Harmful Alcohol Research Articles

Prevalence of Emotional and Binge Eating Among Patients With Obesity Attending a Specialist Weight Management Service for Bariatric Surgery in the United Kingdom.

Emotional eating (EE) is a tendency to consume food in response to positive or negative emotions, leading to obesity and an increased Body Mass Index (BMI). Evidence supports the positive association between EE and binge eating disorder (BED), but little is known about its prevalence among patients referred for bariatric surgery and the psychological characteristics of this patient population. We aim to examine (i) the prevalence of binge eating and EE, (ii) its association with the prevalence of anxiety, depression, diabetes and hypertension and (iii) the correlation between anxiety and depression with emotional and binge eating behaviours among patients attending a regional bariatric service in the UK. A cross-sectional case file design involving 285 participants (mean age = 43.88 ± 11.5, female (80.7%) and male (19.3%)) was used. Outcome measures included body weight, BMI, the Weight Loss Readiness (WLR) Questionnaire, Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9) and Alcohol Use Disorders Identification Test- Consumption (AUDIT-C). Within this patient group, the prevalence of binge eating and EE were 28.8% and 22.1% respectively. Among these, 19.3% had diabetes mellitus, 24.8% hypertension, 21% harmful alcohol use, 65% had high anxiety score and 77% high depression scores. Most correlations between body weight and variables like AUDIT-C, GAD-7, PHQ-9 scores and WLR scores for hunger, binge eating and EE were not significant. A positive association was observed between depression and anxiety with binge eating, and EE behaviours. Patients awaiting bariatric surgery have a wide range of mental and physical health comorbidities, with evidence of positive associations between higher depression and anxiety levels with abnormal eating behaviours. These findings highlight the need for screening for comorbidities in this patient population to optimise patient outcomes postbariatric surgery.

Liberalisation of alcohol policy in Lithuania and the role of public health coalitions: change in policy beliefs and strategy

Purpose This study aims to investigate the role of the public health advocacy coalition (PHC) in the context of policy change. Using the “advocacy coalition framework” theory, this study examines how new ideas and the transformation of the policy subsystem influenced the adaptation of strategy, framing and messaging used by PHC actors. Design/methodology/approach A detailed policy case study was conducted based on a range of primary documents and individual semi-structured interviews (n = 34) with key decision-makers, civil servants, NGO leaders, public health experts and AI representatives. Findings In 2020, the Lithuanian PHC coalition became involved in policy-making with a slightly re-framed strategy, which was based on public health priorities and scientific research evidence. The priorities and relevant activities were aimed at maintaining a wide range of regulative measures. The PHC advocates focused on and prioritised arguments pertaining to the social and economic harms of alcohol. This framework created some ground for policy-influencing action and was important for debates with AI actors. The PHC put a great deal of pressure on Members of Parliament to continue the implementation of evidence-based policies. Originality/value Over two decades, Lithuanian alcohol policy has shifted in waves, from liberalisation to stricter control interventions. The previous wave of strict alcohol policy was effective from the perspective of the measures implemented, and it also reduced alcohol-related harm. In 2020, two liberal and conservative parties focused on a laissez-faire approach to the elimination of some unfavourable restrictions for the alcohol industry (AI).

What’s the Matter? Alcohol Use Risk Among Relatives of People with Mental Illness

Family members who live with relatives with serious mental illness face unique mental health risks, which become worse with alcohol use and without social support. Research has highlighted the damaging effects of harmful substance use among people who feel like they do not matter to others, but few studies have assessed links between mattering and alcohol use within marginalized populations. In the present study, a sample of family members who reside with a relative with mental illness completed an online survey. Using the AUDIT alcohol screening measure, participants were classified into a No–Low Risk Alcohol Use (n = 52) or a Hazardous Drinking (n = 28) group. Hazardous alcohol use was alarmingly high, reaching triple the rate of the general population and categorized at the most severe level of harm. Those who drank hazardously felt like they mattered less to others (p < 0.001), felt like they mattered less to their relative with mental illness (p = 0.035), had greater anti-mattering (e.g., they felt invisible and unheard) (p = 0.008), experienced more hopelessness (p < 0.001), felt less supported by significant others (p = 0.003), endorsed having more problems with mental health services (p = 0.017), had higher stigma (p < 0.001), and had lower psychological well-being (p < 0.001). Findings highlight under-recognized public health risks, implications for public health initiatives, and the need for tailored interventions that boost mattering and reduce harmful alcohol use in this vulnerable family member population.

