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Alcohol drinking problems among New York City residents after the September 11 terrorist attacks.

Recent studies have shown an increase in alcohol use in New York City in the months after the September 11 terrorist attacks; thus far there have been no studies documenting changes in drinking problems. In 2002, a random digit dial phone survey was conducted of residents of New York City. This study provided us with estimates of the prevalence of alcohol drinking problems among residents of New York City 6 months after September 11 compared with the 6 months before September 11. Among 1,570 adults, the prevalence of drinking problems was 3.7% in the 6 months before September 11 and 4.2% in the 6 months after September 11. The incidence of drinking problems among those without drinking problems before September 11 was 2.2%. Persons with incident drinking problems were more likely than those without to report symptoms consistent with posttraumatic stress disorder (17.4% vs. 0.4% in those without drinking problems and 1.4% in nondrinkers), and depression (23.5% vs 5.6% vs. 4.9%, respectively) after September 11. After a disaster, a link between drinking problems and posttraumatic stress disorder or depression should be assessed.

Adolescent↗

Older adults' health and changes in late-life drinking patterns.

This study focused on the prospective associations between older adults' health-related problems and their late-life alcohol consumption and drinking problems. A sample of 1,291 late-middle-aged community residents (55-65 years old at baseline) participated in a survey of health and alcohol consumption, and was followed one year, four years, and 10 years later. Health-related problems increased and alcohol consumption and drinking problems declined over the 10-year interval. Medical conditions, physical symptoms, medication use, and acute health events predicted a higher likelihood of abstinence and less frequent and lower alcohol consumption. However, overall health burden predicted more subsequent drinking problems, even after controlling for alcohol consumption and a history of heavy drinking and increased drinking in response to stressors. Among older adults, increased health problems predict reduced alcohol consumption but more drinking problems. Older adults with several health problems who consume more alcohol are at elevated risk for drinking problems and should be targeted for brief interventions to help them curtail their drinking.

Aged↗

The effect of a campus-community environmental alcohol prevention initiative on student drinking and driving: results from the "a matter of degree" program evaluation.

OBJECTIVE: Motor vehicle crashes involving alcohol are a major contributor to morbidity and mortality among college students in the United States. This study evaluates the effect on drinking and driving outcomes of the "A Matter of Degree" program, a campus-community coalition initiative to reduce college binge drinking. METHODS: We used a quasi-experimental longitudinal study design that compared student responses at 10 colleges participating in the program and students attending 32 similar colleges that did not participate in the program. We also divided the program sites into two groups of five according to their level of program implementation and compared each with the non-program colleges. We examined driving after any alcohol consumption and driving after five or more drinks among drinkers who drove one or more times a week per month and riding with a high or drunk driver among all students at these colleges beginning in 1997 through 2001. Outcomes were based on data collected from repeated cross-sectional surveys using the Harvard School of Public Health College Alcohol Study. Analyses were conducted using MLwiN multilevel statistical software. RESULTS: We found significant reductions in driving after drinking, driving after five or more drinks and riding with a high or drunk driver at the program colleges relative to the comparison colleges. Further analyses indicated that these reductions among the AMOD program colleges occurred at the sites with high program implementation relative to comparison sites, while no statistically significant change was noted at the program sites with low implementation. The program effect on the two drinking and driving outcomes appeared to be mediated by frequent binge drinking, while significant decline in the riding with an intoxicated driver outcome was not mediated by the individual's drinking. CONCLUSIONS: Campus-community based environmental alcohol prevention is a promising approach for reducing alcohol-impaired motor vehicle crashes among this population.

Adult↗

Drinking control attempts and encouragement of alcohol use in couple relationship--a qualitative approach.

The present study addresses previously neglected research areas among couples with normal drinking habits, namely control attempts and encouragement of drinking. In this study, semistructured interviews were conducted in 2001 with 27 individuals living in steady couple relationships in Helsinki. Forms of active social control of drinking were classified into four categories and were investigated on the dimensions of indirect-direct and mild-strong. Further analysis suggests that the form of control reflects the degree of individualization in relationships, at least when drinking is concerned. Later, the exploration of encouragement of drinking shows that the culturally crucial feature of the qualified drinker is the preservation of one's own will. Then, it is concluded that in a couple relationship, social control and encouragement of drinking are, above all, complementary. Finally, the significance of drinking's social control is not restricted to alcohol use only, and it is surprisingly great in couple relationships, especially in preventing deviant drinking behavior. Several factors are presented that contribute to the increase of social control's importance.

