Alcohol Drinking Patterns Research Articles

Changes in alcohol consumption in the 50- to 64-year-old European economically active population during an economic crisis.

The aim was to compare alcohol drinking patterns in economically active people aged 50-64 years before the last economic crisis (2006) and during the crisis (2013). Cross-sectional study with data from 25 479 economically active people aged 50-64 years resident in 11 European countries who participated in wave 2 or wave 5 of the SHARE project (2006 and 2013). The outcome variables were hazardous drinking, abstention in previous 3 months and the weekly average number of drinks per drinker. The prevalence ratios of hazardous drinking and abstention, comparing the prevalence in 2013 vs. 2006, were estimated with Poisson regression models with robust variance, and the changes in the number of drinks per week with Poisson regression models. The prevalence of hazardous drinking decreased among both men (PR = 0.75; 95%CI = 0.63-0.92) and women (PR = 0.91; 95%CI = 0.72-1.15), although the latter decrease was smaller and not statistically significant. The proportion of abstainers increased among both men (PR = 1.11; 95%CI = 0.99-1.29) and women (PR = 1.18; 95%CI = 1.07-1.30), although the former increase was smaller and not statistically significant. The weekly average number of drinks per drinker decreased in men and women. The decreases in consumption were larger in Italy and Spain. From 2006 to 2013, the amount of alcohol consumed by late working age drinkers decreased in Europe, with more pronounced declines in the countries hardest hit by the economic crisis.

Female Sprague-Dawley rats display greater appetitive and consummatory responses to alcohol

The narrowing of the gender gap in alcohol drinking patterns is a concern because women are more susceptible to adverse health consequences of alcohol use. Animal models of alcohol-seeking and -consuming are useful to delineate sex differences to test for effective sex-specific pharmacological treatments. We investigated potential sex differences in appetitive and consummatory responses to alcohol. Appetitive behaviors included numbers of head entries into the dipper access area and active lever presses. Consummatory behaviors included number of reinforcers delivered and consumed. Male and female Sprague-Dawley rats were placed on an overnight alcohol (10%) drinking schedule and trained to lever press for alcohol (10% solution). Separate groups of male and female animals had access to water overnight and were trained to lever press for sucrose (3% solution). Tests were conducted under a progressive ratio schedule of reinforcement. Alcohol-responding females demonstrated higher alcohol intake overnight and showed greater appetitive and consummatory responses compared to males. Similar sex differences were seen in the sucrose group. Effect sizes indicated greater sex differences in consummatory measures in the alcohol vs. sucrose groups. Conversely, greater sex differences in appetitive behaviors were observed in the sucrose vs. alcohol groups. Overall, the magnitude of the sex differences was stronger for appetitive behaviors compared to consummatory behaviors. Findings of quantitative sex differences in appetitive and consummatory behaviors for alcohol and for the natural reinforcer, sucrose, suggest this procedure is useful to assess efficacy of sex-specific treatments aimed at reducing appetitive and consummatory responses to alcohol.

Lifetime drinking history in patients with alcoholic liver disease and patients with alcohol use disorder without liver disease

Objective: To determine the differences in lifetime alcohol intake (LAI) and drinking patterns between patients with alcoholic liver disease (ALD) and alcohol use disorder (AUD) without notable liver injury and between males and females with ALD.Methods: Alcohol drinking patterns were assessed using the Lifetime Drinking History (LDH) a validated questionnaire, during an outpatient visit. Patients with AUD, currently in addiction treatment, were matched for gender and age (±5 years) with the ALD group.Results: A total of 39 patients with ALD (26 males and 13 females; median age 58) and equal number of AUD patients were included (median age 56 years). The onset age for alcohol drinking and duration of alcohol consumption was similar in ALD and AUD. The number of drinking days was higher in women with ALD than in women with AUD: 4075 [(3224–6504) versus 2092 (1296–3661), p = .0253]. The LAI and drinks per drinking day (DDD) were not significantly different between patients with ALD and AUD. Females with ALD had lower LAI than males with ALD: 32,934 (3224–6504) versus 50,923 (30,360–82,195), p = .0385, fewer DDD (p = .0112), and lower proportion of binge drinking as compared to males with ALD (p = .0274).Conclusions: The total LAI was similar in patients with ALD and AUD. The number of drinking days over the lifetime was associated with the development of ALD in females. Females with ALD had significantly lower alcohol consumption than men with ALD despite similar duration in years of alcohol intake which supports the concept of female propensity of ALD.

