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From the laboratory to real life: a pilot study of an expectancy challenge with "heavy drinking" young people on holiday.

The Alcohol Expectancy Challenge (EC) is a promising program for changing alcohol expectancies and reducing alcohol consumption in "heavy drinking" young men in a bar-lab setting. In this study the EC was adapted for use in mixed-gender groups in a holiday setting and its feasibility tested in camping resorts in the Netherlands where a lot of binge drinking takes place (summer 2002). Male and female participants (N = 170; mean age, 18.8 years) were randomly assigned to an EC or to an assessment-only control group. One day before the intervention, alcohol expectancies were measured by a Visual Analogue Scale of arousal-sedation expectancies (VAS expectancies questionnaire). At the same time, alcohol use in everyday life and on holiday was assessed by a General Drinking Questionnaire and a 24-hour drinking diary, respectively. Twenty-four hours after the intervention, the VAS expectancies questionnaire was administered again and alcohol use over the previous 24 hours was reported in the drinking diary. Six weeks after the intervention, participants were telephoned and administered oral versions of the VAS expectancies questionnaire and General Drinking Questionnaire. Data were analyzed using mixed ANOVAs. Although the study was hampered by recruitment difficulties, the EC proved feasible in this setting, was well received by youngsters, and effects on their alcohol expectancies may have been present. No effect was found on alcohol use. In conclusion, implementation must be improved and more studies are needed to come to more definite conclusions about the value of the EC in a real-life targeted intervention.

Adolescent↗

Biodisposition of dibromoacetic acid (DBA) and bromodichloromethane (BDCM) administered to rats and rabbits in drinking water during range-finding reproduction and developmental toxicity studies.

Dibromoacetic acid (DBA) and bromodichloromethane (BDCM), by-products of chlorine disinfection of water, were provided in drinking water in range-finding reproductive/developmental toxicity studies (rats) and a developmental toxicity study (BDCM) in rabbits. Studies included absorption and biodisposition of DBA and BDCM, including passage into placentas, amniotic fluid, fetuses (rats and rabbits), or milk (rats). The DBA and BDCM range-finding reproductive/developmental toxicity studies each included 50 Sprague-Dawley rats/sex/group. DBA (0, 125, 250, 500, or 1000 ppm) or BDCM (0, 50, 150, 450, or 1350 ppm) was provided in drinking water 14 days premating through gestation and lactation (63 to 70 days). The developmental toxicity range-finding study included 25 time-mated New Zealand white rabbits/group given 0, 50, 150, 450, or 1350 ppm BDCM in drinking water on gestation days (GDs) 6 through 29. Satellite groups (6 male, 17 female rats/group/study and 4 rabbits/group) were used for bioanalytical sampling. Rats and rabbits had exposure-related reduced water consumption caused by apparent taste aversion to DBA or BDCM, especially in the parental animals at the two highest exposure levels (500 and 1000 ppm DBA; 450 and 1350 ppm BDCM). Female rats consumed slightly higher mg/kg/day doses of DBA than male rats, especially during gestation and lactation; weanling rats consumed the highest mg/kg/day doses. DBA produced detectable and quantifiable concentrations in plasma, placentas, amniotic fluid, and milk. Plasma samples confirmed that rats drink predominately during the dark; this drinking pattern, not accumulation, produced detectable plasma concentrations for 18 to 24 hours/day. No quantifiable concentrations of BDCM occurred in plasma, placentas, amniotic fluid, or milk, suggesting that BDCM is rapidly degraded or metabolized in vivo. DBA (500 and 1000 ppm, rats) and BDCM (450 and 1350 ppm, rats and rabbits) produced secondary toxicity in the parental generation by reducing water consumption, which caused severe exposure-related apparent dehydration, reduced feed intake and weight gain. Reproductive and developmental parameters were essentially unaffected (mating possibly reduced [DBA at 1000 ppm]; exposure-related decreases in body weights of pups secondary to reduced water and feed consumption [DBA at 250, 500, and 1000 ppm; BDCM at 150, 450, and 1350 ppm]). No effects on development of rabbit fetuses occurred at BDCM concentrations as high as 1350 ppm. Results from these preliminary studies, in which DBA and BDCM were provided in the drinking water at concentrations thousands of times higher than those to which humans are exposed, suggest that neither DBA nor BDCM are reproductive/developmental risks for humans.

Acetates↗

Interactive effects of fluoride and aluminum uptake and accumulation in bones of rabbits administered both agents in their drinking water.

