Excessive Drinkers Research Articles

Alcohol intake and the risk of intracerebral hemorrhage in the elderly: The MUCH-Italy.

To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding. We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH. We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95% CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95% CI, 0.77-1.32). In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.

The development of Drink Less: an alcohol reduction smartphone app for excessive drinkers.

Excessive alcohol consumption poses a serious problem for public health. Digital behavior change interventions have the potential to help users reduce their drinking. In accordance with Open Science principles, this paper describes the development of a smartphone app to help individuals who drink excessively to reduce their alcohol consumption. Following the UK Medical Research Council's guidance and the Multiphase Optimization Strategy, development consisted of two phases: (i) selection of intervention components and (ii) design and development work to implement the chosen components into modules to be evaluated further for inclusion in the app. Phase 1 involved a scoping literature review, expert consensus study and content analysis of existing alcohol apps. Findings were integrated within a broad model of behavior change (Capability, Opportunity, Motivation-Behavior). Phase 2 involved a highly iterative process and used the "Person-Based" approach to promote engagement. From Phase 1, five intervention components were selected: (i) Normative Feedback, (ii) Cognitive Bias Re-training, (iii) Self-monitoring and Feedback, (iv) Action Planning, and (v) Identity Change. Phase 2 indicated that each of these components presented different challenges for implementation as app modules; all required multiple iterations and design changes to arrive at versions that would be suitable for inclusion in a subsequent evaluation study. The development of the Drink Less app involved a thorough process of component identification with a scoping literature review, expert consensus, and review of other apps. Translation of the components into app modules required a highly iterative process involving user testing and design modification.

Trajectories of alcohol consumption in U.S. military veterans: Results from the National Health and Resilience in Veterans Study.

While alcohol use disorder is prevalent in U.S. veterans, little is known about the nature and determinants of predominant trajectories of alcohol consumption in this population. The objective of the current study was to identify predominant trajectories of alcohol consumption over a 4-year period, and baseline determinants of these trajectories in veterans. Data were analyzed from the National Health and Resilience in Veteran Study, which surveyed a nationally representative sample of 3,157 veterans (Wave 1). Assessments (Waves 2 and 3) were conducted every 2 years thereafter. Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test-Consumption, a brief alcohol screen for identifying problematic drinking based on alcohol consumption. Wave 1 sociodemographic, military, health, and psychosocial variables were examined as possible determinants of trajectories of alcohol consumption. Latent growth mixture modeling revealed that a four-class model best fit the data: rare drinkers (65.3%), moderate drinkers (30.2%), excessive drinkers (2.6%), and recovering drinkers (1.9%). Lifetime major depressive disorder (MDD) was linked to an excessive drinking trajectory, while fewer medical conditions and lower social support were linked to a moderate drinking trajectory. Having a secure attachment style and greater social support, and absence of lifetime MDD was linked to recovery from excessive drinking. Four predominant trajectories of alcohol consumption were identified. Targeting MDD and related interpersonal factors such as attachment style and social support in population-based prevention and treatment initiatives may help prevent, mitigate, and promote recovery from excessive alcohol consumption in veterans. (Am J Addict 2018;XX:1-8).

A smartphone app to reduce excessive alcohol consumption: Identifying the effectiveness of intervention components in a factorial randomised control trial

Our aim was to evaluate intervention components of an alcohol reduction app: Drink Less. Excessive drinkers (AUDIT> =8) were recruited to test enhanced versus minimal (reduced functionality) versions of five app modules in a 25 factorial trial. Modules were: Self-monitoring and Feedback, Action Planning, Identity Change, Normative Feedback, and Cognitive Bias Re-training. Outcome measures were: change in weekly alcohol consumption (primary); full AUDIT score, app usage, app usability (secondary). Main effects and two-way interactions were assessed by ANOVA using intention-to-treat. A total of 672 study participants were included. There were no significant main effects of the intervention modules on change in weekly alcohol consumption or AUDIT score. There were two-way interactions between enhanced Normative Feedback and Cognitive Bias Re-training on weekly alcohol consumption (F = 4.68, p = 0.03) and between enhanced Self-monitoring and Feedback and Action Planning on AUDIT score (F = 5.82, p = 0.02). Enhanced Self-monitoring and Feedback was used significantly more often and rated significantly more positively for helpfulness, satisfaction and recommendation to others than the minimal version. To conclude, in an evaluation of the Drink Less smartphone application, the combination of enhanced Normative Feedback and Cognitive Bias Re-training and enhanced Self-monitoring and Feedback and Action Planning yielded improvements in alcohol-related outcomes after 4-weeks.

