Alcohol Use Disorders Identification Test Scores Research Articles

Brief intervention for chronic liver disease patients with alcohol use disorder in a hepatology outpatient unit: Effects and limitations.

It is not uncommon to encounter outpatients in the hepatology department with harmful alcohol habits. When treating such chronic liver disease (CLD) patients, an adequate intervention method for harm reduction of alcohol use, such as brief intervention (BI) or BI and nalmefene, should be considered. This study aimed to elucidate the clinical effectiveness of BI for CLD patients affected by harmful alcohol use. From June 2021 to 2023, 123 Japanese CLD outpatients (hepatitis B virus:hepatitis C virus:alcoholic liver disease:others=32:18:42:31) with an Alcohol Use Disorders Identification Test (AUDIT) score of ≥8 at the initial interview and a repeat interview with AUDIT 9months later were enrolled. Clinical features related to patient behavior following the initial AUDIT interview were retrospectively evaluated, and compared between patients without and with BI treatment. For the non-BI and BI groups, baseline AUDIT score (median 10 [interquartile range (IQR) 9-13] vs. 12 [IQR 10-17], p=0.016) and relative change in AUDIT score (median 0 [IQR -3 to 2] vs. -3 [IQR -7 to 0], p<0.01) showed significant differences, whereas there was no significant difference between the groups for AUDIT score at the time of the second interview (p=0.156). Following BI, significant improvements were observed for items 1, 2, 3, 4, 5, 8, and 10 of AUDIT (each p<0.05). Patients with an alcohol use disorder as well as those with alcohol dependency who received BI showed a significant decline in AUDIT score, although the score of the follow-up AUDIT indicated continued alcohol use disorder. In addition to BI, medication with nalmefene should be considered, based on individual factors.

Tobacco and alcohol co-use among people with HIV (PWH) in Nairobi, Kenya

Introduction. Although the majority of PWH in the world reside in sub-Saharan Africa, little is known about the syndemic of tobacco and alcohol use in that region. The purpose of this study was to describe tobacco and alcohol co-use behaviors among PWH in Nairobi, Kenya. Methods. Between June–November 2021, 50 PWH with concurrent tobacco and alcohol use in Nairobi, Kenya were cross-sectionally assessed with a structured interview. Women were intentionally oversampled in order to constitute 50% of the participant group. Participants completed structured interviews by trained research assistants using standardized, culturally appropriate, tobacco use and alcohol use questionnaires. Results. Fifty PWH completed the study. All participants identified as African with a mean age of 40.3 years. Half of the sample were men, half were women, and all participants were engaged in HIV care and were receiving antiretroviral therapy (ART). Mean cigarettes smoked per day was 8.2, and 57% percent reported moderate/high cigarette dependence. The mean alcohol use disorder identification test (AUDIT) score was 18.6, and 84% reported drinking amounts in the hazardous range. Preferred alcoholic beverages were clear spirits (48%), beer (32%), and changaa (12%), a traditional home-brewed liquor made from millet, corn, or sorghum. Younger age, higher depression score, and higher anxiety score were significantly associated with higher AUDIT scores. Conclusions. Tobacco and alcohol co-use in PWH in Nairobi, Kenya is common. This syndemic may require culturally appropriate and tailored treatment approaches, especially those targeting younger health strata and those with comorbid mental illness, to improve health outcomes.

Prevalence of Alcohol Use Disorders and Self Esteem Levels among Undergraduate Students: A Cross-Sectional Study at Kampala International University's Western Campus, Uganda