The epidemiology of alcohol use in Izmir, Turkey: drinking pattern, impairment and help-seeking.

There is no report on various patterns of alcohol drinking and related impairment, help-seeking in Turkey. We investigated the 12-month prevalence and correlates of drinking patterns and alcohol use disorders in the general population of Izmir-Turkey, with further analyses on role impairment and help-seeking. A multi-stage clustered area probability sample of adult household residents in the Izmir Metropolitan Area was assessed using the Composite International Diagnostic Interview 2.1 (n =4011). Estimation focused on prevalence and correlates of 12-month drinking pattern and DSM-IV alcohol use disorders. The 12-month drinking pattern included groups of non-regular users, regular non-heavy drinkers, regular heavy drinkers, and alcohol abuse disorder and alcohol dependence. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, and were assessed with Short Form-36 for functional impairments. Multinomial logistic regression was used for underlying associations between the covariates and the drinking patterns. The rate of lifetime alcohol abstinence was 52.3% while the prevalence of past-year users was 14.8%. The 12-month prevalence estimates of regular heavy drinkers, and alcohol abuse disorder and dependence were 2.5%, 3.2 and 1.6%, respectively. Any of the drinking patterns and alcohol use disorders was associated with male gender, and higher levels of education, monthly income and socioeconomic status. Alcohol dependence was associated with mental health impairment but not with physical impairment. The 12-month rates of help-seeking in alcohol abuse and dependence were 11.6 and 16.5%. Although alcohol use disorders are lower than estimates of Western countries, alcohol use constitute a major reason of disability with prominent treatment gap.

Adjustment for tobacco smoking and alcohol consumption by simultaneous analysis of several types of cancer

PurposeTobacco smoking and alcohol consumption are risk factors for several types of cancer and may act as confounders in aetiological studies. Large register-based cohorts often lack data on tobacco and alcohol. We present a method for computing estimates of cancer risk adjusted for tobacco and alcohol without exposure information.MethodsWe propose the use of confirmatory factor analysis models for simultaneous analysis of several cancer sites related to tobacco and alcohol. In the analyses, the unobserved pattern of smoking habits and alcohol drinking is considered latent common factors. The models allow for different effects on each cancer site, and also for appropriate latent site-specific factors for subgroup variation. Results may be used to compute expected numbers of cancer from reference rates, adjusted for tobacco smoking and alcohol consumption. This method was applied to results from a large, published study of work-related cancer based on census data (1970) and 21 years of cancer incidence data from the national cancer registry.ResultsThe results from our analysis were in accordance with recognised risks in selected occupational groups. The estimated relative effects from tobacco and alcohol on cancer risk were largely in line with results from Nordic reports. For lung cancer, adjustment for tobacco implied relative changes in SIR between a decrease from 1.16 to 0.72 (Fishermen), and an increase from 0.47 to 0.95 (Forestry workers).ConclusionsWe consider the method useful for achieving less confounded estimates of cancer risk in large cohort studies with no available information on smoking and alcohol consumption.

Computerized alcohol screening identified more at-risk drinkers in a level 2 than a level 1 trauma center