Building a community of practice to address alcohol harms in Canada: Experience from the Canadian Alcohol Policy Evaluation project.

Alcohol is a major cause of health and social costs and harms in Canada. While research and awareness of harms caused by alcohol are on the rise, few transdisciplinary platforms exist that are committed to facilitating bold alcohol policy change to reduce health inequities and improve lives. In response to feedback heard during engagement for the Canadian Alcohol Policy Evaluation project, an alcohol policy-focused community of practice (CoP) was launched in January 2022. Webinars, roundtable discussions, working group meetings, networking events, and a digital platform allow practitioners from various sectors (e.g. public health, alcohol regulation and distribution, public safety, justice, non-governmental organizations), researchers, and people with lived/living experience (PWLLE) to connect, share experiences and resources, and build capacity. More than 500 members have joined the CoP from all Canadian provinces and territories, and international jurisdictions. CoP members engage in learning opportunities, contribute to letter-writing campaigns in support of alcohol policy initiatives, and lead a working group focused on alcohol warning labels. Through the CoP, members report gaining and applying new knowledge in their work, while also establishing valuable connections and collaborations that have supported positive change. This cross-jurisdictional, intersectoral alcohol policy CoP facilitates knowledge sharing, networking, and collaboration among practitioners, policymakers, advocates, and PWLLE, while contributing to public health efforts to prevent alcohol harms. Furthermore, as transdisciplinary approaches continue to be prioritized in research and practice, this CoP offers an example that could be applied to other public health initiatives.

Assessing the association between multiple parental alcohol events and the risk of being maltreated children in a New Zealand population-based birth cohort.

Child maltreatment is an important component of alcohol's harm to others. No previous studies have assessed the association between multiple parental alcohol events and child maltreatment. This study aimed to measure the impact of parental alcohol-attributable events on the incidence rate of child maltreatment events over the span of childhood and adolescence in New Zealand. Longitudinal analysis using the birth cohort data of all live births (n = 58 359) in New Zealand in 2000, with the cohort followed until age 17 years using linked data from the Statistics New Zealand Integrated Data Infrastructure (IDI) from 1995 to 2017. Zero-inflated negative binomial and count regression models were used to measure the association between the number of child maltreatment events [collected from publicly funded hospital discharges, Programme for the Integration of Mental Health Data (PRIMHD), Oranga Tamariki, Children's Action Plan (CAP) and police data sets] and parental exposure to alcohol-attributable hospitalization or service use for mental health/addiction. Potential confounders were included for parents and children. Of 58 359 children in the cohort, 86% (50 319) had not experienced any documented maltreatment events. Among those at risk of being maltreated children, the maltreatment incidence rate ratio increased by 35.2% (95% confidence interval = 18.1-55.6%) if a child was exposed to parental alcohol-attributable hospitalization or service use for mental health addiction events. For each additional parental alcohol-attributable hospitalization or service use for mental health or addiction, the risk of being maltreated children increased by 12.8%. In New Zealand, hazardous alcohol consumption by parents appears to be associated with child maltreatment alongside other contributing factors, in particular parental lower educational attainment.

