Drinking Standards Research Articles

Pre-screening Ability of the Functional-Belief-Based Alcohol Use Questionnaire (FBAQ) among Chiang Mai University Undergraduates: An External Validation Study

BackgroundHigh-risk drinking behavior is common in university students, which often leads to negative consequences. Several standard screening tools to identify high-risk drinkers have been validated in this domain. However, most tools rely on drinking frequency and require standard drink calculations. The Functional-Belief-Based Alcohol use Questionnaire (FBAQ) was recently proposed as a pre-screening tool for high-risk drinkers in the young adult population. We aimed to validate the pre-screening accuracy of the FBAQ when applied to external data of university undergraduates. MethodsData from two prospective cross-sectional surveys of Chiang Mai University undergraduates were used for validation of the FBAQ. A high-risk drinker was defined as a person with the 12-month AUDIT score ≥ 8. Pre-screening performance and accuracy indices were presented separately for dataset I, dataset II, and the combined dataset. The pooled area under the receiver operating characteristic curve (AuROC), sensitivity, and specificity were estimated using individual patient data meta-analysis methods. ResultsFrom the two datasets, 1641 students were included, 811 students in 2019 and 830 students in 2020. Of these, 387 (23.6 %) students were classified as high-risk drinkers. The combined AuROC of the FBAQ score was 0.83 (95 %CI 0.75–0.92) in discriminating high-risk drinkers. The pooled sensitivity and specificity at the FBAQ score cutoff ≥ 6 were 92.8 % (95 %CI 88.0–95.7 %) and 51.6 % (95 %CI 41.1–62.0 %). ConclusionsIn this external validation, the FBAQ shows excellent discriminative ability and is proven to be highly sensitive in detecting high-risk drinkers among Chiang Mai University undergraduates. Therefore, incorporating the FBAQ as a pre-screening tool to the AUDIT could make the initiation of the screening process easier and reduce extensive AUDIT evaluations in students with low risk.

The Effectiveness of a Web-Based Self-Help Program to Reduce Alcohol Use Among Adults With Drinking Patterns Considered Harmful, Hazardous, or Suggestive of Dependence in Four Low- and Middle-Income Countries: Randomized Controlled Trial.

BackgroundGiven the scarcity of alcohol prevention and use disorder treatments in many low- and middle-income countries (LMICs), the World Health Organization has launched an eHealth portal that includes the web-based self-help program “Alcohol e-Health.”ObjectiveWe aimed to test the effectiveness of the Alcohol e-Health program in a randomized controlled trial.MethodsThis was a two-arm, individually randomized, and controlled trial across four LMICs comparing the self-help program and a psychoeducation and internet access as usual waiting list. Participants were broadly recruited from community samples in Belarus, Brazil, India, and Mexico from January 2016 through January 2019. The primary outcome measure was change in the Alcohol Use Disorders Identification Test (AUDIT) score with a time frame of 6 months between baseline and follow-up. Secondary outcomes included self-reported numbers of standard drinks over the previous week and cessation of harmful or hazardous drinking (AUDIT score <8).ResultsFor this study, we recruited 1400 predominantly male (n=982, 70.1%) at least harmful or hazardous alcohol drinkers. The mean age was 37.6 years (SD 10.5). The participants were recruited from Brazil (n=587), Mexico (n=509), India (n=212), and Belarus (n=92). Overall, complete case analysis identified higher AUDIT changes in the intervention group (B=−4.18, 95% CI −5.42 to −2.93, P<.001, d=0.56) that were mirrored by changes in weekly standard drinks (B=−9.34, 95% CI −15.90 to −2.77, P=.005, d=0.28) and cessation rates for harmful or hazardous drinking (χ21=14.56, N=561, P<.001). The supplementary intention-to-treat analyses largely confirmed these initial results.ConclusionsThe expansion of the Alcohol e-Health program to other LMICs with underdeveloped alcohol prevention and treatment systems for alcohol use disorders should be considered after successful replication of the present results.Trial RegistrationISRCTN ISRCTN14037475; https://www.isrctn.com/ISRCTN14037475International Registered Report Identifier (IRRID)RR2-10.1111/add.14034

