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PubMed2002

For all these reasons, I do...drink: a multilevel analysis of contextual reasons for drinking among Canadian undergraduates.

OBJECTIVE: Student drinking is largely related to the setting of the drinking occasion as well as to individual psychosocial characteristics. This article assesses the effect of the reasons for drinking on situational alcohol use above and beyond other environmental and individual factors. METHOD: The data were drawn from the Canadian Campus Survey, a national mail survey conducted in 1998 with a sample of 8,864 students in 18 universities. Each student provided information on up to five drinking occasions, resulting in 25,347 drinking occasions among 6,598 drinkers. At the individual level, this study focused on the university life experience. At the situational level, information about alcohol intake was recorded relative to why, when, where and with whom drinking occurred and the reasons for drinking. RESULTS: Our results show that the reasons for drinking explain 8.3% of the variance in individual alcohol intake per occasion at the individual level and 8.1% at the drinking occasion level. CONCLUSIONS: Reasons for drinking and the drinking setting together influence consumption. Moreover, reasons are context specific, because students drink for different reasons in different contexts. Thus, contextual motivational models may be more effective in helping one understand the various pathways to alcohol use and misuse.

Alcohol Drinking↗
PubMed1978

Predictors of drinking and signs of heavy drinking among high school students.

This paper reports an investigation of factors associated with drinking and heavy drinking among high school students. The relative importance of social characteristics, parental drinking and parental rejection and control are assessed. Data were obtained from 1,439 students in two high schools. It is found that most students drink, but most drink infrequently (less than once a week and one or two drinks at time). Multivariate analysis using the MCA program indicates that students who frequently get drunk are those who are heavy drinkers, drink away from home and in cars, and whose drinking is not known to their parents. Parents' drinking and parental rejection and control have little unique explanatory power. It is suggested that parental modeling may be of most importance at the outset of drinking, whereas place and extent of drinking is most important in predicting the signs of heavy drinking.

Adolescent↗
PubMed2001

[The influence of regional differences in drinking style on hazardous use, excessive drinking, abuse and dependence].

INTRODUCTION: Previous research in Germany identified a "north-south" gradient in the hazardous use of alcoholic drinks, but this had methodological limitations. The present study estimates the hazardous use of alcohol more reliably. In addition, regional differences in drinking style and their relation to indicators of problematic alcohol use are examined. METHODS: Data are from 1995 and 1997 representative samples of the non-institutionalised German general population aged 18 to 59 years. Based on 15,017 complete observations prevalence rates for abstinence, hazardous consumption (>30 g ethanol per day for men; >20 g ethanol per day for women), two or more CAGE-symptoms, and heavy episodic drinking (5+ drinks consumed in a day) were calculated and a cluster analysis was performed with regard to the 16 German federal states. RESULTS: Regional differences exist in the prevalence of abstinence and hazardous drinking, but a "north-south" gradient was not evident. However, cluster analysis results suggest a "north-south" difference in drinking style, i.e. the quantity-frequency pattern of beer, wine, and spirits consumption. Compared with the northern German federal states, those in the south experienced more beer and less wine and spirits consumption in combination with a lower frequency of drinking beer and spirits. No cluster difference was found for hazardous drinking, lifetime prevalence of 2+ CAGE items or consumption of 5+ drinks in a day. Yet, mean consumption of ethanol was significantly higher in the north. CONCLUSIONS: Research suggesting more hazardous consumption in southern Germany must be tempered by these findings that found no 'north-south' gradient in several different indicators of problematic alcohol use. Different drinking styles in northern and southern states do not result in differences concerning prevalence of binge drinking nor alcohol-related problems. Drinking style only made a difference in the mean consumption of ethanol. Methodological differences between the reported studies are discussed.

Adolescent↗
PubMedDate not supplied

Perceived parental approval of drinking and its impact on problem drinking behaviors among first-year college students.

There is a paucity of research investigating the impact that parents may have on college drinking. In this study, the authors investigated the relationship between students' perceptions of parent approval of drinking and problem drinking occurrence. They conducted a Web-based survey of 265 first-year students living on campus during their second semester. The authors used logistic regression to examine the relationship between students' perceptions of their mothers' and fathers' attitudes toward their drinking, their mothers' and fathers' drinking habits, and problem drinking since they had begun college. Sixty-nine percent of respondents reported experiencing at least 1 drinking problem. Over one third of students perceived that their parents would approve of them drinking occasionally. Students perceiving more parental approval for their drinking were more likely to report at least 1 drinking problem. Student perceptions of parental approval of drinking warrant further investigation as a potentially mutable correlate of problem drinking.