Compulsive sexual behavior, sexual functioning problems, and their linkages to substance use among German medical students: exploring the role of sex and trauma exposure

Sexual problems relevant to psychotherapy, such as compulsive sexual behavior (CSB) and sexual functioning problems (SFP), have been related to harmful substance use in several studies. Substance use is prevalent among medical students (MS) and is often considered a maladaptive coping strategy for stress, as well as a risk factor for mental health issues. Sexual problems and substance use share trauma exposure and post-traumatic symptoms as risk factors for their development. This study aimed to explore the interaction effects between problematic sexual behaviors, substance use, and trauma among German MS. A cross-sectional study (n = 359; 69% women, 29% men) was conducted using an online questionnaire. MS at a German university were recruited via email. CSB (CSBD-19), SFP (SBQ), harmful alcohol (AUDIT) and drug use (DAST), childhood trauma exposure (CTQ), and current post-traumatic symptoms (IES-R) were assessed. Multivariate linear and ordinal regressions, as well as path analyses, were conducted to investigate associations between the study variables. CSB was identified in 3% of all MS. The most commonly reported SFPs were decreased sexual desire and difficulties achieving orgasms among women and premature ejaculation among men. Higher CSBD scores were predicted by male sex, elevated AUDIT scores, and increased frequencies of hyperarousal (IES-R). Path analyses revealed associations between the severity of emotional/sexual abuse, the intensity of post-traumatic symptoms, and both CSBD and AUDIT scores. Among female MS, less severe emotional abuse and more severe physical abuse in childhood predicted higher frequencies of orgasmic difficulties. The frequency of SFPs was correlated with the use of benzodiazepines among female MS, with cannabis and MDMA/ecstasy among male MS, and with cocaine/crack, speed, and AUDIT among both sexes. No interaction effects were found between SFPs, substance use, or trauma-related factors in the path analyses. To some extent, there appears to be a relationship between substance use, childhood trauma exposure, and currently persisting post-traumatic symptoms with problematic sexual behaviors among MS. However, further research is required to explore these relationships in greater depth and to identify the underlying pathways. Mental health support measures should incorporate the factors of sexuality, substance use, and trauma while also exploring their relationships with workload, career-related anxieties, and other curriculum-related factors.

Evaluating the association between alcohol sweetness preference, alcohol harm, and alcohol value.

Alcohol use disorder is prevalent, and various risk factors inform drinking onset and drinking patterns. Existing data suggest that alcohol sweet taste preference may be associated with harmful levels of alcohol use and alcohol-related harm. The present exploratory study aimed to characterize people's first alcohol use experience, probe the association between sweet taste preferences and drinking patterns over time, and evaluate the relationship between sweet taste preferences and behavioral economic variables. Participants (N = 277) were recruited through Prolific and completed an assessment of first alcohol exposure, current and historic drinking patterns, alcohol demand, and delay discounting. Participants reporting preference for less sweet alcohol beverages consumed the most drinks per week both currently and during their period of the heaviest use. Trends emerged such that rank order decreases in alcohol consumption were observed from those reporting transitioning from sweet to less sweet preference, then less sweet to sweet preference, and finally consistent sweet taste preference reporting the lowest consumption. Similar associations were observed for alcohol use disorder symptoms counts and alcohol demand intensity. These data broadly suggest that sweet taste preferences in alcohol consumption may serve as an important factor modulating patterns of alcohol use across the lifespan. In terms of translational implications, these data suggest that commonly used sucrose fades in preclinical research may reflect the trend in taste preferences of the majority of the population but do not mirror the typical onset (or course) of chronic, maladaptive drinking behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The landscape and level of alcohol policy enforcement in Tanzania.