An integrated dual process simulation model of alcohol use behaviours in individuals, with application to US population-level consumption, 1984–2012

IntroductionThe Theory of Planned Behaviour (TPB) describes how attitudes, norms and perceived behavioural control guide health behaviour, including alcohol consumption. Dual Process Theories (DPT) suggest that alongside these reasoned pathways, behaviour is influenced by automatic processes that are determined by the frequency of engagement in the health behaviour in the past. We present a computational model integrating TPB and DPT to determine drinking decisions for simulated individuals. We explore whether this model can reproduce historical patterns in US population alcohol use and simulate a hypothetical scenario, “Dry January”, to demonstrate the utility of the model for appraising the impact of policy interventions on population alcohol use. MethodConstructs from the TPB pathway were computed using equations from an existing individual-level dynamic simulation model of alcohol use. The DPT pathway was initialised by simulating individuals’ past drinking using data from a large US survey. Individuals in the model were from a US population microsimulation that accounts for births, deaths and migration (1984–2015). On each modelled day, for each individual, we calculated standard drinks consumed using the TPB or DPT pathway. In each year we computed total population alcohol use prevalence, frequency and quantity. The model was calibrated to alcohol use data from the Behavioral Risk Factor Surveillance System (1984–2004). ResultsThe model was a good fit to prevalence and frequency but a poorer fit to quantity of alcohol consumption, particularly in males. Simulating Dry January in each year led to a small to moderate reduction in annual population drinking. ConclusionThis study provides further evidence, at the whole population level, that a combination of reasoned and implicit processes are important for alcohol use. Alcohol misuse interventions should target both processes. The integrated TPB-DPT simulation model is a useful tool for estimating changes in alcohol consumption following hypothetical population interventions.

From the Editor’s Desk…

From the Editor’s Desk…

The Australian ready-to-drink beverages tax missed its target age group

BackgroundDuring 2008 and 2009, the Australian Government increased the tax on ready-to-drink alcoholic beverages by 70% to discourage drinking among adolescents. MethodsTo evaluate the tax, we use the difference-in-difference and comparative interrupted time series estimators, where age is used to define the control and treatment groups. This methodology is applied to the Household Income and Labour Dynamics in Australia survey. ResultsWe show that the tax did not affect the alcohol consumption of those aged under 25 (the tax targeted age group) but substantially reduced drinking among those aged 25–69, reducing their average daily consumption of standard drinks by 8.9% from 2010 to 2018. ConclusionThe age group under 25 did not respond to the tax likely because of product substitution. Alcohol price policy may need to acknowledge complex substitute/complement relationships between beverages and consider a floor price on alcohol or a uniform volumetric tax per standard drink.

Effects of minimum unit pricing for alcohol in South Africa across different drinker groups and wealth quintiles: a modelling study

ObjectivesTo quantify the potential impact of minimum unit pricing (MUP) for alcohol on alcohol consumption, spending and health in South Africa. We provide these estimates disaggregated by different drinker groups...