Adult↗

Alcohol volume, drinking pattern, and cardiovascular disease morbidity and mortality: is there a U-shaped function?

The health effects of a binge pattern of alcohol consumption have not been widely investigated. The objective of this study was to evaluate the cardiovascular consequences of binge drinking (consumption of eight or more drinks at one sitting) and usual (nonbinge) drinking in a longitudinal, population-based study. Data obtained from 1,154 men and women aged 18-64 years interviewed in Winnipeg, Manitoba, Canada, in 1990 and 1991 were linked to health care utilization and mortality records. Using an 8-year follow-up period, the authors performed separate Cox proportional hazards regression analyses for men and women on time to first event for physician visits, hospitalizations, and deaths due to coronary heart disease, hypertension, and other cardiovascular disease. Binge drinking increased the risk of coronary heart disease in both men (hazard ratio (HR) = 2.26, 95% confidence interval (CI): 1.22, 4.20) and women (HR = 1.10, 95% CI: 1.02, 1.18). It increased the risk of hypertension in men (HR = 1.57, 95% CI: 1.04, 2.35) but not in women. Binge drinking had no effect on the risk of other cardiovascular disease. In contrast, usual drinking had significant cardioprotective effects in both men and women. Thus, the harmful effects of binge drinking on cardiovascular disease morbidity and mortality can be disaggregated from the protective effects of usual drinking at various levels of consumption.

Adult↗

High prevalence, persistent hazardous drinking among New Zealand tertiary students.

AIMS: To determine the prevalence of hazardous drinking and alcohol-related negative consequences in New Zealand tertiary students, and to identify predictors of hazardous drinking across a 6-month period. METHODS: A total of 1480 tertiary students living in halls of residence was surveyed at the start of the academic year, and a subsample of 967 students was followed up 6 months later. Questionnaire items included quantity and frequency of drinking, alcohol-related problems, use of other substances, and the Alcohol Use Disorders Identification Test (AUDIT). Drinking at follow-up was modelled using demographic characteristics, mental well-being, other substance use, alcohol-related problems, and hall drinking norms, measured at baseline. RESULTS: Among drinkers, mean (+/- SD) weekly consumption was 243 +/- 241 and 135 +/- 157 g of ethanol for males and females respectively. The majority of male (60.0%) and female (58.2%) drinkers typically consumed more than national safe drinking guidelines. Mean (+/- SD) AUDIT scores were 10.9 +/- 7.6 for males and 7.6 +/- 5.9 for females. After controlling for AUDIT scores at baseline, increased AUDIT scores at follow-up were higher with lower age, Maori ethnicity, smoking, cannabis use, high levels of alcohol-related negative consequences, and higher levels of drinking in the student's hall of residence. CONCLUSIONS: Hazardous drinking is widespread and persistent among students living in the halls of residence. There is a need for university alcohol policies and intervention approaches among New Zealand tertiary students.

Adolescent↗

Effects of aripiprazole on alcohol intake in an animal model of high-alcohol drinking.