This cross-sectional study conducted at Kampala International University's Western Campus (KIU-WC) in Western Uganda aimed to investigate the prevalence of alcohol use disorders and assess self-esteem levels among undergraduate students. Utilizing the Alcohol Use Disorders Identification Test (AUDIT) and the Rosenberg Self-esteem Scale, data were collected from 366 participants to explore the relationship between alcohol consumption and self-esteem within the academic environment. Results revealed that 33.1% of participants acknowledged alcohol use, with 18.6% identified as being at a higher risk of alcohol use disorder. Among alcohol users, the prevalence of alcohol use disorders (AUDIT score ≥20) was 33.9%, leading to an overall prevalence of 11% across the entire undergraduate student population. Self-esteem scores ranged from 11 to 30, with a median of 18. Findings indicated that 7.9% of respondents exhibited low self-esteem, while 91% demonstrated normal self-esteem, and 1.1% showcased high self-esteem. These findings underscore the need for targeted interventions to address alcohol use disorders and promote positive self-esteem among university students in Uganda. Keywords: Prevalence, Alcohol, Disorders, Self-esteem, Undergraduate Students, Uganda.

Tapping into alcohol use during COVID: Drinking correlates among bartenders and servers.

The COVID pandemic placed a spotlight on alcohol use and the hardships of working within the food and beverage industry, with millions left jobless. Following previous studies that have found elevated rates of alcohol problems among bartenders and servers, here we studied the alcohol use of bartenders and servers who were employed during COVID. From February 12-June 16, 2021, in the midst of the U.S. COVID national emergency declaration, survey data from 1,010 employed bartender and servers were analyzed to quantify rates of excessive or hazardous drinking along with regression predictors of alcohol use as assessed by the 10-item Alcohol Use Disorders Identification Test (AUDIT). Findings indicate that more than 2 out of 5 (44%) people surveyed reported moderate or high rates of alcohol problem severity (i.e., AUDIT scores of 8 or higher)-a rate 4 to 6 times that of the heavy alcohol use rate reported pre- or mid-pandemic by adults within and outside the industry. Person-level factors (gender, substance use, mood) along with the drinking habits of one's core social group were significantly associated with alcohol use. Bartenders and servers reported surprisingly high rates of alcohol problem severity and experienced risk factors for hazardous drinking at multiple ecological levels. Being a highly vulnerable and understudied population, more studies on bartenders and servers are needed to assess and manage the true toll of alcohol consumption for industry employees.

Prevalence of hazardous drinking and suspected alcohol dependence in Japanese primary care settings

ObjectiveWe aimed to assess the prevalence of hazardous drinking and potential alcohol dependence among Japanese primary care patients, and their readiness to change and awareness of others' concerns. MethodsFrom July to August 2023, we conducted a multi-site cross-sectional study as a screening survey for participants in a cluster randomized controlled trial. The trial included outpatients aged 20–74 from primary care clinics. Using the Alcohol Use Disorders Identification Test (AUDIT) alongside a self-administered questionnaire, we evaluated the prevalence of hazardous drinking and suspected alcohol dependence, patients' readiness to change, and their awareness of others' concerns. ResultsAmong the 1388 participants from 18 clinics, 22% (95% confidence interval (CI): 20% to 24%) were identified as engaging in hazardous drinking or suspected of being alcohol dependent. As the AUDIT scores increased, so did their readiness to change. However, only 22% (95%CI: 16% to 28%) of those with scores ranging from 8 to 14 reported that others, including physicians, had expressed concerns about their drinking during the past year. For those with scores of 15 or higher, the figure was 74%. ConclusionsThis study underscores the need for universal or high-risk alcohol screening and brief intervention in Japanese primary care settings.Trial registryUMIN-CTR (https://www.umin.ac.jp/ctr/) (UMIN000051388).

Drinking and mental health in middle adulthood: exploring the impact of wellbeing, mental health literacy, and drinking motives on risk of alcohol dependence