B-PO05-165 ALCOHOL CONSUMPTION AND RISK OF BRADYARRHYTHMIAS: DATA FROM THE UK BIOBANK

There is a paucity of evidence for the role of alcohol consumption on the risk of bradyarrhythmias. Using prospective cohort data from the UK Biobank, we characterised associations of total and beverage-specific alcohol consumption with incident bradyarrhythmias. Self-reported alcohol consumption from a baseline questionnaire was calculated as standard drinks (8g alcohol) per week. Past and never drinkers and those with a history of bradyarrhythmias were excluded. Bradyarrhythmias were defined as a pacemaker insertion or abnormalities in rate/rhythm resulting in a pathologically slow ventricular response. Incident events were assessed through hospitalisation and death records. Consumption was modelled as restricted cubic splines in multivariate Cox regression models and corrected for regression dilution bias. The cohort consisted of 385,670 participants with 4,246 incident bradyarrhythmias over a median (IQR) follow-up duration of 8.0 (7.3-8.6) years. Participants consuming greater amounts of alcohol were younger, more likely male, of white ethnicity, and largely more comorbid. Associations of total and beverage-specific alcohol consumption and bradyarrhythmia risk are shown in the Figure. Disaggregation demonstrated similar associations for alcohol consumption with different bradyarrhythmia outcomes. Amongst current drinkers, alcohol consumption appears to have a protective association with bradyarrhythmia risk. Red and white wine intake was associated with lower risk compared to beer, cider and spirits. Further investigation is required into the biologic mechanisms behind these findings.

Ethanolic Extract of Black Cumin Seed Reduced Radical Reactive from Dimethylbenzanthracene Compounds

Dimethylbenzantracene is a compound that is radical reactive, genotoxic, and immunotoxic. Black cumin seeds have antioxidative properties. The study aimed to determine the effect of the black cumin seed ethanolic extract as an antioxidant by observing the secretion activity of ROI and NO peritoneal macrophages in Sprague Dawley (SD) rats induced by DMBA. This controlled experiment used 30 male SD rats. The test animals were randomly divided into six groups. Group I was given standard food and drink. Group II was given DMBA. Groups III, IV, and V were given EEBCS doses of 5, 25, and 125 mg orally for seven weeks, respectively. Group VI was given Imboost. From week 3 to week seven, all test animals were induced 10x20 DMBA, 2x per week.At week 16, all test animals were sacrificed and isolated and cultured peritoneal macrophage cells. The activity of ROI secretion and NO macrophage secretion was tested. Data on ROI secretion and NO levels were tested for ANOVA, followed by LSD test with a confidence level of 95%. The results showed that DMBA induction increased ROI secretion by macrophages and decreased NO.EEBCS secretion decreased ROI secretion and grew NO. The DMBA group had the lowest NO levels. This study concluded that EEBCS at doses 5 and 125 reduced the flow of ROI peritoneal macrophages in SD rats induced by DMBA but reduced NO levels.

Impact of binge drinking during college on resting state functional connectivity

AimThe current study examined the longitudinal effects of standard binge drinking (4+/5+ drinks for females/males in 2 hours) and extreme binge drinking (8+/10+ drinks for females/males in 2 hours) on resting-state functional connectivity. Method119 college students (61 males) were recruited in groups of distinct bingeing patterns at baseline: non-bingeing controls, standard and extreme bingers. Resting-state scans were first obtained when participants were freshmen/sophomores and again approximately two years later. Associations between longitudinal bingeing (reported during this two-year gap) and network connectivity were examined. Network connectivity was calculated by aggregating all edges affiliated with the same network (an edge is a functional connection between two brain regions). The relationship between longitudinal bingeing and connectivity edges was also studied using connectome-based predictive modeling (CPM). ResultsGreater standard bingeing was negatively associated with change in connectivity between Default Mode Network and Ventral Attention Network (DMN-VAN; False Discovery Rate corrected), controlling for initial binge groups, longitudinal network changes, motions, scanner, SES, sex, and age. The correlations between change in DMN-VAN connectivity and change in cognitive performance (Stroop, Digit Span, Letter Fluency, and Trail Making) were also tested, but the results were not significant. Lastly, CPM failed to identify a generalizable predictive model of longitudinal bingeing from change in connectivity edges. ConclusionsBinge drinking is associated with abnormality in networks implicated in attention and self-focused processes, which, in turn, have been implicated in rumination, craving, and relapse. More extensive alterations in functional connectivity might be observed with heavier or longer binge drinking pattern.

Changes in Alcohol Consumption Pattern Based on Gender during COVID-19 Confinement in Spain.

