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Biomedical subjects

R G Smart

Publications and source records attributed to R G Smart.

At least 55 records · Page 3Linked to original sources
PubMed1991

Reductions in cirrhosis deaths in the United States: associations with per capita consumption and AA membership.

Cirrhosis mortality and morbidity rates have declined in many jurisdictions, including the U.S., in recent years. Previous research in Canada and Europe suggests that these declines are linked to changes in per capita consumption of alcohol and changes in the availability and/or utilization of services to reduce abusive drinking (e.g., treatment, Alcoholics Anonymous). In this study, changes in cirrhosis death rates in the 50 U.S. states and the District of Columbia between 1974 and 1983 were regressed onto changes in per capita consumption (1974-83). AA membership (1974-83) and alcoholism treatment (1979-82). No significant relationship between treatment and cirrhosis changes was observed; however, the measure of change in treatment may not reflect the full extent of changes that occurred in the 1974-83 period. As predicted, decreases in per capita consumption and increases in AA membership were significantly associated with decreases in cirrhosis rates.

Alcohol Drinking↗
PubMed1991

Use of the CAGE scale in a population survey of drinking.

This article examines the use of the CAGE scale, a 4-item self-report screening test designed to identify problem drinkers, among 703 drinkers aged 18 and over interviewed in a general population survey. The results showed that 10.9% of drinkers reported two or more items affirmatively, the suggested cut-off indicative of problem drinking. This rate is similar to the percentage of drinkers who consume four or more standard drinks daily, derived from aggregate per capita consumption estimates. Factor analysis of the items showed a unidimensional scale with good psychometric properties. Other cut-offs are also compared with other alcoholism estimates. In general, the results indicated some utility of the CAGE in general population surveys.

Adolescent↗
PubMed1991

Crack cocaine use: a review of prevalence and adverse effects.

Crack is a potent form of cocaine which results in rapid and striking stimulant effects when smoked. This paper reviews epidemiological research on the extent of use as well as reports of adverse effects. Crack is used by a small minority of adult and student populations but by a large proportion of cocaine users and heavy drug-using groups. Use does not appear to be increasing in general populations, but there are no trend studies for high-risk groups. Crack users tend to be young, heavy polydrug users, many of whom have serious drug abuse problems. The adverse reactions to crack are similar to those of cocaine and include effects on offspring, neurological and psychiatric problems, as well as pulmonary and cardiac abnormalities. However, two adverse reactions unique to crack have been reported. One relates to lung infiltrates and bronchospasm. The other involves neurological symptoms among children living in crack smoke-filled rooms. There is a need for improved treatment and preventive programs for crack use.

Adolescent↗
PubMed1991

World trends in alcohol consumption.

Data from a worldwide alcohol project suggest significant changes in world alcohol consumption since the early 1970s, with many developing countries showing large increases up to 1981. Whether the recent declines in consumption observed in developed countries will be mirrored in the developing world remains to be seen.

Alcohol Drinking↗
PubMed1990

Are increases in treatment levels and Alcoholics Anonymous membership large enough to reduce liver cirrhosis rates?

Recent reductions in liver cirrhosis morbidity and mortality rates have been noted in many Western countries. We have previously observed that these declines are associated with increases in treatment for alcohol abuse over regions of Ontario, and increases in Alcoholics Anonymous (AA) membership over American states. One important question is whether the potential impact of treatment and AA membership increases could be large enough to have an impact on population cirrhosis rates. We explore this issue using estimates of the effects of treatment and AA membership, and of the likelihood of alcohol abusers developing cirrhosis, derived from the research literature. The results suggest that increases in treatment and AA membership could indeed have made important contributions to declines in cirrhosis mortality and morbidity in Ontario (1975-82) and the USA (1979-82).

Alcoholics Anonymous↗
PubMed1990

Drug abuse and alcohol problems among cocaine abusers in an assessment/referral service.

This paper reports the social, demographic and drug abuse backgrounds of cocaine abusers seen at an alcohol and drug abuse assessment centre in Kitchener, Ontario. It compares cocaine abusers to cannabis users and alcoholics of the same age at the same centre. Cocaine and cannabis abusers are mainly young, single males while alcohol abusers are much older. The cocaine and cannabis abusers are both heavy drinkers but the cocaine group contained more high-risk drinkers, more drug injectors and had a higher alcohol consumption. Cocaine abusers are young poly-drug users for whom drinking is also a major problem. Treatment plans should take these problems into account.

Alcoholism↗
PubMed1990

Changes in suicide rates after reductions in alcohol consumption and problems in Ontario, 1975-1983.

In this paper the relationships among suicide rates in Ontario for males, females and the total population, alcohol consumption, and other alcohol-related problems are examined for the period 1963-1983. Suicide rates, like other alcohol-related problems, were strongly correlated with per capita consumption over the total period. However, during the recent period of stabilization in consumption (1975-83), the correlations were markedly reduced and substantial differences in trends for males and females were observed. The contribution to these diverging trends of such factors as increased treatment of alcohol abuse, rising unemployment, and reduced use of tranquilizing drugs is discussed.

Adult↗
PubMed1990

Trends in treatment admissions for cocaine and other drug abusers.

This paper examines the proportion of drug abusers who report cocaine abuse as their primary problem at a Toronto clinic. In addition, characteristics of cocaine abusers are compared with those of alcohol and cannabis abusers. There is a significant increase in the proportion of drug abusers seeking treatment for cocaine use relative to other drugs, and a dramatic increase in their absolute numbers. Differences in age, marital status and socioeconomic status among cocaine, alcohol, and cannabis abusers are also noted.