Consumption of alcohol and blood pressure: Results of the ELSA-Brasil study.

BackgroundPrevention and reduction of excessive use of alcohol represents damages to society in general. In turn, arterial hypertension is the main attributable risk factor premature life lost years and disability.ObjectiveTo investigate the relationship between alcohol consumption and high blood pressure in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).MethodologyA baseline data of total of 7,655 participants volunteers between 35 and 74 years of age, of both genders, in six educational and research institutions of three different regions of the country were interviewed between 2008–2010. Socioeconomic, haemodynamic, anthropometric and health data were collected in the research centers of ELSA-Brasil. The presence of high blood pressure was identified when the systolic blood pressure was ≥140 mm Hg and/or the diastolic was ≥90 mm Hg. Alcohol consumption was estimated and categorized regarding consumption and pattern of ingestion. The Student’s t-test, chi-squared and logistic regression tests were used for analysis, including potential co-variables of the model, and a 5% significance level was adopted.ResultsA dose-response relation was observed for the consumption of alcohol (g/week) in systolic blood pressure and diastolic blood pressure. Alcohol consumption was associated with high blood pressure in men who reported moderate (OR = 1.69; 95%CI 1.35–2.11) and excessive (OR = 2.70; 95%CI 2.04–3.59) consumption. Women have nearly three times more chance of presenting elevated blood pressure when presenting excessive consumption (OR = 2.86, 95%CI 1.77–4.63), and binge drinkers who drink more than 2 to 3 times a month have approximately 70% more chance of presenting with elevated blood pressure, after adjusting for consumption of drinks with meals.ConclusionThe consumption of alcohol beverages increases the odds of elevated blood pressure, especially among excessive drinkers. Therefore alcohol consumption needs a more robust regulation in view of its impact on population health.

Engagement features judged by excessive drinkers as most important to include in smartphone applications for alcohol reduction: A mixed-methods study

ObjectiveEngagement with smartphone applications (apps) for alcohol reduction is necessary for their effectiveness. This study explored (1) the features that are ranked as most important for engagement by excessive drinkers and (2) why particular features are judged to be more important for engagement than others.MethodsTwo studies were conducted in parallel. The first was a focus group study with adult excessive drinkers, interested in reducing alcohol consumption using an app (ngroups = 3). Participants individually ranked their top 10 features from a pre-specified list and subsequently discussed their rankings. The second was an online study with a new sample (n = 132). Rankings were analysed using the intraclass correlation coefficient (ICC) to assess the level of agreement between raters for each study. Qualitative data were analysed using inductive thematic analysis.ResultsThere was low agreement between participants in their rankings, both in the focus groups (ICC = 0.15, 95% confidence interval (CI) = 0.03–0.38) and the online sample (ICC = 0.11, 95% CI = 0.06–0.23). ‘Personalisation’, ‘control features’ and ‘interactive features’ were most highly ranked in the focus groups. These were expected to elicit a sense of benefit and usefulness, adaptability, provide motivational support or spark users’ interest. Results from the online study partly corroborated these findings.ConclusionThere was little agreement between participants, but on average, the features judged to be most important for inclusion in smartphone apps for alcohol reduction were personalisation, interactive features and control features. Tailoring on users’ underlying psychological needs may promote engagement with alcohol reduction apps.

Treatment Outcome Evaluation in Therapeutic Communities in the Czech Republic: Alcohol Consumption and Other Results One Year After Discharge

ABSTRACTThe aim of this article is to investigate changes in alcohol consumption among predominantly methamphetamine users (N = 176) in four residential therapeutic communities for addiction treatment in the Czech Republic. This is a quantitative prospective, naturalistic, cohort study that compares drinking patterns, illicit drug use, injecting, and crime prior to treatment and one year after discharge. The response rate at follow-up was 77.8% (N = 137). At the one-year follow-up the number of excessive drinkers was significantly reduced from 51.1% to 31.4%. The rate of abstinence from alcohol (33.6%) and moderate drinking (35%) at follow-up was not significantly different from the pretreatment level. At the one-year follow-up, 33.6% were consuming no alcohol, whereas 88.3% reported abstinence from methamphetamine. The authors conclude that one year after discharge from the treatment most clients were abstinent from illicit drugs. However, the number of clients who were abstinent from alcohol remains low. The implication for treatment and further research is discussed.