(1) The goal of this study was to analyze the prevalence and pattern of alcohol consumption (frequency of consumption, average daily consumption, and risky consumption) before and during confinement due to the coronavirus disease (COVID-19) in the adult population and based on gender. (2) Methods: Data from 3779 individuals were collected via a set of online surveys. The AUDIT alcohol consumption questions (AUDIT-C) were used to measure the frequency of consumption, the average daily consumption, intensive consumption, risky consumption, and standard drink units. (3) Results: During confinement, the prevalence of alcohol consumption declined in both males and females, but only intensive consumption showed significant differences, with a greater reduction in males. The number of females who consumed alcohol four or more times per week doubled, whereas the number of males who did so was multiplied by a factor of 1.5; in both females and males, the percentage who presented intensive consumption doubled. The percentage of females with risky consumption was higher than that of males both before and during confinement. In addition to gender, the interaction between age and the employment situation explain consumption before and during confinement. (4) Conclusions: During confinement due to COVID-19, alcohol consumption declined in both sexes, but alcohol-risk consumers increased their frequency of use. The interaction between gender, age, and employment situation was related to these changes. These findings are relevant for guiding public health and health-risk management policies related to alcohol consumption in environmental situations similar to COVID-19.

B-PO02-004 TOTAL AND BEVERAGE-SPECIFIC ALCOHOL CONSUMPTION AND INCIDENT ATRIAL FIBRILLATION

Although binge drinking and moderate-to-high alcohol consumption are risk factors for developing atrial fibrillation (AF), the impact of low alcohol consumption remains controversial. Using prospective cohort data from the UK Biobank, we characterised the associations of alcohol consumption with incident AF. Self-reported alcohol consumption from a baseline questionnaire was calculated as standard drinks (8g alcohol) per week. Non-drinkers and those with a history of AF were excluded. Incident AF was assessed through hospitalisation and death records. Consumption was modelled as restricted cubic splines in multivariate Cox regression models and corrected for regression dilution bias. The cohort consisted of 381,236 participants with 11,538 incident AF events over a median (IQR) follow-up duration of 7.9 (7.3-8.6) years. Participants consuming greater amounts of alcohol were younger, more likely male, of white ethnicity, and largely more comorbid. Associations for total and beverage-specific alcohol consumption with risk of AF are shown in the Figure. When included in the analysis, past drinkers but not never drinkers appeared to have a greater risk of AF compared to current drinkers (HR 1.15, 95% CI 1.05-1.26 and HR 1.03, 95% CI 0.94-1.13 respectively). Spirit consumption in females was associated with greater AF risk, though no other significant gender interactions were observed. Amongst current drinkers, low alcohol consumption up to 7 standard drinks/week was not associated with increased AF risk. Red and white wine intake was associated with lower AF risk in comparison to beer, cider and spirits.

A wastewater-based assessment of the impact of a minimum unit price (MUP) on population alcohol consumption in the Northern Territory, Australia.

To test if there was a reduction in alcohol consumption in wastewater samples in the Northern Territory of Australia after the implementation of a minimum unit alcohol price policy (MUP) in October 2018. Between August 2016 and February 2020, wastewater samples were collected across 66 sites in the Northern Territory and all other states and territories in Australia. Samples were collected every 2months in capital cities and every 4months in regional places during this period. Overall, 4917 samples were taken (2816 before MUP and 2101 after). The number of standard drinks per 1000 people per day in the respective catchment areas was estimated based on the concentration of an alcohol-specific metabolite, ethyl sulphate in the samples (using the excretion factor of ethyl sulphate, the flow of wastewater entering the wastewater treatment plants and the population of each wastewater catchment). Results from a linear mixed model showed that there was a large drop in alcohol consumption immediately after the MUP in Northern Territory [estimated drop=1231, 99% confidence interval (CI)=830, 1633; 38.75%]. There was no significant drop in all other states/territories except for Queensland, which showed a significant but much smaller drop (estimated drop: 310; 99% CI=114, 550). One year after the MUP, the drop narrowed to 520 (99% CI=189, 851) and was no longer statistically significant in February 2020 (15months after MUP; estimated drop=283, 99% CI=-114, 681). Per-capita consumption of alcohol appears to have decreased substantially in the Northern Territory of Australia immediately after the implementation of a minimum unit price but consumption steadily recovered and almost returned to the pre-MUP consumption level after 15months.

