, and mortality within a congested urban setting. A hospital-based, observational study of injured bicyclists presenting to a Level I regional trauma center in New York City was conducted. Data were collected prospectively from 2012 to 2014 by interviewing all bicyclists presenting within 24 h of injury and supplemented with medical record review. Variables included demographic characteristics, scene-related data, Glasgow Coma Scale (GCS), computed tomography (CT) scans, and clinical outcomes. Alcohol use at the time of injury was determined by history or blood alcohol level (BAL) >0.01 g/dL. Of 689 bicyclists, 585 (84.9%) were male with a mean age of 35.2. One hundred four (15.1%) bicyclists had consumed alcohol prior to injury. Alcohol use was inversely associated with helmet use (16.5% [9.9–25.1] vs. 43.2% [39.1–47.3]). Alcohol-consuming bicyclists were more likely to fall from their bicycles (42.0% [32.2–52.3] vs. 24.2% [20.8–27.9]) and less likely to be injured by collision with a motor vehicle (52.0% [41.7–62.1] vs. 67.5% [63.5–71.3]). 80% of alcohol-consuming bicyclists underwent CT imaging at presentation compared with 51.5% of non-users. Mortality was higher among injured bicyclists who had used alcohol (2.9% [0.6–8.2] vs. 0.0% [0.0–0.6]). Adjusted multivariable analysis revealed that alcohol use was independently associated with more severe injury (Adjusted Odds Ratio 2.27, p = 0.001, 95% Confidence Interval 1.40–3.68). Within a dense urban environment, alcohol use by bicyclists was associated with more severe injury, greater hospital resource use, and higher mortality. As bicycling continues to increase in popularity internationally, it is important to heighten awareness about the risks and consequences of bicycling while

Chronic alcohol ingestion increases mortality and organ injury in a murine model of septic peritonitis.

PubMed

Yoseph, Benyam P; Breed, Elise; Overgaard, Christian E; Ward, Christina J; Liang, Zhe; Wagener, Maylene E; Lexcen, Daniel R; Lusczek, Elizabeth R; Beilman, Greg J; Burd, Eileen M; Farris, Alton B; Guidot, David M; Koval, Michael; Ford, Mandy L; Coopersmith, Craig M

2013-01-01

Patients admitted to the intensive care unit with alcohol use disorders have increased morbidity and mortality. The purpose of this study was to determine how chronic alcohol ingestion alters the host response to sepsis in mice. Mice were randomized to receive either alcohol or water for 12 weeks and then subjected to cecal ligation and puncture. Mice were sacrificed 24 hours post-operatively or followed seven days for survival. Septic alcohol-fed mice had a significantly higher mortality than septic water-fed mice (74% vs. 41%, p = 0.01). This was associated with worsened gut integrity in alcohol-fed mice with elevated intestinal epithelial apoptosis, decreased crypt proliferation and shortened villus length. Further, alcohol-fed mice had higher intestinal permeability with decreased ZO-1 and occludin protein expression in the intestinal tight junction. The frequency of splenic and bone marrow CD4+ T cells was similar between groups; however, splenic CD4+ T cells in septic alcohol-fed mice had a marked increase in both TNF and IFN-γ production following ex vivo stimulation. Neither the frequency nor function of CD8+ T cells differed between alcohol-fed and water-fed septic mice. NK cells were decreased in both the spleen and bone marrow of alcohol-fed septic mice. Pulmonary myeloperoxidase levels and BAL levels of G-CSF and TFG-β were higher in alcohol-fed mice. Pancreatic metabolomics demonstrated increased acetate, adenosine, xanthine, acetoacetate, 3-hydroxybutyrate and betaine in alcohol-fed mice and decreased cytidine, uracil, fumarate, creatine phosphate, creatine, and choline. Serum and peritoneal cytokines were generally similar between alcohol-fed and water-fed mice, and there were no differences in bacteremia, lung wet to dry weight, or pulmonary, liver or splenic histology. When subjected to the same septic insult, mice with chronic alcohol ingestion have increased mortality. Alterations in intestinal integrity, the host immune response, and

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 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

Does alcohol intoxication protect patients from severe injury and reduce hospital mortality? The association of alcohol consumption with the severity of injury and survival in trauma patients.

PubMed

Hsieh, Chi-Hsun; Su, Li-Ting; Wang, Yu-Chun; Fu, Chih-Yuan; Lo, Hung-Chieh; Lin, Chiu-Hsiu

2013-12-01

Alcohol-related motor vehicle collisions are a major cause of mortality in trauma patients. This prospective observational study investigated the influence of antecedent alcohol use on outcomes in trauma patients who survived to reach the hospital. From 2005 to 2011, all patients who were older than 18 years and were admitted as a result of motor vehicle crashes were included. Blood alcohol concentration (BAC) was routinely measured for each patient on admission. Patients were divided into four groups based on their BAC level, which included nondrinking, BAC less than 100, BAC 100 to 200, and BAC 200 mg/dL or greater. Patient demographics, physical status and injury severity on admission, length of hospital stay, and outcome were compared between the groups. Odds ratios of having a severe injury, prolonged hospital stay, and mortality were estimated. Patients with a positive BAC had an increased risk of sustaining craniofacial and thoracoabdominal injuries. Odds ratios of having severe injuries (Injury Severity Score [ISS] 16 or greater) and a prolonged hospital stay were also increased. However, for those patients whose ISS was 16 or greater and who also had a brain injury, risk of fatality was significantly reduced if they were intoxicated (BAC 200 mg/dL or greater) before injury. Alcohol consumption does not protect patients from sustaining severe injuries nor does it shorten the length of hospital stay. However, there were potential survival benefits related to alcohol consumption for patients with brain injuries but not for those without brain injuries. Additional research is required to investigate the mechanism of this association further.

[Ecological correlation between consumption of alcoholic beverages and liver cirrhosis mortality in Mexico].

PubMed

Narro-Robles, J; Gutiérrez-Avila, J H

1997-01-01

To determine the correlation between alcohol consumption and mortality from liver cirrhosis in Mexico. Analysis of the ecological correlation between the patterns of alcohol consumption determined by the National Addiction Survey in 1993 and mortality by liver cirrhosis, in the period between 1971-1993, in the eight regions in which the country was divided. To determine level of correlation, the Pearson and Spearman coefficients were calculated. Significant correlations were only found with the prevalence of spirits and pulque drinkers; with beer drinkers the correlation was negative. The correlation with pulque is interesting, since pulque consumption is considered to be low scale in some rural areas. The negative correlation with beer may indicate that beer drinking is nor a good indicator of alcoholism. Results, though limited to the possibilities of an ecological study, reveal the necessity of effective actions in the regions where spirits and pulque are consumed in excess.

Relationship between alcohol consumption and cardiovascular mortality--the Warsaw Pol-MONICA Project.

PubMed

Waśkiewicz, Anna; Sygnowska, Elzbieta; Drygas, Wojciech

2004-06-01

Cardioprotective effects of alcohol recently gained wide spread interest and have been examined in several studies. To assess the effects of alcohol consumption on mortality due to cardiovascular diseases (CV) in the population of the Eastern part of Warsaw. The study group consisted of representative, independent and randomly selected samples of the populations of two Warsaw districts (Praga Północ and Praga Południe), aged between 35 and 64 years. The studied subjects were examined in 1984 (2570 subjects), in 1988 (1397 subjects) and in 1993 (1485 subjects). Their survival rates were followed up until 1998. The annual beer, wine and vodka intake was assessed using a standardised questionnaire and calculated for a daily pure ethanol intake. The studied subjects were divided into four groups: abstinents and three groups according to the tertile distribution of the alcohol intake (mean alcohol intake in the first tertile: males 1.1 g/day, females 0.2 g/day, in the second tertile: 3.9 and 0.4 g/day, respectively, and in the third tertile: 28.2 and 2.8 g/day, respectively). The relative risk of death in the analysed groups was assessed using the proportional hazard Cox analysis. In total, 471 males and 244 females died during the follow-up period. There were 221 CV deaths among males and 85 among females. The relative risk of CV death after adjustment for other parameters (age, screening, cigarette smoking, body mass index, education level, cholesterol level, anginal symptoms, systolic blood pressure and self-assessed health status) was approximately 40% lower among males who consumed alcohol compared with the abstinents. The lowest risk of CV death was noted in the first tertile group. Females who consumed alcohol, had a 40-70% lower CV risk of death than abstinents the lowest risk was documented for the third tertile group. Alcohol consumption independently lowers the risk of death due to cardio-vascular diseases.

Recidivistic offending and mortality in alcoholic violent offenders: a prospective follow-up study.

PubMed

Tikkanen, Roope; Holi, Matti; Lindberg, Nina; Tiihonen, Jari; Virkkunen, Matti

2009-06-30

Predictive data supporting prevention of violent criminality are scarce. We examined risk factors for recidivism and mortality among non-psychotic alcoholic violent offenders, the majority having antisocial or borderline personality disorders, or both, which is a group that commits the majority of violent offences in Finland. Criminal records and mortality data on 242 male alcoholic violent offenders were analysed after a 7- to 15-year follow-up, and compared between themselves and with those of 1210 age-, sex- and municipality-matched controls. Recidivism and mortality rates were high. The risk of recidivistic violence was increased by antisocial or borderline personality disorder, or both, childhood maltreatment, and a combination of these. A combination of borderline personality disorder and childhood maltreatment was particularly noxious, suggesting an additive risk increase for a poor outcome. Accurate diagnosis and careful childhood interview may help to predict recidivism and premature death.

Intelligence quotient (IQ) in adolescence and later risk of alcohol-related hospital admissions and deaths--37-year follow-up of Swedish conscripts.

PubMed

Sjölund, Sara; Allebeck, Peter; Hemmingsson, Tomas

2012-01-01

To investigate the relationship between intelligence measured at ages 18-19 and later alcohol-related hospital admission and mortality among men, while controlling for possible confounders. Cohort study. A total of 49,321 Swedish men who were conscripted for military training in 1969-70 and followed until 2007. Intelligence quotient (IQ) measured at conscription is the exposure, while alcohol-related hospital admission and death are the two outcomes. Adjustments for following variables were made: early life circumstances [childhood socio-economic position (SEP), father's drinking], mental health, social adjustment and behavioural factors measured at age 18 (psychiatric diagnosis, contact with police and child care, low emotional control, daily smoking, risky use of alcohol) and adult social position (attained education, SEP and income at age 40). IQ had an inverse and graded association with later alcohol-related problems. For alcohol-related hospital admissions the crude hazard ratio (HR) was 1.29 (95% CI = 1.26-1.31) and for alcohol-related mortality it was 1.21 (95% CI = 1.17-1.24) for every one point decrease on the nine-point IQ scale. Adjustment for risk factors measured at age 18 attenuated the association somewhat for both outcomes. After adjustment for social position as adult, the HR was considerably lower resulting in a HR of 1.06 (95% CI = 1.02-1.10) for alcohol-related hospital admissions and 1.01 (95% CI = 0.95-1.08) for alcohol-related mortality. In Swedish men there is an association between IQ in early adulthood and later alcohol-related hospital admission and death. Social position as adult could be an important contributory factor. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Moderate and heavy alcohol consumption among Turks: long-term impact on mortality and cardiometabolic risk.

PubMed

Onat, Altan; Hergenç, Gülay; Küçükdurmaz, Zekeriya; Uğur, Murat; Kaya, Zekeriya; Can, Günay; Yüksel, Hüsniye

2009-03-01

The impact of alcohol consumption on various outcomes was prospectively evaluated in the participants of the Turkish Adult Risk Factor Study. A total of 3,443 men and women (mean age 47.6+/-12 years) were included at baseline and followed-up for a mean of 7.4 years (range 5 to 9 years). Alcohol drinking status was assessed as abstention and brackets of moderate and heavy intake. Only 19.5% of adults (35% of men and 4.2% of women) reported consumption of alcohol. In each multivariate analysis, individuals with the examined endpoint at baseline were excluded, and alcohol drinking status was adjusted for age, sex, smoking status, and physical activity. Alcohol intake increased overall mortality (by 2-fold) in men drinking heavily, but not in men drinking moderately, nor in women. Heavy drinking in combined sexes predicted the risk for incident coronary heart disease (CHD) (RR 2.3; 95% CI 1.30; 4.05), while moderate drinking tended to be protective (RR 0.72; 95% CI 0.50; 1.035). Heavy intake predicted incident diabetes risk (RR 2.13) and tended to be so for new metabolic syndrome (MetS) in men (RR 1.71), whereas moderate alcohol intake was not significantly associated with subsequent development of diabetes or MetS and the risk for MetS was reduced in women (p=0.10). Risk of alcohol intake depends on the amount used: heavy intake raising the risk for diabetes and CHD in combined sexes, and overall mortality in men, contrasted to moderate intake reducing (borderline) the CHD risk and marginally reducing all-cause mortality. Risk for MetS tends to be reduced in women alone.

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 RELATION BETWEEN DIFFERENT DIMENSIONS OF ALCOHOL CONSUMPTION AND BURDEN OF DISEASE - AN OVERVIEW

PubMed Central

Rehm, Jürgen; Baliunas, Dolly; Borges, Guilherme L. G.; Graham, Kathryn; lrving, Hyacinth; Kehoe, Tara; Parry, Charles D.; Patra, Jayadeep; Popova, Svetlana; Poznyak, Vladimir; Roerecke, Michael; Room, Robin; Samokhvalov, Andriy V.; Taylor, Benjamin

2012-01-01

AIMS As part of a larger study to estimate the global burden of disease and injury attributable to alcohol: To evaluate the evidence for a causal impact of average volume of alcohol consumption and pattern of drinking on diseases and injuries;To quantify relationships identified as causal based on published meta-analyses;To separate the impact on mortality vs. morbidity where possible; andTo assess the impact of the quality of alcohol on burden of disease. METHODS Systematic literature reviews were used to identify alcohol-related diseases, birth complications and injuries using standard epidemiologic criteria to determine causality. The extent of the risk relations was taken from meta-analyses. RESULTS Evidence of a causal impact of average volume of alcohol consumption was found for the following major diseases: tuberculosis, mouth, nasopharynx, other pharynx and oropharynx cancer, oesophageal cancer, colon and rectum cancer, liver cancer, female breast cancer, diabetes mellitus, alcohol use disorders, unipolar depressive disorders, epilepsy, hypertensive heart disease, ischaemic heart disease (IHD), ischaemic and haemorrhagic stroke, conduction disorders and other dysrhythmias, lower respiratory infections (pneumonia), cirrhosis of the liver, preterm birth complications, foetal alcohol syndrome. Dose-response relationships could be quantified for all disease categories except for depressive disorders, with the relative risk increasing with increased level of alcohol consumption for most diseases. Both average volume and drinking pattern were causally linked to IHD, foetal alcohol syndrome, and unintentional and intentional injuries. For IHD, ischaemic stroke and diabetes mellitus beneficial effects were observed for patterns of light to moderate drinking without heavy drinking occasions (as defined by 60+ grams pure alcohol per day). For several disease and injury categories, the effects were stronger on mortality compared to morbidity. There was insufficient

Tobacco-, Alcohol-, and Drug-Attributable Deaths and Their Contribution to Mortality Disparities in a Cohort of Homeless Adults in Boston

PubMed Central

Chang, Yuchiao; Singer, Daniel E.; Porneala, Bianca C.; Gaeta, Jessie M.; O’Connell, James J.; Rigotti, Nancy A.

2015-01-01

Objectives. We quantified tobacco-, alcohol-, and drug-attributable deaths and their contribution to mortality disparities among homeless adults. Methods. We ascertained causes of death among 28 033 adults seen at the Boston Health Care for the Homeless Program in 2003 to 2008. We calculated population-attributable fractions to estimate the proportion of deaths attributable to tobacco, alcohol, or drug use. We compared attributable mortality rates with those for Massachusetts adults using rate ratios and differences. Results. Of 1302 deaths, 236 were tobacco-attributable, 215 were alcohol-attributable, and 286 were drug-attributable. Fifty-two percent of deaths were attributable to any of these substances. In comparison with Massachusetts adults, tobacco-attributable mortality rates were 3 to 5 times higher, alcohol-attributable mortality rates were 6 to 10 times higher, and drug-attributable mortality rates were 8 to 17 times higher. Disparities in substance-attributable deaths accounted for 57% of the all-cause mortality gap between the homeless cohort and Massachusetts adults. Conclusions. In this clinic-based cohort of homeless adults, over half of all deaths were substance-attributable, but this did not fully explain the mortality disparity with the general population. Interventions should address both addiction and non-addiction sources of excess mortality. PMID:25521869

Homozygosity for rs738409:G in PNPLA3 is associated with increased mortality following an episode of severe alcoholic hepatitis.

PubMed

Atkinson, Stephen R; Way, Michael J; McQuillin, Andrew; Morgan, Marsha Y; Thursz, Mark R

2017-07-01

Carriage of rs738409:G in PNPLA3 is associated with an increased risk of developing alcohol-related cirrhosis and has a significant negative effect on survival. Short-term mortality in patients with severe alcoholic hepatitis is high; drinking behaviour is a major determinant of outcome in survivors. The aim of this study was to determine whether carriage of rs738409:G has an additional detrimental effect on survival in this patient group. Genotyping was undertaken in 898 cases with severe alcoholic hepatitis, recruited through the UK Steroids or Pentoxifylline for Alcoholic Hepatitis (STOPAH) trial, and 1188 White British/Irish alcohol dependent controls with no liver injury, recruited via University College London. Subsequent drinking behaviour was classified, in cases surviving ≥90days, as abstinent or drinking. The relationship between rs738409 genotype, drinking behaviour and survival was explored. The frequency of rs738409:G was significantly higher in cases than controls (29.5% vs. 18.9%; p=2.15×10 -15 ; odds ratio 1.80 [95% confidence interval (CI) 1.55-2.08]). Case-mortality at days 28, 90 and 450 was 16%, 25% and 41% respectively. There was no association between rs738409:G and 28-day mortality. Mortality in the 90 to 450-day period was higher in survivors who subsequently resumed drinking (hazard ratio [HR] 2.77, 95% CI 1.79-4.29; p<0.0001) and in individuals homozygous for rs738409:G (HR 1.69, 95% CI 1.02-2.81, p=0.04). Homozygosity for rs738409:G in PNPLA3 confers significant additional risk of medium-term mortality in patients with severe alcoholic hepatitis. Rs738409 genotype may be taken into account when considering treatment options for these patients. Individuals misusing alcohol who carry a particular variant of the gene PNPLA3 are more at risk of developing severe alcoholic hepatitis, a condition with a poor chance of survival. The longer-term outcome in people with this condition who survive the initial illness is strongly influenced by

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

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

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.

Alcohol abuse and liver enzymes (AALE): results of an intercompany study of mortality.

PubMed

Titcomb, C; Braun, R; Roudebush, B; Mast, J; Woodman, H

2001-01-01

Evaluation of applicants for life insurance who have elevations of their liver function tests or an increased probability of alcohol abuse has always been difficult for underwriters. This paper reports the results of an intercompany study in which the pooled mortality experience of a group of insureds with evidence of alcohol abuse, an adverse driving record or elevations of the liver transaminases or gamma-glutamyl transferase is summarized.

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

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

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.

Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study.

PubMed

Smyth, Andrew; Teo, Koon K; Rangarajan, Sumathy; O'Donnell, Martin; Zhang, Xiaohe; Rana, Punam; Leong, Darryl P; Dagenais, Gilles; Seron, Pamela; Rosengren, Annika; Schutte, Aletta E; Lopez-Jaramillo, Patricio; Oguz, Ayetkin; Chifamba, Jephat; Diaz, Rafael; Lear, Scott; Avezum, Alvaro; Kumar, Rajesh; Mohan, Viswanathan; Szuba, Andrzej; Wei, Li; Yang, Wang; Jian, Bo; McKee, Martin; Yusuf, Salim

2015-11-14

Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. We investigated associations between alcohol consumption and outcomes in a prospective cohort of countries at different economic levels in five continents. We included information from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35-70 years. We used Cox proportional hazards regression to study associations with mortality (n=2723), cardiovascular disease (n=2742), myocardial infarction (n=979), stroke (n=817), alcohol-related cancer (n=764), injury (n=824), admission to hospital (n=8786), and for a composite of these outcomes (n=11,963). We included 114,970 adults, of whom 12,904 (11%) were from high-income countries (HICs), 24,408 (21%) were from upper-middle-income countries (UMICs), 48,845 (43%) were from lower-middle-income countries (LMICs), and 28,813 (25%) were from low-income countries (LICs). Median follow-up was 4.3 years (IQR 3.0-6.0). Current drinking was reported by 36,030 (31%) individuals, and was associated with reduced myocardial infarction (hazard ratio [HR] 0.76 [95% CI 0.63-0.93]), but increased alcohol-related cancers (HR 1.51 [1.22-1.89]) and injury (HR 1.29 [1.04-1.61]). High intake was associated with increased mortality (HR 1.31 [1.04-1.66]). Compared with never drinkers, we identified significantly reduced hazards for the composite outcome for current drinkers in HICs and UMICs (HR 0.84 [0.77-0.92]), but not in LMICs and LICs, for which we identified no reductions in this outcome (HR 1.07 [0.95-1.21]; pinteraction<0.0001). Current alcohol consumption had differing associations by clinical outcome, and differing associations by income region. However, we identified sufficient commonalities to support

Beverage habits and mortality in Chinese adults.

PubMed

Odegaard, Andrew O; Koh, Woon-Puay; Yuan, Jian-Min; Pereira, Mark A

2015-03-01

There is limited research examining beverage habits, one of the most habitual dietary behaviors, with mortality risk. This study examined the association between coffee, black and green tea, sugar-sweetened beverages (soft drinks and juice), and alcohol and all-cause and cause-specific mortality. A prospective data analysis was conducted with the use of the Singapore Chinese Health Study, including 52,584 Chinese men and women (aged 45-74 y) free of diabetes, cardiovascular disease (CVD), and cancer at baseline (1993-1998) and followed through 2011 with 10,029 deaths. Beverages were examined with all-cause and cause-specific (cancer, CVD, and respiratory disease) mortality risk with the use of Cox proportional hazards regression. The associations between coffee, black tea, and alcohol intake and all-cause mortality were modified by smoking status. Among never-smokers there was an inverse dose-response association between higher amounts of coffee and black tea intake and all-cause, respiratory-related, and CVD mortality (black tea only). The fully adjusted HRs for all-cause mortality for coffee for <1/d, 1/d, and ≥2/d relative to no coffee intake were 0.89, 0.86, and 0.83, respectively (P-trend = 0.0003). For the same black tea categories the HRs were 0.95, 0.90, and 0.72, respectively (P-trend = 0.0005). Among ever-smokers there was no association between coffee or black tea and the outcomes. Relative to no alcohol, light to moderate intake was inversely associated with all-cause mortality (HR: 0.87; 95% CI: 0.79, 0.96) in never-smokers with a similar magnitude of association in ever-smokers. There was no association between heavy alcohol intake and all-cause mortality in never-smokers and a strong positive association in ever-smokers (HR: 1.56; 95% CI: 1.40, 1.74). Green tea and sugar-sweetened beverages were not associated with all-cause or cause-specific mortality. Higher coffee and black tea intake was inversely associated with mortality in never

Alcohol and alcohol-related harm in China: policy changes needed

PubMed Central

Tang, Yi-lang; Xiang, Xiao-jun; Wang, Xu-yi; Cubells, Joseph F; Babor, Thomas F

2013-01-01

Abstract In China, alcohol consumption is increasing faster than anywhere else in the world. A steady increase in alcohol production has also been observed in the country, together with a rise in alcohol-related harm. Despite these trends, China’s policies on the sale and consumption of alcoholic beverages are weak compared with those of other countries in Asia. Weakest of all are its policies on taxation, drink driving laws, alcohol sale to minors and marketing licenses. The authors of this descriptive paper draw attention to the urgent need for public health professionals and government officials in China to prioritize population surveillance, research and interventions designed to reduce alcohol use disorders. They describe China’s current alcohol policies and recent trends in alcohol-related harm and highlight the need for health officials to conduct a thorough policy review from a public health perspective, using as a model the World Health Organization’s global strategy to reduce the harmful use of alcohol. PMID:23599550

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

The health-related social costs of alcohol in Belgium.

PubMed

Verhaeghe, Nick; Lievens, Delfine; Annemans, Lieven; Vander Laenen, Freya; Putman, Koen

2017-12-16

Alcohol is associated with adverse health effects causing a considerable economic impact to society. A reliable estimate of this economic impact for Belgium is lacking. This is the aim of the study. A prevalence-based approach estimating the direct, indirect and intangible costs for the year 2012 was used. Attributional fractions for a series of health effects were derived from literature. The human capital approach was used to estimate indirect costs, while the concept of disability-adjusted life years was used to estimate intangible costs. Sensitivity and scenario analyses were conducted to assess the uncertainty around cost estimates and to evaluate the impact of alternative modelling assumptions. In 2012, total alcohol-attributable direct costs were estimated at €906.1 million, of which the majority were due to hospitalization (€743.7 million, 82%). The indirect costs amounted to €642.6 million, of which 62% was caused by premature mortality. Alcohol was responsible for 157,500 disability-adjusted life years representing €6.3 billion intangible costs. Despite a number of limitations intrinsic to this kind of research, the study can be considered as the most comprehensive analysis thus far of the health-related social costs of alcohol in Belgium.

Alcohol consumption and cardiovascular mortality accounting for possible misclassification of intake: 11-year follow-up of the Melbourne Collaborative Cohort Study.

PubMed

Harriss, Linton R; English, Dallas R; Hopper, John L; Powles, John; Simpson, Julie A; O'Dea, Kerin; Giles, Graham G; Tonkin, Andrew M

2007-10-01

To investigate the relationship between usual daily alcohol intake, beverage type and drinking frequency on cardiovascular (CVD) and coronary heart disease (CHD) mortality, accounting for systematic misclassification of intake. Prospective cohort study with mean follow-up of 11.4 years. Setting The Melbourne Collaborative Cohort Study, Australia. A total of 38 200 volunteers (23 044 women) aged 40-69 years at baseline (1990-1994). Self-reported alcohol intake using beverage-specific quantity-frequency questions (usual intake) and drinking diary for previous week. Compared with life-time abstention, usual daily alcohol intake was associated with lower CVD and CHD mortality risk for women but not men. For women, the hazard ratio [HR (95% CI)] for CVD for those drinking > 20 g/day alcohol was 0.43 (0.19-0.95; P trend = 0.18), and for CHD, 0.19 (0.05-0.82; P trend = 0.24). Male former drinkers had over twice the mortality risk for CVD [HR = 2.58 (1.51-4.41)] and CHD [HR = 2.91 (1.59-5.33)]. Wine was the only beverage associated inversely with mortality for women. Compared with drinkers who consumed no alcohol in the week before baseline, drinking frequency was associated inversely with CVD and CHD mortality risk for men but not women. HR for men drinking 6-7 days/week was 0.49 (0.29-0.81; P trend = 0.02) for CVD, and 0.49 (0.26-0.92: P trend = 0.23) for CHD. Usual daily alcohol intake was associated with reduced CVD and CHD mortality for women but not men. This benefit appeared to be mainly from wine, although comparison of beverages was not possible. Drinking frequency was associated inversely with CVD and CHD death for men but not women.

Beverage Habits and Mortality in Chinese Adults12

PubMed Central

Odegaard, Andrew O; Koh, Woon-Puay; Yuan, Jian-Min; Pereira, Mark A

2015-01-01

Background: There is limited research examining beverage habits, one of the most habitual dietary behaviors, with mortality risk. Objective: This study examined the association between coffee, black and green tea, sugar-sweetened beverages (soft drinks and juice), and alcohol and all-cause and cause-specific mortality. Methods: A prospective data analysis was conducted with the use of the Singapore Chinese Health Study, including 52,584 Chinese men and women (aged 45–74 y) free of diabetes, cardiovascular disease (CVD), and cancer at baseline (1993–1998) and followed through 2011 with 10,029 deaths. Beverages were examined with all-cause and cause-specific (cancer, CVD, and respiratory disease) mortality risk with the use of Cox proportional hazards regression. Results: The associations between coffee, black tea, and alcohol intake and all-cause mortality were modified by smoking status. Among never-smokers there was an inverse dose-response association between higher amounts of coffee and black tea intake and all-cause, respiratory-related, and CVD mortality (black tea only). The fully adjusted HRs for all-cause mortality for coffee for <1/d, 1/d, and ≥2/d relative to no coffee intake were 0.89, 0.86, and 0.83, respectively (P-trend = 0.0003). For the same black tea categories the HRs were 0.95, 0.90, and 0.72, respectively (P-trend = 0.0005). Among ever-smokers there was no association between coffee or black tea and the outcomes. Relative to no alcohol, light to moderate intake was inversely associated with all-cause mortality (HR: 0.87; 95% CI: 0.79, 0.96) in never-smokers with a similar magnitude of association in ever-smokers. There was no association between heavy alcohol intake and all-cause mortality in never-smokers and a strong positive association in ever-smokers (HR: 1.56; 95% CI: 1.40, 1.74). Green tea and sugar-sweetened beverages were not associated with all-cause or cause-specific mortality. Conclusions: Higher coffee and black tea intake was

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 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

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.

Alcohol industry sponsorship and alcohol-related harms in Australian university sportspeople/athletes.