Trends in lifestyle among three cohorts of adults aged 55-64 years in 1992/1993, 2002/2003 and 2012/2013.

Unhealthy lifestyle factors, such as obesity, smoking, excessive alcohol consumption and physical inactivity, are associated with increased morbidity and mortality risk, even in older age. We investigated trends in lifestyle among three cohorts of adults aged 55-64 years from the Netherlands. Data from the Longitudinal Aging Study Amsterdam were used. This study consisted of three randomly selected samples of men and women. Lifestyle data were collected in 1992/1993 (cohort 1, n = 988), in 2002/2003 (cohort 2, n = 1002) and in 2012/2013 (cohort 3, n = 1023). Trends in lifestyle across cohorts were tested using multivariable regression analyses. Complete lifestyle data were available for 834 participants from cohort 1, 861 from cohort 2 and 845 from cohort 3. Among men, but not in women, mean BMI and prevalence of obesity increased over time. The mean minutes per day spent being physically active decreased among both men and women, from 130 ± 107 and 230 ± 122 (1992/1993) to 114 ± 100 and 192 ± 109 (2002/2003), and 126 ± 98 and 187 ± 112 (2012/2013), respectively. The percentage of men and women defined as excessive drinkers (>7 alcoholic consumptions per week) increased from 54.9%, 62.3% to 65.4% (men) and 22.7%, 36.1% to 37.4% (women), in 1992/1993, 2002/2003 and 2012/2013, respectively. The percentage of non-smoking men and women increased over time. The lifestyle of Dutch adults aged 55-64 years was less healthy in 2012/2013 compared with 2002/2003 and 1992/1993. Political attention regarding healthy ageing should target the prevention of overweight, physical inactivity and excessive alcohol consumption in middle-aged persons.

Risk factors and survival analysis for synchronous esophageal carcinoma in patients with hypopharyngeal carcinoma

Objective: To investigate the risk factors and survival status of hypopharyngeal carcinoma with synchronous second primary carcinoma of the esophagus. Methods: One hundred and sixty patients with newly diagnosed hypopharyngeal carcinoma from January 2009 to December 2012 were retrospectively reviewed. The clinical data, tumor-related information and follow-up results were collected and analyzed. Results: Forty-three synchronous esophageal carcinomas (27%) were detected in 160 patients with hypopharyngeal carcinoma, and most patients (72%) were at an early stage. On univariate analysis, the median age of less than 55 years old (χ(2)=4.525, P=0.033), excessive alcohol consumption (χ(2)=6.942, P=0.008) and invasion site more than 3 anatomical regions (χ(2)=21.503, P=0.000) had a significant correlation with the occurrence of synchronous esophageal carcinomas. Multivariate analysis showed that excessive alcohol consumption (OR=4.787, P=0.029) and invasion site more than 3 anatomical regions (OR=14.391, P=0.000) were independent risk factors. The median survival time was 26 months in 43 patients with synchronous esophageal carcinomas, which was significantly lower than that (58 months) in patients without secondary primary esophageal carcinomas (χ(2)=11.981, P=0.001). Conclusions: There is a high incidence of synchronous esophageal carcinoma in hypopharyngeal carcinoma patients, affecting the prognosis of hypopharyngeal carcinoma. Surveillance for esophageal carcinomas in patients with hypopharyngeal carcinoma, especially in excessive alcohol drinkers, is warranted.

Is Support of Censoring Controversial Media Content for the Good of Others? Sexual Strategies and Support of Censoring Pro-Alcohol Advertising.