Objectives Risky drinking is a concern among UK-based middle-aged adults. We aimed to explore the relationship between risky drinking, drinking motives, wellbeing, and mental health literacy (MHL). Method Cross-sectional analysis of online survey data completed by 193 UK-based adults aged 40–65 who drank alcohol, incorporating the Alcohol Use Disorders Identification Test (AUDIT); Drinking Motives Questionnaire-Revised (DMQ-R); Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS); Mental Health Literacy Scale (MHLS) and demographic questions. Results Coping, enhancement and conformity motives and gender significantly predicted higher AUDIT scores (measuring risky drinking). Enhancement motives were found to mediate the relationship between the self-help component of MHL and AUDIT scores, while coping motives mediated the association between wellbeing and AUDIT scores. Conclusion Findings support research emphasising the influence of drinking motives on risky drinking and highlights how low wellbeing may interact with coping motives to explain risky drinking among middle-aged adults, particularly men. Interventions supporting individuals to understand the relationship between drinking motives and risky drinking, develop adaptive coping strategies, and address the causes of low wellbeing, may be beneficial. However, as the sample was 84% ethnically White, 64% women, 85% educated to at least undergraduate level, and reported a relatively high mean socioeconomic status (6.98 out of 10), the results may not generalise beyond these groups. Future research should use stratified sampling to increase generalisability, as well as exploring whether alcohol-specific, component-specific, or disorder-specific MHL is associated with risky drinking and wellbeing.

Cumulative methotrexate dose is not associated with liver fibrosis in patients with a history of moderate to severe psoriasis.

Liver fibrosis (LF) has established risk factors, but data on the impact of methotrexate on LF in psoriasis patients are lacking. This cross-sectional study aimed to determine the prevalence of LF in psoriasis patients and to evaluate the relationship between LF, cumulative methotrexate dose and other LF risk factors. Adults with a history of moderate to severe chronic plaque psoriasis were recruited between June 2020 and March 2021. Patients underwent transient elastography to evaluate LF. Three values for liver stiffness measurement (LSM) were assessed, indicating mild or worse LF (≥7kPa), moderate or worse LF (≥7.9 kPa) and advanced LF (≥9.5kPa). Cumulative methotrexate dose and other potential risk factors for LF were assessed. 240 patients were recruited and 204 participants with valid LSM values were included in the analysis (median age 48 (IQR 37,57) years; 51% female; 56% Body Mass Index (BMI) ≥30 kg/m2 and median Alcohol Use Disorders Identification Test (AUDIT) score 4 (IQR 1,7, 23% score ≥ 8)). 91% had received methotrexate (median duration 36 months (IQR 14,78)). Prevalence of LF was 36%, 25% and 17 % using LSM ≥7kPa, ≥7.9 kPa and ≥9.5kPa respectively. There was no association between cumulative methotrexate dose (median 2.16 (IQR 0.93, 5.2) and continuous LSM values (unstandardised coefficient 0.16, (95% CI -0.49-0.82, p=0.626) or using the categorical LSM cut off values: ≥7kPa (unadjusted odds ratio 1.06 (95% CI 0.97-1.15), p= 0.192), ≥7.9 kPa (unadjusted odds ratio 1.03 (95% CI 0.94- 1.12), p= 0.577) and ≥9.5kPa (unadjusted odds ratio 1.01 (95% CI 0.91-1.12) p=0.843).The following risk factors were associated with higher LSM values: BMI (p=<0.001), Waist circumference (p=<0.001), metabolic syndrome (p=<0.001), AUDIT score (P=0.020), FIB-4 score (p= 0.03). BMI ≥28, diabetes and metabolic syndrome were shown to be better predictors of LF compared to Fib 4 score. This study confirms a high prevalence of significant LF in patients with psoriasis. Cumulative methotrexate dose was not associated with LF. Patients with BMI ≥28 kg/m2, metabolic syndrome and diabetes are at higher risk for LF. These risk factor may help to identify when a more detailed liver health assessment is needed.