BackgroundAlcohol abuse is recognized as a significant contributor to injury. It is therefore essential that trauma centers implement screening and brief intervention (SBI) to identify patients who are problem drinkers. Although, the utility of SBI in identifying at-risk drinkers have been widely studied in level 1 trauma centers, few studies have been done in level 2 centers. This study evaluates the usefulness of SBI in identifying at-risk drinkers and to investigate the pattern of alcohol drinking among level 2 trauma patients.MethodsThis is a retrospective study of a convenience sample of trauma patients participating in computerized alcohol screening, brief intervention, and referral to treatment (CASI) in an academic level 1 trauma center and a nearby suburban community hospital level 2 trauma center. CASI utilized Alcohol Use Disorders Identification Test (AUDIT) to screen patients. We compared the pattern of alcohol drinking, demographic factors, and readiness-to-change scores between those screened in a level 2 and 1 trauma center.ResultsA total of 3,850 and 1,933 admitted trauma patients were screened in level 1 and 2 trauma centers respectively. There was no difference in mean age, gender, and language between the two centers. Of those screened, 10.2% of the level 1 and 14.4% of the level 2 trauma patients scored at-risk (AUDIT 8–19) (p < 0.005). Overall, 3.7% of the level 1 and 7.2% of the level 2 trauma patients had an AUDIT score consistent with dependency (AUDIT > =20) (p < 0.005). After adjusting for age, sex, education, and language, the odds of being a drinker at the level 2 center was two times of those at the level 1 center (p < 0.005). The odds of being an at-risk or dependent drinker at level 2 trauma center were 1.72 times of those at the level 1 center (p < 0.005).ConclusionsFindings suggest that SBI is effective in identifying at-risk drinkers in level 2 trauma center. SBI was able to identify all drinkers, including at-risk and dependent drinkers at higher rates in level 2 versus level 1 trauma centers. Further studies to evaluate the effectiveness of SBI in altering drinking patterns among level 2 trauma patients are warranted.

Relationship between Alcohol Drinking Patterns and Obesity and Abdominal Obesity in Korean Adult Men

Relationship between Alcohol Drinking Patterns and Obesity and Abdominal Obesity in Korean Adult Men

Counting the costs of alcohol: how useful an aid to policymaking?

Commentary to: Which cost of alcohol? What should we compare it against?

Alcohol consumption and academic performance among higher secondary students in Thimphu, Bhutan

Introduction: Despite known alcohol abuse among adolescence, precise information on the prevalence and pattern of drinking in Bhutan remain sparse. This study, therefore, assesses the pattern of alcohol drinking and consequences including its effects on academic performance among high school students in Thimphu. Methods: Multistage random sampling was employed and a survey was conducted in November 2014 using a self-administered semi-structured questionnaire. A total of 403 students were invited, however, 3 students were absent during the time of survey and 13 respondents were rejected due to incompleteness of the questionnaire. Thus, the findings are based on a sample size of 387. Results: Prevalence of long term alcohol drinkers were 38.8% and 26.6% were current drinkers. The mean age of onset of alcohol use was 15.5 (± 2.6). Binge drinking (greater than or less than four times a week) and GPA (Grade Point Average) were significantly orrelated (p less than or equal to 0.01, r = - 0.120). Therefore, students involved in binge drinking greater than or equal to four times a week are likely to obtain less GPA. Conclusions: Students, comprising both males and females, drink alcohol and those who are involved in frequent binge drinking are more likely to have lower GPA.

Associations between body-mass index and second-hand smoke exposure and stroke recurrence in Chinese patients in Xi'an, Shantou, and Chongqing: a multicentre cross-sectional survey

BackgroundRecurrence of stroke is common and it affects quality of life, mobility, and mortality rates of stroke survivors. Previous studies have shown a paradoxical association between body mass index (BMI) and post-stroke mortality, and a dose-dependent association between second-hand smoke (SHS) exposure and risk of stroke. But the associations between BMI, SHS exposure, and stroke recurrence are unclear. We aimed to examine these associations in stroke survivors. MethodsThis cross-sectional survey was done in Xi'an, Shantou, and Chongqing. Student helpers trained by DYPL and YZ obtained information about stroke recurrence, BMI (underweight defined as <18·5 kg/m2, normal weight as 18·5–23·9 kg/m2, and overweight/obese as ≥24 kg/m2), SHS exposure at home and work, lifestyle (smoking, alcohol drinking, physical activity, and food consumption patterns), and demographic details with a locally validated instrument. Bivariate analyses identified potential confounders. We used logistic regression to assess associations of obesity and SHS exposure with stroke recurrence after adjustment for confounding variables. This study was approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee, and respondents provided informed consent. FindingsWe included surveys completed between April 1, 2012, and Dec 31, 2013, from 503 stroke survivors (325 [65%] male, mean age 66·9 years [SD 11·7]). 202 (40%) participants reported previous stroke recurrence. Logistic regression analysis adjusted by sex, age, diabetes, and hypertension showed that, compared with patients who were normal weight, patients who were underweight were more likely to have stroke recurrence (odds ratio [OR] 3·12, 95% CI 1·39–6·97; p=0·006) while patients who were overweight or obese had a similar risk (0·85, 0·57–1·28; p=0·435). SHS exposure at work and at home were not associated with stroke recurrence in this study (0·60, 0·34–1·06; p=0·146). InterpretationUnderweight patients are at increased risk of recurrent stroke whereas obese patients have similar risk as their normal weight counterparts. Optimal weight management should be promoted as part of secondary prevention and stroke rehabilitation. FundingThe Nethersole School of Nursing, The Chinese University of Hong Kong (NUR-CV1102).