At least in the United States, there are widespread concerns with advertising that encourages alcohol consumption, and previous research explains those concerns as aiming to protect others from the harm of excessive alcohol use.1 Drawing on sexual strategies theory, we hypothesized that support of censoring pro-alcohol advertising is ultimately self-benefiting regardless of its altruistic effect at a proximate level. Excessive drinking positively correlates with having casual sex, and casual sex threatens monogamy, one of the major means with which people adopting a long-term sexual strategy increase their inclusive fitness. Then, one way for long-term strategists to protect monogamy, and thus their reproductive interest is to support censoring pro-alcohol advertising, thereby preventing others from becoming excessive drinkers (and consequently having casual sex) under media influence. Supporting this hypothesis, three studies consistently showed that restricted sociosexuality positively correlated with support of censoring pro-alcohol advertising before and after various value-, ideological-, and moral-foundation variables were controlled for. Also as predicted, Study 3 revealed a significant indirect effect of sociosexuality on censorship support through perceived media influence on others but not through perceived media influence on self. These findings further supported a self-interest analysis of issue opinions, extended third-person-effect research on support of censoring pro-alcohol advertising, and suggested a novel approach to analyzing media censorship support.

Maternal hair testing to disclose self-misreporting in drinking and smoking behavior during pregnancy.

This study aimed to objectively verify smoking and drinking behavior during pregnancy and to disclose self-misreporting through maternal hair analysis. A total of 153 women attending a university hospital in Barcelona (Spain) were selected and interviewed after delivery, on their smoking and drinking habits during pregnancy. A 9-cm hair strand was collected and analyzed by liquid chromatography tandem mass spectrometry for the presence of nicotine (NIC) and ethyl glucuronide (EtG) as biomarkers of tobacco and alcohol consumption, respectively. Concentrations of EtG <7pg/mg hair and ≥30pg/mg hair in the 0-3-cm hair segment have been used to assess, respectively, total abstinence and chronic excessive consumption in the previous 3 months, with repetitive moderate drinking lying in the interval 7-30pg EtG per mg hair. Hair NIC less than 1ng/mg hair indicates non-exposure to tobacco smoke while hair NIC indicates daily active smoking. In the interview, 28.1% of women declared to have smoked occasionally during gestation, while only 2.6% stated to have consumed alcohol on more than one occasion during pregnancy. Hair testing of smoking biomarkers disclosed that 7.2% of women remained active smokers during the whole pregnancy (hair NIC: 3.21-56.98ng/mg hair), 16.3% were passive non-smokers or occasional smokers (hair NIC: 1.04-2.99ng/mg hair), while 76.5% were not exposed to any cigarette smoke (hair NIC<limit of quantification - 0.91ng/mg hair). Conversely, alcohol hair biomarkers showed that only 35.3% of women were totally abstinent during gestation (hair EtG: 3.89-6.73pg/mg hair), while 62.7% drank a non-negligible amount of alcohol during pregnancy (hair EtG: 7.06-26.57pg/mg hair), and 2% were chronic excessive drinkers (hair EtG: 35.33-47.52pg/mg hair). Maternal hair analysis has shown to be significantly more sensitive than interviews in revealing an alarming misreported prevalence of alcohol use during pregnancy. These findings stress the need to use objective measures to assess alcohol exposure and to consider the inclusion of targeted actions to reduce alcohol consumption in maternal-child health policies.

LncRNA AK054921 and AK128652 are potential serum biomarkers and predictors of patient survival with alcoholic cirrhosis.

Alcoholic liver disease (ALD) is one of the leading causes of chronic liver disease. Recent studies have demonstrated the roles of long noncoding RNAs (lncRNAs) in the pathogenesis of several disease processes. However, the roles of lncRNAs in patients with ALD remain unexplored. Global profiling for human lncRNAs from peripheral blood RNA was performed in a well‐characterized cohort of healthy controls (HC; n = 4), excessive drinkers (ED) without liver disease (n = 4), and those with alcoholic cirrhosis (AC) with different severities (n = 12). The expression of unique lncRNA signatures were validated in a separate cohort of HC (n = 17), ED (n = 19), AC (n = 48), and human liver tissues with ALD (n = 19). A detailed analysis of plasma lncRNAs in AC subjects with different severities compared with HC identified 244 commonly up‐regulated lncRNAs and 181 commonly down‐regulated lncRNAs. We further validated top 20 most differentially up‐ and down‐regulated lncRNAs in ED and AC compared with HC and also determined the expression of selected lncRNAs in human liver tissues with or without AC. Among those lncRNAs, AK128652 and AK054921 were two of the most abundantly expressed lncRNAs in normal human plasma and liver, and their levels were significantly elevated in AC. The prognostic significance of AK128652 and AK054921 was determined in 48 subjects with AC who were followed prospectively for 520 days. The expression of AK128652 and AK054921 was inversely associated with survival in patients with AC. Conclusion: lncRNAs AK054921 and AK128652 are potential biomarkers to predict the progression to ALD in individuals with excessive alcohol consumption and are predictors of survival in patients with AC. (Hepatology Communications 2017;1:513–523)