Adolescent↗
PubMed2006

Estimate of the commercial value of underage drinking and adult abusive and dependent drinking to the alcohol industry.

OBJECTIVES: To document quantity and cash value of underage and adult Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-defined abusive and dependent drinking as well as underage drinking and adult DSM-IV-defined abusive and dependent drinking combined to the alcohol industry. DESIGN: Analysis of multiple cross-sectional national data sets. SETTING: The 2001 National Household Survey on Drug Abuse, the 2001 Youth Risk Behavior Survey, the 2001 Behavioral Risk Factor Surveillance Survey, the 2000 US Census, the 2000 to 2001 National Epidemiological Survey on Alcohol and Related Conditions, and the 2001 Adams Business Research. PARTICIPANTS: A total of 260,580 persons aged 12 years and older across 4 data sources. MAIN EXPOSURE: Underage drinking or pathological drinking defined as meeting the DSM-IV criteria for abusive or dependent drinking. MAIN OUTCOME MEASURES: Total amount of alcohol consumed and the cash value for alcohol consumed among underage and adult drinkers with DSM-IV-defined alcohol abuse and dependence as well as all underage drinkers combined with adult drinkers with DSM-IV-defined alcohol abuse and dependence. RESULTS: The short-term cash value of underage drinking to the alcohol industry was 22.5 billion dollars in 2001-17.5% of total consumer expenditures for alcohol. The long-term commercial value of underage drinking is the contribution of underage drinking to maintaining consumption among adult drinkers with alcohol abuse and dependence, which was equal to at least 25.8 billion dollars in 2001. CONCLUSIONS: The combined value of illegal underage drinking and adult pathological drinking to the industry was at least 48.3 billion dollars, or 37.5% of consumer expenditures for alcohol, in 2001. Alternative estimates suggest that these costs may be closer to 62.9 billion dollars, or 48.8% of consumer expenditures for alcohol.

Adolescent↗
PubMedDate not supplied

Differences in Asian and white drinking: consumption level, drinking contexts, and expectancies.

Despite the heterogeneous nature of interethnic drinking differences within racial groups, research has demonstrated that cautious generalizations can be made when comparing Asian and White drinking patterns. Persons in the United States who identify their race as "Asian" drink much less than their White counterparts, and they report fewer problems. Some have speculated that drinking patterns between racial groups are mediated by culturally influenced social learning. To date there has been very little research examining the expectancy of reinforcement from drinking between different racial, cultural or ethnic groups. The current study of 637 white and 179 Asian university students examined differences in alcohol consumption and problem levels, the social context of drinking, and alcohol expectancies. Results show considerable differences between Asian and White drinking and level of associated problems, as well as similarities and differences in social drinking contexts. It also appears that Asians expected greater tension reduction from drinking despite drinking less overall. Implications for further research are suggested that would link racial, and more specifically, ethnic drinking differences with culturally defined alcohol expectancies.

Adult↗
PubMed2004

Prospective association of peer influence, school engagement, drinking expectancies, and parent expectations with drinking initiation among sixth graders.

Early initiation of drinking increases the lifetime risk for substance abuse and other serious health and social problems. An understanding of the predictors of early initiation is needed if successful preventive interventions are to be developed. Surveys were completed by 1009 sixth grade students at the beginning (Time 1) and end (Time 2) of the school year in four schools in one suburban school district. At Time 1, 55/1009 (5.5%) reported drinking in the past 30 days. From Time 1 to Time 2, the percentage of drinkers increase to 127/1009 (10.9%) of whom 101 were new drinkers. In multiple logistic regression analyses, school engagement was negatively associated and peer influence and drinking expectancies were positively associated with drinking initiation. A significant interaction was found between drinking expectancies and parental expectations. Among sixth graders with high drinking expectancies, those with low parental expectations for their behavior were 2.6 times more likely to start drinking than those with parents with high expectations for their behavior. Positive drinking expectancies were significantly associated with drinking initiation only among teens who believed their parents did not hold strong expectations for them not to drink. This finding held for boys and girls, Blacks and Whites and was particularly strong for Black youth. This finding provides new information about the moderating effect of parental expectations on drinking expectancies among early adolescents.

