Estimates Of Alcohol Consumption Research Articles

Effects of alcohol consumption and antipsychotic medication on brain morphology in schizophrenia

Magnetic resonance imaging (MRI) studies have shown smaller volumes of grey matter (GM) and white matter (WM) both in schizophrenia and among patients with alcohol abuse or dependence. The effect of alcohol consumption in non-clinical alcohol consumers, i.e. subjects not recruited as having alcohol use disorders is less studied. In the present study, we investigated the effects of alcohol consumption, antipsychotic medication and a diagnosis of schizophrenia on variation in brain volumes among patients recruited for having schizophrenia and a group of age and gender matched control subjects. A total of 69 patients with schizophrenia ( n = 56), schizoaffective disorder ( n = 12) and schizophreniform disorder ( n = 1) and 97 control subjects were included. Alcohol Use Disorder Identification Test (AUDIT) was used to estimate alcohol consumption. In the entire group of patients and controls higher AUDIT score was significantly related to smaller volumes of WM. When ten patients and six control subjects who met lifetime diagnostic criteria for alcohol use disorders were excluded only a trend level association between AUDIT score and WM volumes was found. Having a diagnosis of schizophrenia was related to smaller volumes of total, frontal and temporal WM, total and temporal GM, and larger volumes of total, frontal and temporal cerebrospinal fluid (CSF). A diagnosis of schizophrenia remained a significant factor for smaller WM volumes even when the effect of alcohol consumption was taken into account. Antipsychotic medication was related to larger volumes of temporal CSF. This study demonstrates that alcohol consumption is an important factor for variation in WM volumes, and this effect should be taken into account in all studies evaluating brain volumes from MR images.

Alcohol use before and during pregnancy: a population‐based study

Few population-based studies have estimated alcohol consumption and binge drinking before and during pregnancy. The study is a longitudinal questionnaire study. In Norway, virtually 100% attend an ultrasound screening at 17-18 weeks of pregnancy. In Oslo, a representative sample attending this between June 2000 and May 2001 were invited to join the study, accepted by 92%. Non-Norwegian-speaking and/or immigrants from non-Western countries were not invited; 1,749 (93%) completed the first questionnaire. T-ACE (screening for pregnancy risk drinking), frequency of alcohol use, Standard Units (SU) per occasion, SU/week, and binge drinking (>or=5 SU per occasion). Binary logistic regression analyses, Student's t-test and Pearson's chi square were used. Alcohol use was reported by 89% pre-pregnancy and by 23% after pregnancy week 12. Binge drinking was reported by 59% pre-pregnancy and by 25% during weeks 0-6. Change of drinking pattern occurred at pregnancy recognition for 85%, although 78% had planned the pregnancy, fetal welfare being the main reason. Participants reporting alcohol use during pregnancy were older, smokers, with more SU/week pre-pregnancy, had some elevated anxiety score, higher income, and a partner with higher education. However, mental health, high income, or education were not predictive of usually drinking 1 SU per occasion or more, and not of binge drinking. The latter was predicted mainly by smoking during pregnancy and being T-ACE positive. The study shows a drinking pattern before pregnancy recognition that, according to other studies, in 25% or more may cause suboptimal fetal development.

Reliability and Validity of the Substance Abuse Outcomes Module

Reliability and Validity of the Substance Abuse Outcomes Module

Survey data need not underestimate alcohol consumption.

There are two main ways to assess alcohol consumption in a population: per capita estimates, usually derived from data on taxable alcohol available for consumption, and population-based surveys. Population-based survey estimates of alcohol consumption are often compared with estimates based on taxable alcohol available for consumption as a measure of validity. Discrepancies between these two measures occur, with the majority of population-based surveys substantially underestimating taxable alcohol available for consumption. This article argues, however, that high proportions of taxable alcohol available for consumption can be accounted for by population-based surveys and reports a method of data collection for a national alcohol survey that has accounted for 94% of the taxable alcohol in New Zealand. The ability of the survey methodology to account for this proportion of taxable alcohol is likely due to the within-location beverage-specific alcohol consumption measures used in the survey, the process of recording the quantity of alcohol consumed, the use of a computer-assisted telephone interview system, and the population coverage achieved. Population-based surveys using the methodology outlined in this article may account for, if not exceed, the high proportions of taxable alcohol available for consumption estimates for some populations.

Alcohol use in Ireland - can we hold our drink?