Alcohol drinking patterns in young people: A survey-based study

Binge drinking represents a major clinical and public health concern. Here, we investigated the prevalence of binge drinking and its related consequences, in a population of young adults. A questionnaire was administered to a sample of 4275 healthy subjects. In the overall sample, the percentage of binge drinkers was 67.6 per cent; among regular alcohol users, 79.5 per cent reported episodes of binge drinking. Among binge drinkers, several serious consequences were identified (staggering and stuttering, amnesia, loss of control, aggressiveness, sexual disinhibition). Raising awareness about the seriousness of binge drinking may help health care providers to identify cases early on and provide appropriate treatments.

Chronic plus binge ethanol exposure causes more severe pancreatic injury and inflammation

Alcohol abuse increases the risk for pancreatitis. The pattern of alcohol drinking may impact its effect. We tested a hypothesis that chronic ethanol consumption in combination with binge exposure imposes more severe damage to the pancreas. C57BL/6 mice were divided into four groups: control, chronic ethanol exposure, binge ethanol exposure and chronic plus binge ethanol exposure. For the control group, mice were fed with a liquid diet for two weeks. For the chronic ethanol exposure group, mice were fed with a liquid diet containing 5% ethanol for two weeks. In the binge ethanol exposure group, mice were treated with ethanol by gavage (5g/kg, 25% ethanol w/v) daily for 3days. For the chronic plus binge exposure group, mice were fed with a liquid diet containing 5% ethanol for two weeks and exposed to ethanol by gavage during the last 3days. Chronic and binge exposure alone caused minimal pancreatic injury. However, chronic plus binge ethanol exposure induced significant apoptotic cell death. Chronic plus binge ethanol exposure altered the levels of alpha-amylase, glucose and insulin. Chronic plus binge ethanol exposure caused pancreatic inflammation which was shown by the macrophages infiltration and the increase of cytokines and chemokines. Chronic plus binge ethanol exposure increased the expression of ADH1 and CYP2E1. It also induced endoplasmic reticulum stress which was demonstrated by the unfolded protein response. In addition, chronic plus binge ethanol exposure increased protein oxidation and lipid peroxidation, indicating oxidative stress. Therefore, chronic plus binge ethanol exposure is more detrimental to the pancreas.

Alcohol consumption among partners of pregnant women in Sweden: a cross sectional study.

BackgroundAntenatal care in Sweden involves a visit in pregnancy week 6–7 for counseling about lifestyle issues, including alcohol. The aim of this study was to investigate alcohol consumption among partners of pregnant women, their motives for changing drinking patterns when becoming a parent and their perceptions of the midwife’s counseling about alcohol.MethodThe study was conducted at 30 antenatal care centers across Sweden in 2009–2010. All partners who accompanied a pregnant women in pregnancy week >17 were asked to participate. The questionnaire included questions on alcohol consumption.ResultsQuestionnaires from 444 partners were analyzed. Most, 95 %, of the partners reported alcohol consumption before pregnancy; 18 % were binge drinking (6 standard drinks or more per occasion, each drink containing 12 grams of pure alcohol) at least once every month during the last year. More than half, 58 %, of all partners had decreased their alcohol consumption following pregnancy recognition and a higher proportion of binge drinkers decreased their consumption compared to non-frequent binge drinkers (p = 0.025). Their motives varied; the pregnancy itself, fewer social gatherings (potentially involving alcohol consumption) and a sense of responsibility for the pregnant partner were reported. Of the partners, 37 % reported support for decreased drinking from others (pregnant partner, parents, friend or workmates). Further, most partners appreciated the midwife’s counseling on alcohol.ConclusionA majority of partners decreased their alcohol consumption in transition to parenthood, which also appears to be a crucial time for changing alcohol-drinking patterns. The partners with higher AUDIT-C scores reported more support for decreased drinking. Most partners appreciated the midwife’s talk about alcohol and pregnancy and those who filled out AUDIT in early pregnancy reported that the counseling was more engaging. During pregnancy it is possible to detect partners with high alcohol consumption, and promote interventions for decreased drinking, also for the partners. Written information addressing alcohol use and directed to partners is needed.