Factors associated with substance use among preclinical medical students in Turkey: a cross-sectional study

Introduction: Medical students experience high levels of stress due to their rigorous training, which can negatively affect their mental health. This study aimed to investigate substance use habits of medical students at Istanbul University-Cerrahpaşa and the association on their mental health and demographic factors. Methods: This cross-sectional survey study was conducted in March-April 2022 among preclinical medical students (years 1-3 of a 6-year program). A confidential, anonymous online survey consisting of four sections on sociodemographic and educational characteristics, nicotine use and dependence [Fagerström Test for Nicotine Dependence (FTND)], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)], mental health status [12-item General Health Questionnaire (GHQ-12)], was distributed to 1131 students via WhatsApp and Telegram text messages. Mann-Whitney U and Kruskal Wallis tests compared variables’ distribution in the questionnaire categories. Spearman's correlation assessed associations between scales. Significance was p &lt; 0.05. Results: The study included 190 medical students. A total of 26.3% of the participants were smokers, with 8.4% showing moderate to high levels of nicotine dependence. An estimated 45.8% and 8.4% reported low-risk consumption and risky usage of alcohol, respectively. There were statistically significant associations between substance use and demographic factors such as sex, GPA, and religious belief. The study found a statistically significant correlation between FTND scores and GHQ-12 scores, and, between FTND scores and AUDIT scores. Conclusion: The findings of this study will inform the development of interventions to improve the mental health and academic performance of medical students at Istanbul University-Cerrahpaşa. Furthermore, it will raise awareness about the importance of addressing substance use among medical students in Turkey.

Leveraging Online Treatment to Re-examine the Association Between Alcohol Use and Disinhibition.

Cognitive disinhibition underpins alcohol and drug use problems. Although higher-risk substance use is consistently associated with poorer disinhibition, current findings may be limited by narrow recruitment methods, which over-represent individuals engaged in traditional treatment services with more severe presentations. We embedded a novel gamified disinhibition task (the Cognitive Impulsivity Suite; CIS) in a national online addiction support service ( https://www.counsellingonline.org.au/ ). Participants aged 18 to 64 ( N = 137; 109 women) completed the Alcohol-Use Disorders Identification Test (AUDIT) and Drug Use Disorders Identification Test (DUDIT) along with the CIS, which measures three aspects of disinhibition (Attentional Control, Information-Sampling, and Feedback Monitoring/Shifting). The majority of the sample comprised people with alcohol use, and AUDIT scores were differentiated into ‘higher-risk’ or ‘lower-risk’ groups using latent-class analysis. These classes were then regressed against CIS performance measures. Compared to lower-risk, higher-risk alcohol use was associated with poorer attentional control and feedback monitoring/shifting. While higher-risk alcohol use was associated with slower information accumulation, this was only observed for older adults, who appeared to compensate with a more conservative response criterion. Our results reveal novel relationships between higher-risk alcohol use and specific aspects of disinhibition in participants who sought online addiction help services.

Genetic Polymorphism in Alcohol Metabolism and Drinking Behavior are Associated with Gastric Cancer Risk in Men.

Objective In recent years, there has been a growing focus on health risks associated with alcohol consumption. The present study investigated whether or not the genetic variant of aldehyde dehydrogenase 2 (ALDH2) influences the risk of gastric cancer among individuals identified as hazardous drinkers using the Alcohol Use Disorders Identification Test (AUDIT), which provides a comprehensive assessment of hazardous drinking behavior. Patients We enrolled men with hazardous drinking behavior (AUDIT score ≥ 8) who had undergone gastric cancer screening (either endoscopy or a barium X-ray examination of the upper gastrointestinal tract) between April 2013 and March 2020 within 1 year from entry and who had subsequently undergone at least one more gastric cancer screening up to March 2021. Functional single-nucleotide polymorphisms of ALDH2 (rs671) were measured using a direct TaqMan PCR method with unprocessed saliva. Results A total of 246 men were enrolled, comprising 193 individuals with active ALDH2 (ALDH2*1/*1) and 53 with less-active ALDH2 (ALDH2*1/*2). The cumulative incidence of gastric cancer in the less-active group was higher than in the active ALDH2 group (p=0.01, hazard ratio: 4.6, 95% confidence interval: 1.2-16.7). Alcohol consumption was lower in the less-active ALDH2 group than in the active ALDH2 group, although no marked difference was observed in the AUDIT score. Conclusion In individuals with hazardous drinking behavior, a heightened risk of gastric cancer was observed among those with less-active ALDH2 variants, even when their alcohol consumption was comparatively lower than in those with active ALDH2 variants.