A parallel test of the SCRAM-CAM transdermal monitors ensuring reliability.

Previous studies validating the transdermal alcohol concentration (TAC) as measured by the Secure Continuous Remote Alcohol Monitors Continuous Alcohol Monitoring (SCRAM-CAM) have tested the monitor against self-reports or breath alcohol concentration (BrAC). This study aims to provide further evidence of the reliability of the SCRAM-CAM testing two monitors in parallel. Participants (N=21) received four standard drinks in a laboratory session while wearing SCRAM-CAMs simultaneously on their left and right ankles. The SCRAM-CAMs sampled TAC every 30 min and participants were monitored for at least 2-3h after their BrAC levels reached zero. Weight and height measures were taken to calculate body mass index (BMI). There was a positive correlation between the TAC measurements from the left and right SCRAM-CAM (r=0.718), a cross-correlation model revealed that this correlation was not significantly different for sex or BMI. Area under the TAC curve (AUC) and peak TAC values as measured by the left and right SCRAM-CAM also show positive correlations (r=0.554 and r=0.579, respectively). Cross-correlation models show a significant effect of BMI on the relationship between left and right peak TAC values, which may be due to outlier effects. No further effects were significant for on both peak and AUC values. Results show that TAC measured by SCRAM-CAMs worn on the left and right showed a good correlation, with correlations between AUC and peak TAC values considered to be fair. TAC monitors show promise for use in research settings; however, work is needed testing the reliability of TAC as measured by two TAC monitors.

Daily associations between cannabis use and alcohol use in young adults: the moderating role of self-report and behavioral measures of impulsivity

Although impulsivity has been implicated in cannabis and alcohol use, its role in alcohol and cannabis co-use behavior requires further study. We examined the moderating role of self-report and behavioral measures of impulsivity in the daily-level relationships between cannabis use and both (a) likelihood of same-day alcohol use and (b) the number of drinks consumed on the same day. Young adults (n = 153) completed a 90-day Timeline Follow Back assessing the amount of cannabis smoked (in grams), other forms of cannabis (e.g. oils, edibles), and the number of standard drinks consumed each day. Participants also completed a structured interview of Alcohol and Cannabis Use Disorders (AUD/CUD), and both self-report (UPPS impulsivity scales) and behavioral (behavioral disinhibition and delay discounting) measures of impulsivity. Zero-inflated multilevel modeling revealed that negative urgency, delay discounting, and disinhibition were significant, unique moderators of the daily relationship between cannabis and alcohol consumption, after controlling for AUD/CUD symptoms and other covariates. Specifically, individuals high (but not low) on negative urgency and delay discounting showed a positive association between grams of cannabis used on a given day and same-day number of standard drinks consumed. Contrary to expectations, individuals low on negative urgency and low in disinhibition showed a stronger relationship between grams of cannabis consumed and odds of engaging in any drinking on the same day. Results extend research on moderators of within-person, daily-level associations between cannabis and alcohol use, suggesting that several impulsivity-related constructs may contribute to complementary use of cannabis and alcohol among young adults.