Harmful use of alcohol causes more deaths in Sub-Saharan Africa than in any other region. In Tanzania, where alcohol use disorders rates are twice the overall African average, harmful alcohol consumption is a public health concern. Given the lack of a contemporary overview of the alcohol policy landscape, we conducted a mixed-methods review of key alcohol-related policies, implementers, and initiatives in Tanzania. We conducted a desk-based review of policy-related documents, and in-depth interviews with eight key informants guided by the 10-composite-indicator framework of a tool for measuring alcohol policy implementation developed by World Health Organization. Representatives were from health-service delivery, community-based organizations, governmental organizations, research, and policymakers whose work is related to alcohol in Tanzania. Data was collected in June and October 2022, and finalized in March 2023. Findings were analyzed using Microsoft Word v2021. Themes were identified, collected, combined, and tabulated. Differences were then resolved by first and second authors. Our findings revealed no single comprehensive national alcohol policy. Pending finalization of a draft policy, various documents and actors govern alcohol production, distribution, licensing, and consumption. Little intersectoral linkage between entities contributes to poor enforcement of these regulations. Regulation is stronger in urban areas, and restrictions more effective on industrial alcohol. However, the majority of consumed alcohol in Tanzania is informally-produced, especially in rural settings. Socio-cultural context plays a key role in alcohol production and consumption, contributing to early-age exposure to alcohol. Alcohol is a growing source of revenue for the Tanzanian government and, therefore, imposing further restrictions is a low priority. There are important policy gaps in various sectors pertaining to alcohol regulation. Our results strongly suggest the need for a comprehensive approach to developing an overarching alcohol policy, with involvement of key stakeholders, stronger enforcement, and increased awareness, resources, and collaborations.

Parental alcohol use and the level of child protection response in Australia (2012-21).

To measure the association of harmful alcohol use by parents and primary caregivers with the level of child protection response. This study was a multivariable logistic regression analysis using data drawn from the Victorian child protection database (2012-21) in Victoria, Australia. Focusing upon the most recent case per child, we analysed whether harmful parental alcohol use was probably associated with children's progression throughout the child protection system (from investigation phase, to substantiation, through to protective intervention, protection application and protection orders), while adjusting for socio-demographic variables. The participants comprised 352 800 children [48.5% female, 50.0% male, 1.6% other/unknown; mean age = 8.1 (0-18 years)] with one or more reports (mean = 1.4) in the child protection system. Child protection workers reported on two risk factor variables indicating parental alcohol use during an intake risk assessment: 'alcohol abuse' and 'alcohol use compromises child's safety'. Of the 95 592 child cases investigated between 2012 and 2021, 50 476 were substantiated. Probable parental alcohol use was reported as a risk factor in 5.1% of children investigated and substantiated in 9.1% of children. The odds of progressing to investigation [odds ratio (OR) = 1.64, 95% confidence interval (CI) = 1.59, 1.69, P < 0.001], substantiation (OR = 2.02, 95% CI = 1.91, 2.13, P < 0.001), protective intervention (OR = 1.40, 95% CI = 1.23, 1.59, P < 0.001), protection application (OR = 1.16, 95% CI = 1.08, 1.25, P < 0.001) and protection order (OR = 1.17, 95% CI = 1.02, 1.34, P = 0.028) were statistically significantly higher for children experiencing probable parental harmful alcohol use. However, the associations for protection application and protection order were not statistically significant after accounting for variables related to family accommodation, income and composition. In Victoria, Australia, in cases where child protection workers document parental alcohol use, those children are more likely to progress through the Victorian child protection system than children whose parents have no documented alcohol use.

Effectiveness of digital screening and brief intervention for alcohol misuse among college students: A state-wide cluster randomized trial from India.

Alcohol misuse is prevalent among college students globally, including in India. Digital screening and brief interventions (DSBI) promise to address this issue. This study assesses DSBI's effectiveness in a state-wide cluster randomized trial among college students in India. We recruited 548 participants (274 in each DSBI and digital screening and brief advice-DSBA) from 40 colleges across 10 districts of Punjab, India. Colleges were selected via two-stage cluster random sampling and were allocated to groups using permuted block randomization. Participants with Alcohol Use Disorder Identification Test (AUDIT) scores between 8 and 19 were included. The digital platform directed eligible participants to their respective groups. DSBI participants received information on alcohol harms, normative and personalized feedback, a decisional balance checklist, and a menu of options. DSBA participants received screening and alcohol harm information. Follow-ups were conducted at 3- and 6-month post-intervention. reduction in AUDIT scores; secondary outcomes: frequency of drinking, drinks per drinking day, and frequency of heavy episodic drinking (HED). Baseline demographics and clinical variables did not significantly differ between groups, except for participants' age. 37.6% were women. Follow-up rates were 513/548 at 3 months and 483/548 at 6 months, with no group differences in attrition. AUDIT scores significantly decreased in both groups at 3 and 6 months (Time F = 1870.11, p < 0.001, partial η2 = 0.77), with no Group × Time effects (F = 0.160, p = 0.85). Drinking frequency, HED frequency, and drinks per drinking day decreased significantly in both groups without between-group differences. The study highlights the potential policy implications of integrating brief digital interventions for alcohol misuse into educational health initiatives.

