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Perceptions of risks of smoking and heavy drinking during pregnancy: 1985 NHIS findings.

As part of the Health Promotion and Disease Prevention Questionnaire administered in the 1985 National Health Interview Survey, nearly 20,000 respondents ages 18-44 answered questions about their awareness of the risks of smoking and heavy drinking during pregnancy. In reference to smoking, interviewers asked about miscarriage, stillbirth, prematurity, and low birth weight; in reference to heavy drinking, they asked about miscarriage, mental retardation, low birth weight, and birth defects, as well as fetal alcohol syndrome. For each of these adverse outcomes, a majority of subjects acknowledged increased risk because of smoking or heavy drinking during pregnancy. The range was 66-80 percent of respondents for the four questions on smoking, with the perceived association to smoking strongest for low birth weight. Approximately 84 percent of respondents associated heavy drinking with increased risk for each of the suggested pregnancy outcomes. Smoking seemed to be perceived to pose a lesser risk to pregnancy than heavy drinking. This relative lack of awareness of the pregnancy risks of smoking was more apparent among respondents with less education and more pronounced among blacks than whites. Women were more likely than men to express some opinion on these pregnancy-related questions and were more cognizant than men of the risks. On this limited survey, Americans ages 18-44 were not very knowledgeable about fetal alcohol syndrome. Among the 55 percent who had heard of fetal alcohol syndrome, fewer than one in four correctly identified it as a set of birth defects when offered three possible definitions. It will be interesting to correlate responses to these "knowledge" questions with NHIS data still forthcoming on reported actual smoking and drinking behavior among women respondents who were recently pregnant.

Adolescent↗

University students' drinking patterns and problems: examining the effects of raising the purchase age.

An extensive review of the literature on college students' drinking patterns and problems since the mid-1930s revealed no radical changes over the past several decades. However, during the past 10 years, drinking and problems related to drinking and driving have gradually decreased among college students. Results of a study of students at the same 56 colleges and universities throughout the United States (3,145 in 1982-83, 2,797 in 1984-85, and 3,375 in 1987-88) revealed few changes in collegiate drinking patterns and problems attributable to the nationwide increase in the minimum age for alcohol purchase. There was a decline in the proportion of students who drank in the period during which the law changed. However, the proportion of students categorized as heavy drinkers remained constant over time and the proportion of underage students (81 percent) who drank was higher than the proportion of legal age students who drank (75 percent). Of 17 problems related to drinking, all but 5 remained stable over the time periods. Three of the problems represent the continuum of an established trend of fewer students to indicating drinking and driving-related problems. As discussed in this paper, creative alcohol programming can assist in controlling alcohol abuse among college students.

Adolescent↗

Drinking in different social contexts among white, black, and Hispanic men.

This paper describes alcohol use by White, Black, and Hispanic men in eight different social settings. Data were obtained from a multi-stage probability sample of the household population of White, Black, and Hispanic adults aged 18 years and over, residing in the 48 contiguous United States. The response rate was 73 percent for Whites, 76 percent for Blacks, and 72 percent for Hispanics. Results show that Whites go more frequently and drink more frequently than Blacks and Hispanics at restaurants, in clubs or organizational meetings, and in bars. Blacks go more frequently than Whites and Hispanics to public settings such as parks, streets, and parking lots; however, the mean number of drinks consumed in these public places and the proportion of men drinking five or more drinks is higher for Hispanics than for Whites and Blacks. Other places where heavier drinking is common in all three ethnic groups are bars, taverns and cocktail lounges, and parties. In all three ethnic groups, men who are younger and those who are single go more frequently than other men to bars or public places such as streets, parks, and parking lots. Men who are younger and those who are single also have a higher rate of heavy drinking and of drunkenness than other men.

Adult↗

Circadian eating and drinking habits in alloxan diabetic rats.

Eating and drinking habits were studied in control and alloxan diabetic rats of up to 12 months' duration of diabetes, with emphasis on the hour-to-hour circadian pattern and the relationship between eating and drinking. In contrast to previous studies food and water intake started to increase immediately after alloxan injection possibly because of avoidance of alloxan induced acute renal insufficiency by kidney protection during alloxan injection. A biphasic circadian pattern of food and water intake was seen in both diabetic and control rats, but day-time eating and drinking were practically absent in controls in contrast to diabetic rats. The diabetic animals' meals and drinking bouts were significantly longer than the controls and the frequency of drinking bouts, but not of meals, was increased. Drinking was mainly associated with meals in both diabetic and control rats. Insulin treatment in diabetic rats partly normalized daily food and water intake.

