Editors' Introduction International Perspectives on Drinking and Damage Based on Population Surveys and Epidemiological Studies

Abstract

In recent decades there have been dramatic international changes in alcohol policy initiatives, access to alcohol, level of consumption, drinking patterns and damage associated with alcohol consumption. A number of studies have shown strong associations among drinking levels, drinking patterns and the physical harms and social problems derived from the effects of alcohol (e.g., Babor, Caetano, Casswell, Edwards, et al. 2003; Edwards 1994; Rehm, Chisholm, Room & Lopez 2006). Concurrently, evaluations and reviews of alcohol policies and other interventions demonstrate that some prevention strategies are more effective than others in reducing alcohol-related harms (Babor et al. 2003). However, recent changes in many jurisdictions have effectively increased access to alcohol, suggesting that drinking rates and levels of damage may increase in the future (e.g., World Health Organization (WHO) 2007).While research has documented the substantial damage from alcohol (Rehm et al. 2006; WHO 2002) and pointed to effective interventions, some of the most effective policy levers have been eroded in recent years (Room, Babor & Rehm 2005). Thus it is expected that alcohol-related social and health harms will increase, particularly in jurisdictions where controls on alcohol are eroded or underdeveloped, where a large portion of drinking occasions involve high-volume consumption and/or where overall alcohol consumption rates are on the rise.The articles in this issue and its companion issue (Volume 34, No. 4) are based on some of the research papers presented at a thematic symposium of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS), which was held in Toronto, Canada, in October 2006. The title of the symposium was Population Level Studies of Alcohol Consumption and Harm. It offered an opportunity to provide an update on recent and ongoing international studies of alcohol consumption and damage and to examine their implications and impact, if any, on the policy process or outcomes. Of particular interest were international and national studies that examined population-level studies of changes in alcohol management and access to alcohol, alcohol control systems, drinking patterns and levels, and damage associated with alcohol use.As illustrated in this issue and its companion issue, articles were presented from several Latin American countries, two European jurisdictions, Canada and the United States. The seven articles in this edition focus on population surveys and epidemiological studies. In the companion edition the focus is on policy-effect studies and policy formation and implementation themes.In the first article, Guilherme Borges and colleagues (2007) report on the Mexican National Comorbidity Survey, which involved 5,826 interviews. They note that just under 8% of respondents were classified as being dependent on alcohol during their lifetimes, but only 31% of all respondents with an alcohol-use disorder had ever used any treatment services, and in many cases only after a delay of several years.A second article from Mexico focuses on interviews with a sample of 211 female inmates. Martha Romero Mendoza (2007) notes that 20% of the women qualified for alcohol dependence on three or more criteria, and many experienced a combination of health problems associated with alcohol consumption, as well as mental health problems such as a major episode of depression. The author points to the need to have enhanced public policies for marginalized women that provide greater access to mental health services and addictions treatment.Maria Lima and colleagues (2007) report on the results of a household interview survey of 1,473 Sao Paulo City residents. They use a logistic regression model to analyze heavy drinking, and note that for both genders heavy drinking was associated with having a heavy-drinking partner, as well as with feeling less inhibited about sex when drinking. …