PubMed

O'Brien, Kerry S; Lynott, Dermot; Miller, Peter G

2013-05-01

Although there is evidence that alcohol sponsorship in sport is related to greater drinking, there is no empirical research on whether alcohol sponsorship is associated with alcohol-related harms. We examined whether there is an association between receipt of alcohol industry sponsorship, and attendance at alcohol sponsor's drinking establishments (e.g. bars), and alcohol-related aggression and antisocial behaviour in university students who play sport. University sportspeople (n = 652) completed surveys (response rate >80%) assessing receipt of alcohol industry sponsorship, attendance at sponsor's establishments and confounders [i.e. age, gender, sport type, location and alcohol consumption measured by Alcohol Use Disorders Identification Test--alcohol consumption (AUDIT-C) scores]. Participants also completed measures assessing displays and receipt of aggressive and antisocial behaviours (e.g. assaults, unwanted sexual advance, vandalism). Logistic regression models including confounders and reported attendance at alcohol sponsor's establishments showed that sportspeople receiving alcohol industry sponsorship were more likely to have been the victim of aggression (adjusted odds ratio 2.62, 95% confidence interval 1.22-5.64). Attending an alcohol sponsor's establishment was not associated with higher rates of other aggressive or antisocial behaviour. However, significant associations where found between AUDIT-C scores and having displayed and received aggression, and having damaged or had property damaged. Male sportspeople were more likely to have displayed and received aggressive and antisocial behaviour. Higher AUDIT-C scores, gender and receipt of alcohol industry sponsorship were associated with alcohol-related aggression/antisocial behaviours in university sportspeople. Sport administrators should consider action to reduce the harms associated with excessive alcohol consumption and alcohol industry sponsorship in sport. © 2012 Australasian Professional

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.

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.

Predicting short-term mortality and long-term survival for hospitalized US patients with alcoholic hepatitis.

PubMed

Cuthbert, Jennifer A; Arslanlar, Sami; Yepuri, Jay; Montrose, Marc; Ahn, Chul W; Shah, Jessica P

2014-07-01

No study has evaluated current scoring systems for their accuracy in predicting short and long-term outcome of alcoholic hepatitis in a US population. We reviewed electronic records for patients with alcoholic liver disease (ALD) admitted to Parkland Memorial Hospital between January 2002 and August 2005. Data and outcomes for 148 of 1,761 admissions meeting pre-defined criteria were collected. The discriminant function (DF) was revised (INRdf) to account for changes in prothrombin time reagents that could potentially affect identification of risk using the previous DF threshold of >32. Admission and theoretical peak scores were calculated by use of the Model for End-stage Liver Disease (MELD). Analysis models compared five different scoring systems. INRdf was closely correlated with the old DF (r (2) = 0.95). Multivariate analysis of the data showed that survival for 28 days was significantly associated with a scoring system using a combination of age, bilirubin, coagulation status, and creatinine (p < 0.001), and an elevated ammonia result within two days of admission (p = 0.012). When peak values for MELD were included, they were the most significant predictor of short-term mortality (p < 0.001), followed by INRdf (p = 0.006). On admission, two scoring systems that identify a subset of patients with severe alcoholic liver disease are able to predict >50 % mortality at four weeks and >80 % mortality at six months without specific treatment.

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

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

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

The impact of race and ethnicity on mortality and healthcare utilization in alcoholic hepatitis: a cross-sectional study.

PubMed

May, Folasade P; Rolston, Vineet S; Tapper, Elliot B; Lakshmanan, Ashwini; Saab, Sammy; Sundaram, Vinay

2016-10-10

Alcoholic Hepatitis (AH) is major source of alcohol-related mortality and health care expenditures in the United States. There is insufficient information regarding the role of race and ethnicity on healthcare utilization and outcomes for patients with AH. We aimed to determine whether there are racial/ethnic differences in resource utilization and inpatient mortality in patients hospitalized with AH. We analyzed data from the Nationwide Inpatient Sample (NIS), years 2008-2011. We calculated demographic, clinical, and healthcare utilization characteristics by race. We then performed logistic regression and generalized linear modeling with gamma distribution (log link), respectively, to determine predictors of inpatient morality and total hospital costs (THC). We identified 11,304 AH patients from 2008 to 2011. Mean age was 47.0 years, and 62.1 % were male, 61.9 % were white, 9.8 % were black, and 9.7 % were Hispanic. Mean LOS was 6.3 days and significantly longer in whites (6.5 d) than both blacks (5.4 d) and Hispanics (5.9 d). In adjusted models, inpatient mortality was lower for blacks than for whites (adj. OR = 0.50; 95 % CI = 0.32-0.78). THC was significantly higher for Hispanics than whites (fold increase = 1.25; 95 % CI = 1.01-1.49). We identified differences in healthcare utilization and mortality by race/ethnicity. THC was significantly higher among Hispanics than for whites and blacks. We also demonstrated lower inpatient mortality in blacks compared to whites. These variations may implicate racial and ethnic differences in access to care, quality of care, severity of AH on presentation, or other factors.

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.

Alcohol consumption in relation to maternal deaths from induced-abortions in Ghana

PubMed Central

2012-01-01

Introduction The fight against maternal deaths has gained attention as the target date for Millennium Development Goal 5 approaches. Induced-abortion is one of the leading causes of maternal deaths in developing countries which hamper this effort. In Ghana, alcohol consumption and unwanted pregnancies are on the ascendancy. We examined the association between alcohol consumption and maternal mortality from induced-abortion. We further analyzed the factors that lie behind the alcohol consumption patterns in the study population. Method The data we used was extracted from the Ghana Maternal Health Survey 2007. This was a national survey conducted across the 10 administrative regions of Ghana. The survey identified 4203 female deaths through verbal autopsy, among which 605 were maternal deaths in the 12 to 49 year-old age group. Analysis was done using Statistical software IBM SPSS Statistics 20. A case control study design was used. Cross-tabulations and logistic regression models were used to investigate associations between the different variables. Results Alcohol consumption was significantly associated with abortion-related maternal deaths. Women who had ever consumed alcohol (OR adjusted 2.6, 95% CI 1.38–4.87), frequent consumers (OR adjusted 2.6, 95% CI 0.89–7.40) and occasional consumers (OR adjusted 2.7, 95% CI 1.29–5.46) were about three times as likely to die from abortion-related causes compared to those who abstained from alcohol. Maternal age, marital status and educational level were found to have a confounding effect on the observed association. Conclusion Policy actions directed toward reducing abortion-related deaths should consider alcohol consumption, especially among younger women. Policy makers in Ghana should consider increasing the legal age for alcohol consumption. We suggest that information on the health risks posed by alcohol and abortion be disseminated to communities in the informal sector where vulnerable groups can best be

Decreased cardiovascular and extrahepatic cancer-related mortality in treated patients with mild HFE hemochromatosis.

PubMed

Bardou-Jacquet, Edouard; Morcet, Jeff; Manet, Ghislain; Lainé, Fabrice; Perrin, Michèle; Jouanolle, Anne-Marie; Guyader, Dominique; Moirand, Romain; Viel, Jean-François; Deugnier, Yves

2015-03-01

Mortality studies in patients with hemochromatosis give conflicting results especially with respect to extrahepatic causes of death. Our objective was to assess mortality and causes of death in a cohort of patients homozygous for the C282Y mutation in the HFE gene, diagnosed since the availability of HFE testing. We studied 1085 C282Y homozygotes, consecutively diagnosed from 1996 to 2009, and treated according to current recommendations. Mortality and causes of death were obtained from death certificates and compared to those of the general population. Standardized mortality ratios (SMRs) were used to assess specific causes of death and the Cox model was used to identify prognostic factors for death. Patients were followed for 8.3±3.9 years. Overall the SMR was the same as in the general population (0.94 CI: 0.71-1.22). Patients with serum ferritin⩾2000 μg/L had increased liver-related deaths (SMR: 23.9 CI: 13.9-38.2), especially due to hepatic cancer (SMR: 49.1 CI: 24.5-87.9). Patients with serum ferritin between normal and 1000 μg/L had a lower mortality than the general population (SMR: 0.27 CI: 0.1-0.5), due to a decreased mortality, related to reduced cardiovascular events and extrahepatic cancers in the absence of increased liver-related mortality. Age, diabetes, alcohol consumption, and hepatic fibrosis were independent prognostic factors of death. In treated HFE hemochromatosis, only patients with serum ferritin higher than 2000 μg/L have an increased mortality, mainly related to liver diseases. Those with mild iron burden have a decreased overall mortality in relation to reduced cardiovascular and extrahepatic cancer-related events. These results support a beneficial effect of early and sustained management of patients with iron excess, even when mild. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Alcohol, red wine and cardiovascular disease.

PubMed

Wollin, S D; Jones, P J

2001-05-01

The objective of this article is to review the existing literature concerning the effects and mechanisms of action of red wine consumption vs. other alcoholic beverages on the risk of cardiovascular disease (CVD). Of particular interest is the form and quantity of alcohol consumed. This relationship between alcohol consumption and mortality is well supported by epidemiologic studies, which have suggested that different forms of alcohol alter the relative risk values for mortality from CVD. Although not without exception, current evidence from epidemiologic and experimental studies suggests a protective effect against the development of CVD with moderate consumption of red wine. The exact nature of the protective effect remains to be established. However, mechanisms including LDL oxidation and alterations in hemostatic variables are being increasingly recognized as contributory. Key components of red wine thought to be responsible for the protective effects include phenolic compounds and alcohol content. Despite the research presented, some questions relating to the current recommendations regarding moderate alcohol consumption and cardiovascular health remain. However, collectively, the literature aids in understanding some of the ways in which alcoholic beverages and their components affect the health of our population.

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

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.

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.

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.

Alcohol Dehydrogenase Activities of Wine Yeasts in Relation to Higher Alcohol Formation

PubMed Central

Singh, Rajendra; Kunkee, Ralph E.

1976-01-01

Alcohol dehydrogenase activities were examined in cell-free extracts of 10 representative wine yeast strains having various productivities of higher alcohols (fusel oil). The amount of fusel alcohols (n-propanol, isobutanol, active pentanol, and isopentanol) produced by the different yeasts and the specific alcohol dehydrogenase activities with the corresponding alcohols as substrates were found to be significantly related. No such relationship was found for ethanol. The amounts of higher alcohols formed during vinification could be predicted from the specific activities of the alcohol dehydrogenases with high accuracy. The results suggest a close relationship between the control of the activities of alcohol dehydrogenase and the formation of fusel oil alcohols. Also, new procedures for the prediction of higher alcohol formation during alcoholic beverage fermentation are suggested. PMID:16345179

49 CFR 199.237 - Other alcohol-related conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Other alcohol-related conduct. 199.237 Section 199... MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.237 Other alcohol-related conduct. (a) No operator shall...

49 CFR 199.237 - Other alcohol-related conduct.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Other alcohol-related conduct. 199.237 Section 199... MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.237 Other alcohol-related conduct. (a) No operator shall...

49 CFR 655.35 - Other alcohol-related conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Other alcohol-related conduct. 655.35 Section 655... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Prohibited Alcohol Use § 655.35 Other alcohol-related conduct. (a) No employer shall permit a...

49 CFR 655.35 - Other alcohol-related conduct.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Other alcohol-related conduct. 655.35 Section 655... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Prohibited Alcohol Use § 655.35 Other alcohol-related conduct. (a) No employer shall permit a...

Terrorism, civil war and related violence and substance use disorder morbidity and mortality: a global analysis.

PubMed

Kerridge, Bradley T; Khan, Maria R; Rehm, Jürgen; Sapkota, Amir

2014-03-01

The purpose of this study is to examine associations between deaths owing to terrorism, civil war, and one-sided violence from 1994-2000 and substance use disorder disability-adjusted life years (DALYs). The relationship between terrorism, and related violence and substance use disorder morbidity and mortality among World Health Organization Member States in 2002, controlling for adult per capita alcohol consumption, illicit drug use, and economic variables at baseline in 1994. Deaths as a result of terrorism and related violence were related to substance use disorder DALYs: a 1.0% increase in deaths as a result of terrorism, war and one-sided violence was associated with an increase of between 0.10% and 0.12% in alcohol and drug use disorder DALYs. Associations were greater among males and 15-44 year-old. Terrorism, war and one-sided violence may influence morbidity and mortality attributable to substance use disorders in the longer-term suggests that more attention to be given to rapid assessment and treatment of substance use disorders in conflict-affected populations with due consideration of gender and age differences that may impact treatment outcomes in these settings. Priorities should be established to rebuild substance abuse treatment infrastructures and treat the many physical and mental comorbid disorders. Copyright © 2014. Published by Elsevier Ltd.

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.

Alcohol-related dementia: an update of the evidence

PubMed Central

2013-01-01

The characteristics of dementia relating to excessive alcohol use have received increased research interest in recent times. In this paper, the neuropathology, nosology, epidemiology, clinical features, and neuropsychology of alcohol-related dementia (ARD) and alcohol-induced persisting amnestic syndrome (Wernicke-Korsakoff syndrome, or WKS) are reviewed. Neuropathological and imaging studies suggest that excessive and prolonged use of alcohol may lead to structural and functional damage that is permanent in nature; however, there is debate about the relative contributions of the direct toxic effect of alcohol (neurotoxicity hypothesis), and the impact of thiamine deficiency, to lasting damage. Investigation of alcohol-related cognitive impairment has been further complicated by differing definitions of patterns of alcohol use and associated lifestyle factors related to the abuse of alcohol. Present diagnostic systems identify two main syndromes of alcohol-related cognitive impairment: ARD and WKS. However, 'alcohol-related brain damage' is increasingly used as an umbrella term to encompass the heterogeneity of these disorders. It is unclear what level of drinking may pose a risk for the development of brain damage or, in fact, whether lower levels of alcohol may protect against other forms of dementia. Epidemiological studies suggest that individuals with ARD typically have a younger age of onset than those with other forms of dementia, are more likely to be male, and often are socially isolated. The cognitive profile of ARD appears to involve both cortical and subcortical pathology, and deficits are most frequently observed on tasks of visuospatial function as well as memory and higher-order (executive) tasks. The WKS appears more heterogeneous in nature than originally documented, and deficits on executive tasks commonly are reported in conjunction with characteristic memory deficits. Individuals with alcohol-related disorders have the potential to at least

Alcohol and liver disease in Europe--Simple measures have the potential to prevent tens of thousands of premature deaths.

PubMed

Sheron, Nick

2016-04-01

In the World Health Organisation European Region, more than 2,370,000 years of life are lost from liver disease before the age of 50; more than lung cancer, trachea, bronchus, oesophageal, stomach, colon, rectum and pancreatic cancer combined. Between 60-80% of these deaths are alcohol related, a disease for which no pharmaceutical therapy has yet been shown to improve long-term survival. The toxicity of alcohol is dose related at an individual level, and is dose related at a population level; overall liver mortality is largely determined by population alcohol consumption. Trends in alcohol consumption correlate closely with trends in overall liver mortality, with 3-5-fold decreases or increases in liver mortality in different European countries over the last few decades. The evidence base for alcohol control measures aimed at reducing population alcohol consumption has been subjected to rigorous evaluation; most recently by the Organisation for Economic Co-Operation and Development (OECD). Effective alcohol policy measures reduce alcohol mortality, including mortality from liver disease. The most effective and cost effective measures have been summarised by the OECD and the World Health Organisation: regular incremental above inflation tax increases, a minimum price for alcohol, effective protection of children from alcohol marketing and low level interventions from clinicians. Simple, cheap and effective changes to alcohol policy by European Institutions and member states have the potential to dramatically reduce liver mortality in Europe. Copyright © 2016. Published by Elsevier B.V.

Alcohol Attenuates Load-related Activation During a Working Memory Task: Relation to Level of Response to Alcohol

PubMed Central

Paulus, Martin P.; Tapert, Susan F.; Pulido, Carmen; Schuckit, Marc A.

2008-01-01

Background A low level of response to alcohol is a major risk factor for the development of alcohol dependence, but neural correlates of this marker are unclear. Method Ten healthy volunteers were classified by median split on level of response to alcohol and underwent 2 sessions of functional magnetic resonance imaging following ingestion of a moderate dose of alcohol and a placebo. The blood oxygen level–dependent activation to an event-related visual working memory test was examined. Results The subjects exhibited longer response latencies and more errors as a function of increasing working memory load and showed a load-dependent increase in activation in dorsolateral prefrontal cortex, posterior parietal cortex, and visual cortex. Alcohol did not affect performance (errors or response latency), but attenuated the working memory load–dependent activation in the dorsolateral prefrontal cortex. During the placebo condition, individuals with a low level of response to alcohol showed greater activation in dorsolateral prefrontal cortex and posterior parietal cortex than those with a high level of response to alcohol. During the alcohol condition, groups showed similar attenuation of load-dependent brain activation in these regions. Conclusion Low-level responders relative to high-level responders exhibited an increased working memory load–dependent activation in dorsolateral prefrontal cortex and posterior parietal cortex when not exposed to alcohol. This increase in brain response was attenuated in low-level responders after ingesting a moderate dose of alcohol. PMID:16899039

Experiences of alcohol-related harassment among medical students.

PubMed

Nagata-Kobayashi, Shizuko; Koyama, Hiroshi; Asai, Atsushi; Noguchi, Yoshinori; Maeno, Tetsuhiro; Fukushima, Osamu; Yamamoto, Wari; Koizumi, Shunzo; Shimbo, Takuro

2010-12-01

Although fatal accidents caused by alcohol-related harassment occur frequently among college students, this issue has not been adequately examined. This study set out to investigate the prevalence of alcohol-related harassment among medical students in Japan. A multi-institutional, cross-sectional survey was carried out across seven medical schools in Japan. A self-report anonymous questionnaire was distributed to 1152 medical students; 951 respondents (82.6%) satisfactorily completed it. From the responses, we determined the reported prevalences of the following types of alcohol-related harassment among medical students by senior medical students or doctors: (i) being coerced into drinking alcohol; (ii) being compelled to drink an alcoholic beverage all at once (the ikki drinking game); (iii) being deliberately forced to drink until unconscious, and (iv) being subjected to verbal abuse, physical abuse or sexual harassment in relation to alcohol. The prevalence of becoming a harasser among medical students was also measured. Multivariate regressions were used to assess the associations between experiences of alcohol-related harassment and student characteristics. A total of 821 respondents (86.3%) had experienced alcohol-related harassment and 686 (72.1%) had harassed others. Experiences of the ikki drinking game were frequently reported by both victims (n=686, 72.1% of all respondents) and harassers (n=595, 62.6% of all respondents). In multivariate regression, having an experience of alcohol-related harassment correlated with both being harassed (odds ratio [OR] 14.22, 95% confidence interval [CI] 8.73-23.98) and being a harasser (OR 13.19, 95% CI 8.05-22.34). The presence of senior members of medical college clubs who were regular drinkers also correlated with both being harassed (OR 2.96, 95% CI 1.88-4.67) and being a harasser (OR 2.97, 95% CI 2.06-4.27). Alcohol-related harassment among medical students is common and tends to occur at drinking parties with

[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.

49 CFR 382.505 - Other alcohol-related conduct.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false Other alcohol-related conduct. 382.505 Section 382... SUBSTANCES AND ALCOHOL USE AND TESTING Consequences for Drivers Engaging in Substance Use-Related Conduct § 382.505 Other alcohol-related conduct. (a) No driver tested under the provisions of subpart C of this...

49 CFR 382.505 - Other alcohol-related conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Other alcohol-related conduct. 382.505 Section 382... SUBSTANCES AND ALCOHOL USE AND TESTING Consequences for Drivers Engaging in Substance Use-Related Conduct § 382.505 Other alcohol-related conduct. (a) No driver tested under the provisions of subpart C of this...

Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment

PubMed Central

Jacobson, Isabel G.; Ryan, Margaret A. K.; Hooper, Tomoko I.; Smith, Tyler C.; Amoroso, Paul J.; Boyko, Edward J.; Gackstetter, Gary D.; Wells, Timothy S.; Bell, Nicole S.

2009-01-01

Context High rates of alcohol misuse after deployment have been reported among personnel returning from past conflicts, yet investigations of alcohol misuse after return from the current wars in Iraq and Afghanistan are lacking. Objectives To determine whether deployment with combat exposures was associated with new-onset or continued alcohol consumption, binge drinking, and alcohol-related problems. Design, Setting, and Participants Data were from Millennium Cohort Study participants who completed both a baseline (July 2001 to June 2003; n=77 047) and follow-up (June 2004 to February 2006; n=55 021) questionnaire (follow-up response rate=71.4%). After we applied exclusion criteria, our analyses included 48 481 participants (active duty, n=26 613; Reserve or National Guard, n=21 868). Of these, 5510 deployed with combat exposures, 5661 deployed without combat exposures, and 37 310 did not deploy. Main Outcome Measures New-onset and continued heavy weekly drinking, binge drinking, and alcohol-related problems at follow-up. Results Baseline prevalence of heavy weekly drinking, binge drinking, and alcohol-related problems among Reserve or National Guard personnel who deployed with combat exposures was 9.0%, 53.6%, and 15.2%, respectively; follow-up prevalence was 12.5%, 53.0%, and 11.9%, respectively; and new-onset rates were 8.8%, 25.6%, and 7.1%, respectively. Among active-duty personnel, new-onset rates were 6.0%, 26.6%, and 4.8%, respectively. Reserve and National Guard personnel who deployed and reported combat exposures were significantly more likely to experience new-onset heavy weekly drinking (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.36–1.96), binge drinking (OR, 1.46; 95% CI, 1.24–1.71), and alcohol-related problems (OR, 1.63; 95% CI, 1.33–2.01) compared with nondeployed personnel. The youngest members of the cohort were at highest risk for all alcohol-related outcomes. Conclusion Reserve and National Guard personnel and younger service

Alcohol-related dysfunction in working-age men in Izhevsk, Russia: an application of structural equation models to study the association with education.

PubMed

Cook, Sarah; Leon, David A; Kiryanov, Nikolay; Ploubidis, George B; De Stavola, Bianca L

2013-01-01

Acute alcohol-related dysfunctional behaviours, such as hangover, are predictive of poor health and mortality. Although much is known about the association of education with alcohol consumption, little is known about its association with these dysfunctional behaviours. The study population was 1,705 male drinkers aged 25-54 years resident in the city of Izhevsk, Russia who participated in a cross-sectional survey (2003-6). Structural equation modelling was used to examine the relationships between education, beverage and non-beverage alcohol intake, drinking patterns, and acute alcohol-related dysfunction score among these drinkers. Dysfunction was related to all other drinking variables, with the strongest predictors being spirit intake, non-beverage alcohol consumption and drinking patterns. There was a strong relationship between education and acute dysfunction which was not explained by adjusting for alcohol intake and drinking patterns (mean adjusted dysfunction score 0.35 SD (95% CI 0.10, 0.61) lower in men with higher versus secondary education). Although by definition one or more aspects of alcohol consumption should explain the educational differences in alcohol-related dysfunction, detailed information on drinking only partly accounted for the observed patterns. Thus beyond their intrinsic interest, these results illustrate the challenges in constructing statistical models that convincingly identify the pathways that link educational differences to health-related outcomes.

Correlates of Alcohol-Related Regretted Sex among College Students

PubMed Central

Orchowski, Lindsay M.; Mastroleo, Nadine R.; Borsari, Brian

2012-01-01

The prevalence of alcohol-related regretted sex in college students warrants a better understanding of the characteristics of students who report such experiences. Therefore, the present study examined correlates of regretted sexual experiences involving alcohol use among two specific high-risk college student samples: Students mandated to alcohol intervention (N = 522) and volunteer first-year students transitioning to college (N = 481). Results indicated that alcohol-related regretted sex occurred in similar rates in mandated and volunteer students, with approximately 25% of the students reporting at least one occurrence in the past month. Women were more likely to report alcohol-related regretted sex compared to men. The belief that alcohol use would result in “liquid courage” was associated with alcohol-related regretted sex among college students, even after accounting for greater alcohol use and problem alcohol use behaviors. These findings have significant implications for intervention efforts and future research. PMID:22448762

Association of physical job demands, smoking and alcohol abuse with subsequent premature mortality: a 9-year follow-up population-based study.

PubMed

Bourgkard, Eve; Wild, Pascal; Massin, Nicole; Meyer, Jean-Pierre; Otero Sierra, Carmen; Fontana, Jean-Marc; Benamghar, Lahoucine; Mur, Jean-Marie; Ravaud, Jean-François; Guillemin, Francis; Chau, Nearkasen

2008-01-01

This study assessed the relationships of physical job demands (PJD), smoking, and alcohol abuse, with premature mortality before age 70 (PM-70) among the working or inactive population. The sample included 4,268 subjects aged 15 or more randomly selected in north-eastern France. They completed a mailed questionnaire (birth date, sex, weight, height, job, PJD, smoking habit, alcohol abuse (Deta questionnaire)) in 1996 and were followed for mortality until 2004 (9 yr). PJD score was defined by the cumulative number of the following high job demands at work: hammer, vibrating platform, pneumatic tools, other vibrating hand tools, screwdriver, handling objects, awkward posture, tasks at heights, machine tools, pace, working on a production line, standing about and walking. The data were analyzed using the Poisson regression model. Those with PM-70 were 126 (3.81 per 1,000 person-years). The leading causes of death were cancers (46.4% in men, 57.1% in women), cardiovascular diseases (20.2% and 11.9%), suicide (9.5% and 7.1%), respiratory diseases (6.0% and 4.8%), and digestive diseases (2.4% and 4.8%). PJD3, smoker, and alcohol abuse had adjusted risk ratios of 1.71 (95% CI 1.02-2.88), 1.76 (1.08-2.88), and 2.07 (1.31-3.26) respectively for all-cause mortality. Manual workers had a risk ratio of 1.84 (1.00-3.37) compared to the higher socio-economic classes. The men had a two-fold higher mortality rate than the women; this difference became non-significant when controlling for job, PJD, smoker and alcohol abuse. For cancer mortality the factors PJD3, smoker, and alcohol abuse had adjusted risk ratios of 2.00 (1.00-3.99), 2.34 (1.19-4.63), and 2.22 (1.17-4.20), respectively. Health promotion efforts should be directed at structural measures of task redesign and they should also concern lifestyle.

Marketing and alcohol-related traffic fatalities: impact of alcohol advertising targeting minors.

PubMed

Smith, Ryan C; Geller, E Scott

2009-10-01

Alcohol-related youth traffic fatalities continue as a major public-health concern. While state and federal laws can be useful in tackling this problem, the efficacy of many laws has not been empirically demonstrated. We examined the impact of state laws prohibiting alcohol advertising to target minors. Using statistics obtained from the Fatality Analysis Reporting System (FARS), youth alcohol-related, single-vehicle, driver traffic fatalities were compared by state as a function of whether the state has a law prohibiting alcohol advertising that targets minors. Overall, states possessing this law experienced 32.9% fewer of the above specified traffic fatalities. DISCUSSION AND IMPACT ON INDUSTRY: The results suggest that not only are youth drinking rates affected by alcohol advertisements targeting youth, but also drink-driving behaviors. Indeed, we estimate that if this type of legislation were adopted in the 26 states that do not prohibit targeting of minors with alcohol advertising, then 400 youth lives could be saved annually.

Alcohol-Related Facebook Activity Predicts Alcohol Use Patterns in College Students

PubMed Central

Marczinski, Cecile A.; Hertzenberg, Heather; Goddard, Perilou; Maloney, Sarah F.; Stamates, Amy L.; O’Connor, Kathleen

2016-01-01

The purpose of this study was to determine if a brief 10-item alcohol-related Facebook® activity (ARFA) questionnaire would predict alcohol use patterns in college students (N = 146). During a single laboratory session, participants first privately logged on to their Facebook® profiles while they completed the ARFA measure, which queries past 30 day postings related to alcohol use and intoxication. Participants were then asked to complete five additional questionnaires: three measures of alcohol use (the Alcohol Use Disorders Identification Test [AUDIT], the Timeline Follow-Back [TLFB], and the Personal Drinking Habits Questionnaire [PDHQ]), the Barratt Impulsiveness Scale (BIS-11), and the Marlowe-Crowne Social Desirability Scale (MC-SDS). Regression analyses revealed that total ARFA scores were significant predictors of recent drinking behaviors, as assessed by the AUDIT, TLFB, and PDHQ measures. Moreover, impulsivity (BIS-11) and social desirability (MC-SDS) did not predict recent drinking behaviors when ARFA total scores were included in the regressions. The findings suggest that social media activity measured via the ARFA scale may be useful as a research tool for identifying risky alcohol use. PMID:28138317

Normative perceptions of alcohol-related consequences among college students.

PubMed

Brett, Emma I; Leavens, Eleanor L; Miller, Mary Beth; Lombardi, Nathaniel; Leffingwell, Thad R

2016-07-01

College students in the U.S. continue to drink in hazardous ways and experience a range of alcohol-related consequences. Personalized feedback interventions (PFIs), which often include normative components comparing personal drinking to that of similar peers, have been effective in reducing alcohol outcomes among college students. Though normative perceptions of the quantity and frequency of alcohol use have been examined in many studies, norms for alcohol-related consequences have received less attention. The current study examined self-other discrepancies (SODs) for alcohol-related consequences among college students. Participants overestimated how often alcohol-related consequences are experienced by other same-sex students on campus and rated consequences as more acceptable for others to experience than themselves. No differences in SODs were found between those who did and did not report alcohol use. Future studies should examine the efficacy of PFIs that incorporate normative feedback on alcohol-related consequences. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cold-related mortality vs heat-related mortality in a changing climate: A case study in Vilnius (Lithuania).