Alcohol use and related harm is now a major public health problem in Ireland. The statistics do not make for pleasant reading. Annual per capita consumption increased by 41% between 1989 and 1999 to 11 litres of pure alcohol per head of population, the second highest level in Europe, and 1.9 litres higher than the EU average. A more telling statistic, estimated alcohol consumption per adult (defined as 15 years and over), was 15.2 litres in the year 2000, the third highest level in the EU and the 12th highest in the world. The dramatic rate of increase in alcohol consumption in Ireland over the past decade, in a time when the vast majority of EU countries have seen a reduction in levels of alcohol consumption, means that Ireland is soon likely to top the EU drinking table.

Survey Data Need Not Underestimate Alcohol Consumption

Background There are two main ways to assess alcohol consumption in a population: per capita estimates, usually derived from data on taxable alcohol available for consumption, and population-based surveys. Population-based survey estimates of alcohol consumption are often compared with estimates based on taxable alcohol available for consumption as a measure of validity. Discrepancies between these two measures occur, with the majority of population-based surveys substantially underestimating taxable alcohol available for consumption. Methods This article argues, however, that high proportions of taxable alcohol available for consumption can be accounted for by population-based surveys and reports a method of data collection for a national alcohol survey that has accounted for 94% of the taxable alcohol in New Zealand. Results The ability of the survey methodology to account for this proportion of taxable alcohol is likely due to the within-location beverage-specific alcohol consumption measures used in the survey, the process of recording the quantity of alcohol consumed, the use of a computer-assisted telephone interview system, and the population coverage achieved. Conclusions Population-based surveys using the methodology outlined in this article may account for, if not exceed, the high proportions of taxable alcohol available for consumption estimates for some populations.

Survey Data Need Not Underestimate Alcohol Consumption

Background There are two main ways to assess alcohol consumption in a population: per capita estimates, usually derived from data on taxable alcohol available for consumption, and population‐based surveys. Population‐based survey estimates of alcohol consumption are often compared with estimates based on taxable alcohol available for consumption as a measure of validity. Discrepancies between these two measures occur, with the majority of population‐based surveys substantially underestimating taxable alcohol available for consumption.Methods This article argues, however, that high proportions of taxable alcohol available for consumption can be accounted for by population‐based surveys and reports a method of data collection for a national alcohol survey that has accounted for 94% of the taxable alcohol in New Zealand.Results The ability of the survey methodology to account for this proportion of taxable alcohol is likely due to the within‐location beverage‐specific alcohol consumption measures used in the survey, the process of recording the quantity of alcohol consumed, the use of a computer‐assisted telephone interview system, and the population coverage achieved.Conclusions Population‐based surveys using the methodology outlined in this article may account for, if not exceed, the high proportions of taxable alcohol available for consumption estimates for some populations.

A comparative analysis of different methods for obtaining estimates of alcohol consumption in a Danish population survey

A comparative analysis of different methods for obtaining estimates of alcohol consumption in a Danish population survey

Red blood cell status in alcoholic and non-alcoholic liver disease

Macrocytosis is most commonly associated with vitamin B12 and folic acid deficiency, followed by alcoholism, liver disease, and other pathologic conditions. We studied the red cell and vitamin status in 423 consecutive patients with various liver diseases, including 31 with acute viral hepatitis (AVH), 105 with chronic hepatitis (CH), and 134 with alcoholic liver disease (ALD), who consisted of 84 with non-cirrhotic alcoholic liver disease (NCALD) and 50 with alcoholic liver cirrhosis (ALC), 60 with non-alcoholic liver cirrhosis (NALC), and 93 with hepatocellular carcinoma (HCC). The mean corpuscular volume (MCV) and red cell distribution width (RDW) were significantly higher in patients with ALD and NALC, and among them macrocytosis occurred more frequently in patients with ALC. Macrocytic anemia was mostly found in cirrhotic patients, in which the Child-Pugh score was closely related to the development of macrocytic anemia. In ALD, the MCV was significantly correlated with the estimated alcohol consumption and inversely correlated with the serum folic acid level, which, however, was often maintained within the normal range in patients with macrocytic ALC. After abstinence from alcohol, the MCV and RDW were reduced significantly and were associated with an increasing serum folic acid level. This suggests that macrocytic anemia was a common feature of alcoholic and non-alcoholic liver cirrhosis and that alcohol abuse and folic acid deficiency play a secondary role in macrocytosis. (J Lab Clin Med 2001;138:332-7)

A comparative analysis of different methods for obtaining estimates of alcohol consumption in a Danish population survey

