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Gerhard Gmel

Publications and source records attributed to Gerhard Gmel.

At least 37 records · Page 2Linked to original sources
PubMed2004

Problems with the graduated frequency approach to measuring alcohol consumption: results from a pilot study in Toronto, Canada.

AIMS: To evaluate advantages and disadvantages of the graduated frequency (GF) approach, which asks about the frequency of alcohol consumption at mutually exclusive quantity levels (i.e. 12 or more drinks, at least eight drinks but less than 12, etc.). METHODS: Telephone survey of 464 adults aged 18 and older in Toronto, Canada, using random digit dialing and computer-assisted telephone interviewing. RESULTS: Respondents reported higher frequency and volume of drinking on the GF compared to overall and beverage-specific quantity-frequency type measures; however, at least 16% of GF responses included double counting on their frequency estimates using the GF. When these cases were excluded or corrected, differences between the GF and quantity-frequency measures mostly disappeared. The GF was superior to quantity-frequency measures for identifying heavy episodic drinkers. However, the GF had little advantage over the weekly recall method except for identifying very infrequent (i.e. less often than twice a month) heavy drinkers. CONCLUSIONS: Because the GF has a high rate of response errors in terms of measuring frequency of alcohol consumption, other combinations of measures, including alternate measures of heavy episodic drinking should be considered.

Adolescent↗
PubMed2004

Emotional wellbeing and violence among social and solitary risky single occasion drinkers in adolescence.

OBJECTIVES: To classify adolescents according to risky single occasion drinking (RSOD) and their level of social integration, and to test whether these groups (social non-RSODs, social RSODs, solitary non-RSODs, solitary RSODs) differ in terms of emotional well-being and violence-related variables. METHOD: K-means cluster and multiple logistic regression analyses were performed based on a cross-sectional national representative sample of 3861 8th and 9th graders in Switzerland (mean age 15.3; SD = 0.88). RESULTS: Although RSODs in general appear to be more violent, social RSODs tend to be more violent than solitary RSODs. Although RSODs reveal a lower life satisfaction generally and tend to have more depressive moods, solitary RSODs are even less satisfied and more depressive. In addition, the latter tend to have lower self-esteem and are more often victims of bullying. CONCLUSIONS: RSODs are not a homogeneous group of adolescents and preventive efforts, such as competence-enhancing and social resistance programmes, should be applied in accordance with the constellation of associated problems: solitary RSODs appear to be socially inhibited, depressive and often victims of bullying, whereas social RSODs appear to be socially accepted but are prone to be violent offenders.

Adolescent↗
PubMed2004

Decreased taxation, spirits consumption and alcohol-related problems in Switzerland.

OBJECTIVE: The spirits market in Switzerland was reformed in 1999 in accordance with the World Trade Organization agreement. The resulting tax reform and increased competition have resulted in markedly reduced prices for foreign spirits, and a previous study showed that spirits consumption increased significantly after the tax reform. The present study examined whether alcohol-related problems also increased at follow-up and if they did, whether the increase was the result of increased spirits consumption. Further correlates of alcohol-related problems were also explored. METHOD: Data were obtained from a longitudinal study on changes in alcohol consumption in Switzerland. The baseline survey was conducted 3 months before the tax reform, and the follow-up was conducted 28 months after the tax reform. A randomly selected sample of 4,007 residents aged 15 years or older participated in the baseline survey, and 73% of this sample participated in the follow-up survey. Alcohol consumption was measured on the basis of a graduated frequency, and alcohol-related problems were measured by items taken from the Alcohol Use Disorder Identification Test (AUDIT). RESULTS: Findings indicate that alcohol-related problems increased significantly at follow-up. The significance disappeared, however, after controlling for spirits consumption, indicating that the increase of alcohol-related problems at follow-up was mainly mediated through increased consumption of spirits. The multiple regression models showed that spirits, beer and wine consumption, gender, Age*Spirits Consumption interaction, region, smoking status, heavy-drinking frequency and average number of drinks were significant correlates of alcohol-related problems. CONCLUSIONS: Alcohol-related problems increased at the follow-up, particularly among younger age groups who consumed more spirits. Prevention programs on alcohol-related problems should target young people.

Adolescent↗
PubMed2003

Alcohol consumption and total mortality/morbidity-definitions and methodological implications.

Two main types of studies of alcohol consumption and total mortality/morbidity are distinguished, namely: individual level studies and aggregate level studies. Alcohol consumption is usually characterized in terms of volume or average volume of consumption. More recently, patterns of drinking, especially heavy drinking occasions, have been introduced. On the individual level, the definition of mortality is trivial (death) and morbidity is either defined by hospitalization or by subjective definitions. On the aggregate level, mortality is defined either in death rates or in years of life lost, and morbidity as hospitalization rates or years of life lost to disability. Disability Adjusted Life Years (DALYs) combine mortality and morbidity into a summary measure of health. Individual level studies clearly should be given preference in assessing the relationship between alcohol and outcomes, as long as the assessment of alcohol consumption is state-of-the-art and the sample includes all relevant drinking patterns, plus if there is adequate control for confounding and adequate statistical analysis.