PubMed

Martinez, Gerardo Sanchez; Diaz, Julio; Hooyberghs, Hans; Lauwaet, Dirk; De Ridder, Koen; Linares, Cristina; Carmona, Rocio; Ortiz, Cristina; Kendrovski, Vladimir; Adamonyte, Dovile

2018-06-21

Direct health effects of extreme temperatures are a significant environmental health problem in Lithuania, and could worsen further under climate change. This paper attempts to describe the change in environmental temperature conditions that the urban population of Vilnius could experience under climate change, and the effects such change could have on excess heat-related and cold-related mortality in two future periods within the 21st century. We modelled the urban climate of Vilnius for the summer and winter seasons during a sample period (2009-2015) and projected summertime and wintertime daily temperatures for two prospective periods, one in the near (2030-2045) and one in the far future (2085-2100), under the Representative Concentration Pathway (RCP) 8.5. We then analysed the historical relationship between temperature and mortality for the period 2009-2015, and estimated the projected mortality in the near future and far future periods under a changing climate and population, assuming alternatively no acclimatisation and acclimatisation to heat and cold based on a constant-percentile threshold temperature. During the sample period 2009-2015 in summertime we observed an increase in daily mortality from a maximum daily temperature of 30 °C (the 96th percentile of the series), with an average of around 7 deaths per year. Under a no acclimatisation scenario, annual average heat-related mortality would rise to 24 deaths/year (95% CI: 8.4-38.4) in the near future and to 46 deaths/year (95% CI: 16.4-74.4) in the far future. Under a heat acclimatisation scenario, mortality would not increase significantly in the near or in the far future. Regarding wintertime cold-related mortality in the sample period 2009-2015, we observed increased mortality on days on which the minimum daily temperature fell below - 12 °C (the 7th percentile of the series), with an average of around 10 deaths a year. Keeping the threshold temperature constant, annual average cold-related

Alcohol-Related Content of Animated Cartoons: A Historical Perspective

PubMed Central

Klein, Hugh; Shiffman, Kenneth S.

2013-01-01

This study, based on a stratified (by decade of production) random sample of 1,221 animated cartoons and 4,201 characters appearing in those cartoons, seeks to determine the prevalence of alcohol-related content; how, if at all, the prevalence changed between 1930 and 1996 (the years spanned by this research); and the types of messages that animated cartoons convey about beverage alcohol and drinking in terms of the characteristics that are associated with alcohol use, the contexts in which alcohol is used in cartoons, and the reasons why cartoon characters purportedly consume alcohol. Approximately 1 cartoon in 11 was found to contain alcohol-related content, indicating that the average child or adolescent viewer is exposed to approximately 24 alcohol-related messages each week just from the cartoons that he/she watches. Data indicated that the prevalence of alcohol-related content declined significantly over the years. Quite often, alcohol consumption was shown to result in no effects whatsoever for the drinker, and alcohol use often occurred when characters were alone. Overall, mixed, ambivalent messages were provided about drinking and the types of characters that did/not consume alcoholic beverages. PMID:24350176

Energy drinks and alcohol-related risk among young adults.

PubMed

Caviness, Celeste M; Anderson, Bradley J; Stein, Michael D

2017-01-01

Energy drink consumption, with or without concurrent alcohol use, is common among young adults. This study sought to clarify risk for negative alcohol outcomes related to the timing of energy drink use. The authors interviewed a community sample of 481 young adults, aged 18-25, who drank alcohol in the last month. Past-30-day energy drink use was operationalized as no-use, use without concurrent alcohol, and concurrent use of energy drinks with alcohol ("within a couple of hours"). Negative alcohol outcomes included past-30-day binge drinking, past-30-day alcohol use disorder, and drinking-related consequences. Just over half (50.5%) reported no use of energy drinks,18.3% reported using energy drinks without concurrent alcohol use, and 31.2% reported concurrent use of energy drinks and alcohol. Relative to those who reported concurrent use of energy drinks with alcohol, and controlling for background characteristics and frequency of alcohol consumption, those who didn't use energy drinks and those who used without concurrent alcohol use had significantly lower binge drinking, negative consequences, and rates of alcohol use disorder (P < .05 for all outcomes). There were no significant differences between the no-use and energy drink without concurrent alcohol groups on any alcohol-related measure (P > .10 for all outcomes). Concurrent energy drink and alcohol use is associated with increased risk for negative alcohol consequences in young adults. Clinicians providing care to young adults could consider asking patients about concurrent energy drink and alcohol use as a way to begin a conversation about risky alcohol consumption while addressing 2 substances commonly used by this population.

Importance of alcohol-related expectations and emotional expressivity for prediction of motivation to refuse alcohol in alcohol-dependent patients.

PubMed

Slavinskienė, Justina; Žardeckaitė-Matulaitienė, Kristina

2014-01-01

The aim of this study was to evaluate the importance of alcohol-dependent patients' emotional expressivity, alcohol-related expectations and socio-demographic factors for prediction of motivation to refuse alcohol consumption. The study sample consisted of 136 alcohol-dependent patients (100 men and 36 women) undergoing treatment in Kaunas center for addictive disorders. Only higher expression of negative alcohol-related expectations (std. beta=0.192, P=0.023), higher emotional impulse intensity (std. beta=0.229, P=0.021) and higher expression of positive emotional expressiveness (std. beta=0.021, P=0.020) as well as gender (std. beta=0.180, P=0.049), education (std. beta=-0.137, P=0.038) and alcohol dependency treatment conditions (members of support group after rehabilitation program) (std. beta=0.288, P=0.001; std. beta=0.608, P=0.001) were significant factors for predicting the different level of alcohol-dependent patients motivation to refuse alcohol consumption. Negative alcohol-related expectations, emotional impulse intensity and positive emotional expressiveness were significant even though quite weak triggers for alcohol-dependent patients' different level of motivation to refuse alcohol consumption. An assumption could be made that by changing these triggers it is possible to change addictive behavior. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Exploring College Students' Use of General and Alcohol-Related Social Media and Their Associations with Alcohol-Related Behaviors

ERIC Educational Resources Information Center

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

2014-01-01

Objective: 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.…

Alcohol and the heart: to abstain or not to abstain?

PubMed

Movva, Rajesh; Figueredo, Vincent M

2013-04-15

Alcohol has been consumed by most societies over the last 7000 years. Abraham Lincoln said "It has long been recognized that the problems with alcohol relate not to the use of a bad thing, but to the abuse of a good thing." Light to moderate alcohol consumption reduces the incidence of coronary heart disease (CHD), ischemic stroke, peripheral arterial disease, CHD mortality, and all-cause mortality, especially in the western populations. However, heavy alcohol consumption is detrimental causing cardiomyopathy, cardiac arrhythmias, hepatic cirrhosis, pancreatitis, and hemorrhagic stroke. In this article, we review the effects of alcohol on CHD, individual cardiovascular risk factors, cardiomyopathy, and cardiac arrhythmias, including the most recent evidence of the effects of alcohol on CHD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Alcohol-related aggression-social and neurobiological factors.

PubMed

Beck, Anne; Heinz, Andreas

2013-10-01

Alcohol-related aggression and violence are a widespread cause of personal suffering with high socioeconomic costs. In 2011, nearly one in three violent acts in Germany was committed under the influence of alcohol (31.8%). The link between alcohol consumption and aggression is promoted by various interacting factors. In this review, based on a selective search for pertinent literature in PubMed, we analyze and summarize information from original articles, reviews, and book chapters about alcohol and aggression and discuss the neurobiological basis of aggressive behavior. Aggression is promoted both by the cognitive deficits arising in connection with acute or chronic alcohol use and by prior experience of violence in particular situations where alcohol was drunk. Only a minority of persons who drink alcohol become aggressive. On the other hand, alcohol abuse and dependence together constitute the second most commonly diagnosed cause of suicide (15-43%). Current research indicates that the individual tendency toward alcohol-induced aggression depends not just on neurobiological factors, but also on personal expectations of the effects of alcohol, on prior experience of violent conflicts, and on the environmental conditions of early childhood, especially social exclusion and discrimination. Gene-environment interactions affecting the serotonergic and other neurotransmitter systems play an important role. Potential (but not yet adequately validated) therapeutic approaches involve reinforcing cognitive processes or pharmacologically modulating serotonergic neurotransmission (and other target processes). Alcohol-related aggression has manifold social and neurobiological causes. Specific treatments must be tested in controlled trials.

Cognitive and neurobiological mechanisms of alcohol-related aggression.

PubMed

Heinz, Adrienne J; Beck, Anne; Meyer-Lindenberg, Andreas; Sterzer, Philipp; Heinz, Andreas

2011-06-02

Alcohol-related violence is a serious and common social problem. Moreover, violent behaviour is much more common in alcohol-dependent individuals. Animal experiments and human studies have provided insights into the acute effect of alcohol on aggressive behaviour and into common factors underlying acute and chronic alcohol intake and aggression. These studies have shown that environmental factors, such as early-life stress, interact with genetic variations in serotonin-related genes that affect serotonergic and GABAergic neurotransmission. This leads to increased amygdala activity and impaired prefrontal function that, together, predispose to both increased alcohol intake and impulsive aggression. In addition, acute and chronic alcohol intake can further impair executive control and thereby facilitate aggressive behaviour.

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/

Alcohol and liver cirrhosis mortality in the United States: comparison of methods for the analyses of time-series panel data models.

PubMed

Ye, Yu; Kerr, William C

2011-01-01

To explore various model specifications in estimating relationships between liver cirrhosis mortality rates and per capita alcohol consumption in aggregate-level cross-section time-series data. Using a series of liver cirrhosis mortality rates from 1950 to 2002 for 47 U.S. states, the effects of alcohol consumption were estimated from pooled autoregressive integrated moving average (ARIMA) models and 4 types of panel data models: generalized estimating equation, generalized least square, fixed effect, and multilevel models. Various specifications of error term structure under each type of model were also examined. Different approaches controlling for time trends and for using concurrent or accumulated consumption as predictors were also evaluated. When cirrhosis mortality was predicted by total alcohol, highly consistent estimates were found between ARIMA and panel data analyses, with an average overall effect of 0.07 to 0.09. Less consistent estimates were derived using spirits, beer, and wine consumption as predictors. When multiple geographic time series are combined as panel data, none of existent models could accommodate all sources of heterogeneity such that any type of panel model must employ some form of generalization. Different types of panel data models should thus be estimated to examine the robustness of findings. We also suggest cautious interpretation when beverage-specific volumes are used as predictors. Copyright © 2010 by the Research Society on Alcoholism.

Effectiveness of Policies Maintaining or Restricting Days of Alcohol Sales on Excessive Alcohol Consumption and Related Harms

PubMed Central

Middleton, Jennifer Cook; Hahn, Robert A.; Kuzara, Jennifer L.; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S.; Toomey, Traci; Lawrence, Briana

2013-01-01

Local, state, and national laws and policies that limit the days of the week on which alcoholic beverages may be sold may be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness for preventing excessive alcohol consumption and related harms of laws and policies maintaining or reducing the days when alcoholic beverages may be sold. Outcomes assessed in 14 studies that met qualifying criteria were excessive alcohol consumption and alcohol-related harms, including motor vehicle injuries and deaths, violence-related and other injuries, and health conditions. Qualifying studies assessed the effects of changes in days of sale in both on-premises settings (at which alcoholic beverages are consumed where purchased) and off-premises settings (at which alcoholic beverages may not be consumed where purchased). Eleven studies assessed the effects of adding days of sale, and three studies assessed the effects of imposing a ban on sales on a given weekend day. The evidence from these studies indicated that increasing days of sale leads to increases in excessive alcohol consumption and alcohol-related harms and that reducing the number of days that alcoholic beverages are sold generally decreases alcohol-related harms. Based on these findings, when the expansion of days of sale is being considered, laws and policies maintaining the number of days of the week that alcoholic beverages are sold at on- and off-premises outlets in local, state, and national jurisdictions are effective public health strategies for preventing excessive alcohol consumption and related harms. PMID:21084079

Effectiveness of policies maintaining or restricting days of alcohol sales on excessive alcohol consumption and related harms.

PubMed

Middleton, Jennifer Cook; Hahn, Robert A; Kuzara, Jennifer L; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci; Lawrence, Briana

2010-12-01

Local, state, and national laws and policies that limit the days of the week on which alcoholic beverages may be sold may be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness for preventing excessive alcohol consumption and related harms of laws and policies maintaining or reducing the days when alcoholic beverages may be sold. Outcomes assessed in 14 studies that met qualifying criteria were excessive alcohol consumption and alcohol-related harms, including motor vehicle injuries and deaths, violence-related and other injuries, and health conditions. Qualifying studies assessed the effects of changes in days of sale in both on-premises settings (at which alcoholic beverages are consumed where purchased) and off-premises settings (at which alcoholic beverages may not be consumed where purchased). Eleven studies assessed the effects of adding days of sale, and three studies assessed the effects of imposing a ban on sales on a given weekend day. The evidence from these studies indicated that increasing days of sale leads to increases in excessive alcohol consumption and alcohol-related harms and that reducing the number of days that alcoholic beverages are sold generally decreases alcohol-related harms. Based on these findings, when the expansion of days of sale is being considered, laws and policies maintaining the number of days of the week that alcoholic beverages are sold at on- and off-premises outlets in local, state, and national jurisdictions are effective public health strategies for preventing excessive alcohol consumption and related harms. Published by Elsevier Inc.

Effectiveness of policies restricting hours of alcohol sales in preventing excessive alcohol consumption and related harms.

PubMed

Hahn, Robert A; Kuzara, Jennifer L; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci; Middleton, Jennifer Cook; Lawrence, Briana

2010-12-01

Local, state, and national policies that limit the hours that alcoholic beverages may be available for sale might be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of such policies. All of the studies included in this review assessed the effects of increasing hours of sale in on-premises settings (in which alcoholic beverages are consumed where purchased) in high-income nations. None of the studies was conducted in the U.S. The review team's initial assessment of this evidence suggested that changes of less than 2 hours were unlikely to significantly affect excessive alcohol consumption and related harms; to explore this hypothesis, studies assessing the effects of changing hours of sale by less than 2 hours and by 2 or more hours were assessed separately. There was sufficient evidence in ten qualifying studies to conclude that increasing hours of sale by 2 or more hours increases alcohol-related harms. Thus, disallowing extensions of hours of alcohol sales by 2 or more should be expected to prevent alcohol-related harms, while policies decreasing hours of sale by 2 hours or more at on-premises alcohol outlets may be an effective strategy for preventing alcohol-related harms. The evidence from six qualifying studies was insufficient to determine whether increasing hours of sale by less than 2 hours increases excessive alcohol consumption and related harms. Published by Elsevier Inc.

Alcohol consumption and mortality: is wine different from other alcoholic beverages?

PubMed

Burns, J; Crozier, A; Lean, M E

2001-08-01

Alcohol has been an integral part of the diets of many cultures for thousands of years, and formed the basis of early antiseptics. However, many health professionals have been loath to recommend its moderate consumption. Fears of increased risks of cancers, strokes and coronary heart disease (CHD), as well as its role in accidents, violence, psychological and social decline (when consumed in excess) meant that alcohol was viewed as generally detrimental to health. Recent reports have examined some of these fears and suggest that the moderate consumption of alcoholic beverages, particularly red wine, may actually protect against the development of CHD. Evidence for the influence of alcoholic drinks on strokes and cancer is less clear. This review discusses the chemical differences between red wine and other alcoholic beverages and their possible effects on the development of CHD, stroke and cancer. Both clinical and experimental evidence suggest that red wine does indeed offer a greater protection to health than other alcoholic beverages. This protection has been attributed to grape-derived antioxidant polyphenolic compounds found particularly in red wine.

Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions.

PubMed

Chavez, Laura J; Williams, Emily C; Lapham, Gwen T; Rubinsky, Anna D; Kivlahan, Daniel R; Bradley, Katharine A

2016-05-01

Brief alcohol interventions are recommended for primary care patients who screen positive for alcohol misuse, but implementation is challenging. The U.S. Veterans Health Administration (Veterans Affairs [VA]) implemented brief interventions for patients with alcohol misuse in 2008, and rates of brief interventions documented in the electronic medical record increased from 24% to 78% (2008-2011). This study examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. This retrospective cross-sectional study included VA outpatient respondents to the VA's Survey of Healthcare Experiences of Patients (SHEP; 2007-2011) who reported past-year alcohol use and answered a question about alcohol-related advice. Alcohol-related advice was defined as a report of past-year advice from a VA clinician to abstain from or reduce drinking. The adjusted prevalence of alcoholrelated advice among patients who screened positive for alcohol misuse (SHEP AUDIT-C ≥ 5) was estimated for each year. Among patients with alcohol misuse (n = 61,843), the adjusted prevalence of alcohol-related advice increased from 40.4% (95% CI [39.3%, 41.5%]) in 2007 to 55.5% (95% CI [53.3%, 57.8%]) in 2011. Rates of alcoholrelated advice increased significantly each year except the last. The VA's efforts to implement brief interventions were associated with increased patient-reported alcohol-related advice over time, with a majority of patients with alcohol misuse reporting its receipt. Other systems considering similar approaches to implementation may benefit from collecting patient-reported measures of brief interventions for an additional perspective on implementation.

Alcohol Expectancies and Evaluations of Aggression in Alcohol-Related Intimate-Partner Verbal and Physical Aggression

PubMed Central

Kachadourian, Lorig K; Quigley, Brian M; Leonard, Kenneth E

2014-01-01

Objective: Alcohol aggression expectancies have been found to be associated with increases in aggressive behavior. However, research has not consistently examined evaluations of such behavior. This is unfortunate as both expectancies and evaluations may play a role in whether such behavior will occur. Given this, the current study cross-sectionally examined the associations between alcohol aggression expectancies, evaluations of alcohol-related aggression, indicators of excessive drinking, and alcohol-related verbal and physical aggression. Method: The sample consisted of 280 married and cohabiting couples. These couples reported on excessive drinking indicators, alcohol expectancies and evaluations, and alcohol-related verbal and physical aggression during the past year. Results: Findings showed that verbal aggression was positively associated with indicators of excessive drinking among females and with alcohol aggression expectancies for females who evaluated such aggression positively. For males, aggression expectancies and indicators of excessive drinking were positively associated with verbal aggression. For physical aggression, results showed that indicators of excessive drinking and aggression expectancies were associated with physical aggression for females. For males, aggression expectancies were positively associated and evaluations were negatively associated with physical aggression. Conclusions: These findings add to previous research on alcohol aggression expectancies in close relationships and emphasize the importance of considering evaluations of alcohol-related behavior and how they may play a role in intimate-partner violence and aggression. PMID:25208191

Survey of alcohol-related presentations to Australasian emergency departments.

PubMed

Egerton-Warburton, Diana; Gosbell, Andrew; Wadsworth, Angela; Fatovich, Daniel M; Richardson, Drew B

2014-11-17

To determine the proportion of alcohol-related presentations to emergency departments (EDs) in Australia and New Zealand, at a single time point on a weekend night shift. A point prevalence survey of ED patients either waiting to be seen or currently being seen conducted at 02:00 local time on 14 December 2013 in 106 EDs in Australia and New Zealand. The number of ED presentations that were alcohol-related, defined using World Health Organization ICD-10 codes. At the 106 hospitals (92 Australia, 14 New Zealand) that provided data, 395 (14.3%; 95% CI, 13.0%-15.6%) of 2766 patients in EDs at the study time were presenting for alcohol-related reasons; 13.8% (95% CI, 12.5%-15.2%) in Australia and 17.9% (95% CI, 13.9%-22.8%) in New Zealand. The distribution was skewed left, with proportions ranging from 0 to 50% and a median of 12.5%. Nine Australian hospitals and one New Zealand hospital reported that more than a third of their ED patients had alcohol-related presentations; the Northern Territory (38.1%) and Western Australia (21.1%) reported the highest proportions of alcohol-related presentations. One in seven ED presentations in Australian and New Zealand at this 02:00 snapshot were alcohol-related, with some EDs seeing more than one in three alcohol-related presentations. This confirms that alcohol-related presentations to EDs are currently underreported and makes a strong case for public health initiatives.

Alcohol tax policy in relation to hospitalization from alcohol-attributed diseases in Taiwan: a nationwide population analysis of data from 1996 to 2010.

PubMed

Lin, Chih-Ming; Liao, Chen-Mao

2013-09-01

The effects of alcohol taxes and prices on drinking and mortality are well established, but the effects of alcohol taxes on measures of alcohol-related morbidity from noninjury health outcomes have not been fully elucidated. We assess the 2 opposing effects of alcohol tax policy interventions (tax rate increase in 2002 and decrease in 2009) on alcohol-attributed diseases (AADs) in Taiwan. Admissions data from 1996 to 2010 were retrieved from the National Health Insurance Research Database (NHIRD) claims file and analyzed in this study. Data on 430,388 men and 34,874 women aged 15 or above who had an admission due to an AAD were collected. An interrupted time series analysis examining the effects of the implementation of alcohol tax policy on quarterly age- and sex-specific incidence rates of hospitalization for AADs was employed. The same method was also used to analyze hospitalizations for alcoholic liver disease. The teen/adult groups all showed significant (p < 0.05) changes in the adjusted incidence rate of hospitalization (AIRH) for AADs and alcoholic liver disease in 2002. Men aged 15 to 64 years showed an abrupt decline in the rate of AADs (9.1%) and in the rate of alcoholic liver disease (10.3%). A 16% reduction in the AAD rate was found in teen/adult women after the alcohol tax increase. In contrast, a 17.4% increase in the same rate was seen in the first quarter of 2010 for this group. A similar pattern was presented for the AIRH for alcoholic liver disease among women. The effect of tax intervention was not significant among the elderly. This study provides evidence that alcohol taxation in response to international trade liberalization has resulted in an immediate reduction of AADs in Taiwan. The policy of increasing alcohol tax rates may have favorable influences on the time trend for the rate of AADs, most notably among young and middle-aged men and women. Copyright © 2013 by the Research Society on Alcoholism.

Antidepressant sales and the risk for alcohol-related and non-alcohol-related suicide in Finland--an individual-level population study.

PubMed

Moustgaard, Heta; Joutsenniemi, Kaisla; Myrskylä, Mikko; Martikainen, Pekka

2014-01-01

A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. We followed a nationally representative sample of 950,158 Finnish adults in 1995-2007 for alcohol-related (n = 2,859) and non-alcohol-related (n = 8,632) suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976-0.998). This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995-2007. However, the rise in the proportion of antidepressant users receiving minimally adequate treatment, possibly

Evaluation of MELD score and Maddrey discriminant function for mortality prediction in patients with alcoholic hepatitis.

PubMed

Monsanto, Pedro; Almeida, Nuno; Lrias, Clotilde; Pina, Jos Eduardo; Sofia, Carlos

2013-01-01

Maddrey discriminant function (DF) is the traditional model for evaluating the severity and prognosis in alcoholic hepatitis (AH). However, MELD has also been used for this purpose. We aimed to determine the predictive parameters and compare the ability of Maddrey DF and MELD to predict short-term mortality in patients with AH. Retrospective study of 45 patients admitted in our department with AH between 2000 and 2010. Demographic, clinical and laboratory parameters were collected. MELD and Maddrey DF were calculated on admission. Short-term mortality was assessed at 30 and 90 days. Student t-test, χ2 test, univariate analysis, logistic regression and receiver operating characteristic curves were performed. Thirty-day and 90-day mortality was 27% and 42%, respectively. In multivariate analysis, Maddrey DF was the only independent predictor of mortality for these two periods. Receiver operating characteristic curves for Maddrey DF revealed an excellent discriminatory ability to predict 30-day and 90-day mortality for a Maddrey DF greater than 65 and 60, respectively. Discriminatory ability to predict 30-day and 90-day mortality for MELD was low. AH remains associated with a high short-term mortality. Maddrey DF is a more valuable model than MELD to predict short-term mortality in patients with AH.

Homicide in Chicago from 1890 to 1930: prohibition and its impact on alcohol- and non-alcohol-related homicides.

PubMed

Asbridge, Mark; Weerasinghe, Swarna

2009-03-01

The aim of the current paper is to examine the impact of the enactment of constitutional prohibition in the United States in 1920 on total homicides, alcohol-related homicides and non-alcohol-related homicides in Chicago. Data are drawn from the Chicago Historical Homicide Project, a data set chronicling 11 018 homicides in Chicago between 1870 and 1930. Interrupted time-series and autoregression integrated moving average (ARIMA) models are employed to examine the impact of prohibition on three separate population-adjusted homicide series. All models control for potential confounding from World War I demobilization and from trend data drawn from Wesley Skogan's Time-Series Data from Chicago. Total and non-alcohol-related homicide rates increased during prohibition by 21% and 11%, respectively, while alcohol-related homicides remained unchanged. For other covariates, alcohol-related homicides were related negatively to the size of the Chicago police force and positively to police expenditures and to the proportion of the Chicago population aged 21 years and younger. Non-alcohol-related homicides were related positively to police expenditures and negatively to the size of the Chicago police force. While total and non-alcohol-related homicides in the United States continued to rise during prohibition, a finding consistent with other studies, the rate of alcohol-related homicides remained unchanged. The divergent impact of prohibition on alcohol- and non-alcohol-related homicides is discussed in relation to previous studies of homicide in this era.

Alcohol effects on family relations: a case study.

PubMed

Reinaldo, Amanda Márcia Dos Santos; Pillon, Sandra Cristina

2008-01-01

Problems related to alcohol abuse have been associated to different factors, regardless of the causes attributed to this phenomenon. Alcohol consumption and dependence is considered a public health problem and deserve attention because of the social, work, family, physical, legal and violence-related risks it represents. This study aimed to identify the effects of alcoholism on family relations and, by means of case management, to encourage the recovery of these relationships. The results show that the problems caused by alcohol abuse impose profound suffering to family members, which contributes to high levels of interpersonal conflict, domestic violence, parental inadequacy, child abuse and negligence, financial and legal difficulties, in addition to clinical problems associated to it.

Alcohol-Related Morbidity and Mortality in North Carolina. SCHS Studies No. 41.

ERIC Educational Resources Information Center

Buescher, Paul A.; Patetta, Michael J.

This document presents data from a variety of secondary sources in an attempt to document that alcohol abuse is a serious problem in North Carolina, resulting in sickness, medical care use, death, and substantial economic costs. The primary source of data presented in this report is the Medical Examiner data system, which contains information for…

Economic issues and public alcohol abuse prevention policies in France

PubMed

Spach, Miléna

2016-10-19

Objective: To analyse the impact of the alcohol market on the implementation of strong-willed public alcohol abuse prevention policies based on a critical review of the literature. Method: Documentary research and analysis of the alcohol market economic data were performed. An overview of public alcohol abuse prevention policies was conducted from a historical perspective by distinguishing drunkenness control policies, protection of vulnerable populations, and the fight against drink driving and drinking in the workplace. Results: Public alcohol abuse prevention policies are primarily designed to reduce the harmful consequences of alcohol occurring as a result of a drinking episode (motor vehicle accident, highway accidents, etc.), while neglecting the long-term consequences (cancer, cirrhosis, etc.). Moreover, while taxation is one of the major public health tools used to reduce the costs of alcohol-related damage on society, the State exercises legislative and tax protection for alcoholic beverages produced in France. In particular, wine benefits from a lower tax rate than other stronger forms of alcohol (spirits, liquors, etc.). The economic weight of the alcohol market can provide an explanation for these public alcohol abuse prevention policies. Conclusion: In view of the mortality caused by alcohol abuse, France must implement a proactive public policy. An alcohol taxation policy based on the alcohol content, a minimum unit pricing for alcohol, or higher taxes on alcohol are public policies that could be considered in order to reduce alcohol-related mortality.

Alcohol-related and alcohol-free activity participation and enjoyment among college students: a behavioral theories of choice analysis.

PubMed

Murphy, James G; Barnett, Nancy P; Colby, Suzanne M

2006-08-01

College student alcohol abuse remains a significant public health problem, and there is a need for theory-driven and empirically based models to guide prevention efforts. Behavioral theories of choice assume that the decision to consume alcohol is influenced by the relative value of alcohol versus other available activities. In the present study, a sample of college student drinkers (N=108; 56% female, 44% male) who had previously completed a mandatory alcohol intervention completed a measure of alcohol-related and alcohol-free activity participation and enjoyment. The goals of the study were to examine the influence of drinking quantity and contextual variables on activity enjoyment and to identify enjoyable alcohol-free activities that take place on evenings when students might otherwise be drinking. Overall, students found alcohol-related activities more enjoyable than alcohol-free activities, and drinking quantity was positively related to enjoyment. However, alcohol-free activities such as watching movies, going to the theater or museums, going to bars or parties, hanging out with friends, eating at restaurants, and engaging in creative activity were generally as enjoyable as drinking. Alcohol-free activities that included peers or dates were more enjoyable than solitary activities. Men were less likely to engage in alcohol-free activities that included peers and reported less enjoyment related to alcohol-free activities than did women. Further research is required to identify procedures for increasing participation in alcohol-free activities and to determine whether increased alcohol-free activity participation results in decreased alcohol consumption.

Reduction of mortality following better detection of hypertension and alcohol problems in primary health care in Spain.

PubMed

Rehm, Jürgen; Gmel, Gerrit; Sierra, Cristina; Gual, Antoni

2018-01-01

Through a simulation study, we estimated the potential effects of better detection of hypertension and improved screening for alcohol problems with subsequent interventions. Results showed that if 50% of Spanish males between 40 and 64 years of age who are currently unaware of their hypertension become aware of their condition and receive the usual treatment, and 50% of these males with hypertension are screened for alcohol and are treated for hazardous drinking or alcohol use disorders, then the percentage of uncontrolled hypertension among men with hypertension decreases from 61.2% to 55.9%, i.e. by 8.6%, with about 1/3 of the effect due to the alcohol intervention. For women, likewise, these interventions would decrease the percentage of women in the same age group with uncontrolled hypertension by 7.4% (about 40% due to the alcohol intervention). The reduction of blood pressure in the population would avoid 412 premature CVD deaths (346 in men, 66 in women) within one year. Therefore, better detection of hypertension and screening for alcohol with subsequent interventions would result in marked reductions of uncontrolled hypertension and CVD mortality.

Workplace responsibility, stress, alcohol availability and norms as predictors of alcohol consumption-related problems among employed workers.

PubMed

Hodgins, David C; Williams, Robert; Munro, Gordon

2009-01-01

The objectives of this study were to determine the prevalence of alcohol use and problems among employed individuals in Alberta, Canada (N = 1,890), and to conduct a multivariate examination of predictors of alcohol consumption-related problems. General alcohol problems were identified by 10%, although very few workers described any specific work-related alcohol problems (1%). Structural equation modeling revealed that, as hypothesized, workplace alcohol availability predicted general alcohol problems. Job responsibility and workplace norms also predicted alcohol problems but only for men. Perceived work stress did not predict alcohol problems. Results support the development of interventions that focus on re-shaping alcohol use norms.