AIMS: This study examined the effects of aripiprazole, a novel atypical antipsychotic drug with partial agonist properties at dopamine D2 receptors, on the voluntary limited access alcohol drinking of alcohol-preferring AA (Alko, Alcohol) rats. METHODS: AA rats were taught to drink 10% alcohol in a 4 h limited access paradigm. Effects of acute aripiprazole (0, 0.3, 1.0, and 3.0 mg/kg) on the limited access alcohol drinking were studied. In repeated treatment experiment, aripiprazole (0, 1.0, and 6.0 mg/kg) was administered once daily over five successive days. To reveal any effect by aripiprazole not selective for alcohol drinking, 0.025% saccharin solution was substituted for alcohol during the 4 h limited access, and acute treatments were repeated. The effects of aripiprazole on ambulatory locomotor activity were tested with doses that were used in the acute experiments. RESULTS: Acute aripiprazole at the doses of 0.3, 1.0, and 3.0 mg/kg had no effect on alcohol drinking. Repeated treatment with the aripiprazole dose of 6.0 mg/kg significantly diminished alcohol drinking at the 1 h time point. This dose had no effect on saccharin drinking when given acutely. Acute aripiprazole at the doses of 1.0, 3.0, and 6.0 mg/kg significantly suppressed locomotor activity. CONCLUSIONS: Aripiprazole decreased limited access alcohol drinking in AA rats, but only at a high dose that also strongly suppressed locomotor activity.

Alcohol Deterrents↗

A conditioning approach to the analysis and treatment of drinking problems.

Drinking problems are a major public health concern and a significant part of this concern arises because drinking habits are very difficult to change once established; although many patients can detoxify successfully there is a high rate of relapse. This chapter describes the analysis and treatment of drinking problems using a behavioural approach based on the concepts and methods of classical conditioning. Recent evidence shows that alcoholic patients show a variety of physiological and subjective responses to the presentation of alcoholic drink cues and these responses may play a part in the regulation of drinking behaviour. The implication is that cue-exposure treatments ought to reduce drinking. In cue-exposure, responses to drink cues are extinguished by repeated presentation of the cue without allowing subsequent consumption of alcohol. The empirical evidence for the effectiveness of such treatments is described and the current status of the approach to the analysis and treatment of drinking problems will be summarised.

Alcohol Drinking↗

How 'sensible' is the UK Sensible Drinking message? Preliminary findings amongst newly matriculated female university students in Scotland.

BACKGROUND: Current levels and patterns of alcohol drinking continue to cause concern, particularly amongst young females. Effective interventions remain elusive. The aim of this study was to investigate the levels of knowledge relating to UK 'Sensible Drinking' guidelines, definitions of binge drinking and attitude to drink labelling initiatives amongst female school leavers enrolling at university. METHODS: Non-standardized questionnaires were administered and completed by researchers during the process of matriculation (response rate 94%; n = 180). RESULTS: The survey revealed that recommended daily guidelines for women were not recalled by 54% of participants; 52% could not quote the unit content of their favoured alcoholic drink, whereas only 14% reported the use of the UK unit system to guide drinking. Personal quantitative definitions of binge drinking varied by a factor of 18. CONCLUSION: A rewording of the UK Sensible Drinking message to one recognizing the needs of different population groups and their particular language of consumption measure is timely.

Adolescent↗

Influence of moderate drinking on purine and carbohydrate metabolism.

BACKGROUND: We examined the influences of a moderate intake level of three types of alcoholic beverages--beer, whisky, and Shochu (Japanese distilled liquor)--on purine and carbohydrate metabolism and excretion in healthy male volunteers, concerning (1) the extent of contribution of purine bodies contained in beer to uric acid metabolism and (2) a comparison between two types of distilled spirits with (whisky) and without (Shochu) aging in oak wood barrel storage. METHODS: Three sets of studies were conducted in which 10 to 13 healthy adult men were instructed to drink three types of alcoholic beverages at a slightly higher level (0.8 ml of ethanol equivalent/kg body weight) than moderate drinking (approximately 30.4 ml or less for men). A low purine beer was test-manufactured by treating nucleosides that were contained in wort and remained in beer with purine nucleoside phosphorylase derived from Ochrobacterium anthropi, thereby converting them into corresponding purine bases that were easily assimilated by beer yeast. RESULTS: Although beer intake enhanced the level of serum uric acid by 13.6%, blood glucose by 26.7%, and insulin level by 5.1-fold, drinking a moderate level of distilled liquor (whisky, Shochu) did not increase the serum uric acid level or the other two parameters. The serum uric acid level observed after drinking beer with a purine body concentration reduced by 28% (68% in nucleosides and purine bases) was almost identical to the level observed after drinking regular beer. Whisky has been found to have a property that decreases the serum uric acid level. Excretion of uric acid from blood is increased by 27% after drinking whisky. CONCLUSIONS: Moderate drinking of distilled liquors did not enhance serum uric acid level, blood glucose, or insulin level in healthy male subjects. Increased serum uric acid after beer intake could not be explained mostly with their purine body congeners. Whisky showed the eliminative property in serum uric acid through excretion of it from blood to urine. At a moderate drinking level, beer and whisky have different effects on purine metabolism or excretion.