Fluoride (F) and aluminum (Al), which are known to form a strong complex, are both present in finished drinking water. The effect of F and AI on one another's tissue accumulation was determined using adult male New Zealand white rabbits. Thirty-six rabbits (three per group) were given Purina Rabbit Chow and drinking water containing no F or AI, F alone (1, 4, or 50 ppm F as NaF), Al alone, (100 or 500 ppm Al as AlCl3), or a combination of F and Al, ad libitum for 10 wk. None of these treatments altered food intake or weight gain in these rabbits. However, rabbits treated with 1 ppm F and 500 ppm Al consumed significantly less water than control rabbits. The F accumulation in plasma, urine, incisors, and tibia was increased as the F addition to the drinking water increased within groups receiving a single concentration of Al. In contrast, F accumulation in plasma, urine, incisors, and tibia decreased as the Al concentration increased within groups receiving a single F concentration, indicative of decreased intestinal absorption. Importantly, Al levels in tibia were significantly increased by the addition of F to the drinking water, even in animals receiving no Al in their drinking water. The effect of F on Al accumulation in bone was confirmed by our evaluating Al levels in sterna harvested from rats treated with 0 or 79 ppm F (as NaF in the drinking water) in a study conducted by the National Toxicology Program (Bucher et al., 1991). Therefore, some of the osteotoxicity seemingly associated with high F levels in bone may be due to the accumulation of Al or an Al-F complex.

Aluminum↗

"You become really close... you talk about the silly things you did, and we laugh": the role of binge drinking in female secondary students' lives.

In Australia, negative attitudes regarding young women's drinking have eased, drinking is on the increase, and there are heightened concerns about 'heavy' or 'binge' drinking. In a climate where underage drinking is frequently considered undesirable, campaigns aimed at reducing 'heavy' alcohol use have failed. This article takes as its departure point the notion that alcohol plays a meaningful role in social lives and relationships. It is through the use of narrative that these young women make sense of their drinking, which is still stigmatized. Any harm encountered along the way tends to be filtered through the 'good story,' brimming with tales of fun, adventure, bonding, sex, gender transgressions, and relationships. Nevertheless, these women implemented their own practical harm minimization strategies, and it is here that professionals can gain a foothold and assist young people and help them to drink more safely.

Adolescent↗

Drinking and parental unpredictability among adult children of alcoholics: a pilot study.

Within-family differences that mediate the relationship between family history for alcoholism and alcohol consumption were investigated. Twenty adult children of alcoholics (ACOAs) and 20 children of social drinking parents (non-ACOAs) were interviewed in 1991 (mean age 24.2 years). Participants described family functioning while growing up and indices of their alcohol consumption. Family history for alcoholism had a direct association with two aspects of drinking. ACOAs reported more lifetime drinks and tended to report drinking more frequently during high school, as compared to non-ACOAs. ACOAs also reported more parental unpredictability, which in turn was associated with the above drinking indices. Finally, family history for alcoholism had an indirect association with drinking, as unpredictability mediated this relationship. Research and prevention implications are discussed.

Adolescent↗

Why do they do it? A qualitative study of adolescent drinking and driving.

Despite a decline in the prevalence of fatal traffic crashes involving adolescent drinking drivers in recent years, underage drinking and driving (DD) and riding with drinking drivers (RWDD) remain serious problems. This article reports the findings of a qualitative study investigating the influence of beliefs and expectancies on adolescents' decisions to participate in DD or RWDD. Forty-four adolescents, who in a previous survey admitted to having been involved in either DD or RWDD, were interviewed in 2000 about their experiences concerning either driving after drinking or getting into a car with a driver who had been drinking. Findings indicate that adolescent DD and RWDD are complex behaviors. Expectancies and control beliefs do not seem to influence the decision, whereas normative beliefs to some extent do. However, findings also indicate that increased enforcement of the laws may be helpful in preventing young people from getting involved in drinking and driving.

Adolescent↗

Simultaneous drinking and gambling: a risk factor for pathological gambling.

The aim of the current study was to determine the effect of simultaneous drinking and gambling on negative consequences from gambling. Data was analyzed from a national telephone survey of 2631 US residents aged 18 or older. Males were more likely than females to drink while gambling. Simultaneous drinking and gambling was more closely associated with video keno, pull tabs, dice (not in a casino) and casino gambling than with other types of gambling. Those who drank while gambling were more likely to be problem gamblers, even when holding constant frequency of gambling, size of the average win or loss, and average alcohol consumption. Those gamblers who are drinkers, but did not drink while gambling, had a prevalence of problem gambling of close to zero. They had a lower prevalence of problem gambling than gamblers who didn't drink alcohol at all in the past year, and a much lower prevalence than those who drank while gambling. These results were interpreted to mean that simultaneous drinking and gambling is an indicator of a more reckless gambler. The results did not support the theory that gambling while under the influence of alcohol causes more risky gambling behavior.