Supporting multidrug-resistant or rifampicin-resistant TB treatment adherence in people with harmful use of alcohol through person-centred care.

TB is concentrated in populations with complex health and social issues, including alcohol use disorders (AUD). We describe treatment adherence and outcomes in a person-centred, multidisciplinary, psychosocial support and harm reduction intervention for people with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) with harmful alcohol use. An observational cohort study, including multilevel mixed-effects logistic regression and survival analysis with people living in Minsk admitted with MDR/RR-TB and AUD during January 2019-November 2021 who received this person-centred, multidisciplinary, psychosocial support and harm reduction intervention, was conducted. There were 89 participants enrolled in the intervention, with a median follow-up of 12.2 (IQR: 8.1-20.5) mo. The majority (n=80; 89.9%) of participants had AUD, 11 (12.4%) also had a dependence on other substances, six (6.7%) a dependence on opioids and three (3.4%) a personality disorder. Fifty-eight had a history of past incarceration (65.2%), homelessness (n=9; 10.1%) or unemployment (n=55; 61.8%). Median adherence was 95.4% (IQR: 90.4-99.6%) and outpatient adherence was 91.2% (IQR: 65.1-97.0%). Lower adherence was associated with hepatitis C, alcohol plus other substance use and outpatient facility-based treatment, rather than video-observed treatment, home-based or inpatient treatment support. This intervention led to good adherence to MDR/RR-TB treatment in people with harmful use of alcohol, a group usually at risk of poor outcomes. Poor outcomes were associated with hepatitis C, other substance misuse and outpatient facility-based treatment support.

The alcohol harm paradox: is it valid for self-reported alcohol harms and does hazardous drinking pattern matter?

BackgroundThe alcohol harm paradox (APH) posits that alcohol harms are more prevalent in low socioeconomic position (SEP) groups compared to high SEP groups, when adjusted for alcohol consumption volume.AimWe explored whether APH is valid for self-reported alcohol harms and whether SEP differences in hazardous drinking patterns may explain SEP differences in alcohol harms, accounting for consumption volume.Data and methodsWe applied cross-sectional data from national population surveys in Norway, restricted to a subsample of past month drinkers aged 25–79 years (n = 8 171). Two binary outcome measures of self-reported alcohol-related harms were constructed from the AUDIT-10 items 4 through 10; alcohol dependence symptoms and alcohol related consequences. We separated two SEP groups based on education level: low versus high. Employing logistic regression models, we examined the extent to which SEP differences in alcohol-related harms were attributable to a more hazardous drinking pattern in terms of: (i) heavy episodic drinking and (ii) proportion of consumption volume by spirits, adjusting for consumption volume and demographic characteristics.ResultsIn the low SEP group, alcohol-related harms were significantly more prevalent as compared to the high SEP group when adjusted for gender and age, and more so after adjustment for consumption volume. Measures of hazardous drinking pattern and having a spouse could only to a minor extent account for the elevated risk of alcohol-related harm in the low SEP group. The findings were robust across various sensitivity analyses.ConclusionLow SEP was associated with alcohol-related harm and a more hazardous drinking pattern but also with lower consumption volume. The findings support the validity of the alcohol harm paradox for self-reported alcohol harms.