Animals↗

The role of acetaldehyde-metabolizing enzymes in the mediation of ethanol consumption: an investigation using a simulated drinking bout.

Laboratory rats in a 24 hr free choice paradigm consume ethanol in a series of discrete drinking bouts. However, little research has been directed at establishing whether these individual bouts were pharmacologically relevant to animals. The present study was designed to investigate the pharmacological efficacy of a simulated ethanol drinking bout and the possible role of acetaldehyde (ACH) and its metabolizing enzymes in mediating these effects using various enzyme manipulations. Following an ethanol screening procedure (2% to 10%, free choice) to establish a drinking baseline, animals were deprived of ethanol for a two week period. Using a limited access procedure, animals were then presented with a 10% ethanol solution for a 10 min period each day for 10 days. On Days 11-15, 4 hr prior to ethanol presentation, animals were divided into four groups and received i.p. injections of either saline (S), 4-methylpyrazole (4MP), cyanamide (C) or 4-methylpyrazole + cyanamide (4MP + C). This latter treatment condition has been shown to prevent the accumulation of ACH in the periphery by cyanamide. On Day 12, 10 min after the drinking session, animals were placed in open field chambers and locomotor activity was recorded for 5 min. Results indicated that animals pretreated with cyanamide (groups S + C and 4MP + C) consumed significantly more ethanol across the 5 test days than groups S + S and 4MP + S. Locomotor activity was significantly depressed for animals pretreated with cyanamide alone (C + S), although drinking levels were comparable to all other groups on Day 12. Together, these data demonstrate that a stimulated drinking bout is a pharmacologically meaningful event since it can be altered by manipulating acetaldehyde-metabolizing enzymes.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetaldehyde↗

Patterns of self-reported drinking and driving in Michigan.

We analyzed a statewide telephone survey of Michigan adults to determine patterns of self-reported drinking and driving. The estimated prevalence of drinking and driving was 13.5 percent for men and 2.9 percent for women; the highest prevalence was among 18- to 24-year-old men (32 percent). Based on these estimates, over half a million Michigan adults drank and drove on over one million occasions during the month preceding the survey. Most drinking drivers (93 percent) reported binge drinking, yet 70 percent of them otherwise reported only moderate routine alcohol consumption, that is, they consumed fewer than 14 drinks a week on average. Because we were concerned about the validity of self-reports, we compared the patterns of self-reported alcohol use with the patterns of alcohol-related motor vehicle crashes. The pattern of self-reported drinking and driving (using age-, sex-, and region-specific estimates) was highly correlated with the pattern of injury in alcohol-related crashes (r = .96; p less than .0001). Self-reported patterns of alcohol use may be used to identify persons at highest risk for being injured or dying in a motor vehicle crash.

Accidents, Traffic↗

Measurements of drinking patterns in the general population and possible applications in studies of the role of alcohol in cancer.

Quantitative information on alcohol consumption patterns derives from four possible sources: indirect measures, observational studies, aggregate consumption statistics, and sample surveys of general populations. The potentials and problems of each method are briefly discussed, with primary attention to the various traditions of survey questioning and data analysis. While medically oriented epidemiologists have often used only an overall drinking volume measure, social scientists have pointed to the importance also of variability in characterizing drinking, particularly in relation to social and casualty as opposed to chronic health problems with drinking. The dimensions of drinking patterns which might be relevant to hypothesized linkages of alcohol and cancer are discussed. It is suggested that measurement will need to extend beyond volume of drinking and may indeed involve studies of new kinds of dimensions in the patterning of drinking.

Alcohol Drinking↗

Assessment of drinking patterns in general practice.