A Study of the association of neurocognition with relapse and quality of life in patients of alcohol dependence

Background: Alcohol is a widely consumed substance associated with around 5.6% of all causes of death. Alcohol use disorder (AUD) is a chronic relapsing and remitting illness and has been known to be associated with impaired executive functions, processing speed, memory, attention, and fluency. It is also associated with impaired quality of life (QoL), which in turn can affect overall prognosis. Aim: To assess neurocognition in patients with alcohol dependence and correlate it with QoL and relapse. Materials and Methods: This study was a prospective, longitudinal study of sixty alcohol dependence patients from January 2020 to June 2021 after appropriate ethical approval. Participants were assessed for baseline alcohol dependence, neurocognition (focused, sustained and divided attention; processing speed; verbal and category fluency; working memory; response inhibition; verbal comprehension; verbal learning and memory; visuospatial construction; visual learning and memory) and QoL using Alcohol Use Disorders Identification Test (AUDIT), National Institute of Mental Health and Neurosciences (NIMHANS) battery for neurocognition and WHO-BREF (WHO-Quality of Life-short-form scale) World Health Organization-scale, respectively. A follow-up was conducted in three months to assess relapse in the patients. Statistical analysis was conducted by International Business Machines Statistical Package for the Social Sciences (IBM SPSS) v16. Results: Mean age of the study participants was 41.3 ± 5.03 years, mean age of onset of alcohol use was 20.88 ± 4.27 years, mean duration of alcohol use of 16.6 ± 7.92 years, and average 14.55 ± 4.86 drinks per day. The mean AUDIT score of the study population was 25.21 ± 7.18. There was significant positive correlation between duration of use and CTT-2; 37 out of 57 participants relapsed to alcohol (three participants had died in follow-up) with mean 37.48 ± 23.27 days of relapse, mean 3.32 ± 1.2 drinking days per week, and mean 6 ± 1.2 drinks per drinking day. There was negative and positive correlation between neurocognition and relapse and between neurocognition and QoL. Conclusion: Alcohol use also resulted in impaired cognitive function of the study participants. There was also significant difference in score for neurocognition test between relapse and abstinent group. The significant correlation between neurocognition and QoL as well as neurocognition and relapse proves the deleterious effect of alcohol in every aspect of life.

Effect of alcohol-dependence on cognitive performance in middle-aged men: Preliminary results

Objectives: The understanding of the relationship between alcohol-related neuropathology, cognitive impairment, and various factors such as alcohol consumption, thiamine levels, and age vulnerability is still poorly understood. Therefore, this study aims to examine the effect of alcohol dependence on cognitive performance in middle-aged men with psycho-biochemical evidence. Materials and Methods: A cross-sectional pilot study with a comparison group including 82 right-handed participants with and without alcohol dependence (n = 41 each). Alcohol dependence was diagnosed clinically by the International Classification of Disease Tenth Edition along with the use of alcohol use disorder identification test (AUDIT) and cognitive screening tests, that is, the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). The serum levels of thiamine (Vitamin B1) were determined using an enzyme-linked immunosorbent assay. Results: The MoCA scores, MMSE scores, and serum thiamine levels were significantly low for alcohol-dependent men (1509.43 ± 898.63 pmol/L) versus non-alcohol-dependent men (1862.81 ± 741.30 pmol/L; P = 0.021). The cognitive sub-domains including orientation, execution, calculation, visuoconstructional skills, and recall functions were also significantly (P &lt; 0.05) affected for the alcohol-dependent patients when compared to non-alcohol-dependent men. Serum thiamine levels showed a positive (P &lt; 0.05) correlation with MoCA scores whereas serum thiamine levels showed a significant (P &lt; 0.05) negative correlation with AUDIT scores. Conclusion: Based on the significant positive association between serum thiamine levels with MoCA scores; therefore, both may be used as a screening tool for the early detection of cognitive impairment in patients with alcohol dependence.