Unemployment Is a Risk Factor for Hospitalization Due to Alcohol Problems: A Longitudinal Study Based on the Stockholm Public Health Cohort (SPHC).

PubMed

Backhans, Mona Christina; Balliu, Natalja; Lundin, Andreas; Hemmingsson, Tomas

2016-11-01

This study examined the associations between unemployment and alcohol-related hospitalization or mortality and to what extent these associations may be confounded by alcohol consumption and alcohol problems before unemployment. The study was based on the Stockholm Public Health Cohort (SPHC), a population-based stratified random sample with a baseline questionnaire in 2002/2003 and record linkages up to year 2011. The final sample in the study consists of 15,841 people aged 18-60 years. Unemployment was defined as any registration at the public employment services during 2003-2005. The outcome was alcohol-related hospitalization and alcohol-related mortality during 2006-2011. Confounders were age, sex, and education, and we further adjusted for baseline alcohol consumption and alcohol-related hospitalization before the study period. Cox proportional hazard models were fit, and associations were expressed as hazard ratios (HRs). In the fully adjusted model, unemployment was associated with an increased risk of alcohol-related hospitalization or mortality, with a more than threefold hazard (HR = 3.38, 95% CI [1.81, 6.31]) compared with no unemployment during the exposure period. There was a moderate attenuating effect of prior alcohol consumption and alcohol-related hospitalization. Any unemployment in 2003-2005 was highly related to having experienced an alcohol-related diagnosis during the 6-year follow-up, even after controlling for risky use of alcohol and prior hospitalization.

Alcohol effects on the epigenome in the germline: role in the inheritance of alcohol-related pathology

PubMed Central

Chastain, Lucy G.; Sarkar, Dipak K.

2017-01-01

Excessive alcohol exposure has severe health consequences, and clinical and animal studies have demonstrated that disruptions in the epigenome of somatic cells, such as those in brain, are an important factor in the development of alcohol-related pathologies, such as alcohol-use disorders (AUDs) and fetal alcohol spectrum disorders (FASDs). It is also well known that alcohol-related health problems are passed down across generations in human populations, but the complete mechanisms for this phenomenon are currently unknown. Recent studies in animal models have suggested that epigenetic factors are also responsible for the transmission of alcohol-related pathologies across generations. Alcohol exposure has been shown to induce changes in the epigenome of sperm of exposed male animals, and these epimutations are inherited in the offspring. This paper reviews evidence for multigenerational and transgenerational epigenetic inheritance of alcohol-related pathology through the germline. We also review the literature on the epigenetic effects of alcohol exposure on somatic cells in brain, and its contribution to AUDs and FASDs. We note gaps in knowledge in this field, such as the lack of clinical studies in human populations and the lack of data on epigenetic inheritance via the female germline, and we suggest future research directions. PMID:28431793

Alcohol Demand, Delayed Reward Discounting, and Craving in relation to Drinking and Alcohol Use Disorders

PubMed Central

MacKillop, James; Miranda, Robert; Monti, Peter M.; Ray, Lara A.; Murphy, James G.; Rohsenow, Damaris J.; McGeary, John E.; Swift, Robert M.; Tidey, Jennifer W.; Gwaltney, Chad J.

2010-01-01

A behavioral economic approach to alcohol use disorders (AUDs) emphasizes both individual and environmental determinants of alcohol use. The current study examined individual differences in alcohol demand (i.e., motivation for alcohol under escalating conditions of price) and delayed reward discounting (i.e., preference for immediate small rewards compared to delayed larger rewards) in 61 heavy drinkers (62% with an AUD). In addition, based on theoretical accounts that emphasize the role of craving in reward valuation and preferences for immediate rewards, craving for alcohol was also examined in relation to these behavioral economic variables and the alcohol-related variables. Intensity of alcohol demand and delayed reward discounting were significantly associated with AUD symptoms, but not with quantitative measures of alcohol use, and were also moderately correlated with each other. Likewise, craving was significantly associated with AUD symptoms, but not with alcohol use, and was also significantly correlated with both intensity of demand and delayed reward discounting. These findings further emphasize the relevance of behavioral economic indices of motivation to alcohol use disorders and the potential importance of craving for alcohol in this relationship. PMID:20141247

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.

Attention and recognition memory bias for alcohol-related stimuli among alcohol-dependent patients attending residential treatment.

PubMed

Klein, Audrey A; Nelson, Lindsay M; Anker, Justin J

2013-03-01

Though studies have examined attentional bias for alcohol-related information among alcohol-dependent individuals, few have examined memory bias. This study examined attention and recognition memory biases for alcohol-related information among patients recently admitted to residential alcohol treatment (n=100; 40% female). Participants completed a computerized attentional task wherein they classified a centrally-presented digit as odd or even. On some trials, an alcohol word, neutral word, or anagram was presented along with the digit. On these dual trials participants first classified the digit and then classified the other stimulus as a word or nonword. Participants took longer to classify digits that appeared with alcohol words compared to neutral words; suggesting the alcohol words distracted them from processing the digit. In a subsequent recognition memory test, participants showed significantly higher hit rates (i.e., correctly classifying an old item as old) and false alarm rates (i.e., incorrectly classifying a new item as old) to the alcohol words compared to the neutral words, and they also showed a more liberal response bias to alcohol words. The findings suggest that alcohol-dependent individuals exhibit both attention and memory bias for alcohol-related information. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Alcohol drinking in the time of political transition in Poland. Report of the National Health Programme ].

PubMed

Moskalewicz, Jacek; Zulewska-Sak, Justyna

2003-01-01

The National Health Programme was adopted in Poland in the mid-1990s. It consists of 18 targets including target 4 that calls for diminishing alcohol consumption and changing its structure as well as limiting health harms associated with alcohol. The programme is being monitored on bi-annual basis. The monitoring covers a level of alcohol consumption and associated harm including trends in mortality and morbidity as well as in road accidents in 1990-2001 period. During the period in point, particularly in the beginning of the transition alcohol consumption increased at least by one third reaching 10-11 litres of pure ethanol per capita, mostly due to sudden disruption of the alcohol control system and high tide of unrecorded supply. Currently, the consumption is estimated to be 9.5-10.0 litres with 30% share of the unrecorded. During last decade recorded morbidity due to mental disorders associated with alcohol increased by 80% and 60% respectively in out- and in-patient system while mortality rates almost doubled. Male mortality due to liver diseases increased by 50% while that of women remained relatively flat. In last few years, alcohol related mortality tended to decline slightly parallel to consumption trends. Significant improvement has been achieved in prevention of drunken diving. The number of deaths in alcohol related road accidents decreased two fold while a rate of drunken crashes per 1000 vehicles dropped three times.

Seasonality of alcohol-related phenomena in Estonia.

PubMed

Silm, Siiri; Ahas, Rein

2005-03-01

We studied alcohol consumption and its consequences as a seasonal phenomenon in Estonia and analysed the social and environmental factors that may cause its seasonal rhythm. There are two important questions when researching the seasonality of human activities: (1) whether it is caused by natural or social factors, and (2) whether the impact of the factors is direct or indirect. Often the seasonality of social phenomena is caused by social factors, but the triggering mechanisms are related to environmental factors like temperature, precipitation, and radiation via the circannual calendar. The indicators of alcohol consumption in the current paper are grouped as: (1) pre-consumption phenomena, i.e. production, tax and excise, sales (beer, wine and vodka are analysed separately), and (2) post-consumption phenomena, i.e. alcohol-related crime and traffic accidents and the number of people detained in lockups and admitted to alcohol treatment clinics. In addition, seasonal variability in the amount of alcohol advertising has been studied, and a survey has been carried out among 87 students of Tartu University. The analysis shows that different phenomena related to alcohol have a clear seasonal rhythm in Estonia. The peak period of phenomena related to beer is in the summer, from June to August and the low point is during the first months of the year. Beer consumption correlates well with air temperature. The consumption of vodka increases sharply at the end of the year and in June; the production of vodka does not have a significant correlation with negative temperatures. The consumption of wine increases during summer and in December. The consequences of alcohol consumption, expressed as the rate of traffic accidents or the frequency of medical treatment, also show seasonal variability. Seasonal variability of alcohol consumption in Estonia is influenced by natural factors (temperature, humidity, etc.) and by social factors (celebrations, vacations, etc.). However

Seasonality of alcohol-related phenomena in Estonia

NASA Astrophysics Data System (ADS)

Silm, Siiri; Ahas, Rein

2005-03-01

We studied alcohol consumption and its consequences as a seasonal phenomenon in Estonia and analysed the social and environmental factors that may cause its seasonal rhythm. There are two important questions when researching the seasonality of human activities: (1) whether it is caused by natural or social factors, and (2) whether the impact of the factors is direct or indirect. Often the seasonality of social phenomena is caused by social factors, but the triggering mechanisms are related to environmental factors like temperature, precipitation, and radiation via the circannual calendar. The indicators of alcohol consumption in the current paper are grouped as: (1) pre-consumption phenomena, i.e. production, tax and excise, sales (beer, wine and vodka are analysed separately), and (2) post-consumption phenomena, i.e. alcohol-related crime and traffic accidents and the number of people detained in lockups and admitted to alcohol treatment clinics. In addition, seasonal variability in the amount of alcohol advertising has been studied, and a survey has been carried out among 87 students of Tartu University. The analysis shows that different phenomena related to alcohol have a clear seasonal rhythm in Estonia. The peak period of phenomena related to beer is in the summer, from June to August and the low point is during the first months of the year. Beer consumption correlates well with air temperature. The consumption of vodka increases sharply at the end of the year and in June; the production of vodka does not have a significant correlation with negative temperatures. The consumption of wine increases during summer and in December. The consequences of alcohol consumption, expressed as the rate of traffic accidents or the frequency of medical treatment, also show seasonal variability. Seasonal variability of alcohol consumption in Estonia is influenced by natural factors (temperature, humidity, etc.) and by social factors (celebrations, vacations, etc.). However

The impact of policies regulating alcohol trading hours and days on specific alcohol-related harms: a systematic review.

PubMed

Sanchez-Ramirez, Diana C; Voaklander, Donald

2018-02-01

Evidence supports the expectation that changes in time of alcohol sales associate with changes in alcohol-related harm in both directions. However, to the best of our knowledge, no comprehensive systematic reviews had examined the effect of policies restricting time of alcohol trading on specific alcohol-related harms. To compile existing evidence related to the impact of policies regulating alcohol trading hours/days of on specific harm outcomes such as: assault/violence, motor vehicle crashes/fatalities, injury, visits to the emergency department/hospital, murder/homicides and crime. Systematic review of literature studying the impact of policies regulation alcohol trading times in alcohol-related harm, published between January 2000 and October 2016 in English language. Results support the premise that policies regulating times of alcohol trading and consumption can contribute to reduce injuries, alcohol-related hospitalisations/emergency department visits, homicides and crime. Although the impact of alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is also positive, these associations seem to be more complex and require further study. Evidence suggests a potential direct effect of policies that regulate alcohol trading times in the prevention of injuries, alcohol-related hospitalisations, homicides and crime. The impact of these alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is less compelling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Liver cirrhosis mortality in Mexico. II. Excess mortality and pulque consumption].

PubMed

Narro-Robles, J; Gutiérrez-Avila, J H; López-Cervantes, M; Borges, G; Rosovsky, H

1992-01-01

Over the years high cirrhosis mortality rates have been reported in Mexico City and in the surrounding states (Hidalgo, Tlaxcala, Puebla and the State of Mexico); on the contrary, well defined areas, such as the northern states, have shown a considerably lower mortality rate. This situation may indicate that some factors such as the pattern of alcoholic intake and other environmental characteristics could explain this striking difference. To determine the role of alcohol, the availability and consumption of alcohol at regional and state level were compared with cirrhosis mortality rates. A high and statistically significant correlation was found with pulque availability and consumption (r = 72-92%, p less than 0.01) in all periods of time under examination. On the contrary, a statistically significant negative association was observed with beer consumption and a positive, but not significant correlation, with distilled alcoholic beverages. Infectious hepatitis incidence, prevalence of exclusive use of native languages (as an indirect index of ethnic background) and nutritional deficiencies were also studied as possible risk factors. Nutritional deficiencies and the prevalence of exclusive use of náhuatl and otomí languages were positively correlated. These results can be useful to conduct further epidemiological studies still needed to determine the etiologic role of pulque consumption as well as of the other risk factors. Nonetheless, the current data stress the need to implement public health programs to reduce alcohol consumption, especially pulque, and to minimize the impact of these risk factors in high mortality areas.

[Alcohol-related cognitive impairment and the DSM-5].

PubMed

Walvoort, S J W; Wester, A J; Doorakkers, M C; Kessels, R P C; Egger, J I M

2016-01-01

It is evident from the dsm-iv-tr that alcohol-related impairment is extremely difficult to classify accurately. As a result, cognitive deficits can easily be overlooked. The dsm-5, however, incorporates a new category, namely 'neurocognitive disorders', which may lead to significant improvements in clinical practice. To compare the classification of alcohol-related cognitive dysfunction in dsm-iv-tr and dsm-5 and to discuss the clinical relevance of the revised classification in the dsm-5. We compare the chapters of the dsm-iv-tr and the dsm-5 concerning alcohol-related cognitive impairment and describe the changes that have been made. The dsm-5 puts greater emphasis on alcohol-related neurocognitive impairment. Not only does dsm-5 distinguish between the degree of severity (major or minor neurocognitive disorder), it also distinguishes between the type of impairment (non-amnestic-type versus confabulating-amnestic type). It also makes a distinction between the durations of impairment (behavioural and/or persistent disorders). The dsm-5 gives a clearer description of alcohol-related neurocognitive dysfunction than does dsm-iv-tr and it stresses the essential role of neuropsychological assessment in the classification, diagnosis, and treatment of neurocognitive disorders.

Changes in directly alcohol-attributable mortality during the great recession by employment status in Spain: a population cohort of 22 million people.

PubMed

Alonso, Ignacio; Vallejo, Fernando; Regidor, Enrique; Belza, M José; Sordo, Luis; Otero-García, Laura; Barrio, Gregorio

2017-08-01

Macroeconomic fluctuations can impact differentially on alcohol-related problems across sociodemographic groups. We assess trend changes in directly alcohol-attributable (DAA) mortality in the population aged 25-64 during the post-2008 recession in Spain according to employment status and other sociodemographic factors. Nationwide cohort study covering 21.9 million people living in Spain in 2001. People were classified by employment status and other factors. The annual percentage change (APC) in mortality rates during 2002-2007 (precrisis) and 2008-2011 (crisis) was estimated by the Poisson regression. The period effect size was then calculated as the difference between crisis and precrisis APCs. The age-adjusted APCs in DAA mortality were 6.9% in 2002-2007 and 3.7% in 2008-2011 among employed people, and -4.3% and -0.4%, respectively, among non-employed people. Statistically significant trend changes in such mortality during the crisis were found, which were favourable in certain employed subgroups (manual workers and employees aged 25-49), and unfavourable in the total non-employed population and certain non-employed subgroups (men, non-married and especially medium/high-wealth people). The greatest unfavourable change corresponded to non-employed people living in households of 72-104 m 2 who had 2 or more cars. Favourable changes were also found in the remaining employed subgroups, especially women and non-married people, although they did not reach statistical significance. Our findings suggest that the post-2008 Spanish crisis had a heterogeneous impact across sociodemographic subgroups on DAA mortality, and that employment status seemed to have an important effect. The impact was especially unfavourable on the non-employed, particularly those with substantial material wealth. 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/.

Alcohol Demand, Future Orientation, and Craving Mediate the Relation Between Depressive and Stress Symptoms and Alcohol Problems.

PubMed

Soltis, Kathryn E; McDevitt-Murphy, Meghan E; Murphy, James G

2017-06-01

Elevated depression and stress have been linked to greater levels of alcohol problems among young adults even after taking into account drinking level. This study attempts to elucidate variables that might mediate the relation between symptoms of depression and stress and alcohol problems, including alcohol demand, future time orientation, and craving. Participants were 393 undergraduates (60.8% female, 78.9% White/Caucasian) who reported at least 2 binge-drinking episodes (4/5+ drinks for women/men, respectively) in the previous month. Participants completed self-report measures of stress and depression, alcohol demand, future time orientation, craving, and alcohol problems. In separate mediation models that accounted for gender, race, and weekly alcohol consumption, future orientation and craving significantly mediated the relation between depressive symptoms and alcohol problems. Alcohol demand, future orientation, and craving significantly mediated the relation between stress symptoms and alcohol problems. Heavy-drinking young adults who experience stress or depression are likely to experience alcohol problems, and this is due in part to elevations in craving and alcohol demand, and less sensitivity to future outcomes. Interventions targeting alcohol misuse in young adults with elevated levels of depression and stress should attempt to increase future orientation and decrease craving and alcohol reward value. Copyright © 2017 by the Research Society on Alcoholism.

Alcohol-Related Blackouts, Negative Alcohol-Related Consequences, and Motivations for Drinking Reported by Newly Matriculating Transgender College Students.

PubMed

Tupler, Larry A; Zapp, Daniel; DeJong, William; Ali, Maryam; O'Rourke, Sarah; Looney, John; Swartzwelder, H Scott

2017-05-01

Many transgender college students struggle with identity formation and other emotional, social, and developmental challenges associated with emerging adulthood. A potential maladaptive coping strategy employed by such students is heavy drinking. Prior literature has suggested greater consumption and negative alcohol-related consequences (ARCs) in transgender students compared with their cisgender peers, but little is known about their differing experiences with alcohol-related blackouts (ARBs). We examined the level of alcohol consumption, the frequency of ARBs and other ARCs, and motivations for drinking reported by the largest sample of transgender college students to date. A Web survey from an alcohol-prevention program, AlcoholEdu for College™, assessed student demographics and drinking-related behaviors, experiences, and motivations of newly matriculating first-year college students. A self-reported drinking calendar was used to examine each of the following measures over the previous 14 days: number of drinking days, total number of drinks, and maximum number of drinks on any single day. A 7-point Likert scale was used to measure ARCs, ARBs, and drinking motivations. Transgender students of both sexes were compared with their cisgender peers. A total of 989 of 422,906 students (0.2%) identified as transgender. Over a 14-day period, transgender compared with cisgender students were more likely to consume alcohol over more days, more total drinks, and a greater number of maximum drinks on a single day. Transgender students (36%) were more likely to report an ARB than cisgender students (25%) as well as more negative academic, confrontation-related, social, and sexual ARCs. Transgender respondents more often cited stress reduction, social anxiety, self-esteem issues, and the inherent properties of alcohol as motivations for drinking. For nearly all measures, higher values were yielded by male-to-female than female-to-male transgender students. Transgender

Cross-border health and productivity effects of alcohol policies.

PubMed

Johansson, Per; Pekkarinen, Tuomas; Verho, Jouko

2014-07-01

This paper studies the cross-border health and productivity effects of alcohol taxes. We estimate the effect of a large cut in the Finnish alcohol tax on mortality, alcohol-related illnesses and work absenteeism in Sweden. This tax cut led to large differences in the prices of alcoholic beverages between these two countries and to a considerable increase in cross-border shopping. The effect is identified using differences-in-differences strategy where changes in these outcomes in regions near the Finnish border are compared to changes in other parts of northern Sweden. We use register data where micro level data on deaths, hospitalisations and absenteeism is merged to population-wide micro data on demographics and labour market outcomes. Our results show that the Finnish tax cut did not have any clear effect on mortality or alcohol-related hospitalisations in Sweden. However, we find that workplace absenteeism increased by 9% for males and by 15% for females near the Finnish border as a result of the tax cut. Copyright © 2014 Elsevier B.V. All rights reserved.

The Influence of Gender and Sexual Orientation on Alcohol Use and Alcohol-Related Problems

PubMed Central

Hughes, Tonda L.; Wilsnack, Sharon C.; Kantor, Lori Wolfgang

2016-01-01

Although there are wide differences in alcohol use patterns among countries, men are consistently more likely than women to be drinkers and to drink heavily. Studies of alcohol use among sexual minorities (SMs), however, reflect a more complex picture. Such research has found higher rates of alcohol use and alcohol-related problems among SM persons than among heterosexuals and greater differences between SM and heterosexual women than between SM and heterosexual men. A variety of factors may contribute to differences in alcohol use and alcohol-related problems between men and women and between SM and heterosexual people. An improved understanding of these factors is important to guide prevention and treatment efforts. Although there is a dearth of literature on use of alcohol by SMs in many parts of the world, especially lower- and middle-income countries, we attempt to review and integrate the sparse data that are available from these lower-resourced countries. The global perspective presented in this article is the first attempt to go beyond a general review of literature in the Western world to document the gender paradox in alcohol use among heterosexuals and SMs in diverse countries worldwide. PMID:27159819

An assessment of statistics on alcohol-related problems

DOT National Transportation Integrated Search

1980-05-05

The report is presented as a contribution to the discussion of alcohol use and its related problems. Its aim is to provide an assessment of government and other statistics regarding certain alcohol-related problems; further research is suggested wher...

Prevalence of non-alcoholic fatty liver disease and risk factors for advanced fibrosis and mortality in the United States.

PubMed

Le, Michael H; Devaki, Pardha; Ha, Nghiem B; Jun, Dae Won; Te, Helen S; Cheung, Ramsey C; Nguyen, Mindie H

2017-01-01

In the United States, non-alcoholic fatty liver disease (NAFLD) is the most common liver disease and associated with higher mortality according to data from earlier National Health and Nutrition Examination Survey (NHANES) 1988-1994. Our goal was to determine the NAFLD prevalence in the recent 1999-2012 NHANES, risk factors for advanced fibrosis (stage 3-4) and mortality. NAFLD was defined as having a United States Fatty Liver Index (USFLI) > 30 in the absence of heavy alcohol use and other known liver diseases. The probability of low/high risk of having advanced fibrosis was determined by the NAFLD Fibrosis Score (NFS). In total, 6000 persons were included; of which, 30.0% had NAFLD and 10.3% of these had advanced fibrosis. Five and eight-year overall mortality in NAFLD subjects with advanced fibrosis was significantly higher than subjects without NAFLD ((18% and 35% vs. 2.6% and 5.5%, respectively) but not NAFLD subjects without advanced fibrosis (1.1% and 2.8%, respectively). NAFLD with advanced fibrosis (but not those without) is an independent predictor for mortality on multivariate analysis (HR = 3.13, 95% CI 1.93-5.08, p<0.001). In conclusion, in this most recent NHANES, NAFLD prevalence remains at 30% with 10.3% of these having advanced fibrosis. NAFLD per se was not a risk factor for increased mortality, but NAFLD with advanced fibrosis was. Mexican American ethnicity was a significant risk factor for NAFLD but not for advanced fibrosis or increased mortality.

Cue-induced alcohol-seeking behaviour is reduced by disrupting the reconsolidation of alcohol-related memories.

PubMed

von der Goltz, Christoph; Vengeliene, Valentina; Bilbao, Ainhoa; Perreau-Lenz, Stephanie; Pawlak, Cornelius R; Kiefer, Falk; Spanagel, Rainer

2009-08-01

In humans, the retrieval of memories associated with an alcohol-related experience frequently evokes alcohol-seeking behaviour. The reconsolidation hypothesis states that a consolidated memory could again become labile and susceptible to disruption after memory retrieval. The aim of our study was to examine whether retrieval of alcohol-related memories undergoes a reconsolidation process. For this purpose, male Wistar rats were trained to self-administer ethanol in the presence of specific conditioned stimuli. Thereafter, animals were left undisturbed in their home cages for the following 21 days. Memory retrieval was performed in a single 5-min exposure to all alcohol-associated stimuli. The protein synthesis inhibitor anisomycin, the non-competitive N-methyl-D: -aspartate (NMDA) receptor antagonist MK-801 and acamprosate, a clinically used drug known to reduce a hyper-glutamatergic state, were given immediately after retrieval of alcohol-related memories. The impact of drug treatment on cue-induced alcohol-seeking behaviour was measured on the following day and 7 days later. Administration of both anisomycin and MK-801 reduced cue-induced alcohol-seeking behaviour, showing that memory reconsolidation was disrupted by these compounds. However, acamprosate had no effect on the reconsolidation process, suggesting that this process is not dependent on a hyper-glutamatergic state but is more related to protein synthesis and NMDA receptor activity. Pharmacological disruption of reconsolidation of alcohol-associated memories can be achieved by the use of NMDA antagonists and protein synthesis inhibitors and may thus provide a potential new therapeutic strategy for the prevention of relapse in alcohol addiction.

Alcohol consumption policies and the prevention of alcohol consumption-related problems: needs, duties, and responsibilities.

PubMed

Allamani, Allaman

2012-10-01

Alcohol-related policies and the prevention of alcohol use-related problems, as well as their creation, are accomplished through planned interventions- laws, social and health programs, community-based initiatives-as well as through complex social movements and efforts implemented by the communities. Among both citizens and alcohol use intervention experts, the following three human dimensions are considered: needs, duties, and responsibilities.

Antidepressant Sales and the Risk for Alcohol-Related and Non-Alcohol-Related Suicide in Finland—An Individual-Level Population Study

PubMed Central

Moustgaard, Heta; Joutsenniemi, Kaisla; Myrskylä, Mikko; Martikainen, Pekka

2014-01-01

Objectives A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. Methods We followed a nationally representative sample of 950,158 Finnish adults in 1995–2007 for alcohol-related (n = 2,859) and non-alcohol-related (n = 8,632) suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. Results The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976–0.998). This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. Conclusion We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995–2007. However, the rise in the proportion of antidepressant

Trends in the epidemiological aspects and mortality of alcoholic liver disease in Korea in the decade between 2000 and 2009.

PubMed

Bang, Hyung-Ae; Kwon, Young-Hwan; Lee, Myeong-Jin; Lee, Won-Chang

2015-02-01

Alcohol consumption and related alcohol liver disease (ALD) have substantially increased in Korea during the last decade. The objective of this study was to evaluate the trends in the epidemiological aspects and mortality rate (MR) of Korea in the decade between 2000 and 2009. The raw data analyzed in this study were obtained from the website of "the ALD" managed by Korea Center for Disease Control and Prevention (KCDC), Korea Public Health Association (KPHA), and statistics website of Statistics Korea. The data analyses were performed using Excel 2007 statistical software (Microsoft Corp., USA). The amount of alcohol-consumption-per-capita-per-year (ACCY) in Korea was 8.38 L in 2000 and 8.54 L in 2009. The most taken alcoholic beverage was soju, followed by beer. There were a total of 1,403 case-fatalities (CF) with an MR of 2.98 per 100,000 populations of ALD in 2000, while a total of 3,588 CF with an MR of 7.21 in 2009 (P < 0.01). The CF and MR of ALD in males were significantly higher than those in females (P < 0.01). In over 40-year-old age groups, the CF and MR were significantly increased (P < 0.01). Moreover, occupational classification revealed that the mistress/students/jobless (MSJ) were the most risky group. The comparison of overall CF and MR of ALD by six key classifications (International Classification of Diseases (ICD)) showed that alcoholic cirrhosis (229 CF and 16.3%) in 2000 tended to be increased in 2009 (2,803 CF and 78.1%), while alcoholic fibrosis and sclerosis (607 CF and 43.3%) in 2000 significantly decreased in 2009 (120 CF and 3.3%), respectively. ALD is one of the most severe diseases in Korea, as indicated by its high CF and MR in this study. As over-consumption of alcoholic beverages is relatively common in Korea, more efforts should be made toward prevention of ALD by raising awareness of the risk factors of ALD by public health education.

Trends in the Epidemiological Aspects and Mortality of Alcoholic Liver Disease in Korea in the Decade Between 2000 and 2009

PubMed Central

Bang, Hyung-Ae; Kwon, Young-Hwan; Lee, Myeong-Jin; Lee, Won-Chang

2015-01-01

Background Alcohol consumption and related alcohol liver disease (ALD) have substantially increased in Korea during the last decade. The objective of this study was to evaluate the trends in the epidemiological aspects and mortality rate (MR) of Korea in the decade between 2000 and 2009. Methods The raw data analyzed in this study were obtained from the website of “the ALD” managed by Korea Center for Disease Control and Prevention (KCDC), Korea Public Health Association (KPHA), and statistics website of Statistics Korea. The data analyses were performed using Excel 2007 statistical software (Microsoft Corp., USA). Results The amount of alcohol-consumption-per-capita-per-year (ACCY) in Korea was 8.38 L in 2000 and 8.54 L in 2009. The most taken alcoholic beverage was soju, followed by beer. There were a total of 1,403 case-fatalities (CF) with an MR of 2.98 per 100,000 populations of ALD in 2000, while a total of 3,588 CF with an MR of 7.21 in 2009 (P < 0.01). The CF and MR of ALD in males were significantly higher than those in females (P < 0.01). In over 40-year-old age groups, the CF and MR were significantly increased (P < 0.01). Moreover, occupational classification revealed that the mistress/students/jobless (MSJ) were the most risky group. The comparison of overall CF and MR of ALD by six key classifications (International Classification of Diseases (ICD)) showed that alcoholic cirrhosis (229 CF and 16.3%) in 2000 tended to be increased in 2009 (2,803 CF and 78.1%), while alcoholic fibrosis and sclerosis (607 CF and 43.3%) in 2000 significantly decreased in 2009 (120 CF and 3.3%), respectively. Conclusion ALD is one of the most severe diseases in Korea, as indicated by its high CF and MR in this study. As over-consumption of alcoholic beverages is relatively common in Korea, more efforts should be made toward prevention of ALD by raising awareness of the risk factors of ALD by public health education. PMID:25436025

Effects of alcohol retail privatization on excessive alcohol consumption and related harms: a community guide systematic review.