Gender differences in the supply of alcohol to adolescent daughters and sons

ABSTRACT Background: Parents are the main supplier of alcohol to children but it is not known whether mothers and fathers equally contribute to the supply of alcohol to their female and male children as these children transition to adulthood. Objectives: i) to determine whether the gender of the parent is associated with the gender of the adolescent offspring when alcohol is supplied and ii) whether the gender of the parent supplying is associated with gender differences in adolescent binge drinking and alcohol related harms. Methods: Longitudinal cohort of 1,927 (males = 1052) Australian adolescents (mean age 12.9 years), recruited in 2010/11 from schools in Australia and surveyed annually for six years. We assessed the association between adolescent and parent gender related to subsequent adolescent drinking, binge drinking (>4 standard drinks), and alcohol-related harms. Results: At mean age of 12.9 years about one in ten children report parental supply of alcohol which increases to about four in ten children by 17.8 years. Mothers consistently more often supply their daughters with alcohol than their sons, [Wave 5 OR 1.77 (1.53,2.05)], while mothers less often supply sons than their daughters, [Wave 5 OR 0.82 (0.71,0.95)]. Mothers’ supply of alcohol to daughters predicts substantially increased odds of daughters binge drinking, [OR 1.67 (1.10,2.53)] and experiencing alcohol related harms, [OR 1.65 (1.10,2.48)]. Conclusion: There is a need to involve both mothers and fathers and to equally target female and male children in programs to reduce the harmful consequences of parental supply of alcohol to their children.

Adherence to guidelines regarding anticoagulation and risk factors for progression of atrial fibrillation in a nurse‐led clinic

Atrial fibrillation (AF) is the commonest cardiac arrhythmia associated with an increased risk of stroke. Evidence suggests that management in a specialty clinic improves clinical outcomes of patients. To assess level of adherence to evidence-based guidelines regarding anticoagulation and the risk factors for progression of AF in a nurse-led AF clinic. A retrospective analysis was conducted on clinical records of 136 patients seen at the AF clinic to determine their risk factors and progression of AF (change in AF type to more advanced types) during follow up. Additionally, the proportion of patients with CHA2 DS2 -VASC score (congestive heart failure, hypertension, age ≥75 (doubled), diabetes mellitus, stroke (doubled)-vascular disease, age 65-74 years, sex category (female)) of ≥2 who were prescribed anticoagulants according to European Society of Cardiology guidelines before and after attending the clinic was determined. Rate of anticoagulation in patients with CHA2 DS2 -VASC score of ≥2 after attending the clinic (91.3%) was significantly higher than the rate before attending the clinic (79.3%) (P = 0.0076). Mean age in those with AF progression (72.5 ± 9.4) was higher than those without AF progression (66.9 ± 13.9) (P = 0.0072). Rate of AF progression was higher in those with obesity (body mass index ≥30 kg/m2 ) (P = 0.0364) and those with excessive alcohol intake (>2 standard drinks) (P = 0.0039). History of hypertension was not a significant predictor of AF progression (P = 0.7507). Management of AF in a nurse-led clinic was associated with high level of adherence to anticoagulation guidelines. Age, obesity and excessive alcohol intake were significant predictors for progression of AF.

Measuring alcohol’s cost, the Russian-language AUDIT, home-drinking, guilt, shame and forgiveness, and alcohol use among sexual minority women

Measuring alcohol’s cost, the Russian-language AUDIT, home-drinking, guilt, shame and forgiveness, and alcohol use among sexual minority women

The case for minimum unit prices on alcohol in South Africa.