Alcohol use among NTNU students 2007-19.

Alcohol consumption is widespread in student environments. The objective of the study was to examine alcohol use among students at the Norwegian University of Science and Technology (NTNU) in a twelve-year perspective. The study is cross-sectional, based on two questionnaire surveys conducted in lecture breaks at NTNU in 2007 and 2019. Participation was voluntary and anonymous. The questionnaire surveyed background variables and alcohol use, and included questions from the Alcohol Use Disorders Identification Test (AUDIT). The respondents were categorised into risk profiles based on their results. An AUDIT score of ≥8 was used as the threshold value for risky/potentially harmful alcohol use. The study included 2,247 students: 857 from 2007 and 1,390 from 2019. The proportion of women was 42.3% in 2007 and 54.9% in 2019. The average age was 21.5 years (2007) and 22.5 years (2019). The average AUDIT score was 10.7 in 2007 and 8.5 in 2019. A total of 937 students (67.6%) consumed alcohol two to four times per month or more in 2019, a reduction of 9.8% from 2007. Altogether 885 students (67.8%) consumed five or more alcohol units on a typical drinking day in 2019, a reduction of 12.8% from 2007. A considerable one-fifth reduction in the proportion of students with risky alcohol use occurred from 2007 to 2019. However, the alcohol use of more than half of the students may still pose a long-term risk.

Effect of typical alcohol use and expectancies on the social manipulation of drinking behavior in a virtual bar pilot study

BackgroundRecent work indicates that increasing the drinking rate of a virtual bar-goer (VB) increases the rate of drinking for participants in a virtual reality (VR) bar environment. Here, we test the hypothesis that biopsychosocial factors including typical drinking pattern and expectancy that alcohol enhances social interactions would moderate this effect. MethodsWe assessed the drinking topography (DT) of participants (N=20) in a VR environment with a programmable VB during two testing sessions: one with a fast-drinking VB (30–60s sip interval) and one in which the VB drank slowly (60–120s sip interval). In this secondary analysis, linear mixed models were used to characterize potential interactions of typical daily alcohol intake (quantity-frequency index [QFI]), maximal alcohol consumed in one bout over the past six months (maxQ), Alcohol Use Disorder Identification Test (AUDIT) score, and expectancy that alcohol enhances social and physical pleasures (SPP) with time in simulation and condition on sip interval and volume. ResultsIndividuals with higher MaxQ showed a reduced effect of time on sip volume such that more intense recent binge episodes were associated with consistent drinking. Greater AUDIT scores were associated with lower sip intervals. In addition, greater SPP expectancy was associated with higher sip volumes, but only in the fast-drinking VB condition. ConclusionsGreater drinking behavior and social expectancies were associated with more rapid drinking topography. In addition, findings suggest challenging alcohol outcome expectancies related to social enhancement could reduce alcohol-related risks by slowing the rate of alcohol intake in social situations.

Relationship between self-stigma about alcohol dependence and severity of alcohol drinking and craving

BackgroundThe correlates and consequences of stigma surrounding alcohol use are complex. Alcohol use disorder (AUD) is typically accompanied by self-stigma, due to numerous factors, such as shame, guilt and negative...

Alcohol use among emergency medicine department patients in Tanzania: A comparative analysis of injury versus non-injury patients.