Adolescent↗
PubMed1990

Drug use in Ontario, Canada.

Two long-term surveys of drug use have been carried out in Ontario, Canada--one involving middle- and high-school students, and the other adults in the general population. These studies revealed that use of tobacco and alcohol is common and that cannabis is the most widely used illicit drug by both the students and adults (15.9% and 9.5%, respectively, in 1987). Use of other illicit drugs is much less common. The trend data from 1977 to 1987 show a decrease in all drug use among students and a basically stable pattern among adults, with the exception of an upward trend in cocaine use. A study of adult cocaine users in the community found that half had experienced intense cravings for cocaine and other adverse effects. Demographic information was also gathered that made it possible to outline the most common characteristics of cannabis and cocaine users.

Adolescent↗
PubMed1990

Comparison of alcohol, tobacco, and illicit drug use among students and delinquents in the Bahamas.

Surveys of drug use were conducted among 4,767 junior and senior high school students in 1987 and 74 incarcerated delinquents in 1988 in the Bahamas. It was found that the majority of both groups reported having drunk alcohol, and substantial proportions had also smoked tobacco, although over twice as many delinquents as students had smoked. However, use of illicit drugs was far more common among delinquents, at seven times the student rate for marijuana and six times their rate for cocaine. Many social and demographic similarities were found among users in both groups, who were likely to be males who had trouble in school or did not attend school, were not religiously active, and came from families where drugs were used or sold. Over one-third of the delinquents had sold drugs, but almost half (44%) of the delinquents and 25% of the students said they would use or sell marijuana or cocaine if they had it. The results of the studies point to the need for increased drug education in the Bahamas and for efforts involving schools, churches, parents, the media, and Government.

Adolescent↗
PubMed1989

Student cannabis use and enforcement activity in Canada: 1977-1987.

This paper explores the relationship between cannabis use among Ontario students and enforcement activity between the years 1977 and 1987. Although the results clearly showed a significant decline in the use of cannabis during this time period, none of the enforcement activity factors were significantly related to prevalence of use. The only significant association showed that quantity of cannabis-related seizures, was correlated with students perceived availability of cannabis. Data with longer time trends and more intervals are needed to establish the existence of any relationship between prevalence of drug use and enforcement activity.

Adolescent↗
PubMed1989

Decreases in alcohol problems and increased Alcoholics Anonymous membership.

In this study, the impact of changes in rates of Alcoholics Anonymous (AA) membership and per capita consumption of alcohol on changes in rates of cirrhosis, drinking-driving charges and liquor act charges are examined for the 10 provinces of Canada over the period 1974-1983. Neither measure was significantly related to changes in cirrhosis rates. However, AA membership and consumption changes were associated, in an interactive manner, with changes in drinking-driving and liquor act charges.

Alcoholics Anonymous↗
PubMed1989

Is the postwar drinking binge ending? Cross-national trends in per capita alcohol consumption.

Examination is made of per capita alcohol consumption data for 33 (largely developed) countries for 4 periods of time--1951-1952, 1968-1970, 1974-1976 and 1983-1984. The trends indicate that there was a large increase in consumption between 1950-1952 and 1974-1976 in most countries. However, after 1974-1976, consumption stabilized or decreased in most. Declines appear to be more common in wine-drinking countries and in those with very high levels of consumption. The tendency for countries to have a dominant beverage has declined: the overall trend has been towards beer consumption and away from spirits consumption. Reasons for the results include demographic changes and life style changes towards greater interest in health.

Alcoholic Beverages↗
PubMed1989

Increased exposure to alcohol and cannabis education and changes in use patterns.

The introduction of new alcohol and cannabis education programs in Ontario schools was associated with significant increases in reported exposure to alcohol and cannabis education. Significant increases were reported for both sexes, all grade levels, and geographic areas. These were associated with decreases in proportions of drinkers, especially among younger students. Little effect was seen on heavy drinking. The evidence also suggests that reported increased exposure to cannabis education was not associated with reduced cannabis use. The challenge remains to develop alcohol education programs which can reduce heavy drinking and to develop effective cannabis education programs.

Adolescent↗
PubMed1989

Ethnicity and drug use: a critical look.

The present study addresses two limitations of the literature regarding the ethnicity-drug use relationship, namely, the absence of ethnically diverse samples and also the inadequate control of background variables. The data employed consisted of responses from 3,697 students derived from a single-stage probability survey from which eight ethnic groupings were constructed: (1) Eastern European, (2) Western European, (3) British Isles, (4) Black, (5) Oriental, (6) East/West Indian, (7) Jewish, and (8) Mediterranean. The findings reveal that, first, the significant zero-order ethnicity effect for alcohol use did not attenuate after controlling for background variables. Also, this relationship was not conditional upon other independent variables. Second, for other substance use measures, the significant zero-order ethnicity effect was found to be spurious or conditional.

Acculturation↗
PubMed1989

[Drug abuse in Ontario, Canada].

Two long-term surveys of drug use have been carried out in Ontario, Canada--one involving middle- and high-school students, and the other adults in the general population. These studies revealed that use of tobacco and alcohol is common and that Cannabis is the most widely used illicit drug by both the students and adults (15.9% and 9.5%, respectively, in 1987). Use of other illicit drugs is much less common. The trend data from 1977 to 1987 show a decrease in all drug use among students and a basically stable pattern among adults, with the exception of an upward trend in cocaine use. A study of adult cocaine users in the community found that half had experienced intense cravings for cocaine and other adverse effects. Demographic information was also gathered that made it possible to outline the most common characteristics of Cannabis and cocaine users.

Adolescent↗