Although only about a third of South African (SA) adults indicate that they consume alcohol, heavy drinking is common. As a result, society carries large alcohol-related mortality and economic burdens. To investigate the feasibility of a minimum unit price (MUP) on alcohol, aimed at reducing the prevalence of heavy drinking. The study calculates unit values, defined as total monthly alcohol expenditure per household, divided by the household's total monthly alcohol consumption, for four categories of drinking households (moderate, intermediate, occasional heavy and regular heavy), using wave 4 data (2015) from the National Income Dynamics Study. A cumulative distribution of the unit values is derived for each of the four categories of drinking households. A number of hypothetical MUPs are imposed, and the impact of these MUPs on the consumption of the different categories of drinking households is estimated, taking cognisance of the fact that these households respond differently to price changes. Moderately drinking households tend to be more price sensitive than regular heavy-drinking households. Occasional and regular heavy-drinking households comprise a quarter of all households (and half of all drinking households) in SA, but consume 84% of all alcohol consumed in the country. There are large differences in the calculated average price of alcohol between different categories of drinking households, ranging from ZAR12.00 per standard drink among moderately drinking households to ZAR1.53 per standard drink among regular heavy-drinking households. An MUP of ZAR3.00 (alternatively ZAR10.00) per standard drink is estimated to reduce alcohol consumption by 11.9% (21.8%) among regular heavy-drinking households, by 3.1% (11.6%) among occasional heavy-drinking households, by 2.3% (15.9%) among intermediate-drinking households and by 0.3% (6.1%) among moderately drinking households. An MUP on alcohol is not a silver bullet, but could have a significant impact on reducing the consumption of alcohol among regular heavy-drinking households, and to a lesser extent among occasional heavy-drinking and intermediate-drinking households. The government should strongly consider implementing such a policy.

The Russian translations of the Alcohol Use Disorders Identification Test (AUDIT): A document analysis and discussion of implementation challenges

Aims: To analyze existing Russian translations of the Alcohol Use Disorders Identification Test (AUDIT) and their applicability in Russian-language populations.&#x0D; Method: Document analysis of different Russian-language versions of the AUDIT and its shorter versions as identified in a systematic search.&#x0D; Findings: A total of 122 Russian translations of the AUDIT or its shorter versions from Russia and other countries were included in the document analysis, 61 of which were unique versions. Across the translations, a series of inconsistencies was identified, most of which related to the first three consumption items and the concept of a standard drink. The identified problems appeared to have been caused by difficulties in adapting the tool to local drinking patterns and local beverage volumes. None of the analyzed sources mentioned systematic translation procedures according to a predetermined protocol.&#x0D; Conclusions: Despite the fact that the AUDIT was developed as a standardized screening tool almost 30 years ago, there is still no official translation into the Russian language according to the commonly used procedures for the translation and adaptation of instruments. A systematic translation and validation appears to be urgently needed in order to have an internationally comparable AUDIT for research and clinical purposes in Russian-speaking populations.

Disclosures of harming others during their most recent drinking session: Findings from a large national study of heavy-drinking adolescents.

The extant Alcohol's Harms to Others (AHTO) literature is largely comprised of reports from victims. We investigated AHTO from perpetrators' perspectives, including how harms were associated with individual characteristics, and alcohol quantities consumed during the perpetration incident. Participants (N=2932) were 14-19 years old, recruited primarily through social media and screened as risky drinkers. They completed face-to-face (n=594) or self-administered (n=2338) surveys. They self-reported whether during their last risky drinking session (LRDS) they had perpetrated any verbal abuse, physical abuse or property damage. A multinomial logistic regression examined whether nine factors were associated with perpetrating zero, one or 2+ categories of AHTO. Eleven percent (n=323) reported perpetrating at least one form of AHTO (7.5% verbal, 1.9% physical and 4.6% property). Perpetration of AHTO at LRDS was uniquely associated with: younger age, male gender, experiences of childhood physical punishment, greater perpetration incident-specific drinking, concurrent illicit drug use, and less frequent use of safety strategies while drinking in the past 12 months. Controlling for the other variables, an increase of six Australian standard drinks (60 g of alcohol) increased the odds of perpetration by 15% [95% confidence interval (CI) adjusted odds ratio (AOR) 1.08, 1.23], and an increase of 15 Australian standard drinks increased the odds by 42% (95% CI AOR 1.20, 1.69). Individual characteristics, larger quantities of alcohol consumed, and a disinclination to practice harm reduction amplified risk of AHTO perpetration. This has implications for health promotion and risk prevention/reduction strategies.