Alcohol is a leading behavioral risk factor for death and disability worldwide. Tanzania has few trained personnel and resources for treating unhealthy alcohol use. In Emergency Medicine Departments (EMDs), alcohol is a well-known risk factor for injury patients. At Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania, 30% of EMD injury patients (IP) test positive for alcohol upon arrival to the ED. While the IP population is prime for EMD-based interventions, there is limited data on if non-injury patients (NIP) have similar alcohol use behavior and potentially benefit from screening and intervention as well. This was a secondary analysis of a systematic random sampling of adult (≥18 years old), KiSwahili speaking, KCMC EMD patients surveyed between October 2021 and May 2022. When medically stable and clinically sober, participants provided informed consent. Information on demographics (sex, age, years of education, type of employment, income, marital status, tribe, and religion), injury status, self-reported alcohol use, and Alcohol Use Disorder (AUD) Identification Test (AUDIT) scores were collected. Descriptive statistics were analyzed in RStudio using frequencies and proportions. Of the 376 patients enrolled, 59 (15.7%) presented with an injury. The IP and NIP groups did not differ in any demographics except sex, an expected difference as females were intentionally oversampled in the original study design. The mean [SD] AUDIT score (IP: 5.8 [6.6]; NIP: 3.9 [6.1]), drinks per week, and proportion of AUDIT ≥8 was higher for IP (IP:37%; NIP: 21%). However, alcohol preferences, drinking quantity, weekly expenditure on alcohol, perceptions of unhealthy alcohol use, attempts and reasons to quit, and treatment seeking were comparable between IPs and NIPs. Our data suggests 37% of injury and 20% of non-injury patients screen positive for harmful or hazardous drinking in our setting. An EMD-based alcohol treatment and referral process could be beneficial to reduce this growing behavioral risk factor in non-injury as well as injury populations.

A mixed-methods comparison of gender differences in alcohol consumption and drinking characteristics among patients in Moshi, Tanzania.

Excessive alcohol use stands as a serious threat to individual and community well-being, having been linked to a wide array of physical, social, mental, and economic harms. Alcohol consumption differs by gender, a trend seen both globally and in Moshi, Tanzania, a region with especially high rates of intake and few resources for alcohol-related care. To develop effective gender-appropriate treatment interventions, differences in drinking behaviors between men and women must be better understood. Our study aims to identify and explore gender-based discrepancies in alcohol consumption among Kilimanjaro Christian Medical Center (KCMC) patients. A systematic random sampling of adult patients presenting to KCMC's Emergency Department (ED) or Reproductive Health Center (RHC) was conducted from October 2021 until May 2022. Patients answered demographic and alcohol use-related questions and completed brief surveys, including the Alcohol Use Disorder Identification Test (AUDIT). Through purposeful sampling, 19 individuals also participated in in-depth interviews (IDIs) that focused on identifying gender differences in alcohol use. Quantitative data was analyzed in RStudio through descriptive frequencies, proportions, ANOVA, and Chi-squared tests, while IDIs were analyzed in Nvivo following a grounded theory approach. During the 8-month data collection timeline, 676 patients were enrolled. Men and women patients at KCMC's ED and RHC were found to have significant differences in their alcohol use behaviors. For our quantitative data, this included lower average AUDIT scores among women (average [SD] AUDIT scores were 6.76 [8.16] among ED men, 3.07 [4.76] among ED women, and 1.86 [3.46] among RHC women). A subsequent IDI analysis revealed greater social restrictions around women's drinking and more secretive alcohol use behaviors for where and when women would drink. For men, excess drinking was normalized within Moshi, tied to men's social interactions with other men, and generally motivated by stress, social pressure, and despair over lack of opportunity. Significant gender differences in drinking behaviors were found, primarily influenced by sociocultural norms. These dissimilarities in alcohol use suggest that future alcohol-related programs should incorporate gender in their conceptualization and implementation.

High-resolution examination of changes in drinking during the COVID-19 pandemic: Nine-wave findings from a longitudinal observational cohort study of community adults