The aim of the present study was to compare different measures of alcohol consumption used in a Danish survey. A stratified random sample was extracted from the Civil Registration System. From January 1997 to January 1998 approximately 8 telephone interviews were conducted every day, including Sundays and holidays, ending with a total of 3,050 interviews after 1 year. Two main approaches to measure alcohol consumption were used: the quantity-frequency and the recent occasion approaches; the latter is subdivided into previous week and previous day approaches. The overall estimated number of units (= 12 g of pure alcohol) per week was 6.8 (95% confidence intervals (CI): 6.5-7.1), 6.7 (95% CI: 6.4-7.1) and 8.5 (95% CI: 7.8-9.1) for the quantity-frequency, previous week and previous day approaches, respectively. A total of 50% of the men and 70% of the women did not drink alcohol the previous day. Among people classified as high consumers in the previous week and previous day approaches, less than 60% and 30%, respectively, were similarly classified in the quantity-frequency approach. There was agreement on the level of alcohol consumption between the quantity-frequency and previous week approaches, but higher estimates when using the previous day approach. The previous day approach varied more in relation to the interview day and season compared with the quantity-frequency approach and the previous week approach. The recent occasions approach showed some difficulties in classifying the individuals. If the alcohol consumption is included in a model as a risk indicator or a confounder, the quantity-frequency approach would be more preferable than the recent occasion approach.

Alcohol consumption and health-promoting behavior in a U.S. household sample: leisure-time physical activity.

Hypothesizing that people who moderate their alcohol intake engage in other health-promoting cardioprotective behavior, this research explored associations between alcohol consumption and leisure-time physical activity. Data representative of the U.S. population (N = 41,104; 52.5% women) were derived from the 1990 National Health Interview Survey, which employed a multistage probability design. Multivariate logistic regression analyses were performed, using lifetime abstainers as the reference group. An inverted J-shaped curve characterized the association between estimates of alcohol consumption and leisure-time physical activity, in which likelihood of displaying a physically active lifestyle (odds ratios) increased from abstinence (1.00) to moderate drinking (1.84), then declined at heavier consumption (1.61). Stratified analyses yielded similar results with peaks at light or moderate consumption for current smokers, persons aged 55 and over, and those with cardiovascular risk conditions. As activity intensity increased, the inverted J-shaped curve persisted with more pronounced peaks at moderate drinking. Robust findings of an association between cardioprotective leisure-time physical activity and moderate alcohol consumption provide evidence for a health-promoting lifestyle that may play an explanatory role in the alcohol-coronary heart disease relationship.

Alcohol consumption estimates in surveys in Europe: Comparability and sensitivity for gender differences

The comparability of general population studies on alcohol from nine European countries is evaluated from three points of view: (1) methodologic aspects influencing alcohol estimates, (2) variation between countries in coverage of sales estimates of alcohol consumption, and (3) associations between type of question used to measure alcohol consumption and gender differences in alcohol consumption. With respect to methodologic aspects, it was found that the studies differed on most of the 10 points included in this comparison. The coverage of sales estimates by surveys varies between 39% (Germany) and 56% (France). With respect to type of question and gender differences, it was found that more elaborate sets of questions on alcohol consumption are associated with smaller gender differences in the prevalence of heavy drinking (>600 g 100% alc/mo). It is concluded that the methodologic differences between studies and the differences in sales coverage do not allow cross‐national comparison of survey estimates of alcohol consumption of different European countries. Compared with more elaborate sets of questions on alcohol consumption, simple questions on alcohol consumption are likely to underestimate gender differences in the prevalence of heavier drinking.

Alcohol is Implicated in the Fluctuations in Cardiovascular Disease in Russia Since the 1980s