A study was undertaken in a north London general practice to see which questions and investigations were useful in assessing the drinking patterns of patients. In a 10-month period in 1984, 855 patients were interviewed by means of a questionnaire about quantity and frequency of drinking and the CAGE questionnaire to determine their drinking habits. They were also asked to blow into an alcolmeter. A blood sample was taken from 119 patients who said they drank more than 20 units of alcohol weekly or who scored more than two on the CAGE questionnaire or who had a positive alcolmeter reading, and gamma glutamyl transpeptidase levels and mean corpuscular volume were determined.The study showed that questions about quantity and frequency of drinking, taking under two minutes to administer in the consultation, are sufficient to raise suspicions about drinking problems. Detailed investigation can then be undertaken in patients who say they drink more than 20 units of alcohol weekly.

Adolescent↗

Drinking patterns and social consequences: a study of middle-class adolescents in two private pediatric practices.

One hundred sixty-two adolescents who were seen at two suburban private pediatric practices completed an anonymous, written questionnaire about drinking and drug habits. The respondents' ages ranged from 14 to 17 years; all were white and from middle- or upper middle-class families. The adolescents reported high self-esteem, good general health, and few psychologic problems. The majority (63%) reported having drunk alcohol at some time, and the proportion who professed never to drink alcohol became progressively smaller with age, to only 15% at age 17 years. Overall, one fifth claimed that they had to drink more than six beers before they "got a buzz," and this proportion increased to 43% by age 17 years. Among the 17-year-old respondents, 40% replied that their good friends had used alcohol more than 50 times. Twenty-four percent of respondents said that a good friend had received a citation for driving while intoxicated. Almost one fifth of respondents stated that someone in their family drinks alcohol every day, and that someone close to them has a drinking problem. Social acceptance of drinking, peer pressure, and the ready availability of alcohol have led to an epidemic of alcohol use among teenagers and to social, academic, and health problems in many frequent users. Pediatricians should play a more active role in the identification and management of alcohol abuse by their adolescent patients.

Adolescent↗

Smoking and drinking behavior before and during pregnancy of married mothers of live-born infants and stillborn infants.

Data from the 1980 National Natality Survey (NNS) and the 1980 National Fetal Mortality Survey (NFMS) are used to describe the drinking and smoking behavior of married mothers before and during pregnancy according to maternal race and Hispanic origin, age, and education. Typically, smokers were white mothers under 25 years of age with a high school education or less, and drinkers were white mothers 25 years of age and older with more than a high school education. When pregnancy was confirmed, reductions in smoking and drinking occurred. However, mothers of stillborn infants were less likely to stop smoking than were the mothers of live-born infants. Although the prevalence of drinking was much higher than was the prevalence of smoking among the mothers included in these surveys, the reduction in drinking was much more pronounced than was the reduction in smoking. For nearly every sociodemographic subgroup, the prevalence of smoking was higher and the prevalence of drinking was lower among mothers of stillborn infants than among mothers of live-born infants. Some of these differences are due to the age-race-health status makeup of the two NNS-NFMS populations sampled, and carefully controlled multivariate analyses are required to specify the relationship of maternal smoking and drinking to birth outcome. This descriptive analysis is the first step in that process.

Adult↗

Young people, drink and the law: a descriptive study covering two London magistrates' courts.

The survey sample consisted of 104 young people between the ages 17 and 25 who appeared in court charged with simple drunkenness, drunk and disorderly and drink and driving charges. Interviewing was carried out in two London magistrates' courts every weekday using a fortnightly rota over a six-month period. The results showed that the majority reported usually drinking in pubs and clubs; lager was the preferred alcoholic beverage. More than half the sample reported drinking in excess of 10 units, often considerably more (one unit = 1/2 pint of beer = 1 single measure of spirits = 1 glass of wine), on a drinking occasion. This rate of consumption was considered moderate drinking by a considerable number who were drinking either almost every day or at least once a week. Responses to a self-administered questionnaire showed that 40% had experienced some degree of psychological or physical dependence during the three months prior to their arrest. Of the sample 67% were surprised by the charge and 70% said that a court appearance would not make them more careful of their alcohol consumption in the future.

Adolescent↗

Convergent results of two methods of estimating the prevalence of problem drinking.

