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Biomedical subjects

R G Smart

Publications and source records attributed to R G Smart.

At least 19 recordsLinked to original sources
PubMed2000

The impact of programs for high-risk drinkers on population levels of alcohol problems.

AIMS: Historically, treatment programs and related activities for alcoholics or high-risk drinkers have been viewed as not relevant to efforts to prevent alcohol problems, and in particular population-based prevention efforts. In this review we consider evidence that high-risk programs may have an impact on population or aggregate levels of these problems. DESIGN: We first summarize recent reviews of the clinical impact of programs for high-risk drinkers, since some level of effectiveness at the individual level is necessary for these programs to have an aggregate level impact. Following that, correlational evidence on the impact of high-risk programs on aggregate problem levels is examined. Estimates of the potential impact of high-risk programs on aggregate problem levels, based on available information on the impact of these programs and the numbers of individuals affected, are then considered, as are estimations of the comparative aggregate level impact of high-risk and consumption reduction strategies. FINDINGS: There is increasing evidence that high-risk programs have beneficial effects for individuals. Available correlational evidence supports the proposal that increases in treatment and AA have contributed to the declines in alcohol-related morbidity and mortality observed in some countries in recent years. Studies estimating the recent impact of increases in levels of treatment and AA membership support that interpretation, and studies comparing estimated effects of high-risk and population strategies find similar potential for aggregate effects. CONCLUSIONS: Programs for high-risk drinkers can have beneficial aggregate-level effects and are thus a valuable component of population-based efforts to reduce alcohol problems.

Alcohol-Related Disorders↗
PubMed2000

The direct and indirect relationships between alcohol prevention measures and alcoholic liver cirrhosis mortality.

OBJECTIVE: The objective of this article is to investigate direct and indirect relationships between prevention measures and alcoholic liver cirrhosis mortality in Canadian provinces from 1968 to 1986. METHOD: The data base that was assembled included alcoholic cirrhosis mortality rates, alcohol availability measures (rate of licensed premises, year in which the legal drinking age was reduced), per capita consumption of alcohol, rates of AA members and groups, and economic and demographic measures. This article develops a two-equation analytic model based on the availability theory of alcohol problems and prevention (Single, 1988). The distinction between direct and indirect effects of prevention measures can be made explicitly with this model. RESULTS: Alcohol availability measures, but not AA measures, had a significant direct potential impact on alcohol consumption. AA measures had a significant direct relationship to cirrhosis mortality rates. Alcohol consumption also had a significant direct relationship to cirrhosis mortality, and alcohol availability measures had an important indirect relationship through their influence on per capita alcohol consumption. CONCLUSIONS: While these observations need to be interpreted cautiously, the two-equation model shows promise as an approach to understanding direct and indirect influences on alcohol problems. As expected, AA measures and per capita alcohol consumption demonstrated significant direct relationship to cirrhosis mortality. In addition, important indirect influences of drinking-age changes and rates of licensed premises on cirrhosis mortality were observed through their relationships to per capita alcohol consumption.

Adult↗
PubMed2000

Do changes in per capita consumption mirror changes in drinking patterns?

OBJECTIVE: The goal of this study was to examine how well per capita alcohol consumption figures derived from beverage sales data relate to changes over time in survey-based measures of drinking patterns. It was expected that strong associations would be found among these various measures of consumption. METHOD: Data from 12 household surveys conducted in Ontario between 1977 and 1997 provided information on: percentages of drinkers; daily drinkers; those drinking five or more drinks at a sitting weekly; those reporting two or more alcohol-related harms; and average number of drinks per week. These variables were then correlated with per capita consumption. RESULTS: Significant correlations were found only between per capita consumption and percentage of daily drinkers, and between percentage of drinkers and average number of drinks per week. CONCLUSIONS: The relationship of per capita consumption to survey measures of drinking is weak. The absence of consistent associations over time between per capita consumption and survey measures may be attributable to the small number of available data points or to increases in unrecorded consumption. Further research is needed to verify and explain these results.

Adult↗
PubMed2000

Cannabis users in the general Canadian population.

In a national survey conducted in 1994, 29.3% of all respondents reported that they had used cannabis at least once, 7.3% reported using at least once during the year of the survey, and 2.0% reported using cannabis at least once a week during the year of survey. Nonusers and those with different patterns of cannabis use could be distinguished by age; gender; the use of alcohol, tobacco, and other drugs; and involvement with drug users. Frequent cannabis use at the time of the survey was associated with "heavy" drinking and drinking problems, drinking and driving, driving within 2 hours of using cannabis, and the use of other drugs, especially among young males. The association between regular cannabis use, "heavy" drinking, and other risk behaviors poses challenges to prevention and harm-reduction initiatives.