Adolescent↗
PubMed1997

Racial differences in women's drinking norms and drinking patterns: a national study.

This study explored whether norms regarding women's drinking were more or less liberal among African American than among Caucasian women, and whether female-specific drinking norms influence drinking rates and drinking problems among the two groups of women. The study is based on data from a 1984 national survey of subsamples of 1,224 African American and 1,034 Caucasian women. Logistic and multiple regression analyses showed that African Americans reported more conservative drinking norms for women than Caucasians even when controlling for general drinking norms and social characteristics. Other findings were that female-specific drinking norms affect the proportion of women drinkers, usual quantity of alcohol consumption, and symptoms of alcohol dependence. African American and Caucasian women were not found to differ in the effect of female-specific drinking norms on alcohol use or on alcohol-related problems. Future research should explore differences in cultural factors that may affect attitudes towards women's drinking as well as more detailed aspects of the relationship between women's drinking norms and problem drinking.

Adult↗
PubMed2001

The relative influence of smoking on drinking and drinking on smoking among high school students in a rural tobacco-growing county.

PURPOSE: To construct and estimate a model that contains a reciprocal relationship between smoking and drinking and to test whether the gateway drug thesis or the cumulative risk behaviors thesis best fits the data. METHODS: Data (n = 630) are from a survey of all students (50% female; aged 16.2 years on average; 2.4 grade point average; and 57% residing in homes with both mother and father present) in a rural, tobacco-growing county's two high schools, one public (85%) and one private, in 1993. The survey was conducted by the schools as part of their alcohol and other drugs (AOD) prevention programs and was coordinated by the county AOD Council. Students completed the questionnaires in their homerooms. Endogenous predictors of drinking and smoking include student's perception of adult drug behavior, peer pressure to drink, degree to which their friends' drink, and attitudes toward drinking and smoking. Path coefficients were estimated by using LISREL. RESULTS: The strong correlation between smoking and drinking resulted from shared causes, rather than from the effects of one type of drug use on the other. Approval of drinking had the strongest association with being a drinker (beta =.57) and with being a smoker (beta =.37). Those who found smoking offensive were less likely to be a smoker (beta = -.25). However, attitude toward smoking was not associated with being a drinker. Having drinking friends increased both the likelihood of being a drinker (beta =.29) and of being a smoker (beta =.23). Peer pressure to drink increased the likelihood of being a smoker (beta =.14) and of being a drinker (beta =.12). Students with lower grade point averages, males, older students, students in public school, and students with family structures other than both parents living in the same household were more likely to be a drinker and were more likely to be a smoker. CONCLUSIONS: Our results support the cumulative risk behaviors thesis. The link between both high-risk behaviors, smoking and drinking, results from common causes rather than from drinking leading to smoking.

Adolescent↗
PubMed2005

Drinking like a guy: frequent binge drinking among undergraduate women.

The purpose of this exploratory study was to examine why there has been an increase in frequent binge drinking among the most recent generation of female undergraduate students. Specifically, we examined whether female undergraduate women associated being able to "drink like a guy" (e.g., drink large amounts of alcohol, drinking competitively) with gender equality. Focus groups were conducted in March of 2003 with 42 female undergraduate women who consumed alcohol. Participants were recruited from respondents of a random sample survey of undergraduate students attending a large, public university and reflected the demographic characteristics of this population: traditional-age college students (i.e., attending college between 18 and 22 years of age), who were primarily white from middle or upper middle class families and living on or near the college campus. Focus groups were based on drinking trajectories during college (Stable High, Stable Low, Decreasers, Increasers) and sorority status. While women of all drinking levels reported feeling pressure to drink "heavily" because of the favorable impression they could make on their male peers, primarily women who were frequent binge drinkers throughout college felt that "drinking like a guy" described their own drinking behaviors. While women reported that being able to "drink like a guy" provided them with a sense of equality with their male peers, analysis of the transcripts suggests that "drinking like a guy" had less to do with gender equality and more to do with emphasizing women's (hetero)sexuality. Findings are discussed in terms of how "heavy alcohol consumption" affords college women positive attention from their male peers, but likely increases their vulnerability to sexual assault and alcohol use related health problems.

Adolescent↗
PubMed2006

'I drink spirits to get drunk and block out my problems...' beverage preference, drinking motives and alcohol use in adolescence.