Alcohol Drinking↗
PubMed2003

How stable is the risk curve between alcohol and all-cause mortality and what factors influence the shape? A precision-weighted hierarchical meta-analysis.

OBJECTIVE: To determine the influence of six determining variables on the shape of the risk curve between alcohol and all-cause mortality. METHODS DATA: Based on a systematic search with clear inclusion criteria, all articles on alcohol and all-cause mortality until 2000 were included. STATISTICAL METHODS: Precision-weighted pooling of relative risks (RRs); precision-weighted hierarchical analysis. VARIABLES: For pooling: RRs for different categories of average volume of drinking, lifetime abstainers and ex-drinkers. For hierarchical analysis: on first level: consumption in grams of pure alcohol per day; on second level: length of follow-up time in months; per capita consumption; average age, proportion of abstainers, average volume of drinking, and variability of average volume of drinking at baseline. OUTCOMES MEASURES: RR of former and current drinkers for all-cause mortality compared to abstainers. RESULTS: The main hypotheses could be confirmed for males: Ex-drinkers had a higher mortality risk than lifetime abstainers; the higher and the more diverse the average volume of alcohol consumption, the wider the dip of the curve; the older the persons at baseline, the more pronounced the protective effect; and the longer the follow-up time, the less pronounced the protective effect. Except for average volume of drinking effects for females went in the same direction but with one exception did not reach significance. CONCLUSIONS: There are systematic influences on the shape of the risk curve between alcohol and all-cause mortality. The overall beneficial effect of light to moderate drinking remained under all scenarios, indicating a high validity of the overall shape despite the heterogeneity between studies.

Age Distribution↗
PubMed2003

Changes in alcohol consumption following a reduction in the price of spirits: a natural experiment in Switzerland.

AIMS: To discover what changes in alcohol consumption had occurred in subgroups defined by age, sex, volume of drinking and drinking occasions, following a reduction in the price of spirits in Switzerland in July 1999. DESIGN: Quasi-experimental. Longitudinal general-population survey with baseline 3 months before and follow-up 3 months after price change. PARTICIPANTS: Probabilistic telephone sample of 1347 individuals with at least monthly consumption on average in the previous 6 months at both interviews. The response rate at baseline was 74,8% and the attrition rate from baseline to follow-up 20.2%. MEASUREMENTS: Alcohol consumption was assessed by means of a beverage-specific graduated-frequency measure. High volume of drinking was defined as 40 + g/day for men and 20 + g/day for women. Binge drinking was defined as six + drinks on an occasion for men and four + drinks for women. FINDINGS: Spirits consumption increased significantly (by 28.6%) in the total sample, and specifically in young males and in individuals who were low-volume drinkers at baseline. Consumption of alcohol overall, or of wine or beer, did not change significantly. No indication of effects of substitution was found. CONCLUSIONS: Spirits consumption showed price-responsiveness in the early postintervention period. This finding is of particular interest, as (a) the increase in spirits consumption took place at a time of generally declining consumption of alcohol in Switzerland; and (b) in contrast to the findings of most studies, the intervention, namely price reduction, increased availability.

Adolescent↗
PubMed2003

The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview.

AIMS: As part of a larger study to estimate the global burden of disease attributable to alcohol: to quantify the relationships between average volume of alcohol consumption, patterns of drinking and disease and injury outcomes, and to combine exposure and risk estimates to determine regional and global alcohol-attributable fractions (AAFs) for major disease and injury categories. DESIGN, METHODS, SETTING: Systematic literature reviews were used to select diseases related to alcohol consumption. Meta-analyses of the relationship between alcohol consumption and disease and multi-level analyses of aggregate data to fill alcohol-disease relationships not currently covered by individual-level data were used to determine the risk relationships between alcohol and disease. AAFs were estimated as a function of prevalence of exposure and relative risk, or from combining the aggregate multi-level analyses with prevalence data. FINDINGS: Average volume of alcohol consumption was found to increase risk for the following major chronic diseases: mouth and oropharyngeal cancer; oesophageal cancer; liver cancer; breast cancer; unipolar major depression; epilepsy; alcohol use disorders; hypertensive disease; hemorrhagic stroke; and cirrhosis of the liver. Coronary heart disease (CHD), unintentional and intentional injuries were found to depend on patterns of drinking in addition to average volume of alcohol consumption. Most effects of alcohol on disease were detrimental, but for certain patterns of drinking, a beneficial influence on CHD, stroke and diabetes mellitus was observed. CONCLUSIONS: Alcohol is related to many major disease outcomes, mainly in a detrimental fashion. While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury. The influence of patterns of drinking may be underestimated because pattern measures have not been included in many epidemiologic studies. Generalizability of the results is limited by methodological problems of the underlying studies used in the present analyses. Future studies need to address these methodological issues in order to obtain more accurate risk estimates.