PubMed

Hahn, Robert A; Middleton, Jennifer Cook; Elder, Randy; Brewer, Robert; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci L; Chattopadhyay, Sajal; Lawrence, Briana; Campbell, Carla Alexia

2012-04-01

Excessive alcohol consumption is the third-leading cause of preventable death in the U.S. This systematic review is one in a series exploring effectiveness of interventions to reduce alcohol-related harms. The focus of this review was on studies evaluating the effects of the privatization of alcohol retail sales on excessive alcohol consumption and related harms. Using Community Guide methods for conducting systematic reviews, a systematic search was conducted in multiple databases up to December 2010. Reference lists of acquired articles and review papers were also scanned for additional studies. A total of 17 studies assessed the impact of privatizing retail alcohol sales on the per capita alcohol consumption, a well-established proxy for excessive alcohol consumption; 9 of these studies also examined the effects of privatization on the per capita consumption of alcoholic beverages that were not privatized. One cohort study in Finland assessed the impact of privatizing the sales of medium-strength beer (MSB) on self-reported alcohol consumption. One study in Sweden assessed the impact of re-monopolizing the sale of MSB on alcohol-related harms. Across the 17 studies, there was a 44.4% median increase in the per capita sales of privatized beverages in locations that privatized retail alcohol sales (interquartile interval: 4.5% to 122.5%). During the same time period, sales of nonprivatized alcoholic beverages decreased by a median of 2.2% (interquartile interval: -6.6% to -0.1%). Privatizing the sale of MSB in Finland was associated with a mean increase in alcohol consumption of 1.7 liters of pure alcohol per person per year. Re-monopolization of the sale of MSB in Sweden was associated with a general reduction in alcohol-related harms. According to Community Guide rules of evidence, there is strong evidence that privatization of retail alcohol sales leads to increases in excessive alcohol consumption. Published by Elsevier Inc.

Missouri Curriculum Guide for Alcohol-Related Traffic Offenders' Program.

ERIC Educational Resources Information Center

Pierce, Don; McClain, Robert

This document contains the second edition of the Alcohol or Drug Related Traffic Offenders' Program (ARTOP) curriculum guide developed by the Missouri Department of Mental Health to reduce alcohol-related traffic offenses by presenting factual information about the physical effects of alcohol on the body and on driving skills. The materials…

Alcohol Demand, Future Orientation, and Craving Mediate the Relation Between Depressive and Stress Symptoms and Alcohol Problems

PubMed Central

Soltis, Kathryn E.; McDevitt-Murphy, Meghan; Murphy, James G.

2017-01-01

Background Elevated depression and stress have been linked to greater levels of alcohol problems among young adults even after taking into account drinking level. The current study attempts to elucidate variables that might mediate the relation between symptoms of depression and stress and alcohol problems, including alcohol demand, future time orientation, and craving. Methods Participants were 393 undergraduates (60.8% female, 78.9% White/Caucasian) who reported at least 2 binge drinking episodes (4/5+ drinks for women/men, respectively) in the previous month. Participants completed self-report measures of stress and depression, alcohol demand, future time orientation, craving, and alcohol problems. Results In separate mediation models that accounted for gender, race, and weekly alcohol consumption, future orientation and craving significantly mediated the relation between depressive symptoms and alcohol problems. Alcohol demand, future orientation, and craving significantly mediated the relation between stress symptoms and alcohol problems. Conclusions Heavy drinking young adults who experience stress or depression are likely to experience alcohol problems and this is due in part to elevations in craving and alcohol demand, and less sensitivity to future outcomes. Interventions targeting alcohol misuse in young adults with elevated levels of depression and stress should attempt to increase future orientation and decrease craving and alcohol reward value. PMID:28401985

A UK student survey investigating the effects of consuming alcohol mixed with energy drinks on overall alcohol consumption and alcohol-related negative consequences.

PubMed

Johnson, Sean J; Alford, Chris; Stewart, Karina; Verster, Joris C

2016-12-01

Previous research reported positive associations between alcohol mixed with energy drink (AMED) consumption and overall alcohol consumption. However, results were largely based on between-subjects comparisons comparing AMED consumers with alcohol-only (AO) consumers, and therefore cannot sufficiently control for differences in personal characteristics between these groups. In order to determine whether AMED consumers drink more alcohol on occasions they consume AMED compared to those when they drink AO additional within-subjects comparisons are required. Therefore, this UK student survey assessed both alcohol consumption and alcohol-related negative consequences when consumed alone and when mixed with energy drinks, using a within-subject design. A total of 1873 students completed the survey, including 732 who consumed AMED. It was found that AMED consumers drank significantly less alcohol when they consumed AMED compared to when they drank AO (p < 0.001). In line with reduced alcohol consumption significantly fewer negative alcohol-related consequences were reported on AMED occasions compared to AO occasions (p < 0.001). These findings suggest that mixing alcohol with energy drinks does not increase total alcohol consumption or alcohol-related negative consequences.

Alcohol-related diseases and alcohol dependence syndrome is associated with increased gout risk: A nationwide population-based cohort study.

PubMed

Tu, Hung-Pin; Tung, Yi-Ching; Tsai, Wen-Chan; Lin, Gau-Tyan; Ko, Ying-Chin; Lee, Su-Shin

2017-03-01

Alcohol intake is strongly associated with hyperuricemia, which may cause gout. This study evaluated the risk of gout in patients with alcohol-related diseases and alcohol dependence syndrome. We used the Taiwan National Health Insurance Research Database (NHIRD) to conduct a nationwide population-based cohort study to assess the risk of gout and gout incidence in patients with alcohol-related diseases and alcohol dependence syndrome (as defined by the International Classification of Diseases, Ninth Revision). In the NHIRD records from 1998 to 2008, we identified 11,675 cases of alcohol-related diseases. The control group comprised 23,350 cases without alcohol-related diseases propensity score-matched (1 case: 2 controls) for age, age group, and sex. The results revealed that alcohol-related diseases were significantly associated with gout risk (adjusted hazard ratio 1.88; P<0.0001). Of the alcohol-related disease cases, 34.1% of the patients had alcohol dependence syndrome (males 34.8%; females 32.4%), and alcohol dependence was independently associated with gout occurrence (relative risk [RR] 2.01; P<0.0001). Severe alcohol-dependent patients (who were also the heavy benzodiazepines users), were associated with an increased risk of gout (RR 1.71 to 4.21, P≤0.0182). Physicians should be aware of the association between alcohol dependence syndrome and gout occurrence, and alcohol use assessment and measures to prevent alcohol dependence should be implemented in the integrative care for patients with gout. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Epigenetic mechanisms of alcoholism and stress-related disorders.

PubMed

Palmisano, Martina; Pandey, Subhash C

2017-05-01

Stress-related disorders, such as anxiety, early life stress, and posttraumatic stress disorder appear to be important factors in promoting alcoholism, as alcohol consumption can temporarily attenuate the negative affective symptoms of these disorders. Several molecules involved in signaling pathways may contribute to the neuroadaptation induced during alcohol dependence and stress disorders, and among these, brain-derived neurotrophic factor (BDNF), corticotropin releasing factor (CRF), neuropeptide Y (NPY) and opioid peptides (i.e., nociceptin and dynorphin) are involved in the interaction of stress and alcohol. In fact, alterations in the expression and function of these molecules have been associated with the pathophysiology of stress-related disorders and alcoholism. In recent years, various studies have focused on the epigenetic mechanisms that regulate chromatin architecture, thereby modifying gene expression. Interestingly, epigenetic modifications in specific brain regions have been shown to be associated with the neurobiology of psychiatric disorders, including alcoholism and stress. In particular, the enzymes responsible for chromatin remodeling (i.e., histone deacetylases and methyltransferases, DNA methyltransferases) have been identified as common molecular mechanisms for the interaction of stress and alcohol and have become promising therapeutic targets to treat or prevent alcoholism and associated emotional disorders. Published by Elsevier Inc.

EPIGENETIC MECHANISMS OF ALCOHOLISM AND STRESS-RELATED DISORDERS

PubMed Central

Palmisano, Martina; Pandey, Subhash C.

2017-01-01

Stress-related disorders, such as anxiety, early life stress and posttraumatic stress disorder appear to be important factors in promoting alcoholism, as alcohol consumption can temporarily attenuate the negative affective symptoms of these disorders. Several molecules involved in signaling pathways may contribute to the neuroadaptation induced during alcohol dependence and stress disorders, and among these, brain-derived neurotrophic factor (BDNF), corticotropin releasing factor (CRF), neuropeptide Y (NPY) and opioid peptides (i.e. nociceptin and dynorphin) are involved in the interaction of stress and alcohol. In fact, alterations in the expression and function of these molecules have been associated with the pathophysiology of stress-related disorders and alcoholism. In recent years, various studies have focused on the epigenetic mechanisms that regulate chromatin architecture thereby modifying gene expression. Interestingly, epigenetic modifications in specific brain regions have been shown to be associated with the neurobiology of psychiatric disorders, including alcoholism and stress. In particular, the enzymes responsible for chromatin remodeling (i.e. histone deacetylases and methyltransferases, DNA methyltransferases) have been identified as common molecular mechanisms for the interaction of stress and alcohol and have become promising therapeutic targets to treat or prevent alcoholism and associated emotional disorders. PMID:28477725

Who 'likes' alcohol? Young Australians' engagement with alcohol marketing via social media and related alcohol consumption patterns.

PubMed

Carrotte, Elise R; Dietze, Paul M; Wright, Cassandra J; Lim, Megan S

2016-10-01

To describe patterns of 'liking' alcohol marketing social media pages, and determine related alcohol consumption patterns among young Australians. Participants were 1,001 Australians aged 15-29 years who completed a cross-sectional online survey. Logistic regression and ordinal logistic regression were used. A quarter (249/1001, 24.9%) liked at least one of the alcohol marketing social media pages, most commonly brands of spirits, cider and alcohol retailers. Underage participants were as likely as older participants to report liking these pages. Alcohol marketing social media use was significantly and independently associated with male gender, living outside a major city, ever using illegal drugs and early age of first alcohol consumption (all p<0.05). Alcohol marketing social media use (OR 2.1, 95% CI 1.5-2.8, p=<0.001) was independently associated with higher categories on the AUDIT-C, indicating riskier alcohol consumption. Liking or following alcohol marketing pages is common regardless of age, and associated with riskier alcohol consumption, among young Australians. There is a need to develop strategies to reduce the exposure to, and potential impact of, alcohol marketing social media pages on young Australians, and ensure these pages are neither accessible to nor targeting underage social media users. © 2016 Public Health Association of Australia.

PREVALENCE AND PSYCHOSOCIAL CORRELATES OF ALCOHOL-RELATED SEXUAL ASSAULT AMONG UNIVERSITY STUDENTS

PubMed Central

Howard, Donna E.; Griffin, Melinda A.; Boekeloo, Bradley O.

2009-01-01

This study examined the psychosocial correlates of alcohol-related sexual assault. Undergraduate students (N = 551) were recruited to complete a web-based survey. The outcome was a composite of 2 items: “experienced an unwanted sexual advance” or “was the victim of sexual assault or date rape” as a result of another’s alcohol use. The predictors were substance use, other alcohol-related interpersonal violence victimization, and alcohol-related protective behaviors. Multivariate logistic regression analyses were conducted. Females reported higher prevalence of alcohol-related sexual assault than did males (20.4% vs. 6.6%). Females who reported binge drinking (OR = 7.74) and other alcohol-related interpersonal violence (OR = 5.03) were more likely to report alcohol-related sexual assault whereas only other alcohol-related interpersonal violence was associated with alcohol-related sexual assault (OR = 43.75) among males. The findings suggest that alcohol-related sexual assault is associated with other risk factors that deserve further attention through longitudinal research and intervention efforts. PMID:19149143

Prevalence and psychosocial correlates of alcohol-related sexual assault among university students.

PubMed

Howard, Donna E; Griffin, Melinda A; Boekeloo, Bradley O

2008-01-01

This study examined the psychosocial correlates of alcohol-related sexual assault. Undergraduate students (N = 551) were recruited to complete a web-based survey. The outcome was a composite of 2 items: "experienced an unwanted sexual advance" or "was the victim of sexual assault or date rape" as a result of another's alcohol use. The predictors were substance use, other alcohol-related interpersonal violence victimization, and alcohol-related protective behaviors. Multivariate logistic regression analyses were conducted. Females reported higher prevalence of alcohol-related sexual assault than did males (20.4% vs. 6.6%). Females who reported binge drinking (OR = 7.74) and other alcohol-related interpersonal violence (OR = 5.03) were more likely to report alcohol-related sexual assault whereas only other alcohol-related interpersonal violence was associated with alcohol-related sexual assault (OR = 43.75) among males. The findings suggest that alcohol-related sexual assault is associated with other risk factors that deserve further attention through longitudinal research and intervention efforts.

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.

Teaching Students with Fetal Alcohol Syndrome and Possible Prenatal Alcohol-Related Effects.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Special Education Branch.

This guide provides a review of the characteristics of children with fetal alcohol syndrome (FAS) or possible prenatal alcohol-related effects (PPAE) and describes specific intervention strategies. Section 1 offers a general review of the diagnostic procedures, the prevalence of FAS and the physical, educational, and behavioral characteristics of…

Alcohol-related emergency department visits associated with collegiate football games.

PubMed

Shook, Janice; Hiestand, Brian C

2011-01-01

In 2003, after several post-college football game riots, multiple strategies including strict enforcement of open container laws were instituted by the authors' city and university. The authors compared alcohol-related visits to the on-campus emergency department (ED) associated with home football games in 2002 and 2006, hypothesizing that alcohol-related visits should decline. ED patients during home game weekends. Retrospective cohort study comparing the 2002 and 2006 home games-similar seasons wherein the team went undefeated. Logistic regression assessed the impact of environmental and patient characteristics on the likelihood of an ED visit being alcohol related. In total 2,220 visits in 2002 and 2,146 visits in 2006 were reviewed. Alcohol-related visits increased from 2002 (7.9%) to 2006 (9.5%, p = .06). Despite community interventions, the odds of an ED visit being alcohol related increased (odds ratio [OR] 1.3, 95% confidence interval [CI₉₅] 1.06-1.64). Community measures did not reduce alcohol-related visits to the ED.

MAOA genotype, family relations and sexual abuse in relation to adolescent alcohol consumption.

PubMed

Nilsson, Kent W; Comasco, Erika; Åslund, Cecilia; Nordquist, Niklas; Leppert, Jerzy; Oreland, Lars

2011-04-01

The aim of the present study was to investigate MAOA gene-environment (G*E) interactions in relation to adolescent alcohol consumption. In the county of Västmanland, Sweden, all 17-18-year-old students were asked to complete an anonymous questionnaire and provide a saliva sample during class hours. A total of 2263 students completed the questionnaire (77.4%) and a saliva sample was provided by 2131 participants. Failed MAOA u-variable number of tandem repeats (VNTR) genotype analyses and internal non-responses left 851 boys and 735 girls (total n=1586) to be investigated. Alcohol use disorder identification test was used to measure hazardous alcohol consumption. MAOA u-VNTR was used to measure biological risk in interaction with poor family relations and experience of sexual abuse. The model was also adjusted for non-independent socioeconomic variables, separated parents, type of housing and parental unemployment. Results showed that the MAOA u-VNTR, in interaction with psychosocial risk factors, such as the quality of family relations and sexual abuse, was related to high alcohol consumption among adolescents. Girls, carrying the long MAOA u-VNTR variant showed a higher risk of being high alcohol consumers, whereas among boys, the short allele was related to higher alcohol consumption. The present study supports the hypothesis that there is a relation between MAOA u-VNTR and alcohol consumption and that this relation is modulated by environmental factors. Furthermore, the present study also supports the hypothesis that there is a sex difference in the G*E interaction. © 2010 The Authors, Addiction Biology © 2010 Society for the Study of Addiction.

Effects of AlcoholEdu for College on Alcohol-Related Problems Among Freshmen: A Randomized Multicampus Trial*

PubMed Central

Paschall, Mallie J.; Antin, Tamar; Ringwalt, Christopher L.; Saltz, Robert F.

2011-01-01

Objective: AlcoholEdu for College is a 2- to 3-hour online course for incoming college freshmen. This study was the first multicampus trial to examine effects of AlcoholEdu for College on alcohol-related problems among freshmen. Method: Thirty universi participated in the study. Fifteen were randomly assigned to receive AlcoholEdu, and the other 15 were assigned to the control condition. AlcoholEdu was implemented by intervention schools during the summer and/or fall semester. Cross-sectional surveys of freshmen were conducted at each university beginning before the intervention in spring 2008/2009; post-intervention surveys were administered in fall 2008/2009 and spring 2009/2010. The surveys included questions about the past-30-day frequency of 28 alcohol-related problems, from which we created indices for the total number of problems and problems in seven domains: physiological, academic, social, driving under the influence/riding with drinking drivers, aggression, sexual risk taking, and victimization. Multilevel Poisson regression analyses were conducted to examine intent-to-treat and dosage effects of AlcoholEdu for College on these outcomes. Results: Multilevel intent-to-treat analyses indicated significant reductions in the risk for past-30-day alcohol problems in general and problems in the physiological, social, and victimization domains during the fall semester immediately after completion of the course. However, these effects did not persist in the spring semester. Additional analyses suggested stronger AlcoholEdu effects on these outcomes at colleges with higher rates of student course completion. No AlcoholEdu effects were observed for alcohol-related problems in the other four domains. Conclusions: AlcoholEdu for College appears to have beneficial short-term effects on victimization and the most common types of alcohol-related problems among freshmen. Universities may benefit the most by mandating AlcoholEdu for College for all incoming freshmen and

The relationship between exposure to alcohol-related content on Facebook and predictors of alcohol consumption among female emerging adults.

PubMed

Miller, Joseph; Prichard, Ivanka; Hutchinson, Amanda; Wilson, Carlene

2014-12-01

Consuming an unhealthy level of alcohol is a significant problem for some young women. Potential determinants of excess consumption include perceptions of usual consumption among peers-perceptions of what is "normal." The present study examined whether perceptions of social normative endorsement of drinking, operationalized by measures of perceived alcohol consumption of close friends (proximal norms), the consumption of the "average student" (distal norms), and the extent of alcohol-related content posted by peers on Facebook were related to alcohol-related attitudes and self-reported consumption. Female university students (n=129; Mage=21.48 years, SD=3.00) completed an online questionnaire assessing Facebook use, perceived alcohol-related norms, and self-reported alcohol attitudes and consumption. Perceptions of the consumption of the average female student were a negative predictor of attitudes. Positive alcohol attitudes, extent of own alcohol-related photographic posts on Facebook, average female student alcohol consumption, and report of male close friend consumption predicted self-report of own alcohol consumption. Interestingly, female close friend norms failed to predict consumption, whereas male close friend norms predicted consumption but not attitudes, suggesting the possibility of separate cognitive pathways for alcohol-related attitudes and behavior. This study builds on existing research by casting new light on predictors of alcohol-related attitudes, as well as describing the potential role of social networking sites such as Facebook in the formation of social norms and the modulation of drinking behavior.

Non-Employment Histories of Middle-Aged Men and Women Who Died from Alcohol-Related Causes: A Longitudinal Retrospective Study

PubMed Central

Paljärvi, Tapio; Martikainen, Pekka; Leinonen, Taina; Pensola, Tiina; Mäkelä, Pia

2014-01-01

Background Long-term patterning of non-employment among problem drinkers is poorly understood. We determined the level and timing of non-employment, and the relative contribution of various types of non-employment among middle-aged persons who died of alcohol-related causes. Methods We conducted a longitudinal retrospective register-based study of Finnish men and women aged 45–64 years who died of alcohol-related causes (n = 15 552) or other causes (n = 39 166) in the period 2000–07, or who survived (n = 204 422) until the end of 2007. We traced back the number of days in employment and non-employment for up to 17 years before death or before the end of the study period for the survivors. Results The majority (≥56%) of persons who died of alcohol-related causes were in employment up to ten years before death. Over the 17-year period before death, those who died of alcohol-related causes were in employment on average two years less (mean 6.3 years, 95%CI 6.2–6.4) than those dying of other causes (8.2, 8.1–8.3), and five years less than survivors (11.6, 11.5–11.7), when sex and age were adjusted for. The relative role of various types of non-employment differed markedly across the two mortality groups. Among those who died of alcohol-related causes, unemployment accounted for 54% of the total burden of non-employment, in comparison with 29% among those who died of other causes. In contrast, disability pension accounted for 41% of the total burden of non-employment among those who died of alcohol-related causes, but 65% among those who died of other causes. Conclusions The results indicate the feasibility of preventing movement out of employment among middle-aged men and women with severe alcohol-related harm, provided that they are identified early on during their working careers and offered effective interventions. PMID:24874518

Anesthesia-related mortality in pediatric patients: a systematic review.

PubMed

Gonzalez, Leopoldo Palheta; Pignaton, Wangles; Kusano, Priscila Sayuri; Módolo, Norma Sueli Pinheiro; Braz, José Reinaldo Cerqueira; Braz, Leandro Gobbo

2012-01-01

This systematic review of the Brazilian and worldwide literature aimed to evaluate the incidence and causes of perioperative and anesthesia-related mortality in pediatric patients. Studies were identified by searching EMBASE (1951-2011), PubMed (1966-2011), LILACS (1986-2011), and SciElo (1995-2011). Each paper was revised to identify the author(s), the data source, the time period, the number of patients, the time of death, and the perioperative and anesthesia-related mortality rates. Twenty trials were assessed. Studies from Brazil and developed countries worldwide documented similar total anesthesia-related mortality rates (<1 death per 10,000 anesthetics) and declines in anesthesia-related mortality rates in the past decade. Higher anesthesia-related mortality rates (2.4-3.3 per 10,000 anesthetics) were found in studies from developing countries over the same time period. Interestingly, pediatric perioperative mortality rates have increased over the past decade, and the rates are higher in Brazil (9.8 per 10,000 anesthetics) and other developing countries (10.7-15.9 per 10,000 anesthetics) compared with developed countries (0.41-6.8 per 10,000 anesthetics), with the exception of Australia (13.4 per 10,000 anesthetics). The major risk factors are being newborn or less than 1 year old, ASA III or worse physical status, and undergoing emergency surgery, general anesthesia, or cardiac surgery. The main causes of mortality were problems with airway management and cardiocirculatory events. Our systematic review of the literature shows that the pediatric anesthesia-related mortality rates in Brazil and in developed countries are similar, whereas the pediatric perioperative mortality rates are higher in Brazil compared with developed countries. Most cases of anesthesia-related mortality are associated with airway and cardiocirculatory events. The data regarding anesthesia-related and perioperative mortality rates may be useful in developing prevention strategies.

Developmental Relations between Alcohol Expectancies and Social Norms in Predicting Alcohol Onset

ERIC Educational Resources Information Center

Janssen, Tim; Treloar Padovano, Hayley; Merrill, Jennifer E.; Jackson, Kristina M.

2018-01-01

Expectations about alcohol's effects and perceptions of peers' behaviors and beliefs related to alcohol use are each shown to strongly influence the timing of drinking onset during adolescence. The present study builds on prior work by examining the conjoint effects of within-person changes in these social-cognitive factors on age of adolescent…

Characterization of gastrointestinal hemorrhage and prediction of mortality in Asian patients with alcoholic hepatitis.

PubMed

Kim, Su Hwan; Kim, Byeong Gwan; Kim, Won; Oh, Sohee; Kim, Hwi Young; Jung, Yong Jin; Jeong, Ji Bong; Kim, Ji Won; Lee, Kook Lae

2016-04-01

Gastrointestinal bleeding (GIB) often accompanies alcoholic hepatitis (AH). The study aimed to investigate clinical characteristics of GIB in AH patients and to identify risk factors for mortality in AH patients with GIB. Data from 329 patients hospitalized with AH in a single center during 1999-2014 were retrospectively analyzed. Patients with AH were dichotomized into GIB and non-GIB groups. The GIB group was further divided into portal hypertensive bleeding (PHB) and non-PHB groups. Clinical characteristics and survival outcomes were compared between the groups. Risk factors for mortality were analyzed using Cox regression. Among the 329 AH patients, 132 experienced GIB at admission or during hospitalization. The most common cause of GIB was an esophageal varix. The GIB group had worse survival outcomes than the non-GIB group (log-rank test, P = 0.034). The PHB group had worse survival outcomes than the non-PHB group (log-rank test, P = 0.001). On multivariate analysis, alcohol consumption, ascites, encephalopathy, infection, Maddrey's discriminant function, and the model for end-stage liver disease (MELD) score independently predicted mortality in the entire AH cohort. The MELD score (hazard ratio, 1.085; 95% confidence interval, 1.052-1.120; P < 0.001) and PHB (hazard ratio, 2.162; 95% confidence interval, 1.021-4.577; P = 0.044) were significant prognosticators for patients with AH and GIB. The presence of PHB and a higher MELD score adversely affected survival in AH patients with GIB. Accordingly, prompt endoscopic examination for exploring the etiologies of GIB may alert physicians to predict the risk of death in AH patients with GIB. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Alcohol-Related Blackouts, Negative Alcohol-Related Consequences, and Motivations for Drinking Reported by Newly Matriculating Transgender College Students

PubMed Central

Tupler, Larry A.; Zapp, Daniel; DeJong, William; Ali, Maryam; O’Rourke, Sarah; Looney, John; Swartzwelder, H. Scott

2017-01-01

Background Many transgender college students struggle with identity formation and other emotional, social, and developmental challenges associated with emerging adulthood. A potential maladaptive coping strategy employed by such students is heavy drinking. Prior literature has suggested greater consumption and negative alcohol-related consequences (ARCs) in transgender students compared with their cisgender peers, but little is known about their differing experiences with alcohol-related blackouts (ARBs). We examined the level of alcohol consumption, the frequency of ARBs and other ARCs, and motivations for drinking reported by the largest sample of transgender college students to date. Methods A Web survey from an alcohol-prevention program, AlcoholEdu for College™, assessed student demographics and drinking-related behaviors, experiences, and motivations of newly matriculating first-year college students. A self-reported drinking calendar was used to examine each of the following measures over the previous 14 days: number of drinking days, total number of drinks, and maximum number of drinks on any single day. A 7-point Likert scale was used to measure ARCs, ARBs, and drinking motivations. Transgender students of both sexes were compared with their cisgender peers. Results 989 of 422,906 students (0.2%) identified as transgender. Over a 14-day period, transgender compared with cisgender students were more likely to consume alcohol over more days, more total drinks, and a greater number of maximum drinks on a single day. Transgender students (36%) were more likely to report an ARB than cisgender students (25%) as well as more negative academic, confrontation-related, social, and sexual ARCs. Transgender respondents more often cited stress reduction, social anxiety, self-esteem issues, and the inherent properties of alcohol as motivations for drinking. For nearly all measures, higher values were yielded by male-to-female than female-to-male transgender students

Event-Related Oscillations in Alcoholism Research: A Review

PubMed Central

Pandey, Ashwini K; Kamarajan, Chella; Rangaswamy, Madhavi; Porjesz, Bernice

2013-01-01

Alcohol dependence is characterized as a multi-factorial disorder caused by a complex interaction between genetic and environmental liabilities across development. A variety of neurocognitive deficits/dysfunctions involving impairments in different brain regions and/or neural circuitries have been associated with chronic alcoholism, as well as with a predisposition to develop alcoholism. Several neurobiological and neurobehavioral approaches and methods of analyses have been used to understand the nature of these neurocognitive impairments/deficits in alcoholism. In the present review, we have examined relatively novel methods of analyses of the brain signals that are collectively referred to as event-related oscillations (EROs) and show promise to further our understanding of human brain dynamics while performing various tasks. These new measures of dynamic brain processes have exquisite temporal resolution and allow the study of neural networks underlying responses to sensory and cognitive events, thus providing a closer link to the physiology underlying them. Here, we have reviewed EROs in the study of alcoholism, their usefulness in understanding dynamical brain functions/dysfunctions associated with alcoholism as well as their utility as effective endophenotypes to identify and understand genes associated with both brain oscillations and alcoholism. PMID:24273686

Lightning-related mortality and morbidity in Florida.

PubMed Central

Duclos, P J; Sanderson, L M; Klontz, K C

1990-01-01

Cases of lightning-related deaths and injuries that occurred in Florida in 1978-87 were reviewed to determine the factors involved, to quantify the morbidity and mortality related to lightning strikes, and to describe epidemiologically the injuries and circumstances involved. Statewide information on deaths was obtained from death certificates, autopsy reports, and investigative reports. Information about morbidity was obtained from the Florida Hospital Cost Containment Board data base and the National Climatic Data Center data base for all Florida counties, as well as from hospitals in selected counties. Lightning-related deaths totaled 101 in Florida during the period 1978-87, an annual average of 10.1. Eight percent of the victims were from other States. The overall yearly death rate for State residents was 0.09 per 100,000 population, with the highest rate being that for men aged 15-19 years, 0.38 per 100,000. Thirteen percent of victims were females. The ratio of lightning-related injuries to deaths in Florida was estimated at about four to one. Thirty percent of all deaths were occupationally related. The first strikes of lightning from a thunderstorm may be the most dangerous, not in terms of impact, but because of the element of surprise. During thunderstorms, people may seek shelter under isolated trees because they believe erroneously that a tree offers protection from lightning, or perhaps because their top priority is to escape from rain rather than lightning. People may not seek adequate shelter during thunderstorms because they do not know the dangers of remaining outdoors or their judgment is impaired by drugs or alcohol. PMID:2113687

Lightning-related mortality and morbidity in Florida.