Recently in this Journal, Bobak and Marmot challenged the sence of valid conventional, individual-level epidemiologiview that alcohol might be a major factor in the Russian cal data. It is in this context that the indirect evidence, mortality crisis of the 1990s (1). While conceding that whatever its limitations, remains salient. We would argue, alcohol may play a part in the dramatic increase in deaths however, that it is also more persuasive than Bobak and from external causes, they argue that evidence that it has Marmot imply (1). First, the cause-specific pattern of mortalcontributed to the similarly dramatic rise in cardiovascular ity decline associated with the anti-alcohol campaign of disease is weak. They make four main points. First, they the mid-1980s is in many respects the mirror image of the contend that any evidence that does exist to link the two increase seen in the 1990s (3). The fluctuations in mortality is indirect, with no direct evidence from Russia that heavy were observed in most of the former Soviet Republics, all drinking is associated with cardiovascular disease. Second, of which were subject to the anti-alcohol campaign and they argue that estimates of alcohol consumption are too which, as White has shown in great detail (4), was highly low to produce the observed effects. Third, the observed effective in reducing access to alcohol, contrary to what mortality changes would require not only that the prevaBobak and Marmot (1) suggest. lence of drinking changed but also that the relative risk of While the fluctuations in mortality were similar in shape death increased, an idea they deem unlikely. Fourth, the in nearly all Soviet Republics, the magnitude was least in biological mechanisms underlying the proposed relationship those with significant Muslim populations, where alcohol are unclear. In an accompanying Editorial, Balkau (2) was consumption is known to be less (5). There was also variacritical of Bobak and Marmot’s (1) conclusions but we betion among Russian regions where change in deaths directly lieve that, in addition to the issues raised by Balkau (2), attributable to alcohol and to cardiovascular diseases bethere are several others which may help to resolve this tween 1991 and 1994 are also closely correlated (6). Interestcontroversy. At the outset, however, we should emphasise ingly, Poland, which also has a culture of vodka drinking, that we agree with Bobak and Marmot (1) that this question experienced a short lived decline in cardiovascular disease can only be finally resolved when evidence from well-conin the early 1980s during martial law when access to alcohol ducted epidemiological studies in Russia becomes available. was restricted, coinciding with an interruption in the previously increasing death rate from cirrhosis (7).

The Reliability of Personal Alcohol Consumption Estimates in a Working Population

Health and safety problems related to alcohol consumption represent a major concern in many businesses and consequently pre-employment questionnaires and workplace health promotion packages frequently contain questions seeking basic estimates of alcohol consumption. Although individuals with very heavy drinking patterns often attract much attention, on a population basis most morbidity is likely to arise from drinkers consuming above the recommended limits but not sufficient to result in gross occupational or social effects. This study reviews the research on the reliability of questionnaire techniques used to quantify alcohol consumption and compares the most valid retrospective interview based estimate of consumption, the time line follow-back (TLFB), with a prospective daily diary (DD) method in a working population. The DD method was acceptable and produced significantly higher estimates of consumption and for 'normal' subjects gave consistent estimates of +/- 10 units/week over several weeks. Appropriate questionnaire design is discussed and the use of a DD method in health promotion activities recommended.

Estimating Alcohol Consumption: Measurement and Policy Issues Related to Legal and Illegal Sources of Alcohol

There are several challenges to obtaining an accurate estimate of alcohol consumption and per capita consumption in a jurisdiction. There are difficulties in estimating the extent of illegal production and fraudulent transportation activities. In some jurisdictions there is extensive home production, which is difficult to estimate. There are challenges to estimating the amount of alcohol that is brought into a country or is taken out, primarily by individuals. This includes “slippage” between official and unofficial production and consumption. As drinking preferences change and stronger or weaker brands are marketed, the conventional conversion factors from beverage to absolute alcohol volumes need to be adjusted. Finally, in light of extensive international travel there are challenges in determining the appropriate denominators in calculating some rates of consumption or damage. The eight papers in this special issue of Contemporary Drug Problems address a number ofthe challenges related to measurement issues and to estimating “unrecorded” consumption, and they note the underlying social and political dynamics and the applications of estimates. They also point to the need forfurther research on the reasons for gaps between different estimation methods, consequences ofhigh rates ofsmuggling or use ofillegal alcohol, and impacts ofvarious interventions to curtail illegal consumption.

Are Estimates of the Concentration of Alcohol Consumption Affected by Undercoverage? Evidence from Five Pooled U.S. Surveys

Conclusions concerning the properties of alcohol consumption distributions are often based on surveys that underestimate the amount consumed by sampled populations. Relationships between underreporting of alcohol consumption and the concentration of heavy drinking could present problems for several important research findings. Using data from five US telephone surveys, we compared state-level survey estimates of alcohol consumption and concentration with published estimates based on sales and taxes. Demographic factors predicting undercoverage were assessed in a multilevel analysis. Concentration was not significantly related to coverage, but it was related to rates of any drinking. State-level undercoverage was predicted by the proportion of males, younger age, political conservatism, Hispanic ethnicity, and the proportion of ethanol sold as spirits. Additional research is needed to determine the consequences ofthe relationships between these factors and undercoverage, but national estimates ofconsumption distribution properties are unlikely to be affected greatly by low coverage rates.