Adolescent↗

Study of the relationship between cigarette smoking, alcohol drinking and cognitive impairment among elderly people in China.

OBJECTIVE: the incidence of cognitive impairment is increasing; however, little is known about the prevalence and risk factors for cognitive impairment of elderly people in China. This report focuses on investigating the relationship between cigarette smoking, alcohol drinking and cognitive impairment in elderly people. METHODS: 3012 participants aged 60 years old and over were enrolled from six communities of Chongqing. Cognitive function was measured by the Mini-Mental State Examination and Activities of Daily Living. The chi(2) test and logistic regression was used to find the relationship between cigarette smoking, alcohol drinking and cognitive impairment. RESULT: the rate of abnormal cognitive function in elderly people was 11.95%. Smoking was closely related to cognitive impairment (chi(2)=6.59, P=0.027). Alcohol drinking was also associated with cognitive impairment (chi(2)=6.31, P=0.025). In all smokers, current smoking was associated with a significantly increased risk of cognitive impairment (RR 2.33; 95% CI=1.37-5.82). In all people who drink every day, there was a significantly increased risk of cognitive impairment (RR 3.47; 95% CI=1.79-6.71). CONCLUSION: smoking and drinking are risk factors for cognitive impairment among elderly people. Cessation of smoking and reduction of drinking could be considered as part of a strategy to reduce the incidence of cognitive impairment.

Aged↗

Binge drinking during pregnancy--is it possible to obtain valid information on a weekly basis?

It has been suggested that future research into the adverse effects of binge drinking in pregnancy should take into account the time of binge drinking, and a method has been proposed. In a representative sample of 1,311 pregnant Danish women in 2000, the agreement between two different measures of binge drinking during the first half of pregnancy obtained from interviews and questionnaires was assessed. Compared with self-administered questionnaires, the interview provided an overall higher response rate and a higher response rate to the specific questions about binge drinking. Furthermore, a higher proportion of women admitted to binge episodes, and the internal consistency was better in the interviews compared with the questionnaires. The percent agreement between the methods ranged between 76% and 100% irrespective of the definition of binge drinking. Self-administered questionnaires are generally easier and cheaper to administer than interviews and, for descriptive purposes, the questionnaires may be sufficient to get an overall impression of the distribution of binge drinking. However, if the goal is to obtain data on the association of binge episodes during specific weeks of pregnancy and adverse pregnancy outcomes, the present results seem to suggest that personal interviews should be conducted if at all possible, particularly because of high internal consistency.

Adult↗

Socioeconomic and psychosocial exposures across the life course and binge drinking in adulthood: population-based study.

Despite recognition of the health risks of binge drinking, its life-course precursors have not been widely examined. Data from the Kuopio Ischemic Heart Disease Risk Factor Study (1984-1989) were used to investigate the association between socioeconomic and psychosocial exposures across the life course and binge drinking in a population-based sample of 2,316 middle-aged men. Binge drinking was defined as drinking at least four bottles of beer, one bottle of wine, one bottle of strong wine, or six servings of spirits on a single occasion. A composite indicator of childhood socioeconomic position was based on parental education, occupation, and number of rooms and divided into tertiles. Low childhood socioeconomic position increased the odds of binge drinking (odds ratio = 1.70, 95% confidence interval: 1.26, 2.31) when other early life exposures were adjusted. Additional adjustment of adult socioeconomic and psychosocial factors attenuated the odds of bingeing associated with low childhood socioeconomic position (odds ratio = 1.29, 95% confidence interval: 0.93, 1.79). Adult socioeconomic conditions, marital status, hostility, and organizational membership were independently associated with bingeing. This study shows that both early and later life characteristics including socioeconomic conditions and adult psychosocial factors contribute to adult binge drinking in this population, but the effects of adult characteristics are stronger.

Adult↗

At which drinking level to advise a patient? General practitioners' views.