Adult↗

Inconsistencies between actual and estimated blood alcohol concentrations in a field study of college students: do students really know how much they drink?

BACKGROUND: Alcohol use by college students is commonly measured through the use of surveys. The validity of such data hinge on the assumption that students are aware of how much alcohol they actually consume. Recent studies call this assumption into question. Students tend to overestimate the appropriate sizes of standard drinks, suggesting that they might underestimate how much alcohol they consume. If this is true, then students' actual blood alcohol concentrations (BACs) should be higher than BACs estimated based on self-report data. The present study examined this issue METHODS: Breathalyzer readings and self-reported drinking data were collected from 152 college students during the fall of 2004. Estimated BACs were calculated by means of a standard formula, and the relation between actual and estimated BACs was examined. Factors contributing to discrepancies between the two values were identified RESULTS: Estimated BAC levels were significantly higher, not lower, than breath BAC measures. The accuracy of estimated BACs decreased as the number of drinks and amount of time spent drinking increased. Being male and drinking only beer predicted greater accuracy of estimated BACs CONCLUSIONS: Although laboratory data suggest that students underestimate how much they drink, the hypothesis was not supported by data collected in the field. It appears that students might actually overestimate rather than underestimate their levels of consumption when surveyed in the midst of a night of drinking. The findings corroborate observations made by other researchers and suggest that the findings of laboratory studies on college drinking do not necessarily extend to real-world settings.

Adult↗

Re-examining whether and why acculturation relates to drinking outcomes in a rigorous, national survey of Latinos.

BACKGROUND: Fundamental limitations have hampered conclusions surrounding acculturation's effects among Latinos. This research re-examines associations between acculturation and alcohol use, addressing the most troubling of these limitations. The research also explores mediators of the association, and the dimensional structure of acculturation. METHODS: Linear regressions and scale analyses were used to analyze data from Latino adults in the U.S. (825 women, 761 men) sampled in the 1995 National Alcohol Survey. Analyses used a standard, reliable acculturation scale and well-validated drinking measures; systematically accounted for demographic covariates; and analyzed men and women separately. RESULTS: As expected, higher acculturation was positively associated with a higher probability of drinking (vs. abstinence) among women, and higher average volumes and more frequent drunkenness among female drinkers. Acculturation was unrelated to alcohol use among men. Also as expected, mediational analyses of average volume supported expectations that gender-specific drinking norms would mediate acculturation's effects (though norms did not explain acculturation's associations with either drinking status or frequency of drunkenness). Analyses investigating depressive symptoms showed no support for the acculturation-stress model. Factor analyses of the acculturation scale supported the hypothesized distinctions between linguistic acculturation, attitudinal acculturation, and the social environment of acculturation. Further, items implying more intimate exposure to Anglo culture (i.e., language use) were most strongly related to drinking outcomes among women, supporting the normative interpretation of acculturation's effects on drinking. CONCLUSIONS: Results underline acculturation's influence on alcohol consumption among Latina women, and highlight the role of drinking norms in mediating this association. Results also suggest a multidimensional view of acculturation. The article recommends further research on drinking norms and other potential mediators of acculturation's effects among Latina women.

Acculturation↗

Fluoride in the drinking water and the geographical variation of coronary heart disease in Finland.