PubMed

Duclos, P J; Sanderson, L M; Klontz, K C

1990-01-01

Cases of lightning-related deaths and injuries that occurred in Florida in 1978-87 were reviewed to determine the factors involved, to quantify the morbidity and mortality related to lightning strikes, and to describe epidemiologically the injuries and circumstances involved. Statewide information on deaths was obtained from death certificates, autopsy reports, and investigative reports. Information about morbidity was obtained from the Florida Hospital Cost Containment Board data base and the National Climatic Data Center data base for all Florida counties, as well as from hospitals in selected counties. Lightning-related deaths totaled 101 in Florida during the period 1978-87, an annual average of 10.1. Eight percent of the victims were from other States. The overall yearly death rate for State residents was 0.09 per 100,000 population, with the highest rate being that for men aged 15-19 years, 0.38 per 100,000. Thirteen percent of victims were females. The ratio of lightning-related injuries to deaths in Florida was estimated at about four to one. Thirty percent of all deaths were occupationally related. The first strikes of lightning from a thunderstorm may be the most dangerous, not in terms of impact, but because of the element of surprise. During thunderstorms, people may seek shelter under isolated trees because they believe erroneously that a tree offers protection from lightning, or perhaps because their top priority is to escape from rain rather than lightning. People may not seek adequate shelter during thunderstorms because they do not know the dangers of remaining outdoors or their judgment is impaired by drugs or alcohol.

Relation of attachment style to family history of alcoholism and alcohol use disorders in early adulthood.

PubMed

Vungkhanching, Martha; Sher, Kenneth J; Jackson, Kristina M; Parra, Gilbert R

2004-07-15

The present study examined the association between paternal alcoholism and attachment style in early adulthood and sought to determine whether attachment style might, at least partially, mediate intergenerational risk for alcoholism. The current report focuses on the cross-sectional relation between family history (FH) of alcoholism, attachment styles, and alcohol use disorders (AUD) when cohort members were, on average, 29 years old (N = 369; 46% male; 51% FH+). Results indicated that FH+ participants were more likely to have insecure attachment, characterized by fearful-avoidant and dismissed-avoidant styles. Additionally, fearful-avoidant and dismissed-avoidant attachment styles were related to the presence of an AUD even after controlling for sex and FH (P < 0.05). There was little evidence, however, that attachment style mediated the relation between paternal alcoholism and AUD in offspring; the FH-AUD association was only negligibly reduced when the effect of attachment style was controlled. Our findings suggest that insecure attachment style is a risk factor for AUD, independent of familial risk for alcoholism.

Wernicke-Korsakoff syndrome not related to alcohol use: a systematic review.

PubMed

Scalzo, Simon J; Bowden, Stephen C; Ambrose, Margaret L; Whelan, Greg; Cook, Mark J

2015-12-01

Although Wernicke-Korsakoff syndrome (WKS) is a common condition, diagnosis remains difficult. WKS not associated with alcohol is rare and thought to present differently to alcohol-related WKS. We conducted a systematic review of WKS not related to alcohol to enhance understanding of WKS not related to alcohol and WKS in general. A systematic review was conducted of case reports, published in English, of Wernicke's encephalopathy and WKS in patients without a history of alcohol-use disorder. Main data sources: MEDLINE, Index Medicus. Eligible cases totaled 623. Publication dates ranged from 1867 to 2014. Comparisons of clinical presentation were made with published data on samples comprising, almost exclusively, alcohol-related WKS. A wide array of illnesses precipitated WKS. When diagnosis of WKS was performed postmortem, non-alcohol-related cases presented a similar number of signs of the classic triad as alcohol-related cases (p=0.662, Cohen's w=0.12) but more signs when diagnosed antemortem (p<0.001, Cohen's w=0.46). The most common sign was altered mental state. Korsakoff syndrome or ongoing memory impairment was reported in 25% of non-alcohol-related WKS, although cognitive status was not explicitly reported in many cases. When duration of memory impairment was reported, 56% had clinically obvious memory impairment lasting beyond the period of acute presentation. Non-alcohol-related WKS was more often associated with female gender, younger age, shorter duration of precipitating illness and better survival rate compared to alcohol-related WKS. Thiamine deficiency in the absence of an alcohol-use disorder can cause the full clinical spectrum of WKS, including chronic cognitive impairment and Korsakoff syndrome. 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/

Response inhibition toward alcohol-related cues using an alcohol go/no-go task in problem and non-problem drinkers.

PubMed

Kreusch, Fanny; Vilenne, Aurélie; Quertemont, Etienne

2013-10-01

Previous results suggested that alcohol abusers and alcohol dependent patients show cognitive biases in the treatment of alcohol-related cues, especially approach and inhibition deficit biases. Response inhibition was often tested using the go/no-go task in which the participants had to respond as quickly as possible to a class of stimuli (go stimuli) while refraining from responding to another class of stimuli (no-go stimuli). Previous studies assessing specific response inhibition deficits in the process of alcohol-related cues obtained conflicting results. The aims of the present study were to clarify response inhibition for alcohol cues in problem and non-problem drinkers, male and female and to test the effect of alcohol brand logos. Thirty-six non-problem drinker and thirty-five problem drinker undergraduate students completed a modified alcohol go/no-go task using alcohol and neutral object pictures, with or without brand logos, as stimuli. An additional control experiment was carried out to check whether participants' awareness that the study tested their response to alcohol might have biased the results. All participants, whether problem or non-problem drinkers, showed significantly shorter mean reaction times when alcohol pictures are used as go stimuli and significantly higher percentages of commission errors (false alarms) when alcohol pictures are used as no-go stimuli. Identical effects were obtained in the control experiment when participants were unaware that the study focused on alcohol. Shorter reaction times to alcohol-related cues were observed in problem drinkers relative to non-problem drinkers but only in the experimental condition with no brand logos on alcohol pictures. The addition of alcohol brand logos further reduced reaction times in light drinkers, thereby masking group differences. There was a tendency for female problem drinkers to show higher rates of false alarms for alcohol no-go stimuli, although this effect was only very close

Alcohol consumption and risk of recurrent cardiovascular events and mortality in patients with clinically manifest vascular disease and diabetes mellitus: the Second Manifestations of ARTerial (SMART) disease study.

PubMed

Beulens, J W J; Algra, A; Soedamah-Muthu, S S; Visseren, F L J; Grobbee, D E; van der Graaf, Y

2010-09-01

This study investigated the relation between alcohol consumption and specific vascular events and mortality in a high risk population of patients with clinical manifestations of vascular disease and diabetes. Patients with clinically manifest vascular disease or diabetes (n=5447) from the SMART study were followed for cardiovascular events and mortality. Alcohol consumption was assessed with a baseline questionnaire and analysed in relation with coronary heart disease (CHD), amputations, stroke, and all-cause and vascular death. After a follow up of 4.7 years, we documented 363 cases of CHD, 187 cases of stroke, 79 amputations and 641 cases of all-cause death, of which 382 were vascular. In multivariate-adjusted models, alcohol consumption was inversely associated with CHD (p(linear trend)=0.007) and stroke (p(linear trend)=0.051) with respective hazard ratios of 0.39 (95%CI: 0.20-0.76) and 0.67 (0.31-1.46) for consuming 10-20 drinks/week compared with abstainers. We observed significant U-shaped associations between alcohol consumption and amputations (p(quadratic trend)=0.001), all-cause death (p(quadratic trend)=0.001) and vascular death (p(quadratic trend)=0.013). Hazard ratios for consuming 10-20 drinks/week were 0.29 (0.07-1.30) for amputations, 0.40 (0.24-0.69) for all-cause death and 0.34 (0.16-0.71) for vascular death compared with abstainers. Similar associations were observed for red wine consumption only. Moderate alcohol consumption (1-2 drinks/day) is not only associated with a reduced risk of vascular and all-cause death in a high risk patients with clinical manifestations of vascular disease, but also with reduced risks of non-fatal events like CHD, stroke and possibly amputations. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Economic costs of alcohol use in Sri Lanka.

PubMed

Ranaweera, Sajeeva; Amarasinghe, Hemantha; Chandraratne, Nadeeka; Thavorncharoensap, Montarat; Ranasinghe, Thushara; Karunaratna, Sumudu; Kumara, Dinesh; Santatiwongchai, Benjarin; Chaikledkaew, Usa; Abeykoon, Palitha; De Silva, Amala

2018-01-01

Alcohol related disease conditions are responsible for a significant proportion of morbidity and mortality in Sri Lanka. This study quantified the economic cost of selected alcohol related disease conditions in Sri Lanka in 2015. This study uses the prevalence-based cost of illness methodology specified by the World Health Organization, and uses the gross costing approach. The direct costs includes the costs of curative care (inpatient and outpatient care borne by the state and out of pocket expenditure borne by patients) for alcohol related diseases, weighted by the respective population attributable fractions. Indirect costs consist of lost earnings due to absenteeism of the patient and carers due to seeking care and recuperation, and the loss of income due to mortality. Data form the Ministry of Health, Registrar General's Department, Department of Census and Statistics and the National Cancer Registry was used. Systemic and house costs and population attributable fractions were obtained from research studies. Economists, Public Health Experts, Medical Administrators and Clinical Specialists were iteratively consulted during the estimation and validation of the costs and the results. The estimated present value of current and future economic cost of the alcohol-related conditions for Sri Lanka in 2015 was USD 885.86 million, 1.07% of the GDP of that year. The direct cost of alcohol related disease conditions was USD 388.35 million, which was 44% of the total cost, while the indirect cost was USD 497.50 million, which was 66% of the total cost. Road Injury cost was the highest cost category among the conditions studied. Addressing alcohol use and its harms through effective implementation of evidence-based polices and interventions is urgently required to address the economic costs of alcohol use in Sri Lanka as it imposes a significant burden to the country.

Economic costs of alcohol use in Sri Lanka

PubMed Central

Ranaweera, Sajeeva; Amarasinghe, Hemantha; Thavorncharoensap, Montarat; Ranasinghe, Thushara; Karunaratna, Sumudu; Santatiwongchai, Benjarin; Chaikledkaew, Usa; Abeykoon, Palitha; De Silva, Amala

2018-01-01

Aim Alcohol related disease conditions are responsible for a significant proportion of morbidity and mortality in Sri Lanka. This study quantified the economic cost of selected alcohol related disease conditions in Sri Lanka in 2015. Methods This study uses the prevalence-based cost of illness methodology specified by the World Health Organization, and uses the gross costing approach. The direct costs includes the costs of curative care (inpatient and outpatient care borne by the state and out of pocket expenditure borne by patients) for alcohol related diseases, weighted by the respective population attributable fractions. Indirect costs consist of lost earnings due to absenteeism of the patient and carers due to seeking care and recuperation, and the loss of income due to mortality. Data form the Ministry of Health, Registrar General’s Department, Department of Census and Statistics and the National Cancer Registry was used. Systemic and house costs and population attributable fractions were obtained from research studies. Economists, Public Health Experts, Medical Administrators and Clinical Specialists were iteratively consulted during the estimation and validation of the costs and the results. Results The estimated present value of current and future economic cost of the alcohol-related conditions for Sri Lanka in 2015 was USD 885.86 million, 1.07% of the GDP of that year. The direct cost of alcohol related disease conditions was USD 388.35 million, which was 44% of the total cost, while the indirect cost was USD 497.50 million, which was 66% of the total cost. Road Injury cost was the highest cost category among the conditions studied. Conclusion Addressing alcohol use and its harms through effective implementation of evidence-based polices and interventions is urgently required to address the economic costs of alcohol use in Sri Lanka as it imposes a significant burden to the country. PMID:29879178

Alcohol-Attributable Fraction in Liver Disease: Does GDP Per Capita Matter?

PubMed

Kröner, Paul T; Mankal, Pavan Kumar; Dalapathi, Vijay; Shroff, Kavin; Abed, Jean; Kotler, Donald P

2015-01-01

The alcohol-attributable fraction (AAF) quantifies alcohol's disease burden. Alcoholic liver disease (ALD) is influenced by alcohol consumption per capita, duration, gender, ethnicity, and other comorbidities. In this study, we investigated the association between AAF/alcohol-related liver mortality and alcohol consumption per capita, while stratifying to per-capita gross domestic product (GDP). Data obtained from the World Health Organization and World Bank for both genders on AAF on liver disease, per-capita alcohol consumption (L/y), and per-capita GDP (USD/y) were used to conduct a cross-sectional study. Countries were classified as "high-income" and "very low income" if their respective per-capita GDP was greater than $30,000 or less than $1,000. Differences in total alcohol consumption per capita and AAF were calculated using a 2-sample t test. Scatterplots were generated to supplement the Pearson correlation coefficients, and F test was conducted to assess for differences in variance of ALD between high-income and very low income countries. Twenty-six and 27 countries met the criteria for high-income and very low income countries, respectively. Alcohol consumption per capita was higher in high-income countries. AAF and alcohol consumption per capita for both genders in high-income and very low income countries had a positive correlation. The F test yielded an F value of 1.44 with P = .357. No statistically significant correlation was found among alcohol types and AAF. Significantly higher mortality from ALD was found in very low income countries relative to high-income countries. Previous studies had noted a decreased AAF in low-income countries as compared to higher-income countries. However, the non-statistically significant difference between AAF variances of low-income and high-income countries was found by this study. A possible explanation is that both high-income and low-income populations will consume sufficient amount of alcohol, irrespective of its

Duration of residence was not consistently related to immigrant mortality.

PubMed

Bos, Vivian; Kunst, Anton E; Garssen, Joop; Mackenbach, Johan P

2007-06-01

This paper aimed to examine immigrant mortality according to duration of residence in the Netherlands and to compare duration-specific mortality levels to levels of mortality in the native Dutch population. For the years 1995-2000, we linked the national cause of death register, that contains information on deaths of legal residents, to the municipal population register, that contains information on all legal residents. We studied mortality in relation to period of immigration by means of directly standardized mortality rates and Poisson regression. All cause mortality was not related to year of immigration among Turkish and Moroccan men and women, and among Surinamese women. Among Surinamese men and among Antilleans/Aruban men and women, mortality was higher in more recent immigrants. Part of their excess mortality was due to their relatively low socioeconomic status. For most specific causes of death, no consistent relation with duration of residence was observed. A consistent relation between duration of residence and immigrant mortality was only observed in some immigrant groups. The results suggest that the healthy migrant effect or adaptation of health-related behaviors were no predominant determinants of immigrant mortality in the Netherlands.

Do well-connected landscapes promote road-related mortality?

USGS Publications Warehouse

Grilo, C.; Ascensao, F.; Santos-Reis, M.; Bissonette, J.A.

2011-01-01

Cost surface (CS) models have emerged as a useful tool to examine the interactions between landscapes patterns and wildlife at large-scale extents. This approach is particularly relevant to guide conservation planning for species that show vulnerability to road networks in human-dominated landscapes. In this study, we measured the functional connectivity of the landscape in southern Portugal and examined how it may be related to stone marten road mortality risk. We addressed three questions: (1) How different levels of landscape connectivity influence stone marten occurrence in montado patches? (2) Is there any relation between montado patches connectivity and stone marten road mortality risk? (3) If so, which road-related features might be responsible for the species' high road mortality? We developed a series of connectivity models using CS scenarios with different resistance values given to each vegetation cover type to reflect different resistance to species movement. Our models showed that the likelihood of occurrence of stone marten decreased with distance to source areas, meaning continuous montado. Open areas and riparian areas within open area matrices entailed increased costs. We found higher stone marten mortality on roads in well-connected areas. Road sinuosity was an important factor influencing the mortality in those areas. This result challenges the way that connectivity and its relation to mortality has been generally regarded. Clearly, landscape connectivity and road-related mortality are not independent. ?? 2010 Springer-Verlag.

Attitudes and beliefs of emergency department staff regarding alcohol-related presentations.

PubMed

Indig, Devon; Copeland, Jan; Conigrave, Katherine M; Rotenko, Irene

2009-01-01

This study examined emergency department (ED) staff attitudes and beliefs about alcohol-related ED presentations in order to recommend improved detection and brief intervention strategies. The survey was conducted at two inner-Sydney hospital EDs in 2006 to explore ED clinical staff's attitudes, current practice and barriers for managing alcohol-related ED presentations. The sample included N=78 ED staff (54% nurses, 46% doctors), representing a 30% response rate. Management of alcohol-related problems was not routine among ED staff, with only 5% usually formally screening for alcohol problems, only 16% usually conducting brief interventions, and only 27% usually providing a referral to specialist treatment services. Over 85% of ED staff indicated that lack of patient motivation made providing alcohol interventions very difficult. Significant predictors of good self-reported practice among ED staff for patients with alcohol problems included: being a doctor, being confident and having a sense of responsibility towards managing patients with alcohol-related problems. This study reported that many staff lack the confidence or sense of clinical responsibility to fully and appropriately manage ED patients with alcohol-related problems. ED staff appear to require additional training, resources and support to enhance their management of patients with alcohol-related problems.

The Relation between Stress and Alcohol Use among Hispanic Adolescents

PubMed Central

Goldbach, Jeremy T.; Cardoso, Jodi Berger; Cervantes, Richard C.; Duan, Lei

2015-01-01

We explored the relation between eight domains of Hispanic stress and alcohol use and frequency of use in a sample of Hispanic adolescents between 11 and 19 years old (N = 901). Independent t-tests were used to compare means of domains of Hispanic stress between adolescents who reported alcohol use and those who reported no use. In addition, multinomial logistic regression was used to examine whether domains of Hispanic stress were related to alcohol use and whether the relation differed by gender and age. Multiple imputation was used to address missing data. In the analytic sample, 75.8% (n = 683) reported no use and 24.2% (n = 218) reported alcohol use during the previous 30 days. Higher mean Hispanic stress scores were observed among youths who reported alcohol use during the previous 30 days in five domains: acculturation gap, community and gang violence, family economic, discrimination, and family and drug-related stress. Increased community and gang violence, family and drug, and acculturative gap stress were found to be associated with some alcohol use categories beyond the effect of other domains. Few differences in the association between Hispanic stress and alcohol use by gender and age were observed. Study findings indicate that family and drug-related, community and gang violence, and acculturative gap stress domains are salient factors related to alcohol use among Hispanic adolescents, and their implications for prevention science are discussed. PMID:26551265

Consideration of driver home county prohibition and alcohol-related vehicle crashes.

PubMed

Schulte Gary, Sarah Lynn; Aultman-Hall, Lisa; McCourt, Matt; Stamatiadis, Nick

2003-09-01

This study examines the characteristics of alcohol-related crashes in wet versus dry counties in the state of Kentucky, USA and incorporates the location of driver residences through use of geographic information system (GIS) analysis. Between 1991 and 1997, 39344 alcohol-related crashes by Kentucky residents on Kentucky State roads were reported. The location of the crash and the home ZIP code from the driver's address were used to consider distance from home in the GIS. Analysis of the crash data revealed that a similar proportion of crashes in wet and dry counties are alcohol-related but that a higher proportion of dry counties residents are involved in an alcohol-related crash. However, when the distance from home variable is considered, several results suggest that dry county residents may be driving further when consuming alcohol. In part due to the rural nature of dry counties, drivers from dry counties have both alcohol-related and non-alcohol related crashes farther from their homes than residents from wet counties. Alcohol-related crashes by dry county residents in wet counties are the greatest average distance from home while crashes by wet county residents in wet counties are the smallest average distance. Drivers from dry counties over 21 years of age have alcohol-related crashes significantly farther from home than those under 21 who would not legally be admitted to drinking establishments in the wet counties. Furthermore, residents from dry counties that do not border wet counties have alcohol-related crashes on average farther from home than the border county residents. These last three results provide circumstantial evidence that some dry county drivers may be driving to wet counties to consume alcohol thus increasing impaired driving exposure. In conclusion, by considering crash location and driver residence, these findings indicate that county-level prohibition is not necessarily effective in improving highway safety.

Managing alcohol related aggression in the emergency department (Part I).

PubMed

Ferns, Terry; Cork, Alison

2008-01-01

Internationally, violence in the emergency department (ED) is of a constant concern to emergency practitioners. Frequently, both original research papers and anecdotal reports emphasise the phenomenon of alcohol related aggression in the ED. In this first paper, we highlight the literatures discussion of alcohol related violence in the emergency department and the potential psychological effects of alcohol intoxication. In the second we offer personal and organisational strategies clinical nursing staff may consider appropriate to minimise the risk of assault when caring for service users projecting alcohol related aggression.

Alcohol Activates the Hedgehog Pathway and Induces Related Pro-carcinogenic Processes in the Alcohol-Preferring Rat Model of Hepatocarcinogenesis

PubMed Central

Chan, Isaac S.; Guy, Cynthia D.; Machado, Mariana V.; Wank, Abigail; Kadiyala, Vishnu; Michelotti, Gregory; Choi, Steve; Swiderska-Syn, Marzena; Karaca, Gamze; Pereira, Thiago A.; Yip-Schneider, Michele T.; Schmidt, C. Max; Diehl, Anna Mae

2014-01-01

Background Alcohol consumption promotes hepatocellular carcinoma (HCC). The responsible mechanisms are not well understood. Hepatocarcinogenesis increases with age and is enhanced by factors that impose a demand for liver regeneration. Because alcohol is hepatotoxic, habitual alcohol ingestion evokes a recurrent demand for hepatic regeneration. The alcohol-preferring (P) rat model mimics the level of alcohol consumption by humans who habitually abuse alcohol. Previously, we showed that habitual heavy alcohol ingestion amplified age-related hepatocarcinogenesis in P-rats, with over 80% of alcohol-consuming P rats developing HCCs after 18 months of alcohol exposure, compared to only 5% of water-drinking controls. Methods Herein, we used quantitative real time PCR and quantitative immunocytochemistry to compare liver tissues from alcohol-consuming P rats and water-fed P rat controls after 6, 12, or 18 months of drinking. We aimed to identify potential mechanisms that might underlie the differences in liver cancer formation, and hypothesized that chronic alcohol ingestion would activate Hedgehog (HH), a regenerative signaling pathway that is over-activated in HCC. Results Chronic alcohol ingestion amplified age-related degenerative changes in hepatocytes, but did not cause appreciable liver inflammation or fibrosis even after 18 months of heavy drinking. HH signaling was also enhanced by alcohol exposure, as evidenced by increased levels of mRNAs encoding HH ligands, HH-regulated transcription factors, and HH-target genes. Immunocytochemistry confirmed increased alcohol-related accumulation of HH ligand-producing cells and HH-responsive target cells. HH-related regenerative responses were also induced in alcohol-exposed rats. Three of these processes (i.e., deregulated progenitor expansion, the reverse-Warburg effect, and epithelial-to-mesenchymal transitions) are known to promote cancer growth in other tissues. Conclusions Alcohol-related changes in Hedgehog signaling

Sharing of Alcohol-Related Content on Social Networking Sites: Frequency, Content, and Correlates.

PubMed

Erevik, Eilin K; Torsheim, Torbjørn; Vedaa, Øystein; Andreassen, Cecilie S; Pallesen, Ståle

2017-05-01

The present study aimed to explore students' reports of their sharing of alcohol-related content on different social networking sites (i.e., frequency of sharing and connotations of alcohol-related posts), and to identify indicators of such posting. Students at the four largest institutions for higher education in Bergen, Norway, were invited to participate in an Internet-based survey. The sample size was 11,236 (a 39.4% response rate). The survey included questions about disclosure of alcohol-related content on social networking sites, alcohol use (using the Alcohol Use Disorders Identification Test), personality factors (using the Mini-IPIP), and demographic characteristics. Binary logistic regressions were used to analyze indicators of frequent sharing of alcohol-related content depicting positive and negative aspects of alcohol use. A majority of the students had posted alcohol-related content (71.0%), although few reported having done so frequently. Positive aspects of alcohol use (e.g., enjoyment or social community) were most frequently shared. Young, single, and extroverted students with high alcohol consumption were more likely to report frequent sharing of alcohol-related content. Positive attitudes toward posting alcohol-related content and reports of exposure to such content particularly increased the likelihood of one's own posting of alcohol-related content. Positive aspects of alcohol use seem to be emphasized on social networking sites. Sharing of alcohol-related content is associated with heightened alcohol use, which implies that such sites can be relevant for prevention agents. Social influence from social networking sites, such as exposure to others' alcohol-related content, is associated with one's own sharing of similar content.

Non-alcoholic beverage and caffeine consumption and mortality: the Leisure World Cohort Study

PubMed Central

Paganini-Hill, Annlia; Kawas, Claudia H; Corrada, María M

2007-01-01

Objective To examine the effects of non-alcoholic beverage and caffeine consumption on all-cause mortality in older adults. Methods The Leisure World Cohort Study is a prospective study of residents of a California retirement community. A baseline postal health survey included details on coffee, tea, milk, soft drink, and chocolate consumption. Participants were followed for 23 years (1981–2004). Risk ratios (RRs) of death were calculated using Cox regression for 8644 women and 4980 men (median age at entry, 74 years) and adjusted for age, gender and multiple potential confounders. Results Caffeine consumption exhibited a U-shaped mortality curve. Moderate caffeine consumers had a significantly reduced risk of death (multivariable-adjusted RR=0.94, 95% CI: 0.90, 0.99 for 100–199 mg/day and RR=0.90, 95% CI: 0.85, 0.94 for 200–399 mg/day compared with those consuming <50 mg/day). Individuals who drank more than 1 can/week of artificially sweetened (but not sugar-sweetened) soft drink (cola and other) had a 8% increased risk (95% CI: 1.01–1.16). Neither milk nor tea had a significant effect on mortality after multivariable adjustment. Conclusions Moderate caffeine consumption appeared beneficial in risking risk of death. Attenuation in the observed associations between mortality and intake of tea and milk with adjustment for potential confounders suggests that such consumption identifies those with other mortality-associated lifestyle and health risks. The increased death risk with consumption of artificially sweetened, but not sugar-sweetened, soft drinks suggests an effect of the sweetener rather than other components of the soft drinks, although residual confounding remains a possibility. PMID:17275898

Non-alcoholic beverage and caffeine consumption and mortality: the Leisure World Cohort Study.

PubMed

Paganini-Hill, Annlia; Kawas, Claudia H; Corrada, María M

2007-04-01

To examine the effects of non-alcoholic beverage and caffeine consumption on all-cause mortality in older adults. The Leisure World Cohort Study is a prospective study of residents of a California retirement community. A baseline postal health survey included details on coffee, tea, milk, soft drink, and chocolate consumption. Participants were followed for 23 years (1981-2004). Risk ratios (RRs) of death were calculated using Cox regression for 8644 women and 4980 men (median age at entry, 74 years) and adjusted for age, gender, and multiple potential confounders. Caffeine consumption exhibited a U-shaped mortality curve. Moderate caffeine consumers had a significantly reduced risk of death (multivariable-adjusted RR=0.94, 95% CI: 0.89, 0.99 for 100-199 mg/day and RR=0.90, 95% CI: 0.85, 0.94 for 200-399 mg/day compared with those consuming <50 mg/day). Individuals who drank more than 1 can/week of artificially sweetened (but not sugar-sweetened) soft drink (cola and other) had an 8% increased risk (95% CI: 1.01-1.16). Neither milk nor tea had a significant effect on mortality after multivariable adjustment. Moderate caffeine consumption appeared beneficial in reducing risk of death. Attenuation in the observed associations between mortality and intake of tea and milk with adjustment for potential confounders suggests that such consumption identifies those with other mortality-associated lifestyle and health risks. The increased death risk with consumption of artificially sweetened, but not sugar-sweetened, soft drinks suggests an effect of the sweetener rather than other components of the soft drinks, although residual confounding remains a possibility.

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.

Protective behavioral strategies and negative alcohol-related consequences in college students.

PubMed

Araas, Teresa E; Adams, Troy B

2008-01-01

Alcohol abuse among college students is associated with a quality of life burden. The current study replicated and extended previous research on protective behavioral strategies (PBS) by examining relationships between PBS use and negative alcohol-related consequences. A national sample of 29,792 U.S. college students who completed the National College Health Assessment during spring 2004 was included. Using a retrospective analysis of cross-sectional data, relationships between PBS use and negative alcohol-related consequences were examined. Greater PBS use was associated with fewer negative alcohol-related consequences, while less frequent use of PBS was correlated with increased negative alcohol-related consequences. The current study findings strongly support expanded educational alcohol-intervention programs promoting greater PBS use aimed at reducing or completely alleviating negative alcohol-related consequences (e.g., BASICS, ASTP). Future research should further investigate such PBS-based intervention programs, examine the existence of latent PBS, and study use of combined PBS.

Differences in Alcohol Use and Alcohol-Related Problems between Transgender- and Nontransgender-identified Young Adults

PubMed Central

Coulter, Robert W.S.; Blosnich, John R.; Bukowski, Leigh A.; Herrick, A. L.; Siconolfi, Daniel E.; Stall, Ron D.

2015-01-01

Background Little is known about differences in alcohol use and alcohol-related problems between transgender- and nontransgender-identified populations. Using data from a large-scale health survey, we compare the drinking patterns and prevalence of alcohol-related problems of transgender-identified individuals to nontransgender-identified males and females. For transgender-identified people, we examine how various forms of victimization relate to heavy episodic drinking (HED). Methods Cross-sectional surveys were completed by 75,192 students aged 18–29 years attending 120 post-secondary educational institutions in the United States from 2011–2013. Self-reported measures included alcohol use, alcohol-related problems, victimization, and sociodemographics, including 3 gender-identity groups: transgender-identified individuals; nontransgender-identified males; and nontransgender-identified females. Results Compared to transgender-identified individuals, nontransgender-identified males were more likely to report HED in the past 2 weeks (relative risk=1.42; p=0.006); however, nontransgender-identified males and females reported HED on fewer days than transgender-identified people (incidence-rate ratios [IRRs] ranged from 0.28–0.43; p-values<0.001). Compared to transgender-identified people, nontransgender-identified males and females had lower odds of past-year alcohol-related sexual assault and suicidal ideation (odds ratios ranged from 0.24–0.45; p-values<0.05). Among transgender-identified people, individuals who were sexually assaulted (IRR=3.21, p=0.011) or verbally threatened (IRR=2.42, p=0.021) in the past year had greater HED days than those who did not experience those forms of victimization. Conclusions Compared to transgender-identified people, nontransgender-identified males and females: have fewer HED occasions (despite nontransgender-identified males having greater prevalence of HED); and are at lower risk for alcohol-related sexual assaults and

The relationship of sex-related alcohol expectancies to alcohol consumption and sexual behavior.