Few multi-wave longitudinal studies have examined changes in drinking across extended periods of the coronavirus 2019 (COVID-19) pandemic. Using multiple indicators over three years, the current study examined: a) overall drinking changes; b) sex, income, age, and pre-COVID drinking level as moderators of changes; and c) the clinical significance of the observed changes. Using a longitudinal observational cohort design with nonclinical adults from the general community (N = 1395), assessments were collected over nine waves, two pre-COVID (April 2019 and October 2019) and seven intra-COVID (April 2020–April 2022). Drinking was measured as percent drinking days, percent heavy drinking days, and the Alcohol Use Disorders Identification Test (AUDIT) score. Clinically significant changes were defined based on the World Health Organization risk levels. All indicators exhibited significant changes from pre-pandemic to intra-pandemic periods, with drinking changes comprising early pandemic increases followed by subsequent decreases and AUDIT scores consistently declining. Pre-pandemic drinking level substantially moderated all changes. Heavier drinkers exhibited larger decreases compared to other drinking groups. In terms of clinically important changes, ∼10% of pre-pandemic abstinent or low-risk drinkers transitioned to medium- or high-risk status during the pandemic. In contrast, 37.1% of medium-risk drinkers and 44.6% of high-risk drinkers exhibited clinically significant decreases during the intra-pandemic period. Collectively, these findings highlight the multifarious impacts of the pandemic on drinking over time, comprising both increases and decreases in drinking behaviour.

Digital interventions for reducing alcohol use in general populations: An updated systematic review and meta-analysis.

This article updates a 2017 review on the effectiveness of digital interventions for reducing alcohol use in the general population. An updated systematic search of the MEDLINE database was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to identify randomized controlled trials (RCTs) published from January 2017 to June 2022 that evaluated the effectiveness of digital interventions compared with no interventions, minimal interventions, and face-to-face interventions aimed at reducing alcohol use in the general population and, that also reported changes in alcohol use (quantity, frequency, quantity per drinking day, heavy episodic drinking (HED), or alcohol use disorders identification test (AUDIT) scores). A secondary analysis was performed that analyzed data fromRCTs conducted in students. The review was not preregistered. The search produced 2224 articles. A total of 80 studies were included in the review, 35 of which were published after the last systematic review. A total of 66, 20, 18, 26, and 9 studies assessed the impact of digital interventions on alcohol quantity, frequency, quantity per drinking day, HED, and AUDIT scores, respectively. Individuals randomized to the digital interventions drank 4.12 (95% confidence interval (CI): 2.88, 5.36) fewer grams of alcohol per day, had 0.17 (95% CI 0.06, 0.29) fewer drinking days per week, drank approximately 3.89 (95% CI: 0.40, 7.38) fewer grams of alcohol per drinking day, had 1.11 (95% CI: 0.32, 1.91) fewer HED occasions per month, and had an AUDIT score 3.04 points lower (95% CI: 2.23, 3.85) than individuals randomized to the control condition. Significant reductions in alcohol quantity, frequency, and HED, but not quantity per drinking day, were observed among students. Digital interventions show potential for reducing alcohol use in general populations and could be used widely at the population level to reduce alcohol-attributable harms.

Decreasing alcohol use among young adults presenting for service in the U.S. Air Force: An epidemiological surveillance study

ABSTRACT U.S. surveys demonstrate recent decreases in the prevalence of alcohol use and binge drinking among young adults. The current study aims to determine whether similar trends are evident in a similarly aged cohort of service members in the US Air Force to inform ongoing prevention efforts. Participants were 103,240 Air Force personnel in entry-level training between 2016 and 2019. Participants anonymously completed the AUDIT (Alcohol Use Disorder Identification Test) regarding their pre-service drinking. Logistic regression analyses and the Cochran-Armitage test were conducted to measure population trends over the study duration with stratification by age (<21 vs. ≥21) and evaluation of specific alcohol behaviors. Between 2016 and 2019, the proportion of young service members endorsing any alcohol use significantly decreased for both the <21 group (i.e. from 38.9% to 32.6%) and the ≥21 group (i.e. from 80.6% to 77.5%). Among those who endorsed drinking, a decrease over time in binge use was also observed from 46.6% to 37.8% for the <21 group and from 34.2% to 27.5% for the ≥21 group. Responses to other specific alcohol risk items and total AUDIT scores also demonstrated decreases. Binge use and risky drinking remained disproportionately common among those under the legal drinking age. It is encouraging to observe a shift toward abstinence and decreased binge use among this population of young military recruits. However, given the risk for many adverse health and legal consequences in this population, more work is needed to prevent problematic drinking, especially among those under the legal drinking age.