AIMS: To investigate among adolescents whether (i) drinking motives are related to beverage preference; (ii) beverage preference is related to alcohol use (drinking levels and risky drinking occasions); (iii) the association between beverage preference and alcohol use is moderated or mediated by drinking motives. METHOD: Data from a national representative sample of 5379 8th-10th graders in Switzerland (mean age 15.1, SD = 0.95) were analysed using multiple regression analyses. Beverage preference was based on the proportion of a specific beverage in the total amount of drinks consumed at the last drinking occasion. Drinking motives were assessed by the drinking motive questionnaire revised (DMQ-R). RESULTS: A significant positive association was found between enhancement motives and a preference for beer and spirits; the association was negative with regard to a preference for wine and alcopops. Conformity motives were positively related to a wine preference but negatively to a beer preference. Only a preference for beer and spirits was significantly associated with alcohol use in models that exclude motives. However, the association between beer preference and adolescent alcohol use was mediated by drinking motives. A preference for alcopops and spirits was moderated by motives: social drinkers who preferred alcopops drank less than those who did not prefer alcopops. Coping drinkers who preferred spirits drank more than those who preferred other alcoholic drinks. CONCLUSIONS: Drinking motives are potential explanatory factors for the association between beverage preference and alcohol use. Prevention approaches should target coping motives, particularly for adolescents who show a preference for spirits.

Adolescent↗
PubMed2006

College student drinking, attitudes toward risks, and drinking consequences.

OBJECTIVE: This study examined whether college students' attitudes toward risks explain significant variance in drinking consequences beyond gender, alcohol use, and self-protective strategies. METHOD: A derivation sample (N=276; 52% women) and a replication sample (N=216; 52% women) of undergraduate students completed the Campus Alcohol Survey (CAS) and the Attitudes Toward Risks Scale (ATRS). RESULTS: Scores on the ATRS correlated positively with students' self-reported typical number of drinks and negative drinking consequences (p<.001). Hierarchical regression analyses indicated that ATRS scores explained significant variance in negative drinking consequences beyond college students' gender, typical number of drinks, and use of protective strategies (p<.001). Furthermore, a significant Drinks x ATRS interaction revealed that heavy-drinking students who scored high on the ATRS experienced the most harm from drinking (p<.01). Students with high-risk attitudes showed a stronger link between typical number of drinks and negative drinking consequences. CONCLUSIONS: Even when controlling for students' gender, alcohol use, and protective strategies, college students' attitudes toward risks explain significant variance in drinking consequences.

Adolescent↗
PubMedDate not supplied

Team awareness, problem drinking, and drinking climate: workplace social health promotion in a policy context.

PURPOSE: (1) To determine the effectiveness of classroom health promotion/prevention training designed to improve work climate and alcohol outcomes; (2) to assess whether such training contributes to improvements in problem drinking beyond standard workplace alcohol policies. DESIGN: A cross-sectional survey assessed employee problem drinking across three time periods. This was followed by a prevention intervention study; work groups were randomly assigned to an 8-hour training course in workplace social health promotion (Team Awareness), a 4-hour informational training course, or a control group. Surveys were administered 2 to 4 weeks before and after training and 6 months after posttest. SETTING AND SUBJECTS: Employees were surveyed from work departments in a large municipality of 3000 workers at three points in time (year, sample, and response rates are shown): (1) 1992, n = 1081, 95%; (2) 1995, n = 856, 97%; and (3) 1999, n = 587, 73%. Employees in the 1999 survey were recruited from safety-sensitive departments and were randomly assigned to receive the psychosocial (n = 201), informational (n = 192), or control (n = 194) condition. INTERVENTION: The psychosocial program (Team Awareness) provided skills training in peer referral, team building, and stress management. Informational training used a didactic review of policy, employee assistance, and drug testing. MEASURES: Self-reports measured alcohol use (frequency, drunkenness, hangovers, and problems) and work drinking climate (enabling, responsiveness, drinking norms, stigma, and drink with co-workers). RESULTS: Employees receiving Team Awareness reduced problem drinking from 20% to 11% and working with or missing work because of a hangover from 16% to 6%. Information-trained workers also reduced problem drinking from 18% to 10%. These rates of change contrast with changes in problem drinking seen from 1992 (24%) to 1999 (17%). Team Awareness improvements differed significantly from control subjects, which showed no change at 13%. Employees receiving Team Awareness also showed significant improvements in drinking climate. For example, scores on the measure of coworker enabling decreased from pretest (mean = 2.19) to posttest (mean = 2.05) and follow up (mean = 1.94). Posttest measures of drinking climate also predicted alcohol outcomes at 6 months. CONCLUSION: Employers should consider the use of prevention programming as an enhancement to standard drug-free workplace efforts. Team Awareness training targets work group social health, aligns with employee assistance efforts, and contributes to reductions in problem drinking.