Two studies were conducted using different methods of estimating the prevalence of problem drinking among the Canadian Armed Forces. In one case, data on alcohol sales from base outlets were used to calculate mean per capita consumption, which in turn was applied to a theoretical and, to some extent, empirically-validated plot of the distribution of consumption often referred to as the Ledermann curve. Criteria for different levels of problem drinking were then applied to this distribution. In the other case, estimates of problem drinking and presumptive problem drinking were derived from self-reported data on the correlates and sequelae of excessive drinking. The results derived from the two methods were highly convergent. As in the case of studies from the United States, the estimates were disturbingly high, both placing approximately 18% of the respective populations in he hazardous drinking category. The preventive and treatment-related implications of these findings are discussed.

Alcohol Drinking↗

How Americans say they drink: preliminary data from two recent national surveys.

Data from two recent National Center for Health Statistics (NCHS) surveys which included alcohol consumption questions are described. These surveys are the Health and Nutrition Examination Survey (HANES I), providing alcohol consumption, dietary recall, health and demographic data for over 20,000 respondents; and the Health Habits Section of the 1977 Health Interview Survey (HIS) which provides responses of 23,000 people on drinking behavior and health factors such as smoking, physical disabilities, and dietary habits. Drinking data from these surveys are limited but of sufficient accuracy to be useful for cross-classification of drinking with health, socio-economic and demographic variables. Drinking patterns correlate reasonably well with those reported in other national surveys. Selected findings show that patterns of drinking and dietary intake are similar at national and regional levels, with the South remaining the region lowest in alcohol consumption levels. Surveys consistently under-report alcohol quantities expected from sales in all regions; potential reasons for this are discussed. Highest consumption is reported by males (3 to 4 times that of females), those with European national origins, those who are working or in school (college) rather than those who are retired or keeping house, and those between 25 and 64 years old. Beer remains the beverage of choice, particularly among those who are the heaviest drinkers. The potential for future analyses of drinking behavior and its health implications is explored, and areas for further investigation are suggested. Data preparations have been completed so that information on alcohol consumption can be more readily related to medical history, medical examination, laboratory findings, disability, and health care data in these surveys.

Adolescent↗

[Alcohol drinking patterns among policemen in Shiga, Kyoto, Yamaguchi and Okinawa prefectures].

Alcohol drinking patterns among policemen in Shiga, Kyoto, Yamaguchi and Okinawa prefectures were surveyed using a questionnaire on alcohol drinking during 1987-88. The responses from 1812 (male) subjects (average age of 36) were compared to a similar survey in 1975-79. Drinkers accounted for 91.3% of all subjects, of which 6.6% drank daily, 65.6% drank more than once a week, 6.5% usually did not drink at all and 2.1% were abstainers. The percentage of daily drinkers decreased during the 10 years (13.5%) though the total number of drinkers slightly increased nationwide. Preferred beverages were, beer 39.9%, whisky 21.4% Japanese sake 17.9%, Japanese shochu 11.0%. The percentage of beer and Japanese shochu drinkers increased and that of Japanese sake decreased during the ten-year period. However, Japanese sake was the second most popular beverage in Shiga, Kyoto and Yamaguchi prefectures. In Okinawa, awamori (a strong kind of shochu) was the favorite. Especially, drinkers aged over 50 in Okinawa preferred awamori rather than beer. Though drinking frequency at home (banshaku) and parties (enkai) did not change, the consumption volume decreased during the ten-year period. In In particular, young drinkers drank less frequently at home. Intake increased with age. Our results indicate that drinking frequency and volume decreased during the ten-year period. In general, drinking frequency and volume is reported to have increased. This difference might be related to the character of a policeman's occupation.

Adult↗

Law officers' views on enforcement of the minimum drinking age: a four-state study.

Qualitative data on enforcement of the minimum drinking age in the United States were obtained through in depth interviews with law enforcement officers in May and June 1992. Interviews were conducted with 37 supervisory and line law enforcement personnel in 15 city and county law enforcement agencies in four States. The selected agencies had varying levels of enforcement as measured by arrest rates. Interviews focused on the social and political context of enforcement of the drinking age, constraints to enforcement, and officers' recommendations for improving enforcement efforts. Officers generally perceive an acceptance of youth drinking by many segments of their communities, and they do not receive significant encouragement from community members to increase enforcement efforts. Political factors are thought to play some role in determining enforcement levels, especially in sheriffs' departments. Reported constraints on enforcement of the minimum drinking age include resource limitations, a number of practical problems, perceptions that punishments are inadequate, time and effort required for processing and paperwork, and the low status accorded enforcement of the minimum drinking age. Officers report facing a number of evidentiary and procedural challenges. Officers suggested a number of ways in which enforcement of the minimum drinking age could be improved.