BACKGROUND: Fluoride in drinking water prevents dental disease, which in turn has been reported to increase the risk of coronary heart disease (CHD). Since mortality from CHD in Finland is high in the north-east where the fluoride content of drinking water is low, the association was examined here in more detail. DESIGN: Mortality from CHD during the period 1961-1995 in 365 rural areas of Finland (188 888 deaths) was linked with 2131 drinking water fluoride determinations performed in 1958 using negative binomial regression, adjustments being made for sex, age, mean income of the resident commune and drinking water magnesium and calcium. RESULTS: An inverse J-shaped relationship was found between drinking water fluoride and CHD, the association being most pronounced in the 1960s and levelling off consistently as a function of time. In 1961-1970, the adjusted mortality from CHD was 22% (95% confidence interval 18-27%) lower in the fourth quintile of fluoride (0.15-0.30 mg/l) than in the first quintile (0.00-0.06 mg/l) but this deficit reduced to 13% (7-18%) in 1991-1995. CONCLUSIONS: Although causality cannot be asserted, the geographical pattern of CHD in Finland is consistent with the concentration of fluoride in drinking water. One mechanism could be that fluoride prevents dental infections, which in turn reduces mortality from CHD. The more widespread use of fluoridated toothpastes, soft drinks and certain food items since the 1960s may have reduced the significance of drinking water as a source of fluoride.

Adult↗

Young people's alcohol consumption in public drinking places: reasoned behaviour or related to the situation?

Two contrasting perspectives are used to study correlates of young people's (16-25 years) alcohol consumption in public drinking places. One perspective is the theory of reasoned behaviour, or the Fishbein-Ajzen model, extended with self-efficacy. The other perspective assumes that exposure to drinking situations and aspects of the actual drinking situation (size of drinking group and group pressure) determine young people's alcohol consumption. Multiple regression analysis shows that variables indicating situational influences are correlated with the alcohol consumption of young men and women, even when controlling for the Fishbein-Ajzen variables. Among young men frequency of visiting public drinking places contributes more to the explained variance than the four Fishbein-Ajzen variables together. Young people's alcohol consumption in public drinking places appears to be less fully controlled by alcohol-specific beliefs, norms and perceived skills than the Fishbein-Ajzen model assumes. The Fishbein-Ajzen variables are only weakly correlated with the variables indicating situational influences. It is concluded that, from the individual's perspective, the influence of situational factors means that part of his consumption is determined by more or less accidental circumstances like the opportunities to drink, the size of the drinking group and group pressure.

Adolescent↗

Drinking in California: theoretical and empirical analyses of alcohol consumption patterns.

A theoretical model is presented in which alcohol consumption patterns are expressed in terms of frequencies of initiation and probabilities of continued drinking once consumption has begun. The model is used to explicate the relationships between measures of drinking frequency, drinking quantity, modal or typical drinking and total alcohol consumption. A mathematical realization of this model is developed and applied to data on quantities and frequencies of alcohol use obtained from a general population survey of California consumers. These data were used to estimate the basic parameters of the alcohol consumption model, obtain drinking pattern estimates derived from the model and analyse these measures in the context of background demographic variables. Pattern estimates from the model were bench-marked against self-reports available in the original data. The results of these analyses showed that: (1) frequencies of drinking were exponentially distributed; (2) probabilities of continued drinking were best characterized by a log-logistic function; and (3) estimates of modal and total drinking levels derived from the model were substantively related to self reports. Estimates of total consumption obtained from the model were 28% greater than those obtained from standard quantity-frequency estimates. This difference was consistent with expectations based upon the theoretical model.

Adult↗

Risky drinking and alcohol use patterns in a national sample of women of childbearing age.

AIMS: We examined risky drinking and alcohol use patterns associated with prenatal effects of alcohol exposure in women of childbearing age, using various definitions of low-risk drinking. DESIGN: Computer-assisted telephone interview (CATI) methodology was used to gather information in a cross-sectional survey on alcohol use and problems, pregnancy and likelihood of future pregnancy. SETTING: Participants were respondents in the 2000 National Alcohol Survey (NAS, N10, response rate 58%) which includes men and women from all 50 states of the United States and the District of Columbia. PARTICIPANTS: A total of 1504 women aged 18-39 years were included; 72 were pregnant, 511 were currently not pregnant but reported being likely to be pregnant in the next 5 years, and 921 women were neither pregnant nor likely to be in the next 5 years. MEASUREMENTS: Various alcohol use patterns in the past 12 months including average volume, amount per session, drinking with food and time spent drinking were assessed. FINDINGS: Seven per cent of childbearing age women exceeded guidelines used to classify women as risky drinkers in the past month. Thirty per cent were classified as risky drinkers when these guidelines were extended to past-year drinking. Examination of specific alcohol use patterns revealed that while under 10% of risky drinkers reported past-month heavy episodic drinking, 30% or more reported heavy episodic drinking and exceeding daily limits for alcohol consumption in the past year. CONCLUSIONS: Public health professionals should note that past-year drinking in a significant proportion of women of childbearing age exceeds guidelines for alcohol use. When targeting such prevention efforts, they should thus include assessment of past-year alcohol use patterns.