PubMed

Leigh, B C

1990-07-01

Recent psychosocial research on alcohol expectancies--beliefs about the effects of alcohol on behavior, moods and emotions--has suggested that these expectancies mediate not only decisions about drinking but the alcohol effects displayed by those who have been drinking. Results of a study of drinking and sexual behavior showed that individuals of different gender and sexual orientation differed in their beliefs about the effects of alcohol on sexual responding. In addition, expectations of sexual enhancement and disinhibition were related to the initiation of sexual activity and to the proportion of sexual encounters that took place while drinking, and interacted with sex guilt to predict the amount drunk in the most recent sexual encounter. These results suggest that beliefs about the effects of alcohol on sex may affect the characteristics of sexual encounters that involve drinking.

Insight into alcohol-related problems and its associations with severity of alcohol consumption, mental health status, race, and level of acculturation in southern Taiwanese indigenous people with alcoholism.

PubMed

Yen, Cheng-Fang; Hsiao, Ray C; Ries, Richard; Liu, Shu-Chun; Huang, Chi-Fen; Chang, Yu-Ping; Yu, Ming-Lung

2008-01-01

While not well known in the West, Taiwan has a substantial indigenous population, and this population has rapidly developed alcohol problems. This study examined the level of insight into alcohol-related problems and its associations with the severity of alcohol consumption, mental health status, race, and the level of acculturation among indigenous populations with alcohol problems in southern Taiwan. A total of 332 indigenes, whose total Alcohol Use Disorders Identification Test (AUDIT) score was equal to 8 or higher, were interviewed. The associations between the level of insight into alcohol-related problems and the severity of alcohol drinking on the AUDIT, mental health status on the Chinese Health Questionnaire-12 (>or= 4 vs. < 4), race (Bunun vs. non-Bunun), and the level of acculturation on the Taiwan Aboriginal Acculturation Scale were examined using logistic regression models. The results of this study found that 72.6% of the participants had poor insight into alcohol-related problems and no participant had good insight. Participants who had more severe alcohol drinking or poor mental health were more likely to have a higher level of insight into alcohol-related problems. Participants who were non-Bunun were also more likely to have a higher level of insight into alcohol-related problems, but the level of acculturation was not associated with the level of insight into alcohol-related problems. These findings suggest that most alcoholic indigenes in southern Taiwan have poor insight into their own alcohol-related problems. Cultural specific interventions targeting and improving the indigenes' insight into alcohol-related problems are needed.

Does drinking refusal self-efficacy mediate the impulsivity-problematic alcohol use relation?

PubMed

Stevens, Angela K; Littlefield, Andrew K; Blanchard, Brittany E; Talley, Amelia E; Brown, Jennifer L

2016-02-01

There is consistent evidence that impulsivity-like traits relate to problematic alcohol involvement; however, identifying mechanisms that account for this relation remains an important area of research. Drinking refusal self-efficacy (or a person's ability to resist alcohol; DRSE) has been shown to predict alcohol use among college students and may be a relevant mediator of the impulsivity-alcohol relation. The current study examined the indirect effect of various constructs related to impulsivity (i.e., urgency, sensation seeking, and deficits in conscientiousness) via several facets of DRSE (i.e., social pressure, opportunistic, and emotional relief) on alcohol-related problems among a large sample of college students (N=891). Overall, results indicated that certain DRSE facets were significant mediators of the relation between impulsivity-related constructs and alcohol problems. More specifically, emotional-relief DRSE was a mediator for the respective relations between urgency and deficits in conscientiousness and alcohol problems, whereas social-DRSE was a significant mediator of the respective relations between urgency and sensation seeking with alcohol problems. Results from this study suggest particular types of DRSE are important mediators of the relations between specific impulsivity constructs and alcohol-related problems. These findings support prevention and intervention efforts that seek to enhance drinking refusal self-efficacy skills of college students, particularly those high in certain personality features, in order to reduce alcohol-related problems among this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

The frequency of company-sponsored alcohol brand-related sites on Facebook™-2012.

PubMed

Nhean, Siphannay; Nyborn, Justin; Hinchey, Danielle; Valerio, Heather; Kinzel, Kathryn; Siegel, Michael; Jernigan, David H

2014-06-01

This research provides an estimate of the frequency of company-sponsored alcohol brand-related sites on Facebook™. We conducted a systematic overview of the extent of alcohol brand-related sites on Facebook™ in 2012. We conducted a 2012 Facebook™ search for sites specifically related to 898 alcohol brands across 16 different alcoholic beverage types. Descriptive statistics were produced using Microsoft SQL Server. We identified 1,017 company-sponsored alcohol-brand related sites on Facebook™. Our study advances previous literature by providing a systematic overview of the extent of alcohol brand sites on Facebook™.

Cognitive Biases for Social Alcohol-Related Pictures and Alcohol Use in Specific Social Settings: An Event-Level Study.

PubMed

Groefsema, Martine; Engels, Rutger; Kuntsche, Emmanuel; Smit, Koen; Luijten, Maartje

2016-09-01

Alcohol use occurs mainly among friends, in social contexts, and for social reasons. Moreover, cognitive biases, such as attentional and approach biases, have repeatedly been associated with alcohol use. This study aimed to test whether nondependent drinkers display cognitive biases for social alcohol-related (SA) pictures and whether these biases are associated with alcohol use in social drinking contexts. The visual dot probe task and stimulus-response compatibility tasks were used to measure attentional and approach biases for alcohol-related pictures at baseline. Event-level alcohol use was measured using Ecological Momentary Assessments via personal smartphones. One hundred and ninety-two young adults (51.6% men; Mage  = 20.73) completed the study, resulting in 11,257 assessments conducted on Thursday, Friday, and Saturday evenings for 5 consecutive weeks. While no overall attentional bias for alcohol-related pictures was found, young adults showed an approach bias for both social and nonsocial alcohol-related pictures. Multilevel models revealed no direct association between cognitive biases for alcohol-related pictures and alcohol use. However, higher levels of attentional bias for SA pictures were associated with more drinking when individuals were surrounded by a greater number of friends of opposite gender. Higher levels of an approach bias for SA pictures were associated with more drinking in women surrounded by a greater number of friends of the same gender. In a nondependent sample, cognitive biases for SA pictures could not be associated with drinking directly. However, a cognitive bias for SA pictures moderated the association between alcohol use and number of friends present. As most observed effects were gender and situation specific, replication of these effects is warranted. Copyright © 2016 by the Research Society on Alcoholism.

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/

Multiple sclerosis and alcohol use disorders: In-hospital mortality, extended hospital stays, and overexpenditures.

PubMed

Gili-Miner, M; López-Méndez, J; Vilches-Arenas, A; Ramírez-Ramírez, G; Franco-Fernández, D; Sala-Turrens, J; Béjar-Prado, L

2016-10-22

The objective of this study was to analyse the impact of alcohol use disorders (AUD) in patients with multiple sclerosis (MS) in terms of in-hospital mortality, extended hospital stays, and overexpenditures. We conducted a retrospective observational study in a sample of MS patients obtained from minimal basic data sets from 87 Spanish hospitals recorded between 2008 and 2010. Mortality, length of hospital stays, and overexpenditures attributable to AUD were calculated. We used a multivariate analysis of covariance to control for such variables as age and sex, type of hospital, type of admission, other addictions, and comorbidities. The 10,249 patients admitted for MS and aged 18-74 years included 215 patients with AUD. Patients with both MS and AUD were predominantly male, with more emergency admissions, a higher prevalence of tobacco or substance use disorders, and higher scores on the Charlson comorbidity index. Patients with MS and AUD had a very high in-hospital mortality rate (94.1%) and unusually lengthy stays (2.4 days), and they generated overexpenditures (1,116.9euros per patient). According to the results of this study, AUD in patients with MS results in significant increases in-hospital mortality and the length of the hospital stay and results in overexpenditures. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Neurological manifestations of excessive alcohol consumption.

PubMed

Planas-Ballvé, Anna; Grau-López, Laia; Morillas, Rosa María; Planas, Ramón

2017-12-01

This article reviews the different acute and chronic neurological manifestations of excessive alcohol consumption that affect the central or peripheral nervous system. Several mechanisms can be implicated depending on the disorder, ranging from nutritional factors, alcohol-related toxicity, metabolic changes and immune-mediated mechanisms. Recognition and early treatment of these manifestations is essential given their association with high morbidity and significantly increased mortality. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

Alcohol-attributable cancer deaths under 80 years of age in New Zealand.

PubMed

Connor, Jennie; Kydd, Robyn; Maclennan, Brett; Shield, Kevin; Rehm, Jürgen

2017-05-01

Cancer deaths made up 30% of all alcohol-attributable deaths in New Zealanders aged 15-79 years in 2007, more than all other chronic diseases combined. We aimed to estimate alcohol-attributable cancer mortality and years of life lost by cancer site and identify differences between Māori and non-Māori New Zealanders. We applied the World Health Organization's comparative risk assessment methodology at the level of Māori and non-Māori subpopulations. Proportions of specific alcohol-related cancers attributable to alcohol were calculated by combining alcohol consumption estimates from representative surveys with relative risks from recent meta-analyses. These proportions were applied to both 2007 and 2012 mortality data. Alcohol consumption was responsible for 4.2% of all cancer deaths under 80 years of age in 2007. An average of 10.4 years of life was lost per person; 12.7 years for Māori and 10.1 years for non-Māori. Half of the deaths were attributable to average consumption of <4 standard drinks per day. Breast cancer comprised 61% of alcohol-attributable cancer deaths in women, and more than one-third of breast cancer deaths were attributable to average consumption of <2 standard drinks per day. Mortality data from 2012 produced very similar findings. Alcohol is an important and modifiable cause of cancer. Risk of cancer increases with higher alcohol consumption, but there is no safe level of drinking. Reduction in population alcohol consumption would reduce cancer deaths. Additional strategies to reduce ethnic disparities in risk and outcome are needed in New Zealand. [Connor J, Kydd R, Maclennan B, Shield K, Rehm J. Alcohol-attributable cancer deaths under 80 years of age in New Zealand. Drug Alcohol Rev 2017;36:415-423]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Spatial analysis of alcohol-related motor vehicle crash injuries in southeastern Michigan.

PubMed

Meliker, Jaymie R; Maio, Ronald F; Zimmerman, Marc A; Kim, Hyungjin Myra; Smith, Sarah C; Wilson, Mark L

2004-11-01

Temporal, behavioral and social risk factors that affect injuries resulting from alcohol-related motor vehicle crashes have been characterized in previous research. Much less is known about spatial patterns and environmental associations of alcohol-related motor vehicle crashes. The aim of this study was to evaluate geographic patterns of alcohol-related motor vehicle crashes and to determine if locations of alcohol outlets are associated with those crashes. In addition, we sought to demonstrate the value of integrating spatial and traditional statistical techniques in the analysis of this preventable public health risk. The study design was a cross-sectional analysis of individual-level blood alcohol content, traffic report information, census block group data, and alcohol distribution outlets. Besag and Newell's spatial analysis and traditional logistic regression both indicated that areas of low population density had more alcohol-related motor vehicle crashes than expected (P < 0.05). There was no significant association between alcohol outlets and alcohol-related motor vehicle crashes using distance analyses, logistic regression, and Chi-square. Differences in environmental or behavioral factors characteristic of areas of low population density may be responsible for the higher proportion of alcohol-related crashes occurring in these areas.

Brand preferences of underage drinkers who report alcohol-related fights and injuries.

PubMed

Roberts, Sarah P; Siegel, Michael B; DeJong, William; Naimi, Timothy S; Jernigan, David H

2015-04-01

A significant body of research has demonstrated an association between adolescent alcohol consumption and subsequent fights and injuries. To date, however, no research has identified which brands are associated with alcohol-related fights and injuries among underage drinkers. We aimed to: (1) report the prevalence of alcohol-related fights and injuries among a national sample of underage drinkers in the U.S. and (2) describe the relationship between specific alcohol brand consumption and these alcohol-related negative consequences. We recruited 1,031 self-reported drinkers (ages 13-20 years) via an internet panel maintained by Knowledge Networks to complete an online survey. Respondents reported their past-month overall and brand-specific alcohol consumption, risky drinking behavior, and past-year alcohol-related fights and injuries. Over one-quarter of the respondents (26.7%, N = 232) reported at least one alcohol-related fight or injury in the past year. Heavy episodic drinkers were over six times more likely to report one of these negative alcohol-related consequences (AOR: 6.4, 95% CI: 4.1-9.9). Respondents of black race and those from higher-income households were also significantly more likely to report that experience (AOR: 2.2, 95% CI: 1.3-3.7; AOR: 1.8, 95% CI: 1.1-3.0 and 1.1-3.2, respectively). We identified eight alcohol brands that were significantly associated with alcohol-related fights and injuries. CONCLUSIONS/IMPORTANCE: Alcohol-related fights and injuries were frequently reported by adolescent respondents. Eight alcohol brands were significantly more popular among drinkers who experienced these adverse consequences. These results point to the need for further research on brand-specific correlates of underage drinking and negative health outcomes.

Alcohol-impaired motor vehicle crash risk and the location of alcohol purchase.

PubMed

Cotti, Chad; Dunn, Richard A; Tefft, Nathan

2014-05-01

Motor vehicle crashes involving alcohol impairment are among the leading causes of mortality and morbidity in the U.S. In this study, we examine how the probability of driving after a binge-drinking episode varies with the location of consumption and type of alcohol consumed. We also investigate the relationship between the location of alcohol purchase and the number of alcohol-impaired fatal motor vehicle crashes. Using multiple datasets that are representative of the U.S. between 2003 and 2009, we find that binge-drinkers are significantly more likely to drive after consuming alcohol at establishments that sell alcohol for on-premises consumption, e.g., from bars or restaurants, particularly after drinking beer. Further, per capita sales of alcohol for off-premises consumption are unrelated to the rate of alcohol-impaired fatal motor vehicle crashes. When disaggregating alcohol types, per capita sales of beer for off-premises consumption are negatively associated with the rate of alcohol-impaired fatal motor vehicle crashes. In contrast, total per capita sales of alcohol from all establishments (on- and off-premises) are positively related to the rate of alcohol-impaired fatal motor vehicle crashes and the magnitude of this relationship is strongest for beer sales. Thus, policies that shift consumption away from bars and restaurants could lead to a decline in the number of motor vehicle crashes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Interventions in sports settings to reduce risky alcohol consumption and alcohol-related harm: a systematic review.

PubMed

Kingsland, Melanie; Wiggers, John H; Vashum, Khanrin P; Hodder, Rebecca K; Wolfenden, Luke

2016-01-21

Elevated levels of risky alcohol consumption and alcohol-related harm have been reported for sportspeople and supporters compared to non-sporting populations. Limited systematic reviews have been conducted to assess the effect of interventions targeting such behaviours. A review was undertaken to determine if interventions implemented in sports settings decreased alcohol consumption and related harms. Studies were included that implemented interventions within sports settings; measured alcohol consumption or alcohol-related injury or violence and were either randomised controlled trials, staggered enrollment trials, stepped-wedged trials, quasi-randomised trials, quasi-experimental trials or natural experiments. Studies without a parallel comparison group were excluded. Studies from both published and grey literature were included. Two authors independently screened potential studies against the eligibility criteria, and two authors independently extracted data from included studies and assessed risk of bias. The results of included studies were synthesised narratively. The title and abstract of 6382 papers and the full text of 45 of these papers were screened for eligibility. Three studies met the inclusion criteria for the review. One of the included studies was a randomised controlled trial (RCT) of a cognitive-behavioural intervention with athletes within an Olympic training facility in the USA. The study reported a significant change in alcohol use between pre-test and follow-up between intervention and control groups. The other two studies were RCTs in community sports clubs in Ireland and Australia. The Australian study found a significant intervention effect for both risky alcohol consumption at sports clubs and overall risk of alcohol-related harm. The Irish study found no significant intervention effect. A limited number of studies have been conducted to assess the effect of interventions implemented in sports settings on alcohol consumption and related

Gender matters: the relationship between social anxiety and alcohol-related consequences.

PubMed

Schry, Amie R; Norberg, Melissa M; Maddox, Brenna B; White, Susan W

2014-01-01

Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. In the present study, 573 undergraduate students (M(age) = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female) completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role). Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences.

Management of alcohol misuse in patients with liver diseases

PubMed Central

Peng, Jennifer L; Patel, Milan Prakash; McGee, Breann; Liang, Tiebing; Chandler, Kristina; Tayarachakul, Sucharat; O’Connor, Sean; Liangpunsakul, Suthat

2017-01-01

Excessive alcohol use not only causes alcoholic liver disease (ALD) but also increases the risk of liver-related mortality in patients who already have other chronic liver diseases. Screening for alcohol misuse or alcohol use disorder (AUD) among patients with underlying liver disease is essential. This clinical review covers what is known about ALD, the impact of alcohol in patients with underlying liver diseases, current management of alcohol misuse and AUD, and the management of alcohol misuse and AUD specifically in patients with liver diseases. Several treatment options for alcohol misuse and AUD exist such as psychosocial intervention and behavioral and pharmacological therapies. The strategies used in the treatment of alcohol misuse and AUD are still applicable in those who consume alcohol and have underlying liver disease. However, certain medications still need to be carefully used due to potentially worsening already compromised liver function. Screening of ongoing alcohol use in subjects with liver disease is important, and prompt intervention is needed to prevent the associated morbidity and mortality from the detrimental effects of continued alcohol use on underlying liver disease. Considering alcoholism is a complex disease, probably a multidisciplinary approach combining psychotherapy and comprehensive medical care will be the most effective. Future research could focus on identifying additional treatment options for addressing the psychotherapy component since the self-determination and will to quit drinking alcohol can play such a crucial role in promoting abstinence. PMID:27940551

A comparison of alcohol positive and alcohol negative trauma patients requiring an emergency laparotomy.

PubMed

Benson, Cedric; Weinberg, Janice; Narsule, Chaitan K; Brahmbhatt, Tejal S

2018-07-01

The effect of alcohol exposure on patients undergoing a laparotomy for trauma is unknown. The purpose of this study was to compare outcomes of morbidity and mortality between alcohol positive and alcohol negative trauma patients who required emergent laparotomies using the National Trauma Data Bank (NTDB). A retrospective database analysis was performed using 28,354 NTDB incident trauma cases, from 2007 through 2012, who had been tested for alcohol and who required abdominal operations (using ICD-9-CM procedure codes) within 24h of presentation. Variables used: age, gender, admission year, alcohol presence, ISS, GCS, injury type & mechanism, discharge status, hospital LOS, ICU stay, ventilator use, and hospital complications. In adjusted analyses, there were no statistically significant differences between the alcohol positive and alcohol negative cohorts when evaluating in-hospital mortality (OR, 0.93; 95% CI: 0.84-1.03), likelihood of earlier hospital discharge (HR, 1.02; 95% CI: 0.99-1.05), and the all-inclusive category of in-hospital complications (OR, 1.04; 95% CI: 0.97-1.12). After adjusting for age, gender, admission year, ISS, GCS, and injury mechanism, there were no major differences between the alcohol positive and alcohol negative cohorts when it came to in-hospital mortality, likelihood of earlier hospital discharge, and most of the in-hospital complications measured among adult trauma patients requiring emergency laparotomies. Copyright © 2017 Elsevier Inc. All rights reserved.

University Students' Knowledge of Alcoholic Drinks and Their Perception of Alcohol-Related Harm

ERIC Educational Resources Information Center

Hasking, Penelope; Shortell, Carly; Machalek, Mireille

2005-01-01

A total of 371 university students were asked to estimate the amount of alcohol contained in a standard drink and to estimate the number of standard drinks contained in popular alcoholic beverages. In addition, students completed questionnaires assessing their perception of short and long term harm related to the consumption of beer, wine, spirits…

Brand preferences of underage drinkers who report alcohol-related fights and injuries

PubMed Central

Roberts, Sarah P.; Siegel, Michael B.; DeJong, William; Naimi, Timothy S.; Jernigan, David H.

2014-01-01

Background A significant body of research has demonstrated an association between adolescent alcohol consumption and subsequent fights and injuries. To date, however, no research has identified which brands are associated with alcohol-related fights and injuries among underage drinkers. Objectives We aimed to: 1) report the prevalence of alcohol-related fights and injuries among a national sample of underage drinkers in the U.S. and 2) describe the relationship between specific alcohol brand consumption and these alcohol-related negative consequences. Methods We recruited 1,031 self-reported drinkers (ages 13–20 years) via an internet panel maintained by Knowledge Networks to complete an online survey. Respondents reported their past-month overall and brand-specific alcohol consumption, risky drinking behavior, and past-year alcohol-related fights and injuries. Results Over one-quarter of the respondents (26.7%, N=232) reported at least one alcohol-related fight or injury in the past year. Heavy episodic drinkers were over six times more likely to report one of these negative alcohol-related consequences (AOR: 6.4, 95% CI: 4.1–9.9). Respondents of black race and those from higher-income households were also significantly more likely to report that experience (AOR: 2.2, 95% CI: 1.3–3.7; AOR: 1.8, 95% CI: 1.1–3.0 and 1.1–3.2, respectively). We identified eight alcohol brands that were significantly associated with alcohol-related fights and injuries. Conclusions/Importance Alcohol-related fights and injuries were frequently reported by adolescent respondents. Eight alcohol brands were significantly more popular among drinkers who experienced these adverse consequences. These results point to the need for further research on brand-specific correlates of underage drinking and negative health outcomes. PMID:25612075

Are energy drinks unique mixers in terms of their effects on alcohol consumption and negative alcohol-related consequences?

PubMed

Johnson, Sean J; Alford, Chris; Stewart, Karina; Verster, Joris C

2018-01-01

Previous research has suggested that consuming alcohol mixed with energy drinks (AMED) increases overall alcohol consumption. However, there is limited research examining whether energy drinks are unique in their effects when mixed with alcohol, when compared with alcohol mixed with other caffeinated mixers (AOCM). Therefore, the aim of this survey was to investigate alcohol consumption on AMED occasions, to that on other occasions when the same individuals consumed AOCM or alcohol only (AO). A UK-wide online student survey collected data on the frequency of alcohol consumption and quantity consumed, as well as the number of negative alcohol-related consequences reported on AO, AMED and AOCM occasions (N=250). Within-subjects analysis revealed that there were no significant differences in the number of alcoholic drinks consumed on a standard and a heavy drinking session between AMED and AOCM drinking occasions. However, the number of standard mixers typically consumed was significantly lower on AMED occasions compared with AOCM occasions. In addition, when consuming AMED, students reported significantly fewer days consuming 5 or more alcohol drinks, fewer days mixing drinks, and fewer days being drunk, compared with when consuming AOCM. There were no significant differences in the number of reported negative alcohol-related consequences on AMED occasions to AOCM occasions. Of importance, alcohol consumption and negative alcohol-related consequences were significantly less on both AMED and AOCM occasions compared with AO occasions. The findings that heavy alcohol consumption occurs significantly less often on AMED occasions compared with AOCM occasions is in opposition to some earlier claims implying that greatest alcohol consumption occurs with AMED. The overall greatest alcohol consumption and associated negative consequences were clearly associated with AO occasions. Negative consequences for AMED and AOCM drinking occasions were similar, suggesting that energy

Effectiveness of lockouts in reducing alcohol-related harm: Systematic review.

PubMed

Nepal, Smriti; Kypri, Kypros; Pursey, Kirrilly; Attia, John; Chikritzhs, Tanya; Miller, Peter

2018-05-01

Australian jurisdictions have introduced lockouts to prevent alcohol-related violence. Lockouts prohibit patrons from entering licensed premises after a designated time while allowing sale and consumption of alcohol to continue. Their purposes include managing the movement of intoxicated patrons, and preventing violence and disorder by dispersing times that patrons leave premises. We sought to evaluate the effectiveness of lockouts in preventing alcohol-related harm. We systematically searched electronic databases and reference lists and asked authors to identify relevant studies published to 1 June 2017. We deemed studies eligible if they evaluated lockouts, and if outcome measures included: assault, emergency department attendances, alcohol-related disorders or drink-driving offences. Two reviewers independently extracted data. After screening 244 records, we identified five studies from electronic databases, two from reference lists search and one from a Google search (N = 8). Two studies showed a decline in assaults; a third study showed reductions occurred only inside licensed premises; two studies showed an increase in assaults; and three studies showed no association. The studies had significant design and other limitations. Lockouts have been implemented across Australian jurisdictions as a strategy to prevent alcohol-related harm, despite limited evidence. In this systematic review, we synthesised findings from studies that evaluated lockouts as stand-alone interventions, to help clarify debate on their utility as a harm prevention strategy. There is not good evidence that lockouts prevent alcohol-related harm, in contrast to what is known about stopping the sale of alcohol earlier, for which there is evidence of effectiveness. © 2018 Australasian Professional Society on Alcohol and other Drugs.

Evaluating the Brazilian zero tolerance drinking and driving law: Time series analyses of traffic-related mortality in three major cities.

PubMed

Volpe, Fernando Madalena; Ladeira, Roberto Marini; Fantoni, Rosely

2017-05-19

A zero tolerance alcohol restriction law was adopted in Brazil in 2008. In order to assess the effectiveness of this intervention, the present study compares specific mortality in 2 time series: 1980-2007 and 2008-2013. Data on mortality and population were gathered from official Brazilian Ministry of Health information systems. Segmented regression analyses were carried out separately for 3 major Brazilian capitals: Belo Horizonte, Rio de Janeiro, and São Paulo. In 2 cities (Belo Horizonte and Rio de Janeiro) there were no significant changes in mortality rate trends in 2 periods, 1980 to 2007 and 2008 to 2013, where the observed rates did not differ significantly from predicted rates. In São Paulo, a decreasing trend until 2007 unexpectedly assumed higher levels after implementation of the law. There is no evidence of reduced traffic-related mortality in the 3 major Brazilian capitals 5.5 years after the zero tolerance drinking and driving law was adopted.

Alcohol-related problems in primary care patients in Nigeria.

PubMed

Abiodun, O A

1996-04-01

A total of 440 (50.1%) drinking patients were found in a study of 878 primary care patients in Nigeria, of whom 126 (28.6%) of drinking patients were observed to have alcohol-related problems. Those with alcohol-related problems were significantly more likely to be males, middle-aged and to belong to higher occupational groups. In addition, they were also more likely to be separated, divorced or widowed, made more frequent visits to health care facilities and were more likely to have associated mental morbidity. The primary health care (PHC) workers did not recognize these problem drinkers in their care. The need to improve the ability of PHC workers to detect and manage primary care patients with alcohol-related problems in developing countries through the use of reliable and valid short alcohol screening instruments (e.g. CAGE, AUDIT) and brief intervention techniques is emphasized. It is also suggested that, on a long-term basis, the training curricula for medical and paramedical primary care personnel in third world countries should include more hours on alcohol education.

Delta Opioid Pharmacology in Relation to Alcohol Behaviors

PubMed Central

Alongkronrusmee, Doungkamol; Chiang, Terrance

2016-01-01

Delta opioid receptors (DORs) are heavily involved in alcohol-mediated processes in the brain. In this chapter we provide an overview of studies investigating how alcohol directly impacts DOR pharmacology and of early studies indicating DOR modulation of alcohol behavior. We will offer a brief summary of the different animal species used in alcohol studies investigating DORs followed by a broader overview of the types of alcohol behaviors modulated by DORs. We will highlight a small set of studies investigating the relationship between alcohol and DORs in analgesia. We will then provide an anatomical overview linking DOR expression in specific brain regions to different alcohol behaviors. In this section, we will provide two models that try to explain how endogenous opioids acting at DORs may influence alcohol behaviors. Next, we will provide an overview of studies investigating certain new aspects of DOR pharmacology, including the formation of heteromers and biased signaling. Finally, we provide a short overview of the genetics of the DORs in relation to alcohol use disorders (AUDs) and a short statement on the potential of using DOR-based therapeutics for treatment of AUDs. PMID:27316912

Gender Matters: The Relationship between Social Anxiety and Alcohol-Related Consequences

PubMed Central

Schry, Amie R.; Norberg, Melissa M.; Maddox, Brenna B.; White, Susan W.

2014-01-01

Background and Objectives Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. Methods In the present study, 573 undergraduate students (M age = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female) completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role). Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. Results After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. Discussion and Conclusions These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. Scientific Significance This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences. PMID:25541722

Recent diabetes-related mortality trends in Romania.

PubMed

Ioacara, Sorin; Sava, Elisabeta; Georgescu, Olivia; Sirbu, Anca; Fica, Simona

2018-05-17

As there are no published articles on country-level diabetes-related mortality in Romania, we aimed to investigate this aspect for the 1998-2015 period. Anonymized demographic and diabetes-related mortality data (underlying or first secondary cause of death) were retrospectively obtained from the National Institute of Statistics/Eurostat microdata. Age-standardized mortality rates (ASMR) and their annual percentage change (APC) were analysed. During 1998-2015, 4,567,899 persons died in Romania, among whom, diabetes was responsible for 168,854 cases. The ASMR for diabetes was 39.34 per 100,000 person-years (p-y) (95% CI 39.32-39.35). There was an increase in ASMR from 27.10 per 100,000 p-y (95% CI 27.01-27.19) in women and 30.88 per 100,000 p-y (95% CI 30.77-30.99) in men in 1998 to 35.42 per 100,000 p-y (95% CI 35.34-35.51) in women and 48.41 per 100,000 p-y (95% CI 48.29-48.52) in men, in 2015. The mean APC in women was 3.8% per year (95% CI 3.5-4.0, p < 0.001) during 1998-2010 and - 1.9% per year (95% CI - 2.7 to - 1.1, p < 0.001) during 2010-2015. The mean APC in men was 5.3% per year (95% CI 5.0-5.5, p < 0.001) during 1998-2010 and - 1.5% per year (95% CI - 2.2 to - 0.8, p < 0.001) during 2010-2015. Diabetes-related mortality rates increased with age, with men experiencing higher mortality rates than women for most age groups and calendar years. Diabetes-related mortality rates increased significantly in Romania during 1998-2010, followed by a steady decline during 2010-2015.