This study examined the views of 64 general practitioners (GPs) on how much a patient has to drink to be advised by them and compared the results to the recommended Finnish threshold values of heavy drinking. The levels stated by GPs were not too high to prevent early-phase intervention in heavy drinking; rather, they were so low that numerous moderate drinkers were also included. The mean (SD) level was 15.5 (6.5) drinks for male and 11.0 (4.6) drinks for female patients per week. These are about two-thirds of the Finnish threshold values of heavy drinking. Attempting to advise such high proportions of patients, including both heavy and moderate drinkers, might mean a discouraging burden for GPs. However, there may be a discrepancy between GPs' statements about when to advise and when they actually do so.

Adult↗

Reported levels of alcohol consumption and binge drinking within the UK undergraduate student population over the last 25 years.

Results of a literature review of 18 studies investigating the drinking behaviour of undergraduate students at UK universities over a period of 25 years are presented. While comparison between studies is complicated by inconsistencies in the terms employed to describe drinking behaviour, it is concluded that significant numbers of both male and female students are reported to exceed sensible weekly consumption guidelines. Recorded levels of binge drinking among both female and male students are extremely variable between studies. Further research is needed to clarify this position. However, if the most recent research evidence is substantiated, female and male binge drinking levels may exceed those of their peers in the general population and their US counterparts. The reported ramifications of harmful drinking for the health and well-being of students are reviewed. A possible link between poor academic performance and alcohol consumption appears tenuous and merits further investigation. Evidence relevant to the view that the drinking behaviour of female students is changing is considered.

Adolescent↗

Impact of an alcohol misuse intervention for health care workers--1: Frequency of binge drinking and desire to reduce alcohol use.

AIMS: This report presents results of a 3-year study to evaluate the effects of an enhanced substance misuse prevention/early intervention programme on binge drinking and desire to reduce alcohol use among health care professionals employed in a managed care organization. METHODS: The intervention was implemented at one site, but not at satellite locations, which were used for comparison. The intervention included relatively low-cost elements, such as substance misuse awareness training for managers and the use of health risk appraisals (HRAs) and educational videos on how to reduce stress, depression and binge drinking. We evaluated intervention effects by comparing HRA scores of employees at the intervention site to all other employees who completed the HRA, while adjusting for demographic factors, reported stress levels, employment site and the effects of time. Outcomes analysed included number of days binge drinking (drinking 5 or more drinks per occasion in the past 30 days) and desire to reduce alcohol use. RESULTS: Binge drinking rates were not affected by the intervention. Among those who binge-drank, however, employees who completed the HRA at the intervention site in the post-intervention period were 2.59 times more likely to report a desire to cut down on alcohol use, compared with the pre-intervention time period and with both time periods in the comparison site (P < 0.05). CONCLUSIONS: We conclude that while the intervention did not significantly affect reported alcohol use, it did increase motivation to reduce alcohol use among binge drinkers.

Adult↗

School matters: drinking dimensions and their effects on alcohol-related problems among Ontario secondary school students.

AIMS: To test the hypotheses that average volume of alcohol consumption and patterns of drinking, each influence alcohol-related problems and that both act at individual and aggregate levels. METHODS: The 2003 cycle of the Ontario Student Drug Use Survey obtained self-administered questionnaires from a representative classroom-based survey of 2455 Ontario secondary school students (grades 9-12) from 74 schools, with a student completion rate of 72%. Average volume of alcohol consumption was assessed using a quantity-frequency measure. Heavy drinking occasions were operationalized by four dummy variables indicating less than monthly, monthly, weekly and daily consumption of five or more drinks per occasion, with never having a heavy drinking occasion serving as the reference group. Alcohol-related problems were measured by using seven items of the Alcohol Use Disorders Identification Test. RESULTS: As hypothesized, both the average volume of alcohol consumption and patterns of drinking influenced alcohol-related problems at the student level, independently of each other. At the school level, both determinants significantly influenced the problems, but not when simultaneously entered into the equation. CONCLUSIONS: Future prevention of alcohol-related problems in adolescents should consider both the average volume and patterns of drinking. Both prevention and research should also try to include environmental determination of alcohol-related problems.

Adolescent↗

Establishing rates of binge drinking in the UK: anomalies in the data.

AIMS: Several studies funded by the UK government have been influential in understanding rates of 'binge drinking' in the UK. This analysis aims to establish consistency between results and clarify UK rates of binge drinking. METHOD: The relevant sections of these surveys were compared: the Scottish Health Survey (SHS) 1998, the General Household Survey (GHS) 2002, and the Health Survey for England (HSE) 2003. In addition the methodology used by the Health Protection Agency in the Adult Drinking Patterns in Northern Ireland (2003) was compared with the approach used by the SHS, GHS, and HSE. RESULTS: Marked differences were observed between the results of the GHS 2002 and both the SHS 1998 and the HSE 2002 despite each using a similar methodology, with the HSE 2003 reporting a rate of 'binge drinking' in young males of 57%, and the GHS reporting a rate of 35%. This difference may be largely attributed to variations in the criteria in binge drinking in each study. These differences in interpretation do not appear to have been acknowledged. Indeed several key documents on alcohol harm reduction made inaccurate citations of previous surveys. CONCLUSION: The media rhetoric on escalating rates of binge drinking in the UK should be regarded with caution until trends are based on standardized recording and reporting.