Acute Disease↗
PubMed2003

Does price matter? The effect of decreased price on spirits consumption in Switzerland.

BACKGROUND: On July 1st, 1999, the spirits market in Switzerland was reformed based on the World Trade Organization (WTO) agreement. The tax reform, in addition to increased competition, has resulted in a 30-50% decrease in price for foreign spirits (liquor). The purpose of the present study is to examine whether decreased prices due to the tax reform and the liberalized spirits market in Switzerland have had an effect on spirits consumption, and whether the effect differs by demographic and other correlates. METHODS: The present study uses data from a longitudinal study on changes in alcohol consumption in Switzerland's resident population. The baseline survey was conducted 3 months before the tax reform and the follow-up was conducted 28 months after the tax reform. A randomly selected sample of 4007 residents aged 15 years or older participated in the baseline survey and 73% in the follow-up survey. The data were obtained by computer-assisted telephone interview, including detailed questions on alcohol consumption, drinking habits, problem drinking, purchase of spirits and socio-demographic characteristics. RESULTS: Consumption of spirits increased after the price of spirits decreased. The increase in spirits consumption was consistent across subgroups, with the exception of the group aged 60 or older. Moreover, the increase in spirits consumption persisted even after adjustment for significant correlates of spirits consumption. Apart from age, there was no evidence that the increase in spirits consumption differed between subgroups as defined by sex, region, working status, education, smoking, drinking frequency, or average number of drinks. CONCLUSIONS: The findings demonstrate that younger people are more affected by price than older persons. This study demonstrated that price should be considered an effective policy to reduce alcohol misuse and alcohol-related problems, especially among the younger population.

Adolescent↗
PubMed2003

The global distribution of average volume of alcohol consumption and patterns of drinking.

AIMS: To make quantitative estimates on a global basis of exposure of disease-relevant dimensions of alcohol consumption, i.e. average volume of alcohol consumption and patterns of drinking. DESIGN: Secondary data analysis. MEASUREMENTS: Level of average volume of drinking was estimated by a triangulation of data on per capita consumption and from general population surveys. Patterns of drinking were measured by an index composed of several indicators for heavy drinking occasions, an indicator of drinking with meals and an indicator of public drinking. Average volume of consumption was assessed by sex and age within each country, and patterns of drinking only by country; estimates for the global subregions were derived from the population-weighted average of the countries. For more than 90% of the world population, per capita consumption was known, and for more than 80% of the world population, survey data were available. FINDINGS: On the country level, average volume of alcohol consumption and patterns of drinking were independent. There was marked variation between WHO subregions on both dimensions. Average volume of drinking was highest in established market economies in Western Europe and the former Socialist economies in the Eastern part of Europe and in North America, and lowest in the Eastern Mediterranean region and parts of Southeast Asia including India. Patterns were most detrimental in the former Socialist economies in the Eastern part of Europe, in Middle and South America and parts of Africa. Patterns were least detrimental in Western Europe and in developed countries in the Western Pacific region (e.g., Japan). CONCLUSIONS: Although exposure to alcohol varies considerably between regions, the overall exposure by volume is quite high and patterns are relatively detrimental. The predictions for the future are not favorable, both with respect to average volume and to patterns of drinking.

Alcohol Drinking↗
PubMed2003

Alcohol as a risk factor for global burden of disease.

AIM: To make quantitative estimates of the burden of disease attributable to alcohol in the year 2000 on a global basis. DESIGN: Secondary data analysis. MEASUREMENTS: Two dimensions of alcohol exposure were included: average volume of alcohol consumption and patterns of drinking. There were also two main outcome measures: mortality, i.e. the number of deaths, and disability-adjusted life years (DALYs), i.e. the number of years of life lost to premature mortality or to disability. All estimates were prepared separately by sex, age group and WHO region. FINDINGS: Alcohol causes a considerable disease burden: 3.2% of the global deaths and 4.0% of the global DALYs in the year 2000 could be attributed to this exposure. There were marked differences by sex and region for both outcomes. In addition, there were differences by disease category and type of outcome; in particular, unintentional injuries contributed most to alcohol-attributable mortality burden while neuropsychiatric diseases contributed most to alcohol-attributable disease burden. DISCUSSION/CONCLUSIONS: The underlying assumptions are discussed and reasons are given as to why the estimates should still be considered conservative despite the considerable burden attributable to alcohol globally.