Health Behaviors Among School-Aged Children: a Cross Sectional Study in Lebanese Private Schools

There is insufficient data on health-risk behaviors of school students in Lebanon. The objective of our study is to provide data about the prevalence of cigarette and waterpipe smoking as well as alcohol drinking patterns among school students, focusing on gender differences and searching for tobacco and alcohol uses’ predictors. The dissemination of such information is required in order to promote health and assist the local authorities in Lebanon in designing tobacco and alcohol control prevention programs with a particular attention to youth. Using a convenient sample of Lebanese students, aged between 11 and 20 years, a cross-sectional study was carried out in nine private schools in Beirut and Mount Lebanon. A standardized questionnaire was used for collecting data related to socio-demographic characteristics, tobacco and alcohol consumption, entourage consumption, and health-related behaviors. Additional questions related to the general perception of personal health and life satisfaction, social activities, physical activity and sedentary behavior, school environment, family and peer relationships were also included in the questionnaire. The summary of responses is analyzed using two methods: bivariate and multivariable analyses. Among 1982 participants, 10.3, 16.9, and 42.4 % are cigarette smokers, waterpipe smokers, and alcohol consumers respectively. Higher rates of smoking and alcohol consumption are found out among boys as opposed to girls (p < 0.001). We identified that a significant association exists between tobacco and alcohol consumption based on age, district, socioeconomic status, connectivity with family, family and entourage influence, days spent with friends, drunkenness and binge drinking, energy drink consumption, weight status, self-rated health, electronic media communication, and last quarter average (aOR going from 0.50 till 0.87 for protective factors and inverse relationships and from 1.19 till 5.80 for positive associations). Substantial proportions of school students in Lebanon adopt risky behaviors. Health-promotion activities need to be established in order to decrease the occurrence of such behaviors and prevent deleterious health outcomes.

Association of alcohol consumption pattern with risk of hypertension in Korean adults based on the 2010-2012 KNHANES.

We examined the association between alcohol-drinking pattern and hypertension in Korean adults. This cross-sectional study included 15,052 participants (7054 men and 7998 women) who were included in the 2010-2012 Korean National Health and Nutrition Examination Survey (KNHANES). We categorized alcohol-drinking patterns into three groups based on the Alcohol Use Disorders Identification Test (AUDIT) score: low-risk (score: 0-7), intermediate-risk (score: 8-14), and high-risk (score: ≥15). Hypertension was defined as systolic blood pressure ≥140mmHg, diastolic blood pressure ≥90mmHg, or current use of anti-hypertensive medications. In the study population, 25.2% of men and 4.6% of women were high-risk drinkers. Hypertension prevalence was 30.8% in men and 20.6% in women. Of the total population, 13.8% of men and 13.6% of women were using anti-hypertensive drugs. Age-adjusted hypertension prevalence was 30.8, 40.9, and 45.3% in men, and 24.6, 27.0, and 32.3% in women in the low-, intermediate-, and high-risk drinking group, respectively. Compared to the low-risk drinking group, the prevalence ratio (95% confidence interval [CI]) for hypertension was 1.664 (1.4331.933) and 2.070 (1.772-2.418) for men and 1.012 (0.774-1.323) and 1.650 (1.080-2.522) for women in the intermediate- and high-risk drinking group, respectively, after adjusting for age and other confounding factors. In conclusion, our study suggests high-risk drinking appears to be associated with a higher risk of hypertension in men and women.