Adolescent↗
PubMed1999

Heavy drinking and problems among wine drinkers.

OBJECTIVE: The purpose of this study was to see whether adults who drank wine exclusively would have lower quantity-frequency scores, less intoxication and fewer alcohol-related problems than those who drank other types of alcohol. METHOD: Data were analyzed from a national survey of the use of alcohol and other drugs conducted in Canada in 1994 (N = 8,758). RESULTS: Wine only drinkers were less often intoxicated than other drinkers. They also had lower quantity-frequency scores and reported fewer alcohol-related problems than other drinkers. These results were maintained when age, gender and quantity-frequency were taken into account. CONCLUSIONS: Wine only drinkers drink less than other types of drinkers and have fewer problems. As wine is often drunk with meals there is probably more social control over drinking. Also, since wine drinkers drink with meals their blood alcohol concentrations may be lower.

Adolescent↗
PubMed1998

Changes in liver cirrhosis death rates in different countries in relation to per capita alcohol consumption and Alcoholics Anonymous membership.

OBJECTIVE: This study examines how trends in liver cirrhosis relate to per capita alcohol consumption and Alcoholics Anonymous (AA) membership in 33 countries between 1965 and 1991. It was expected that reductions in liver cirrhosis deaths seen in many countries would be related to both decreased consumption and increased AA membership. METHOD: Data on liver cirrhosis death rates, alcohol consumption and AA membership were gathered from a variety of international sources. The data were analyzed with regression analyses (Ordinary Least Squares). RESULTS: Cirrhosis deaths and alcohol consumption levels were positively related in all analyses. In two of the four analyses, the negative relationship between cirrhosis deaths and AA group rates was marginally significant. CONCLUSIONS: Liver cirrhosis rates were strongly related to alcohol consumption and showed some relationship to AA group rates. The modest impact of AA may be due to the weakness of the true relationship but also to incompleteness in the cirrhosis and AA data in some countries.

Alcohol Drinking↗
PubMed1997

Interventions by students in friends' alcohol, tobacco, and drug use.

This article investigates self-reported interventions by students in the alcohol, tobacco, illicit drug use, and drinking-driving of their friends. The data came from a study of 1184 students in Ontario schools in grades 7, 9, 11, and 13. We found that about a third of students intervened in friends' illegal drug use and drinking-driving but about half intervened about smoking. Students who intervened were more likely to be older and spend fewer nights at home. They were less likely to use cannabis, but had more friends using cannabis and illegal drugs. Also, they had more exposure to drug education and were more disapproving of drug use. Drug education may give students the knowledge and confidence to intervene in friends' drug use.

Accidents, Traffic↗
PubMed1997

Do increased levels of drug abuse treatment lead to fewer drug-related problems?

It has been argued that increased levels of treatment for drug abuse are effective in reducing the levels of drug problems. During the 1980s in Ontario levels of treatment increased considerably. More treatment facilities were opened, and the number of drug abuse cases increased by a factor of about seven. It was expected that drug-related problems (mortality, morbidity, and convictions) would decrease, as happened for alcohol problems when alcohol treatment levels increased. However, the results were inconsistent. Hospital separations for drug problems decreased in the late 1970s and then increased in the 1980s. However, deaths from drug psychoses and drug dependency showed an opposite trend. Convictions for cocaine offences increased while those for narcotics, LSD, and hallucinogenic drugs showed a substantial decline from the early 1980s to the present. Significant negative correlations (suggestive of a beneficial impact) were found between treatment rates and three drug-problem measures (deaths rates from drug psychoses and drug dependence, other drug-related deaths, and convictions under the Food and Drug Act); however, a significant positive correlation was found between treatment rates and Narcotic Control Act convictions. Thus, although some of the predicted negative relationships between treatment rates and drug problems were observed, the correlations did not provide a consistent picture of the effects of increased drug treatment. More research is needed to identify better indicators of drug problems and monitor the factors that influence them.

Adult↗
PubMed1996

Does increased spending on alcoholism treatment lead to lower cirrhosis death rates?

The purpose of this study was to see if recent changes in the funding of alcoholism programmes in the United States were related to changes in liver cirrhosis death rates. Data on per-capita spending, per-capita alcohol consumption and cirrhosis death rates were gathered from various sources for the years 1979 and 1989 for the 50 states and the District of Columbia. Regression analysis showed that greater increases in spending on alcoholism across US states were associated with greater declines in cirrhosis mortality rates. Since alcohol-related deaths cause large productivity losses and treatment is relatively cheap this creates large savings for society.