Adult↗
PubMed2006

Surveillance for waterborne disease and outbreaks associated with drinking water and water not intended for drinking--United States, 2003-2004.

PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists have maintained a collaborative Waterborne Disease and Outbreaks Surveillance System for collecting and reporting data related to occurrences and causes of waterborne disease and outbreaks (WBDOs). This surveillance system is the primary source of data concerning the scope and effects of WBDOs in the United States. REPORTING PERIOD: Data presented summarize 36 WBDOs that occurred during January 2003-December 2004 and nine previously unreported WBDOs that occurred during 1982-2002. DESCRIPTION OF SYSTEM: The surveillance system includes data on WBDOs associated with drinking water, water not intended for drinking (excluding recreational water), and water of unknown intent. Public health departments in the states, territories, localities, and Freely Associated States (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC by using a standard form. RESULTS: During 2003-2004, a total of 36 WBDOs were reported by 19 states; 30 were associated with drinking water, three were associated with water not intended for drinking, and three were associated with water of unknown intent. The 30 drinking water-associated WBDOs caused illness among an estimated 2,760 persons and were linked to four deaths. Etiologic agents were identified in 25 (83.3%) of these WBDOs: 17 (68.0%) involved pathogens (i.e., 13 bacterial, one parasitic, one viral, one mixed bacterial/parasitic, and one mixed bacterial/parasitic/viral), and eight (32.0%) involved chemical/toxin poisonings. Gastroenteritis represented 67.7% of the illness related to drinking water-associated WBDOs; acute respiratory illness represented 25.8%, and dermatitis represented 6.5%. The classification of deficiencies contributing to WBDOs has been revised to reflect the categories of concerns associated with contamination at or in the source water, treatment facility, or distribution system (SWTD) that are under the jurisdiction of water utilities, versus those at points not under the jurisdiction of a water utility or at the point of water use (NWU/POU), which includes commercially bottled water. A total of 33 deficiencies were cited in the 30 WBDOs associated with drinking water: 17 (51.5%) NWU/POU, 14 (42.4%) SWTD, and two (6.1%) unknown. The most frequently cited NWU/POU deficiencies involved Legionella spp. in the drinking water system (n = eight [47.1%]). The most frequently cited SWTD deficiencies were associated with distribution system contamination (n = six [42.9%]). Contaminated ground water was a contributing factor in seven times as many WBDOs (n = seven) as contaminated surface water (n = one). INTERPRETATION: Approximately half (51.5%) of the drinking water deficiencies occurred outside the jurisdiction of a water utility in situations not currently regulated by EPA. The majority of the WBDOs in which deficiencies were not regulated by EPA were associated with Legionella spp. or chemicals/toxins. Problems in the distribution system were the most commonly identified deficiencies under the jurisdiction of a water utility, underscoring the importance of preventing contamination after water treatment. The substantial proportion of WBDOs involving contaminated ground water provides support for the Ground Water Rule (finalized in October 2006), which specifies when corrective action is required for public ground water systems. PUBLIC HEALTH ACTIONS: CDC and EPA use surveillance data to identify the types of water systems, deficiencies, and etiologic agents associated with WBDOs and to evaluate the adequacy of current technologies and practices for providing safe drinking water. Surveillance data also are used to establish research priorities, which can lead to improved water-quality regulation development. The growing proportion of drinking water deficiencies that are not addressed by current EPA rules emphasizes the need to address risk factors for water contamination in the distribution system and at points not under the jurisdiction of water utilities.

Communicable Diseases↗
PubMed1992

The association of drinking levels and drinking attitudes among Japanese in Japan and Japanese-Americans in Hawaii and California.