Frequency and intensity of alcohol consumption: new evidence from Sweden

There is an increasing body of evidence that the intensity in which alcohol is drunk is of greater concern than the frequency or overall quantity consumed. This paper provides an extensive analysis of the demand for alcohol as measured by total quantity, frequency, and intensity. A unique large sample of cross-sectional data from Sweden 2004–2011 allows reduced-form alcohol demand equations to be estimated for beer, wine, and spirits, split by alcohol drinking pattern (average vs. binge drinkers) and gender. Results find a negative beer excise rate effect for participation and frequency, and positive effect for intensity. The effect was stronger for binge drinkers. Generally, the results also show a positive socioeconomic (income and education) gradient in frequency demand and a negative gradient in the intensity demand. Female wine drinkers show a positive socioeconomic gradient in both frequency and intensity. The findings highlight the complexity of this policy space. Tax increases appear to reduce frequency but raise intensity consumed. The more educated and higher earners drink more in total, but less intensely when they do and this is likely to explain in part why poor health is concentrated amongst lower socioeconomic status individuals.

Alcohol drinking patterns and risk of functional limitations in two cohorts of older adults

Several studies have found that moderate alcohol intake is associated with lower risk of functional limitations in older adults. However, no previous investigation has assessed this association in older adults from Mediterranean countries, who show characteristic drinking patterns. Data were taken from the UAM and the Seniors-ENRICA cohorts in Spain, comprising community-dwelling people aged ≥60 years. At baseline, participants in both cohorts were classified as non-drinkers, ex-drinkers, moderate drinkers and heavy drinkers (the threshold between moderate and heavy intake was ≥40g/day in men and ≥24g/day in women). The Seniors-ENRICA cohort allowed assessment of a Mediterranean Drinking Pattern (MDP), defined as moderate alcohol intake, with wine preference (≥80% of alcohol consumed as wine) and drinking only with meals. The incidence of limitation in mobility, agility, and instrumental activities of daily living (IADL) was ascertained in each cohort at the end of a 3.5-year follow-up. Analyses were adjusted for sex, age, education, lifestyle, BMI, chronic conditions, and functional limitations at baseline others than the studied limitation. Compared with non-drinkers, ex-drinkers showed a higher risk of IADL limitation (pooled adjusted odds ratio [paOR]: 1.63; 95% confidence interval [CI]: 1.04-2.21). By contrast, moderate drinkers had a lower risk of limitations in mobility (paOR: 0.80; 95% CI: 0.63-0.97), agility (paOR: 0.82; 95% CI: 0.65-0.99) and IADL (paOR: 0.54; 95% CI: 0.39-0.69). Among individuals reporting poor or fair health, the MDP was associated with lower risk of mobility limitation (aOR: 0.51; 95% CI: 0.27-0.97). In older adults, moderate alcohol consumption, as well as the MDP in specific subgroups, is associated with lower risk of functional limitation. These results should not serve to promote alcohol intake, because older adults are particularly vulnerable to its harmful effects.

High-risk drinking is associated with dyslipidemia in a different way, based on the 2010–2012 KNHANES

BackgroundThe Alcohol Use Disorders Identification Test (AUDIT) questionnaire is a simple and useful method for the early detection of hazardous and harmful drinking. In this study, we examined the association between alcohol drinking pattern and dyslipidemia in Korean adults. MethodsThis cross-sectional study included 14,308 participants who took part in the 2010–2012 Korean National Health and Nutrition Examination Survey. We categorized alcohol drinking patterns into three groups. We classified dyslipidemia into hypercholesterolemia, hypertriglyceridemia, hypo-HDL-cholesterolemia, hyper-LDL-cholesterolemia, and hyper-non-HDL-cholesterolemia. ResultsOf those who participated, 25.1% of men and 4.8% of women were high-risk drinkers. Compared with the low-risk group, Odd Ratios for hypercholesterolemia and hypertriglyceridemia in the high-risk group were 1.198 (1.001–1.434) and 1.979 (1.622–2.413) for men. Odd Ratios for hypo-HDL-cholesterolemia in the high-risk group was 0.351 (0.279–0.441) in men and 0.413 (0.291–0.586) in women. Compared with the low-risk participants, the high-risk group was associated with higher prevalence and increased risk for hyper-LDL-cholesterolemia in both sexes (1.541 [1.467–1.913] for men and 1.631 [1.034–2.575] for women). ConclusionsHigh-risk drinking was associated with higher risk for hypertriglyceridemia and hyper-LDL-cholesterolemia in both sexes and hypercholesterolemia in men but lower risk for hypo-HDL-cholesterolemia in both sexes.