Screening and Following Up Harmful Alcohol Use "… is Not Necessarily Your Primary Focus": A Qualitative Study Exploring Health Professionals' Experiences Addressing Harmful Alcohol Use in a Norwegian Hospital.

Alcohol use remains a leading cause of excess mortality and morbidity worldwide, and identifying and following up harmful alcohol use represents a key component of alcohol harm reduction policies. This article explores health professionals' experiences implementing these policies in a Norwegian hospital. To explore health professionals' views and experiences of systematic screening and tailored follow-up of harmful and hazardous alcohol use in a Norwegian hospital. We conducted semi-structured interviews with 13 specialty registrars and nurses working in the emergency department and observation ward of a hospital in Oslo, Norway. Interviews were carried out between May and December 2022, coded using NVivo v.14 and analyzed thematically. We identified three themes: (i) standardized and clinical assessment, referring to tensions between standardized and clinical alcohol risk assessment; (ii) formal and informal treatment guidelines, encompassing the informal patient care practices enacted in the emergency department and on the wards, and; (iii) training delivery and barriers to implementation, referring to the training penetration rate and identified need for "clear and simple" alcohol treatment guidelines. This study highlights tensions between alcohol-related harm and alcohol-related norms as these pertain to screening and following up harmful and hazardous alcohol use in a Norwegian hospital. Results suggest training should focus on zero alcohol recommendations, the use of assessment tools, the acceptability of screening to patients and "clear and simple" patient follow-up procedures.

Obstetrics and Gynecology Provider Experience Screening for Harmful Alcohol Use: An Unmet Need for Standardized Screening and Intervention.

Introduction Early identification of at-risk alcohol use is key to preventing complications of alcohol use disorder (AUD). Obstetrics and gynecology (OB/GYN) providers are in a unique position to screen for alcohol use in young female patients who may not otherwise seek traditional primary care. The purpose of this study was to learn how OB/GYN providers screen for and manage harmful alcohol use in their clinical care. Method We surveyed OB/GYN providers in a single health care system regarding how they screen for and manage alcohol use. The results were reported using descriptive statistics. Bivariate analysis to assess the impact of physician characteristics on responses was performed using chi-square testing. Results From the results, it was observed that 64.7% and 60.6% of OB/GYN providers screen for alcohol use most or all of the time during obstetrics and gynecologic visits, respectively. Less than half of providers refer patients with at-risk use for further interventions or treatment (41.0% referred to an addiction specialist, 41.0% recommended discussing their behavior with their PCP, 35.9% referred to social work, 10.4% referred to gastroenterology or hepatology). Providers who screened did so most commonly by directly asking patients about their alcohol use (70.6% during obstetrics and 60.1% during gynecologic visits).Only 11.8% and 15.2% of providers who screened did so using standardized screening methods (e.g. CAGE (Cut down, Annoyed, Guilty, and Eye-opener) questionnaire and Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)) during obstetrics and gynecologic visits, respectively.Only 30.8% of the providers felt they received adequate training on AUD. Providers who had experience taking care of a patient with severe alcohol-related liver disease (100% v. 0%, χ2=4.69, p=0.047) or died from this (100% v. 0%, χ2=11.35, p<0.01) were more likely to refer to gastroenterology. Conclusions Further work needs to be done to improve screening for and management of harmful alcohol use in OB/GYN clinics. Standardized screening methods were rarely used. Education of OB/GYN providers on AUD management and facilitating referrals for addiction care are opportunities to prevent the consequences of AUD in at-risk female patients.

An alcohol-related liver disease multi-stakeholder hub (ARMS-Hub) to enhance research activity in underserved communities in the UK.