Alcoholism↗
PubMed1996

Alcohol, drugs and gambling in the Ontario adult population, 1994.

OBJECTIVE: To demonstrate the link between gambling, alcohol and drug problems among Ontario adults and to present information on the relationship between expenditures on gambling and type of gambling with gambling problems. METHOD: Using data collected in a 1994 telephone survey of 2,016 randomly chosen Ontario adults, gambling problems are related to the CAGE scale of alcohol problems and the ICD-10 measure of alcohol dependence, as well as smoking, other drug use, and demographic variables. Descriptive tables based on crosstabulations and means are provided, as well as a series of 9 logistic regression models. RESULTS: The most significant predictor of gambling problems was the amount spent on gambling in the preceding 30 days, with alcohol dependence on the ICD-10 scale and age also important predictors. Lottery players, compared to other gamblers, are more likely to be male, relatively less affluent, older on average, more likely to report alcohol problems (but not dependence) and be currently smoking. CONCLUSIONS: The results make clear that heavy drinking and drinking problems are associated with higher levels of spending on gambling and reports of gambling problems. This leads to the suggestion that treatment programs for those with gambling, alcohol or other drug problems should assess that possibility of comorbidity, since the presence of more than one of these problems can significantly affect the success of treatment and contribute to relapse.

Adult↗
PubMed1996

Procurement of alcohol and underage drinking among adolescents in Ontario.

OBJECTIVE: The purpose of this article is to examine the procurement of alcohol among underage drinkers. METHOD: The data are based on a survey of 3,571 students in Ontario schools. Underage drinkers were those younger than 19 years of age. Data were gathered with an anonymous questionnaire administered in classrooms in 1992. The data include descriptive analysis of underage procurement and a cluster analysis of underage drinker types (n = 1,125: 566 female). RESULTS: Most students found alcohol easy to obtain, with the most common access being from parents' supplies or older friends. Four types of underage drinkers were identified: bar drinkers (5%), frequent purchasers (10%), frequent obtainers (3%) and infrequent obtainers (83%). CONCLUSIONS: Frequent self purchasers and infrequent secondary purchasers have the highest levels of consumption and problems. However, most underage drinkers report no problems.

Adolescent↗
PubMed1996

Alcohol-related measures as factors in traffic fatalities.

OBJECTIVE: The purpose of this study was to determine if alcohol-related measures (per capita consumption, drinking-driving arrest rate, alcohol abuse treatment rate and Alcoholics Anonymous [AA] membership rate) were related to differences between states in traffic fatality rates (total and alcohol-related). METHOD: Fatality rates were regressed onto the alcohol-related variables, using state level data for 1982 and 1990 as well as measures of relative change between the 2 years. RESULTS: Fatality rates demonstrated significant positive relationships with per capita consumption and drinking-driving arrest rates, and significant negative relationships with AA membership rates, for the years 1982 and 1990. Also, changes in per capita consumption were significantly and positively related to changes in both traffic fatality measures. CONCLUSIONS: Per capita alcohol consumption measures were the strongest and most consistent determinants of traffic fatality measures. The negative relationship between AA membership rates and traffic fatality measures for 1982 and 1990 suggests a beneficial impact of AA on these measures at the aggregate level, although other explanations are possible.

Accidents, Traffic↗
PubMed1996

Behavioral and social consequences related to the consumption of different beverage types.

OBJECTIVE: The purpose of this article is to review the literature on the effects of beer, wine and spirits on the behavioral consequences of alcohol consumption. METHOD: The methods involve library research and analysis of the various published articles relating to experimental and survey studies of different effects RESULTS: The major results indicate that (1) after spirits consumption blood alcohol concentrations rise more quickly than after beer; (2) for most behavioral tasks beer creates less impairment than brandy at the same dose levels; (3) brandy also leads to more emotional and aggressive responses; (4) those who drink beer or beer and spirits have more alcohol-related problems than others; and (5) beer drinkers are more likely than others to drink and drive, to be arrested for drinking-driving and to be in alcohol-related accidents. CONCLUSIONS: It appears that beer and spirits lead to greater problems than does wine consumption. However, there is a need for more studies of women and confirmed drinkers of various beverages. There is also a need to study the effects of wine consumption on behavioral impairment. Lastly, there is a need to determine if there is a beer-drinking culture which supports heavy drinking and driving after drinking.

Accidents, Traffic↗