Alcohol Drinking↗
PubMed2003

Alcohol-related morbidity and mortality.

Alcohol use is related to a wide variety of negative health outcomes including morbidity, mortality, and disability. Research on alcohol-related morbidity and mortality takes into account the varying effects of overall alcohol consumption and drinking patterns. The results from this epidemiological research indicate that alcohol use increases the risk for many chronic health consequences (e.g., diseases) and acute consequences (e.g., traffic crashes), but a certain pattern of regular light-to-moderate drinking may have beneficial effects on coronary heart disease. Several issues are relevant to the methodology of studies of alcohol-related morbidity and mortality, including the measurement of both alcohol consumption and the outcomes studied as well as study design. Broad summary measures that reflect alcohol's possible effects on morbidity, mortality, and disability may be more useful than measures of any one outcome alone.

Alcohol Drinking↗
PubMed2003

Harmful alcohol use.

Alcohol misuse can harm people other than the drinker, and can have negative consequences for society as a whole. It is commonly believed to play a role in decreased worker productivity, increased unintentional injuries, aggression and violence against others, and child and spouse abuse. Research findings support the idea that drinking is involved in or associated with many of these social harms, but do not offer evidence that it causes these effects. Methodological flaws characterize much of the research in this area. Use of better design and statistical methodology is necessary in order to clarify the relationship between drinking and the harmful consequences it is believed to cause.

Absenteeism↗
PubMed2003

International comparisons of alcohol consumption.

International comparisons of alcohol consumption and its consequences can serve multiple purposes. For example, despite differences among countries in drinking cultures, drink sizes and strengths, and methods of measuring alcohol consumption, international survey research has provided a substantial amount of information on the rates of abstinence or current drinking, the frequency of drinking or binge drinking, and the mean consumption among both adults and youths in many countries. Other studies using aggregate-level data have analyzed per capita alcohol consumption in various countries. These studies can be used to relate per capita consumption to certain alcohol-related outcomes and to evaluate changes of both consumption and different outcomes within a country or across countries over time. Some problems associated with international research, however, such as issues of comparability of surveys, still need to be resolved.

Alcohol Drinking↗
PubMed2002

[Changes in the age of onset of cannabis use: results of the 2nd Swiss Health Survey 1997].

OBJECTIVES: Based on data from the second Swiss Health Survey conducted in 1997, the present study investigates changes in the onset of cannabis use and associated consequences. METHODS: Telephone interviews were conducted with 7743 individuals aged 15 to 49 years. Life time prevalences, onsets of illicit drugs use, and cessation of cannabis use were investigated. RESULTS: Using survival analysis, the study shows that, in Switzerland onset into the use of cannabis has decreased by almost nine months between 1992 and 1997 down to 15.83 years old. An early onset is associated with higher prevalences of other illicit drug use (e.g., cocaine, ecstasy, hallucinogens), and early onsets into the use of these drugs. Similarly, cessation of cannabis use is less frequent in early onset users. CONCLUSION: Results are discussed in the light of increasing prevalences of cannabis use and the discussion about an increasing legalization, respectively depenalization, of cannabis use in Switzerland.

Adolescent↗
PubMed2001

Investigating Gender Convergence in Alcohol Consumption in Finland, Germany, The Netherlands, and Switzerland: A Repeated Survey Analysis.

Since the 1970s there has been concern that women may have started to adopt the drinking behaviors of men, a process seen as the result of emancipation in which women increasingly move into professions and/or lifestyles similar to those of men. This is called the convergence hypothesis. The present analysis investigated a possible closing of the gender gap and includes four countries that had national survey data for at least two time points: Finland (1984, 1992), Germany (1984, 1990), The Netherlands (1981, 1989), and Switzerland (1987, 1992). Significant convergence could be found only in Finland, which consisted of a greater increase of Finnish women becoming current drinkers and of a greater relative increase in the women's mean consumption. The fact that gender convergence was found only for Finland could be due not only to the longer observation period, but also to the egalitarian position of women and the changing drinking culture of the country.

Journal Article↗
PubMed2000

Women's Roles and Women's Drinking: A Comparative Study in Four European Countries.

The present study analyzes the influence of role combinations on heavy drinking in four European countries: Finland, France, Germany, and Switzerland. Data sets come from nationally representative surveys. A growing number of studies have investigated the influence of social roles on alcohol consumption. Different theories such as role accumulation, role overload, and role deprivation aim to explain the association between roles and poor mental health, including heavy alcohol consumption. The results show that roles and role combinations influence heavy drinking differently in each country. The findings also indicate that the social position of women in a country is strongly connected to the differing associations between specific role combinations and heavy drinking across countries. No single role theory can be applied cross-culturally. Large-scale surveys are needed to test statistically the association between role combinations and heavy drinking.

Journal Article↗