Alcohol use is the third leading risk factor of death and disability in the UK and costs the NHS £3.5 billion per year. Despite the high prevalence and healthcare burden of Alcohol-related Liver Disease (ArLD), there has been minimal research addressing prevention, morbidity and mortality. Reasons for this include stigma and lack of interest from public, charitable and commercial funding bodies. The objectives of this project were to identify and develop interdisciplinary partnerships, to explore stigma in ArLD, to develop a representative Patient and Public Involvement and Engagement (PPIE) group, to build research capacity, and to develop interdisciplinary research proposals targeting key research priorities. ArLD networks were identified by members of the Project Steering Group. Health Care Professionals (HCPs) from different backgrounds were invited to join the ARMS-Hub. PPIE representatives were invited through charities and support groups. Research areas were identified, discussed, prioritised and ranked. Research questions were refined during an in-person symposium. A mentorship programme was created to encourage and facilitate networking and knowledge exchange for early career researchers. We established the ARMS-Hub with 31 HCPs and 40 PPIE members. There were five stakeholder meetings, which included PPIE representation. Three virtual and three in-person PPIE meetings took place. Topics relevant to stigma in ARLD identified during the meetings were education and awareness, language, and access. Priorities identified were the disconnect between mental health and liver services, education around the wider harms of alcohol, and education of HCPs regarding stigma. We established a mentorship network that regularly meets to support development of new research ideas. Stigma is central to lack of research engagement from professionals and PPIE. The main priority identified relates to the disconnect between mental health and liver services. This collaborative study has allowed development of a research agenda to address this priority.

Alcohol consumption and risky sexual behaviours: consistent patterns in France and South Korea

Abstract Background Despite the concurrent increase in harmful alcohol use and risky sexual behaviours associated with STIs and HIV/AIDS among young adults, their relationship remains inconsistent due to the inherent influence of sociodemographic and cultural factors on drinking and sexual practices. This study aims to examine the relationship between alcohol consumption and risky sexual behaviours and cross-validate this relationship in France and South Korea. Methods We conducted a cross-sectional survey among young adults aged 18 to 30 in France and in South Korea in 2023-2024 (n = 998; 489 in France, 509 in Korea). A spearman partial correlation and a z-test on Fisher-transformed correlation coefficients were used to determine the relationship between alcohol use and risky sexual behaviours, as well as the consistency of this relationship across both samples. Results After controlling for age, gender, occupation, education, and perceived socioeconomic status, a positive correlation was found between the age of alcohol initiation and the age at first sexual intercourse in both samples (r=.17 in France, r=.28 in Korea; p &amp;lt; 0.001). Alcohol Use Disorder Identification Test (AUDIT) score and the frequency of drunkenness showed positive correlations with the number of sexual partners (r=.19, r=.26 in France; r=.19, r=.23 in Korea; p &amp;lt; 0.001). These two alcohol use indicators were also correlated with the frequency of inconsistent condom use (r=.15, r=.12 in France; r=.06, r=.14 in Korea; p &amp;lt; 0.001). The Z test confirmed that there is no significant difference in all correlation coefficients between the French and Korean samples. (p &amp;gt; 0.05, 95% CI). Conclusions An integrated health intervention aimed at simultaneously addressing harmful alcohol use and risky sexual behaviours is warranted to prevent high prevalence of sexually transmitted infections among young adults. Key messages • Recent data support that alcohol use is associated with risky sexual behaviours among young adults. • This relationship is consistent regardless of different sociodemographic and cultural settings.

A global research agenda for understanding the role of alcohol consumption in older women’s lives