Estimates of total alcohol consumption in Russia, 1980–1994

It is important to estimate real alcohol consumption in Russia in the past 15 years because large quantities, and in recent years the bulk, of consumed alcohol evades state registration. In this study, trends in total consumption are estimated indirectly using an indicator of alcohol-related harm derived from forensic reports on accidental and violent deaths (Nemtsov, A.V., 1998. Anti-alcohol campaign, consequences, and actual alcohol consumption in Moscow, Addiction, in press). Using blood alcohol coefficients (BAC), the regression coefficients are estimated using the ratio of BAC-positive and BAC-negative accidental and violent deaths in 1983–1986 in connection with the Moscow anti-alcohol campaign; the coefficients are then used to estimate consumption as a total sum of legal sales of alcoholic beverages and illegal spirits made from sugar. Data were obtained of violent BAC-positive and BAC-negative deaths in 17–25 oblasts of Russia in 1981–1994. The derived estimates indicate that in 1984 consumption exceeded 14 l per capita, per annum (10.5 registered+4.2 unregistered); that consumption fell to 10.8 l in 1986 (during the anti-alcohol campaign), and that it then began to rise owing to a sharp increase in estimated unregistered alcohol consumption-climbing to 13.6 l (5.0+8.6) in 1993, and followed by a slight decline to 13.3 in 1994. These estimates are broadly consistent with estimates that have been made using unrelated methods, thus allowing some confidence in the overall picture obtained. Russia probably remains one of the heaviest-drinking countries in Europe. The reasons why indicators of alcohol-related harm in the mid-1990s exceed those recorded before the anti-alcohol campaign remain to be clarified.

Can surveys measure alcohol consumption? Advances in survey methodology in the KALK project1 2

This articles explores the merits and problems of survey research in analysing national alcohol consumption. Whereas sales and taxation records usually provide the macro‐level data for estimating alcohol consumption in a country as a whole, this data say very little about both the distribution of alcohol consumption with smaller social groups or the consumption of alcohol that is not registered by sales or taxes (such as the consumption of alcohol abroad or contraband liquor). However, survey research into alcohol consumption faces significant challenges: typically, alcohol consumption reported in surveys accounts for about 40–60% of overall consumption. The article evaluates, assesses and compares different survey and questionaire methods aimed at minimizing the problem of underreporting of alcohol consumption. These methods combine both conventional positivist as well as more interpretative approaches.

The causal relationship between socioeconomic factors and alcohol consumption: a Granger-causality time series analysis, 1950-1993.

This article examines the relationships between social, demographic and economic factors that influence alcohol consumption. The effects of each factor on alcohol consumption and on each other is examined using a Granger-causality time series framework. Specifically, causal determinations are made between per capita alcohol consumption, social and demographic variables consisting of the age structure of the male population, female labor force participation rates, marital instability and educational accomplishment, and the economic variables consisting of the real price of alcohol, median household income and income inequality. Causal equations are determined from identified bivariate relationships and combined into one structural equation predicting alcohol consumption. The findings indicate that the economic variables are Granger-caused by the social or demographic changes over the past four decades and, therefore, have little direct influence on alcohol consumption. The structural equation predicts over 95% of the variance in alcohol consumption. This work indicates that economic factors have little direct influence on alcohol consumption but, rather, reflect or are a conduit for changes in social and demographic variables. Excluding economic variables as predictors of per capita ethanol consumption results in little substantive change when estimating alcohol consumption.

Estimated alcohol consumption in the 1995 National Health Survey: Some methodological issues

ObjectiveThis paper critically examines the methodology used to ascertain alcohol consumption in the 1995 Australian Bureau of Statistics National Health Survey (NHS). MethodThe 1995 NHS was the second in a series of regular, five-yearly population surveys designed to obtain national benchmark information on a range of health-related issues and enable the monitoring of trends over time. The first survey was conducted in 1989-90.In the 1995 NHS, respondents were asked about the quantity of each of seven types of alcohol consumed on up to three days of the week before the interview day. In the 1989-90 NHS, however, respondents were asked about alcohol consumption on each of the seven days before the interview. This paper uses Unit Record Data from the 1989-90 National Health Survey to investigate the methodology used in 1995. ResultsIt is shown that the estimates of alcohol consumption obtained using the 1995 methodology are highly dependent on the day of the week on which the interviews were conducted. ConclusionIt is recommended that the 1995 methodology not be used in future NHS surveys. The 1989-90 methodology of seven-day retrospective diaries would seem a better choice for future National Health Surveys.