Adolescent↗

[Maternal drinking and smoking and the risk of birth defects].

Maternal drinking or smoking and the risk of birth defects was studied in a case-control study, performed on 1,789 babies, born between 1990 and 1992 in the Tokai University hospital, and their mothers. The findings were as follows: The proportion of maternal drinking before or during pregnancy was higher in the mothers of children with birth defects (odds ratio 2.2; 95% confidence intervals 0.5-8.9). However, this difference was not statistically significant. Maternal smoking, defined as 11 or more cigarettes per day before pregnancy, was 13.5% in the mothers of children with birth defects, compared to 6.7% in the mothers of controls (odds ratio 2.2; 95% CI 0.6-7.4). This difference was not statistically significant. A total of 78 classified deformities were reported in the 52 children with birth defects, of which 24.4% were associated with maternal drinking and 16.7% were associated with maternal smoking, respectively. A significant association was found between premature birth and mothers who reported drinking during pregnancy (odds ratio 3.3 95% CI 1.1-10.9). The frequency of spontaneous abortion was higher among mothers who reported both drinking and smoking during pregnancy. In addition the frequency of complications during pregnancy was higher. Analysis of factors related to birth defects showed that the risk for birth defective infants was higher for mothers above 35 years of age than for those under 35 (p < 0.05). This study supports an association between maternal drinking during pregnancy and infant birth defects, but does not implicate maternal smoking because the number of mothers who smoked during pregnancy was too small to be of significance.

Adult↗

Enforcement of the legal minimum drinking age in the United States.

We studied patterns and levels of enforcement of the legal drinking age in the United States. Major findings include: (1) rates of enforcement of the legal drinking age are very low; (2) actions against outlets or adults providing alcohol to youth are particularly rare; (3) two of every thousand occasions of illegal drinking by youth under 21 are estimated to result in an arrest; (4) five of every 100,000 youth drinking occasions are estimated to result in an Alcohol Beverage Control agency action against an alcohol outlet; (5) penalties appear too lenient to deter providers of alcohol; and (6) levels of enforcement of the drinking age vary significantly across states. Recommendations for public policy and enforcement actions include: (1) increased enforcement effort be directed at those who provide alcohol to underage youth; (2) significant increases in the numbers of Alcohol Beverage Control enforcement personnel are needed; (3) one or more officers in each local enforcement agency should be designated as the alcohol control officer; (4) regular sting operations in retail alcohol outlets are needed; (5) all police-attended alcohol-involved incidents should include a record of the source of the alcohol; and (6) effective long-term efforts will require attention to the broader environment that encourages youth drinking.

Adolescent↗

Consumption and harm: drinking patterns of the Irish, the English and the Irish in England.

There has been controversy over the relationship between alcohol consumption and related problems amongst the Irish in England. Irish migrants have high Standardised Mortality Ratios for chronic liver disease and cirrhosis and high hospital admission rates for alcohol-related diagnoses in England. Yet it has been considered that people from the Republic of Ireland, whether living in Ireland (Conniffe et al., 1990) or in England (Pearson et al., 1991), actually drink less than the English. This paper reviews the evidence. In recent years Irish per capita volume alcohol consumption has been comparable to that of the U.K., although the distribution of consumption differs. Women in Ireland are less likely to drink than women in England and Wales, while men in Ireland are more likely to drink at high-risk levels than men in England and Wales: their average weekly consumption levels are closer to those of high-consuming men in Yorkshire and Humberside, who also drink more than the U.K. national average. Men in Ireland also appear to be more likely to experience drinking problems than their counterparts in England and Wales, although this may be related to factors other than the total amount of alcohol consumed. Although a previous study of General Household Survey data indicated low-risk alcohol consumption levels for people from the Irish Republic living in Britain, a reanalysis of these data adjusting for age and gender shows drinking rates that are very high.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