Adult↗

Seeing through the glass darkly? A qualitative exploration of GPs' drinking and their alcohol intervention practices.

BACKGROUND: Brief alcohol intervention is influenced by patients' personal characteristics as well as their clinical risk. Risk-drinkers from higher social-status groups are less likely to receive brief intervention from GPs than those from lower social-status groups. Thus GPs' perception of social similarity or distance may influence brief intervention. OBJECTIVE: To explore the role that GPs' drinking behaviour plays in their recognition of alcohol-related risk in patients. METHOD: A qualitative interview study with 29 GPs recruited according to maximum variation sampling. All interviews were audio-recorded and transcribed verbatim. Analysis was inductive with constant comparison within and between themes plus deviant case analysis. Analysis developed until category saturation was reached. RESULTS: GPs described a range of personal drinking practices that broadly mirrored population drinking patterns. Many saw themselves as part of mainstream society, sharing in culturally sanctioned behaviour. For some GPs, shared drinking practices could increase empathy for patients who drank, and facilitate discussion about alcohol. However, several GPs regarded themselves as distinct from 'others', separating their own drinking from that of patients. Several GPs described a form of bench-marking, wherein only patients who drank more, or differently, to themselves were felt to be 'at risk'. CONCLUSION: Alcohol is clearly a complex and emotive health and social issue and GPs are not immune to its effects. For some GPs' shared drinking behaviour can act as a window of opportunity enabling insight on alcohol issues and facilitating discussion. However, other GPs may see through the glass more darkly and selectively recognize risk only in those patients who are least like them.

Adult↗

Understanding soft drink consumption among female adolescents using the Theory of Planned Behavior.

This study identified factors that influence regular soda consumption among 707 female students, aged 13-18 years, attending North Los Angeles County public high schools. Participants completed a group-administered Theory of Planned Behavior-based questionnaire. Almost all of the participants, 96.3%, reported that they currently drink soda; 50.1% reported drinking 2 glasses of soda or more per day during the past year. Students reported drinking regular soda more than diet soda and reported drinking phosphoric acid-containing soda more than non-phosphoric acid-containing soda. Attitude, subjective norm and perceived behavioral control had statistically significant positive associations with intention, and were each significant predictors of intention to drink regular soda and together explained 64% of its variance. The strongest predictor was attitude, followed by perceived behavioral control and subjective norm. Our results suggest that efforts to reduce soda consumption among female adolescents should include parents and friends. It is also important that soda should not be excessively available at home or widely accessible to teenagers at schools. Healthy eating messages for adolescents need to be developed and incorporated into existing and future campaigns to reinforce the perception that there are other healthier drinks that quench thirst and that taste good as well.

Adolescent↗

Assessment methods for alcohol consumption, prevalence of high risk drinking and harm: a sensitivity analysis.

BACKGROUND: There are no standardized ways to assess alcohol consumption in epidemiological studies. The main objective of the present study was to compare three widely used methods for assessing alcohol consumption with respect to resulting prevalence estimates for high risk drinking and harm as defined by morbidity and mortality indicators. METHODS: A within-subjects design was used to compare a quantity frequency, a graduated frequency, and a weekly drinking recall measure. Data consisted of a representative sample of 3961 adult residents of the province of Ontario, Canada, who participated in a multi-wave cross-sectional survey between 1990-1994. Cross-tabulation, Spearman correlation, and standard methodologies for prevalence-based cost-of-illness studies were used. RESULTS: The graduated frequency measure consistently yielded higher estimates of the prevalences of high risk drinking and harm. Differences were marked on all indicators, but were most pronounced for harmful drinking as defined by consuming an average of >60 g pure alcohol per day for males, and >40 g per day for females. Prevalence estimates of harmful drinking were almost five times higher for graduated frequency versus weekly drinking measures, and almost three times higher for graduated frequency versus quantity frequency measures. CONCLUSIONS: The characteristics of different measures of alcohol consumption should be considered in future research in epidemiology.

Adult↗