This study examined cross-cultural differences in drinking attitudes and drinking levels and their correlation among Japanese in Japan and Japanese-Americans in Hawaii or California. In most situations, an increase in drinking levels was associated with more tolerant drinking attitudes in all three groups. Abstainers were less likely to say that getting drunk is sometimes all right, whereas the reverse was true for heavier drinkers. Drinking levels among Japanese, especially among Japanese women, were not highly associated with how much drinking was perceived as acceptable in each situation, whereas among Japanese-Americans, drinking levels were highly associated with drinking attitudes. Although the Japanese had generally tolerant attitudes toward drinking, they indicated higher abstention rates before driving than Japanese-Americans regardless of their drinking levels. This may reflect the impact of public education on drunken driving in Japan.

Adolescent↗
PubMedDate not supplied

Measuring excessive alcohol use in college drinking contexts: the Drinking Context Scale.

Research on youthful drinking has shown that the greatest risks associated with alcohol abuse are related to contextual factors that may potentiate heavy drinking as well as increase risks for adverse consequences. These contextual factors include interacting psychological, interpersonal, and environmental dimensions of alcohol use. However, despite considerable college drinking research to identify these factors, few formal instruments have been produced for measuring excessive drinking in multidimensional contexts. The current study of 197 college students who were cited their first time for breaking university drinking rules focuses on the development and validation of a scale for measuring the likelihood of excessive drinking across an array of psychological, interpersonal and situational contexts resulting in the 23-item Drinking Context Scale (DCS). Three distinct factors emerged defining Convivial drinking, Private Intimate drinking, and drinking as a form of Negative Coping. These three factors explained 61.5% of the variance after principal components analysis and varimax rotation, showed excellent internal reliabilities, and were moderately intercorrelated. MANOVA analysis demonstrated concurrent validity with the Quality Frequency Index (QFI) and a modified version of the Michigan Alcoholism Screening Test (MAST). Implications for further research with the DCS are suggested.

Adaptation, Psychological↗
PubMed2000

Drinking and heavy drinking by students in 18 countries.

This paper examines how levels of drinking, daily drinking and heavy drinking are related in 18 countries. There is wide national variation in consumption patterns. The proportions of students drinking and the proportion drinking at least six times in the past month correlated with per capita consumption in the total adult population. Some student drinking variables correlated with each other. Most countries (n=14) could be classified into one of two distinct groups based on the percentage of students who reported drinking at least six times per month, the percentage reporting drinking at least five drinks per day at any time in the last month and per capita alcohol consumption. Some countries in these groups were geographically close but others were not. Further research is needed to understand differences and similarities among countries with respect to student drinking.

Adolescent↗
PubMed2001

Is frequency of drinking an indicator of problem drinking? A psychometric analysis of a modified version of the alcohol use disorders identification test in Switzerland.

BACKGROUND: To study the psychometric properties of a modified Alcohol Use Disorders Identification Test in the multilingual context of Switzerland. METHODS: Data were obtained from the most extensive health survey to date in Switzerland, with a response rate of 69%. Seven core items of AUDIT were used. The first two items of AUDIT (frequency of drinking, quantity of drinking) were not used in their original form, but reconstructed from a quantity-frequency instrument (QF) measuring alcohol consumption, and categorized according to the AUDIT. The third AUDIT item (frequency of binge drinking) was similarly not used in its original form, but 8+ drinks instead of 6+ drinks was used. All 10 items of the modified AUDIT were completed by 10321 subjects - 6677 in the German-speaking region and 3644 in the Latin-language (French, Italian) regions. The dimensionality of the modified AUDIT was modelled by confirmatory factor analysis. The contribution of each item to the total modified AUDIT score was investigated by the prevalence of positively screened subjects when items were deleted, and factor loadings of the unidimensional model. RESULTS: In Switzerland the modified AUDIT fitted neither a unidimensional nor the hypothesized tri-dimensional model. Consumption items, especially frequency of drinking, showed almost no correlation with items measuring alcohol-related problems, but the latent constructs 'harmful drinking' and 'alcohol dependence' were highly correlated, indicating a shared underlying factor. Frequency of drinking was the item that most influenced whether an individual screened positively or not. Except for the correlation of frequency and binge drinking, results were almost identical for both linguistic regions. CONCLUSIONS: The current form of the modified AUDIT may have to be changed for screening in Switzerland, as the study raised questions about the suitability of the frequency-of-drinking item as an indicator of a screening device for alcohol-related problems in this country.

Adult↗