Adolescent↗

Longitudinal trajectories of heavy drinking in adults in the United States of America.

AIMS: To estimate age, period, cohort and other demographic influences on heavy alcohol consumption and trajectories of heavy drinking in American adults. DESIGN: Prospective cohort of 14 127 participants, aged 25-74 years at baseline. Generalized estimating equations to model longitudinal change in the probability of heavy drinking and its association with demographic factors. Setting National, population-based sample of non-institutionalized civilians. MEASUREMENTS: Heavy alcohol consumption (usual number of drinks per occasion >or= five for men; >or= four for women) at baseline (1971-74) and three follow-ups until 1992. FINDINGS: Heavy alcohol consumption declined with increasing age (age effect) and tracked national average consumption (period effect). There was no cohort effect. Higher probability of heavy drinking was associated with male gender (relative risk: RR = 2.4), being not married (RR = 1.4), having less than high school education (RR = 1.7), having annual income below the median (RR = 1.5), not living in the South-east (RR = 1.7), and smoking (RR = 3.4). Getting married and quitting smoking during the study were each associated with reduction in heavy drinking (RR = 0.55 and 0.61, respectively). Slower age-related decline in the probability of heavy drinking was seen in men (P < 0.0001), married individuals (P = 0.03), and smokers (P = 0.05). CONCLUSIONS: Demographic predictors of trends in heavy drinking are different from those for trends in average alcohol consumption. The likelihood of heavy drinking declined more slowly with increasing age in men and smokers, suggesting that the negative health effects of alcohol in older ages may be greatest in these groups.

Adult↗

Formation of nonculturable Escherichia coli in drinking water.

AIMS: To examine whether incubation of Escherichia coli in nondisinfected drinking water result in development of cells that are not detectable using standard procedures but maintain a potential for metabolic activity and cell division. METHODS AND RESULTS: Survival and detectability of four different E. coli strains were studied using drinking water microcosms and samples from contaminated drinking water wells. Recovery of E. coli was compared using different cultivation-dependent methods, fluorescence in situ hybridization (FISH) using specific oligonucleotide probes, direct viable counts (DVC), and by enumeration of gfp-tagged E. coli (green fluorescent protein, GFP). Two levels of stress responses were observed after incubation of E. coli in nondisinfected drinking water: (i) the presence of cells that were not detected using standard cultivation methods but could be cultivated after gentle resuscitation on nonselective nutrient-rich media, and (ii) the presence of cells that responded to nutrient addition but could only be detected by cultivation-independent methods (DVC, FISH and GFP). Collectively, the experiments demonstrated that incubation for 20-60 days in nondisinfected drinking water resulted in detection of only 0.7-5% of the initial E. coli population using standard cultivation methods, whereas 1-20% could be resuscitated to a culturable state, and 17-49% could be clearly detected using cultivation-independent methods. CONCLUSIONS: Resuscitation of stressed E. coli on nonselective nutrient-rich media increased cell counts in drinking water using both traditional (CFU), and cultivation-independent methods (DVC, FISH and GFP). The cultivation-independent methods resulted in detection of 10-20 times more E. coli than the traditional methods. The results indicate that a subpopulation of substrate-responsive but apparent nonculturable E. coli may develop in drinking water during long-term starvation survival. SIGNIFICANCE AND IMPACT OF THE STUDY: The existence of substrate-responsive but nonculturable cells should be considered when evaluating the survival potential of E. coli in nondisinfected drinking water.

Cell Survival↗