Abstract Background The alcohol industry has targeted women for profit and resisted global efforts to address the impact of alcohol on women’s health. Scholars have called for research that moves beyond individual determinants of alcohol consumption in women, to investigate the range of social, environmental, and commercial factors that may contribute to women’s alcohol attitudes, risk/benefit perceptions, and consumption behaviours. While qualitative research has explored younger and midlife women’s perspectives on alcohol consumption, there is a notable lack of research focusing on older women. Methods This study investigated the factors that influence how older Australian women drinkers conceptualised the role of alcohol in their lives, using data collected from an online qualitative survey with n = 144 women aged 60-88 years. Qualitative responses were analysed using a ‘Big Q’ reflexive approach to thematic analysis. Results Participants perceived alcohol consumption as a socially accepted and normalised activity within Australian culture. For some women, alcohol served as a coping mechanism for life changes, such as retirement, and for managing stressful situations. Alcohol also formed part of daily routines and rituals, such as having wine with dinner. Participants had personal expectancies regarding ‘responsible drinking’, often aligning with alcohol industry messaging and resulting in a reduced perception of alcohol-related risks. Conclusions This research provides global lessons for future public health research examining the factors that may shape older women’s alcohol consumption beliefs and behaviours. The authors consider the unique needs and potential vulnerabilities of older women drinkers, and how these may be potentially exploited by the alcohol industry. Further public health research and policy attention should focus on the impact of alcohol industry messaging on older women’s knowledge, attitudes, and behaviours about alcohol risks and harms. Key messages • This research highlights the role of alcohol in older women’s lives, urging further public health research and policy attention to prevent alcohol-related harms in older women. • Older women’s perceptions of responsible alcohol consumption mirror the ambiguous messaging employed by the alcohol industry, highlighting the necessity for targeted interventions.

The role of emotion regulation in decreasing alcohol harm for veterans

Using the socio-ecological model, this study aims to understand factors associated with alcohol misuse in veterans of the New Zealand Defence Forces, and identify approaches for reducing harm. Using interviews, veterans were asked to recount their relationship to alcohol, and provide a narrative of its use before, during and after military service. Seven themes were identified including bars and drinking as 1) social hubs; and 2) social lubrication; providing others with 3) duty of care; the military 4) consequences of harmful drinking; and use of alcohol as 5) emotion regulation strategies; with the impact of that on 6) Civvy street, and 7) family impacts. Duty of care in military drinking environments is a new theme to the literature. Introducing emotion regulation training throughout the personnels’ career, from transition to becoming civilians and beyond, was identified as key to effective health marketing interventions.

Besides the drinking in alcohol's harm to others: potential economic and environmental factors.

This paper considers how harm from others' drinking is distributed across several economic and environmental factors. Economic, environmental, demographic and drinking measures include: household income, financial disadvantage indicators, home spaciousness; neighbourhood socioeconomic status (SES), connections and safety; and respondent's gender, age group and risky drinking status. The paper explores interactions of these factors with harms from the drinking of others in a 2021 survey of 2574 Australian adults. The home's degree of crowding (persons per bedroom) is related to harms from others in the household, while financial disadvantage is related to harm from drinkers outside the household, whether known or strangers. Perceived neighbourhood safety and knowing neighbours are negatively related to harms from the drinking of others outside the household. In multivariate analyses for harms from household members and from strangers, these findings are little affected by three individual factors related to harms from others' drinking: the respondent's gender, age group and risky drinking status. Some economic and ecological factors play an important role in the occurrence of harms from others' drinking, but the relationship varies both between factors and by the category of other person involved.

Act now - serious pathology of the spine is affected by health inequalities

Early diagnosis of serious spinal pathology is the key to optimise patient outcomes, yet early diagnosis can be adversely affected by health inequalities. In this paper we consider the impact of health inequalities on the incidence and outcome for serious spinal musculoskeletal (MSK) pathologies. Health inequalities can be experienced by people grouped around a range of factors. These include socio-economic factors, the environmental conditions in which people live, protected characteristics such as ethnicity, and socially excluded groups such as people who are homeless. These factors can affect people's exposure to health risks and their opportunities to lead healthy lives. A person's behaviour is a key determinant of their health status. ‘Risky’ health behaviours include smoking, poor diet, harmful alcohol consumption and lack of exercise, and are more common in these groups. Importantly, socio-economic factors combined with health behaviours influence the health inequalities a person may experience. The most significant social and economic factors influencing poor MSK health are poverty, education, employment, environment, and food ethos. These determinants of health not only predispose people living in deprivation to having benign MSK conditions at a younger age and with worse outcomes, they are also risk factors of more serious MSK pathologies.