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

PubMed

Midanik, Lorraine T; Greenfield, Thomas K

2010-07-01

Interactive voice response (IVR), a computer-based interviewing technique, can be used within a computer-assisted telephone interview (CATI) survey to increase privacy and the accuracy of reports of sensitive attitudes and behaviours. Previous research using the 2005 National Alcohol Survey indicated no overall significant differences between IVR and CATI responses to alcohol-related problems and alcohol dependence. To determine if this result holds for demographic subgroups that could respond differently to modes of data collection, this study compares the prevalence rates of lifetime and last-year alcohol-related problems by gender, ethnicity, age and income subgroups obtained by IVR versus continuous CATI interviewing. As part of the 2005 National Alcohol Survey, subsamples of English-speaking respondents were randomly assigned to an IVR group that received an embedded IVR module on alcohol-related problems (n = 450 lifetime drinkers) and a control group that were asked identical alcohol-related problem items using continuous CATI (n = 432 lifetime drinkers). Overall, there were few significant associations. Among lifetime drinkers, higher rates of legal problems were found for white and higher income respondents in the IVR group. For last-year drinkers, a higher percentage of indicators of alcohol dependence was found for Hispanic respondents and women respondents in the CATI group. Data on alcohol problems collected by CATI provide largely comparable results to those from an embedded IVR module. Thus, incorporation of IVR technology in a CATI interview does not appear strongly indicated even for several key subgroups.

Disorganization of Attachment in Relation to Maternal Alcohol Consumption.

ERIC Educational Resources Information Center

O'Connor, Mary J.; And Others

The relation between maternal alcohol consumption and infant attachment behavior at one year of age was investigated in this study. Alcohol consumption was estimated by self-report questionnaires filled out by mothers who were over 30 years of age. The questionnaire elicited information about the amount of alcohol mothers consumed prior to,…

Sexual identity and alcohol-related outcomes: contributions of workplace harassment.

PubMed

Nawyn, S J; Richman, J A; Rospenda, K M; Hughes, T L

2000-01-01

While workplace sexual harassment has received a great deal of attention in both the popular media and scientific literature, less attention has been directed to the differential occurrence of sexual harassment among lesbians, gay men, and heterosexual men and women, and the relationships between these experiences and alcohol-related outcomes. Additionally, the distribution of alcohol-related outcomes of non-sexual forms of workplace harassment among these groups have not been adequately explored. Using data from a university-based study of workplace harassment and alcohol use (N = 2492), we focus on exposure to workplace harassment and alcohol-related outcomes for lesbians, gay men, and bisexuals compared to heterosexual men and women. Lesbian/bisexual women did not differ significantly from heterosexual women in their experiences of workplace harassment. However, stronger linkages between harassment and increased alcohol consumption and problems were found for lesbian and bisexual women than for heterosexual women. Gay/bisexual men, on the other hand, experienced significantly more sexual harassment than heterosexual men, but did not report a corresponding increase in alcohol use and abuse. Implications for future research on sexual identity, alcohol use, and workplace harassment are discussed.

Epidemiology of Alcohol Consumption and Related Problems In Latin American Countries: contributions of Psychology

PubMed Central

Cremonte, Mariana; Biscarra, Maria Ayelén; Conde, Karina; Cherpitel, Cheryl J.

2017-01-01

Alcohol consumption is the leading risk factor for morbi-mortality in many Latin American Countries. However, epidemiologic studies are relatively scarce. Among factors such as limited research capacity, disciplinary traditions and an emphasis on psychopathology within the field of psychology, have been postulated to account for this. The aim of this paper is to review epidemiologic research on alcohol in Spanish Speaking Latin American Countries, and to measure the contribution of psychology to the field. A systematic search was performed in English and Spanish using regional and international data bases. We identified 269 articles. Most focused on consumption patterns in youth, with samples from a single school and using a variety of measures. With the exception of multinational efforts like ERCAAP or those supported by WHO/PAHO, studies reviewed reflected little cross country collaboration. Mexico accounted for most of the productivity, while many countries had very few or no articles. Most research was performed by health science researchers with a small contribution from psychology, but which increased significantly over time. The results of this review provide a broad identification of patterns regarding epidemiologic research on alcohol, and demonstrate the need for national scientific policies to promote research on public health topics. PMID:27594582

Drugs and Alcohol: Their Relative Crash Risk

PubMed Central

Romano, Eduardo; Torres-Saavedra, Pedro; Voas, Robert B.; Lacey, John H.

2014-01-01

Objective: The purpose of this study was to determine (a) whether among sober (blood alcohol concentration [BAC] = .00%) drivers, being drug positive increases the drivers' risk of being killed in a fatal crash; (b) whether among drinking (BAC > .00%) drivers, being drug positive increases the drivers' risk of being killed in a fatal crash; and (c) whether alcohol and other drugs interact in increasing crash risk. Method: We compared BACs for the 2006, 2007, and 2008 crash cases drawn from the U.S. Fatality Analysis Reporting System (FARS) with control drug and blood alcohol data from participants in the 2007 U.S. National Roadside Survey. Only FARS drivers from states with drug information on 80% or more of the drivers who also participated in the 2007 National Roadside Survey were selected. Results: For both sober and drinking drivers, being positive for a drug was found to increase the risk of being fatally injured. When the drug-positive variable was separated into marijuana and other drugs, only the latter was found to contribute significantly to crash risk. In all cases, the contribution of drugs other than alcohol to crash risk was significantly lower than that produced by alcohol. Conclusions: Although overall, drugs contribute to crash risk regardless of the presence of alcohol, such a contribution is much lower than that by alcohol. The lower contribution of drugs other than alcohol to crash risk relative to that of alcohol suggests caution in focusing too much on drugged driving, potentially diverting scarce resources from curbing drunk driving. PMID:24411797

Perceived sexual control, sex-related alcohol expectancies and behavior predict substance-related sexual revictimization.

PubMed

Walsh, Kate; Messman-Moore, Terri; Zerubavel, Noga; Chandley, Rachel B; Denardi, Kathleen A; Walker, Dave P

2013-05-01

Although numerous studies have documented linkages between childhood sexual abuse (CSA) and later sexual revictimization, mechanisms underlying revictimization, particularly assaults occurring in the context of substance use, are not well-understood. Consistent with Traumagenic Dynamics theory, the present study tested a path model positing that lowered perceptions of sexual control resulting from CSA may be associated with increased sex-related alcohol expectancies and heightened likelihood of risky sexual behavior, which in turn, may predict adult substance-related rape. Participants were 546 female college students who completed anonymous surveys regarding CSA and adult rape, perceptions of sexual control, sex-related alcohol expectancies, and likelihood of engaging in risky sexual behavior. The data fit the hypothesized model well and all hypothesized path coefficients were significant and in the expected directions. As expected, sex-related alcohol expectancies and likelihood of risky sexual behavior only predicted substance-related rape, not forcible rape. Findings suggested that low perceived sexual control stemming from CSA is associated with increased sex-related alcohol expectancies and a higher likelihood of engaging in sexual behavior in the context of alcohol use. In turn these proximal risk factors heighten vulnerability to substance-related rape. Programs which aim to reduce risk for substance-related rape could be improved by addressing expectancies and motivations for risky sexual behavior in the context of substance use. Implications and future directions are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Perceived Sexual Control, Sex-Related Alcohol Expectancies and Behavior Predict Substance-Related Sexual Revictimization

PubMed Central

Walsh, Kate; Messman-Moore, Terri; Zerubavel, Noga; Chandley, Rachel B.; DeNardi, Kathleen A.; Walker, Dave P.

2013-01-01

Objectives Although numerous studies have documented linkages between childhood sexual abuse (CSA) and later sexual revictimization, mechanisms underlying revictimization, particularly assaults occurring in the context of substance use, are not well-understood. Consistent with Traumagenic Dynamics theory, the present study tested a path model positing that lowered perceptions of sexual control resulting from CSA may be associated with increased sex-related alcohol expectancies and heightened likelihood of risky sexual behavior, which in turn, may predict adult substance-related rape. Methods Participants were 546 female college students who completed anonymous surveys regarding CSA and adult rape, perceptions of sexual control, sex-related alcohol expectancies, and likelihood of engaging in risky sexual behavior. Results The data fit the hypothesized model well and all hypothesized path coefficients were significant and in the expected directions. As expected, sex-related alcohol expectancies and likelihood of risky sexual behavior only predicted substance-related rape, not forcible rape. Conclusions Findings suggested that low perceived sexual control stemming from CSA is associated with increased sex-related alcohol expectancies and a higher likelihood of engaging in sexual behavior in the context of alcohol use. In turn these proximal risk factors heighten vulnerability to substance-related rape. Programs which aim to reduce risk for substance-related rape could be improved by addressing expectancies and motivations for risky sexual behavior in the context of substance use. Implications and future directions are discussed. PMID:23312991

Alcoholic hepatitis: Translational approaches to develop targeted therapies.

PubMed

Mandrekar, Pranoti; Bataller, Ramon; Tsukamoto, Hidekazu; Gao, Bin

2016-10-01

Alcoholic liver disease is a leading cause of liver-related mortality worldwide. In contrast to recent advances in therapeutic strategies for patients with viral hepatitis, there is a significant lack of novel therapeutic options for patients with alcoholic liver disease. In particular, there is an urgent need to focus our efforts on effective therapeutic interventions for alcoholic hepatitis (AH), the most severe form of alcoholic liver disease. AH is characterized by an abrupt development of jaundice and complications related to liver insufficiency and portal hypertension in patients with heavy alcohol intake. The mortality of patients with AH is very high (20%-50% at 3 months). Available therapies are not effective in many patients, and targeted approaches are imminently needed. The development of such therapies requires translational studies in human samples and suitable animal models that reproduce the clinical and histological features of AH. In recent years, new animal models that simulate some of the features of human AH have been developed, and translational studies using human samples have identified potential pathogenic factors and histological parameters that predict survival. This review summarizes the unmet needs for translational studies on the pathogenesis of AH, preclinical translational tools, and emerging drug targets to benefit the AH patient. (Hepatology 2016;64:1343-1355). © 2016 by the American Association for the Study of Liver Diseases.

Association between alcohol and substance use disorders and all-cause and cause-specific mortality in schizophrenia, bipolar disorder, and unipolar depression: a nationwide, prospective, register-based study.

PubMed

Hjorthøj, Carsten; Østergaard, Marie Louise Drivsholm; Benros, Michael Eriksen; Toftdahl, Nanna Gilliam; Erlangsen, Annette; Andersen, Jon Trærup; Nordentoft, Merete

2015-09-01

People with severe mental illness have both increased mortality and are more likely to have a substance use disorder. We assessed the association between mortality and lifetime substance use disorder in patients with schizophrenia, bipolar disorder, or unipolar depression. In this prospective, register-based cohort study, we obtained data for all people with schizophrenia, bipolar disorder, or unipolar depression born in Denmark in 1955 or later from linked nationwide registers. We obtained information about treatment for substance use disorders (categorised into treatment for alcohol, cannabis, or hard drug misuse), date of death, primary cause of death, and education level. We calculated hazard ratios (HRs) for all-cause mortality and subhazard ratios (SHRs) for cause-specific mortality associated with substance use disorder of alcohol, cannabis, or hard drugs. We calculated standardised mortality ratios (SMRs) to compare the mortality in the study populations to that of the background population. Our population included 41 470 people with schizophrenia, 11 739 people with bipolar disorder, and 88 270 people with depression. In schizophrenia, the SMR in those with lifetime substance use disorder was 8·46 (95% CI 8·14-8·79), compared with 3·63 (3·42-3·83) in those without. The respective SMRs in bipolar disorder were 6·47 (5·87-7·06) and 2·93 (2·56-3·29), and in depression were 6·08 (5·82-6·34) and 1·93 (1·82-2·05). In schizophrenia, all substance use disorders were significantly associated with increased risk of all-cause mortality, both individually (alcohol, HR 1·52 [95% CI 1·40-1·65], p<0·0001; cannabis, 1·24 [1·04-1·48], p=0·0174; hard drugs, 1·78 [1·56-2·04], p<0·0001) and when combined. In bipolar disorder or depression, only substance use disorders of alcohol (bipolar disorder, HR 1·52 [95% CI 1·27-1·81], p<0·0001; depression, 2·01 [1·86-2·18], p<0·0001) or hard drugs (bipolar disorder, 1·89 [1·34-2·66], p=0�

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

When abuse primes addiction - automatic activation of alcohol concepts by child maltreatment related cues in emotionally abused alcoholics.

PubMed

Potthast, Nadine; Neuner, Frank; Catani, Claudia

2015-09-01

Recent research indicates that there is a link between emotional maltreatment and alcohol dependence (AD), but the underlying mechanisms still need to be clarified. There is reason to assume that maltreatment related cues automatically activate an associative memory network comprising cues eliciting craving as well as alcohol-related responses. The current study aimed to examine this network in AD patients who experienced emotional abuse using a priming paradigm. A specific priming effect in emotionally abused AD subjects was hypothesized for maltreatment related words that preceded alcohol related words. 49 AD subjects (n=14 with emotional abuse vs. n=35 without emotional abuse) and 34 control subjects performed a priming task with maltreatment related and neutral prime words combined with alcohol related and neutral target words. Maltreatment related words consisted of socially and physically threatening words. As hypothesized, a specific priming effect for socially threatening and physically threatening cues was found only in AD subjects with emotional abuse. The present data are the first to provide evidence that child maltreatment related cues automatically activate an associative memory network in alcoholics with emotional abuse experiences. Copyright © 2015 Elsevier Ltd. All rights reserved.

Alcohol-Related Sexual Assault Victimization Among Adolescents: Prevalence, Characteristics, and Correlates*

PubMed Central

YOUNG, AMY; GREY, MELISSA; ABBEY, ANTONIA; BOYD, CAROL J.; McCABE, SEAN ESTEBAN

2009-01-01

Objective The purpose of this study was to document the prevalence and describe the characteristics of alcohol-related sexual assault among middle and high school students. Method A Web-based, self-administered survey was used to collect data on 7th- through 12th-grade students (n = 1,037) in a large metropolitan area in the Midwest. A modified version of the Sexual Experiences Survey was used to ask students about their sexual victimization experiences so as to examine the involvement of alcohol within specific assault events. The sample was equally distributed by biological gender and ethnicity (white vs black) and was, on average (SD), 14 (2) years of age. Results Findings from the study indicate that alcohol was involved in approximately 12%–20% of the assault cases, depending on age and gender of the respondent. For females, the presence of alcohol during assault differed significantly based on the location at which the assault occurred, ranging from 6% (at the survivor’s home) to 29% (at parties or someone else’s home). Furthermore, alcohol-related assault among females was more likely to involve physical force than non-alcohol-related assault. Conclusions Results are discussed in light of the risk factors of alcohol-related assault among adolescents as well as the nature of social contexts that fosters alcohol-related sexual assault among both adolescents and college students. PMID:18080063

A Systematic Review of the Impact of Exposure to Internet-Based Alcohol-Related Content on Young People's Alcohol Use Behaviours.

PubMed

Gupta, Himanshu; Pettigrew, Simone; Lam, Tina; Tait, Robert J

2016-11-01

To conduct a systematic review of studies exploring the relationship between exposure to Internet-based alcohol-related content and alcohol use among young people. Searches of electronic databases and reference lists of relevant articles were conducted to retrieve studies of relevance up until December 2015. Full texts of the studies that met the inclusion criteria were read, appraised for quality using the Kmet forms and guidelines, and included in this review. Fifteen relevant studies were identified. The included studies were a mix of cross-sectional, longitudinal, experimental and qualitative studies conducted in the USA, the UK, Australia and New Zealand. The age range of the participants involved in these studies was 12-25 years. Included studies employed a variety of study designs and a range of different exposure variables and outcome measures. Studies demonstrated significant associations between exposure to Internet-based alcohol-related content and intentions to drink and positive attitudes towards alcohol drinking among young people. Exposure to alcohol-related content on the Internet might predispose young people to patterns of alcohol use by promoting alcohol as a natural and vital part of life. However, the research exploring the influence of this novel form of advertising on young people's alcohol use is emergent, and comprised primarily of cross-sectional studies. To evaluate the direction of the association between exposure to online alcohol-related content and alcohol use, we call for further research based on longitudinal designs. From 15 relevant studies identified, this review reports significant associations between exposure to Internet-based alcohol-related content and intentions to drink and positive attitudes towards alcohol drinking among young people, with different influences found at different stages of alcohol use. ©The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Divergent Paths for Adult Mortality in Russia and Central Asia: Evidence from Kyrgyzstan

PubMed Central

Guillot, Michel; Gavrilova, Natalia; Torgasheva, Liudmila; Denisenko, Mikhail

2013-01-01

Adult mortality has been lower in Kyrgyzstan vs. Russia among males since at least 1981 and among females since 1999. Also, Kyrgyzstan’s mortality fluctuations have had smaller amplitude. This has occurred in spite of worse macro-economic outcomes in Kyrgyzstan. To understand these surprising patterns, we analyzed cause-specific mortality in Kyrgyzstan vs. Russia for the period 1981-2010, using unpublished official data. We find that, as in Russia, fluctuations in Kyrgyzstan have been primarily due to changes in external causes and circulatory causes, and alcohol appears to play an important role. However, in contrast with Russia, mortality from these causes in Kyrgyzstan has been lower and has increased by a smaller amount. As a result, the mortality gap between the two countries is overwhelmingly attributable to external and cardio-vascular causes, and more generally, to causes that have been shown to be strongly related to alcohol consumption. These cause-specific results, together with the existence of large ethnic differentials in mortality in Kyrgyzstan, highlight the importance of cultural and religious differences, and their impact on patterns of alcohol consumption, in explaining the mortality gap between the two countries. These findings show that explanatory frameworks relying solely on macro-economic factors are not sufficient for understanding differences in mortality levels and trends among former Soviet republics. PMID:24116034

Alcohol intake in relation to diet and obesity in women and men.

PubMed

Colditz, G A; Giovannucci, E; Rimm, E B; Stampfer, M J; Rosner, B; Speizer, F E; Gordis, E; Willett, W C

1991-07-01

We studied relations between alcohol intake, body mass index, and diet in 89,538 women and 48,493 men in two cohort studies. Total energy increased with alcohol consumption (partial r = 0.11, P less than 0.001), and carbohydrate intake decreased from 153 g/d in abstainers to 131 g/d in women drinking 2.5.0-49.9 g alcohol/d. The decrease in carbohydrate intake was due mainly to decreased sugar consumption with higher alcohol intake (partial r = -0.05, P less than 0.001), reflecting decreased energy consumption from sources excluding alcohol. In men total energy increased with alcohol consumption (partial r = 0.19, P less than 0.001), from 7575.6 (abstainers) to 9821.5 kJ/d (greater than 50 g alcohol/d). Energy intake excluding alcohol varied little with alcohol intake (partial r = 0.003, P = 0.48) but sucrose intake decreased with higher alcohol intake. These data suggest that calories from alcohol were added to energy intake from other sources in men, and that in women, energy from alcohol intake displaced sucrose. The consumption of candy and sugar is inversely related to alcohol intake, raising the possibility that it is related to appetite for alcohol.

College Students' Alcohol-Related Problems: An Autophotographic Approach

ERIC Educational Resources Information Center

Casey, Patrick F.; Dollinger, Stephen J.

2007-01-01

This study related standard self-report measures to an innovative approach (the autophotographic essay) as a way to provide insight into patterns of alcohol consumption and associated problem behaviors. College students (N = 135) completed self-report measures of alcohol consumption and created autophotographic essays of identity coded for alcohol…

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.

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

Income inequality, alcohol use, and alcohol-related problems.

PubMed

Karriker-Jaffe, Katherine J; Roberts, Sarah C M; Bond, Jason

2013-04-01

We examined the relationship between state-level income inequality and alcohol outcomes and sought to determine whether associations of inequality with alcohol consumption and problems would be more evident with between-race inequality measures than with the Gini coefficient. We also sought to determine whether inequality would be most detrimental for disadvantaged individuals. Data from 2 nationally representative samples of adults (n = 13,997) from the 2000 and 2005 National Alcohol Surveys were merged with state-level inequality and neighborhood disadvantage indicators from the 2000 US Census. We measured income inequality using the Gini coefficient and between-race poverty ratios (Black-White and Hispanic-White). Multilevel models accounted for clustering of respondents within states. Inequality measured by poverty ratios was positively associated with light and heavy drinking. Associations between poverty ratios and alcohol problems were strongest for Blacks and Hispanics compared with Whites. Household poverty did not moderate associations with income inequality. Poverty ratios were associated with alcohol use and problems, whereas overall income inequality was not. Higher levels of alcohol problems in high-inequality states may be partly due to social context.

Chernobyl cleanup workers from Estonia: follow-up for cancer incidence and mortality

PubMed Central

Rahu, Kaja; Auvinen, Anssi; Hakulinen, Timo; Tekkel, Mare; Inskip, Peter D; Bromet, Evelyn J; Boice, John D; Rahu, Mati

2013-01-01

This study examined cancer incidence (1986–2008) and mortality (1986–2011) among the Estonian Chernobyl cleanup workers in comparison with the Estonian male population. The cohort of 4,810 men was followed through nationwide population, mortality and cancer registries. Cancer and death risks were measured by standardized incidence ratio (SIR) and standardized mortality ratio (SMR), respectively. Poisson regression was used to analyze the effects of year of arrival, duration of stay, and time since return on cancer and death risks. The SIR for all cancers was 1.06 with 95% confidence interval 0.93–1.20 (232 cases). Elevated risks were found for cancers of pharynx, oesophagus, and the joint category of alcohol-related sites. No clear evidence of an increased risk of thyroid cancer, leukaemia, or radiation-related cancer sites combined was apparent. The SMR for all causes of death was 1.02 with 95% confidence interval 0.96–1.08 (1,018 deaths). Excess mortality was observed for mouth and pharynx cancer, alcohol-related cancer sites together, and suicide. Duration of stay rather than year of arrival was associated with increased mortality. Twenty-six years of follow-up of this cohort indicates no definite health effects attributable to radiation, but the elevated suicide risk has persisted. PMID:23532116

Abortion-related maternal mortality in the Russian Federation.

PubMed

Zhirova, Irina Alekseevna; Frolova, Olga Grigorievna; Astakhova, Tatiana Mikhailovna; Ketting, Evert

2004-09-01

This study examines characteristics and determinants of maternal mortality associated with induced and spontaneous abortion in the Russian Federation. In addition to national statistical data, the study uses the original medical files of 113 women, representing 74 percent of all women known to have died after undergoing an abortion in 1999. The number of abortions and abortion-related maternal deaths fell fairly steadily during the 1991-2000 decade to levels of 56 percent and 52 percent of the 1991 base, respectively. Regional and urban-rural variation is limited. Nine percent of abortion-related maternal mortality is due to spontaneous abortion; 24 percent is related to induced abortions performed inside and 67 percent to those performed outside a medical institution. In the latter group, older women, usually with a history of several pregnancies, are overrepresented. The high rate of abortion-related maternal mortality is due largely to the number of abortions performed at 13-21 weeks' and 22-27 weeks' gestation both inside and outside medical institutions. Improving access to safe second-trimester abortion, preventing delays during the abortion procedure, and adequate treatment of complications are key strategies for reducing abortion-related maternal mortality.

Out of control mortality matters: the effect of perceived uncontrollable mortality risk on a health-related decision.

PubMed

Pepper, Gillian V; Nettle, Daniel

2014-01-01

Prior evidence from the public health literature suggests that both control beliefs and perceived threats to life are important for health behaviour. Our previously presented theoretical model generated the more specific hypothesis that uncontrollable, but not controllable, personal mortality risk should alter the payoff from investment in health protection behaviours. We carried out three experiments to test whether altering the perceived controllability of mortality risk would affect a health-related decision. Experiment 1 demonstrated that a mortality prime could be used to alter a health-related decision: the choice between a healthier food reward (fruit) and an unhealthy alternative (chocolate). Experiment 2 demonstrated that it is the controllability of the mortality risk being primed that generates the effect, rather than mortality risk per se. Experiment 3 showed that the effect could be seen in a surreptitious experiment that was not explicitly health related. Our results suggest that perceptions about the controllability of mortality risk may be an important factor in people's health-related decisions. Thus, techniques for adjusting perceptions about mortality risk could be important tools for use in health interventions. More importantly, tackling those sources of mortality that people perceive to be uncontrollable could have a dual purpose: making neighbourhoods and workplaces safer would have the primary benefit of reducing uncontrollable mortality risk, which could lead to a secondary benefit from improved health behaviours.

Multiple Risk Factors of Alcoholic and Non-Alcoholic Myocardial Infarction Patients.

PubMed

Harisharan; Singh, Awnish Kumar; Dangal, Nidhu Ram; Surapaneni, Krishna Mohan; Joshi, Ashish

2015-05-17

Myocardial infarction (MI) is one of the most critical medical emergency and contributor to morbidity and mortality worldwide. Myocardial infarction is the most common form of coronary heart disease and leading cause of premature death. Past century has seen substantial advancement in the field of medical sciences but still mortality trends due to myocardial infarction is increasing in developing countries including India. We have conducted this study to compare the Sociodemographic characteristics of alcoholic and non alcoholic MI patients admitted in coronary care unit of Saveetha Medical College, Chennai, India. An exploratory cross sectional study was performed by enrolling a convenient sample of 100 Myocardial Infarction patients. Information about Sociodemographic characteristics, past medical history, alcohol and tobacco intake, physical activity, psychological stress and biochemical measurements was gathered. The mean age of the respondents was 46 (SD=6) years and majority of them were male i.e. 82%. 100% married and 89% literate, there were 24% past and 22% present alcoholics. Consumption of alcohol on a monthly, weekly and daily basis was 8%, 11% and 5% respectively. Preference to brandy was 67%, rum was 21% and that the beer was 12%. Current smoker were 20% and former were 11%. 93% and 52% respondents were under medication of beta blocker and angiotensin-converting-enzyme (ACE) inhibitors respectively. Worldwide, MI is the most common cause of mortality and morbidity and hence early diagnosis and management is most essential. Results from our study revealed that, participants had sedentary lifestyles where risk factors of MI such as alcohol consumption, and smoking does existed.

Influence of Motivational Interviewing on Explicit and Implicit Alcohol-Related Cognition and Alcohol Use in At-Risk Adolescents

PubMed Central

Thush, Carolien; Wiers, Reinout W.; Moerbeek, Mirjam; Ames, Susan L.; Grenard, Jerry L.; Sussman, Steve; Stacy, Alan W.

2011-01-01

Both implicit and explicit cognitions play an important role in the development of addictive behavior. This study investigated the influence of a single-session motivational interview (MI) on implicit and explicit alcohol-related cognition and whether this intervention was successful in consequently decreasing alcohol use in at-risk adolescents. Implicit and explicit alcohol-related cognitions were assessed at pretest and one month posttest in 125 Dutch at-risk adolescents ranging in age from 15 to 23 (51 males) with adapted versions of the Implicit Association Test (IAT) and an expectancy questionnaire. Motivation to change, alcohol use and alcohol-related problems were measured with self-report questionnaires, at pretest, at posttest after one month, and at the six-month follow-up. Although the quality of the intervention was rated positively, the results did not yield support for any differential effects of the intervention on drinking behavior or readiness to change at posttest and six-month follow-up. There were indications of changes in implicit and explicit alcohol-related cognitions between pretest and posttest. Our findings raise questions regarding the use of MI in this particular at-risk adolescent population and the mechanisms through which MI is effective. PMID:19290699

Russia-specific relative risks and their effects on the estimated alcohol-attributable burden of disease.

PubMed

Shield, Kevin D; Rehm, Jürgen

2015-05-10

Alcohol consumption is a major risk factor for the burden of disease globally. This burden is estimated using Relative Risk (RR) functions for alcohol from meta-analyses that use data from all countries; however, for Russia and surrounding countries, country-specific risk data may need to be used. The objective of this paper is to compare the estimated burden of alcohol consumption calculated using Russia-specific alcohol RRs with the estimated burden of alcohol consumption calculated using alcohol RRs from meta-analyses. Data for 2012 on drinking indicators were calculated based on the Global Information System on Alcohol and Health. Data for 2012 on mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life Years (DALYs) lost by cause were obtained by country from the World Health Organization. Alcohol Population-Attributable Fractions (PAFs) were calculated based on a risk modelling methodology from Russia. These PAFs were compared to PAFs calculated using methods applied for all other countries. The 95% Uncertainty Intervals (UIs) for the alcohol PAFs were calculated using a Monte Carlo-like method. Using Russia-specific alcohol RR functions, in Russia in 2012 alcohol caused an estimated 231,900 deaths (95% UI: 185,600 to 278,200) (70,800 deaths among women and 161,100 deaths among men) and 13,295,000 DALYs lost (95% UI: 11,242,000 to 15,348,000) (3,670,000 DALYs lost among women and 9,625,000 DALYs lost among men) among people 0 to 64 years of age. This compares to an estimated 165,600 deaths (95% UI: 97,200 to 228,100) (29,700 deaths among women and 135,900 deaths among men) and 10,623,000 DALYs lost (95% UI: 7,265,000 to 13,754,000) (1,783,000 DALYs lost among women and 8,840,000 DALYs lost among men) among people 0 to 64 years of age caused by alcohol when non-Russia-specific alcohol RRs were used. Results indicate that if the Russia-specific RRs are used when estimating the health burden attributable to alcohol consumption in

Projecting future temperature-related mortality in three largest Australian cities.