Patterns of Betel Quid, Cigarette, and Alcohol Use, and Their Correlates With Betel Quid Cessation in a Male Inmate Population

ABSTRACT Background: There are few published studies addressing multiple substance uses and their effects on subsequent cessation of betel quid (BQ) chewing in the Asia Pacific region. Objectives: This study aims to investigate the usage patterns of BQ chewing, cigarette smoking, and alcohol drinking, and their correlates with subsequent BQ cessation among a male inmate population. Methods: Data from 473 male inmates with a history of BQ use who were incarcerated in Taiwan Kaohsiung Prison was used for this analysis. Participants were asked to report their lifetime usage patterns of cigarette, alcohol, and BQ, and their cessation status of each substance. A stepwise logistic regression analysis was performed to identify predictors of voluntary BQ cessation. Results: Seventy-five percent of all participants reported habitual use of all three substances. A total of 185 (39%) participants reported voluntary cessation of BQ prior to incarceration, and 288 (61%) reported cessation because of incarceration. Inmates who quit smoking before incarceration were more likely to voluntarily quit BQ. Inmates who had drinking habits were less likely to quit BQ, but those who quit drinking before incarceration were more likely to quit BQ. Inmates who preferred the type of BQ known as lao-hwa quid were more likely to quit BQ, and a longer chewing history correlated with a lower likelihood of quitting BQ. Conclusions Importance: Our data suggest that coexisting habitual use of cigarette, alcohol, and BQ is very common in this inmate population. BQ cessation is significantly associated with not only inmates' usage patterns of cigarette and alcohol, but also their cessation status of these substances.

Continuous and Intermittent Alcohol Free-Choice from Pre-gestational Time to Lactation: Focus on Drinking Trajectories and Maternal Behavior.

Background: Alcohol consumption during pregnancy and lactation induces detrimental consequences, that are not limited to the direct in utero effects of the drug on fetuses, but extend to maternal care. However, the occurrence and severity of alcohol toxicity are related to the drinking pattern and the time of exposure. The present study investigated in female rats long-term alcohol drinking trajectories, by a continuous and intermittent free-choice paradigm, during pre-gestational time, pregnancy, and lactation; moreover, the consequences of long-term alcohol consumption on the response to natural reward and maternal behavior were evaluated.Methods: Virgin female rats were exposed to home-cage two-bottle continuous- or intermittent “alcohol (20% v/v) vs. water” choice regimen along 12 weeks and throughout pregnancy and lactation. Animals were tested for saccharin preference, and maternal behavior was assessed by recording dams' undisturbed spontaneous home-cage behavior in the presence of their offspring.Results: Our results show that the intermittent alcohol drinking-pattern induced an escalation in alcohol intake during pre-gestational time and lactation more than the continuous access, while a reduction in alcohol consumption was observed during pregnancy, contrarily to the drinking trajectories of the continuous access-exposed rats. Long-term voluntary alcohol intake induced a decreased saccharin preference in virgin female rats and a significant reduction in maternal care, with respect to control dams, although the intermittent drinking produced a greater impairment than the continuous-access paradigm.Conclusion: The present data indicate that both alcohol-drinking patterns are associated to modifications in the drinking trajectories of female rats, in pre-gestational time, during pregnancy and lactation. Moreover, long-lasting alcohol intake can affect sensitivity to natural rewarding stimuli and maternal behavior and sensitivity to natural rewarding stimuli in a pattern–related manner. This study underlies the importance of modeling human alcohol habit and its consequences on the mother-infant dyad, in order to prevent detrimental effects on offspring development and maturation.