Quantity of alcohol drinking positively correlates with serum levels of endotoxin and markers of monocyte activation

It is unknown if LPS (lipopolysaccharides) and markers of immune activation, soluble CD14 (sCD14) and CD163 (sCD163) are associated with the quantity of alcohol consumption. 148 subjects were enrolled (97 excessive drinkers (ED) and 51 controls). Time Line Follow-Back questionnaire was used to quantify the amount of alcohol consumed. Serum LPS, sCD14, and sCD163 were measured. Peripheral blood mononuclear cells (PBMCs) were also isolated. Compared to controls, ED had higher total drinks in the past 30 days, higher levels of LPS, sCD14 and sCD163. The levels of serum LPS, sCD14, and sCD163 were higher among ED with recent alcohol consumption (last drink <10 days before enrollment) compared to those without recent drinking. Similar bacterial genome copy numbers were detected in control and ED groups. We found that ethanol primed PBMCs for LPS-induced inflammatory responses. A positive correlation between serum LPS, sCD14, sCD163 and the quantity of alcohol drinking was observed after adjusting for covariates and that abstinence was associated with decline in the levels of LPS, sCD14 and sCd163. We found an increase in the levels of LPS and markers of monocyte activations in ED. Further studies are needed to determine whether these can be used as the biomarkers for excessive alcohol use.

Hepatitis C in a Mobile Low-Threshold Methadone Program.

Data on the epidemiology of hepatitis C among individuals who use drugs in low-threshold settings are lacking, although crucial to assess the burden of disease and aid in the design of treatment strategies. The aim of this study was to characterize the epidemiology and disease related to hepatitis C in a population attending a low-threshold methadone program. A cross-sectional study in the population attending the Mobile Low-Threshold Methadone Program in Lisbon, Portugal, was carried out. The survey included assessment of risk factors for infection with hepatitis C virus (HCV) and liver disease, HCV serology and RNA detection, HCV genotyping, and liver disease staging. A total of 825 participants were enrolled, 81.3% men, mean age 44.5 years. Injecting drug use (IDU) was reported by 58.4% - among these, 28.2% were people who inject drugs. Excessive drinking and HIV coinfection were reported by 33.4 and 15.9%, respectively. Among participants with active infection, 16.9% were followed up in hospital consultation. The overall seroprevalence for HCV was 67.6% (94.2% in IDU, 30.0% in non-IDU, 97.1% in people who inject drugs, and 75.6% in excessive drinkers). Among seropositives for HCV, active infection was present in 68.4%. Among individuals with active infection, the most common genotypes were 1a (45.3%) and 3a (28.7%), whereas 30% had severe liver fibrosis or cirrhosis. Age 45 years or older, HCV genotype 3, and coinfection with HIV were significant predictors of cirrhosis. This population has a high burden of hepatitis C and several characteristics that favor dissemination of infection. Healthcare strategies are urgently needed to address hepatitis C in this setting.

Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data

SummaryBackgroundAlcohol-related mortality and morbidity are high in socioeconomically disadvantaged populations compared with individuals from advantaged areas. It is unclear if this increased harm reflects differences in alcohol consumption between these socioeconomic groups, reverse causation (ie, downward social selection for high-risk drinkers), or a greater risk of harm in individuals of low socioeconomic status compared with those of higher status after similar consumption. We aimed to investigate whether the harmful effects of alcohol differ by socioeconomic status, accounting for alcohol consumption and other health-related factors.MethodsThe Scottish Health Surveys are record-linked cross-sectional surveys representative of the adult population of Scotland. We obtained baseline demographics and data for alcohol consumption (units per week and binge drinking) from Scottish Health Surveys done in 1995, 1998, 2003, 2008, 2009, 2010, 2011, and 2012. We matched these data to records for deaths, admissions, and prescriptions. The primary outcome was alcohol-attributable admission or death. The relation between alcohol-attributable harm and socioeconomic status was investigated for four measures (education level, social class, household income, and area-based deprivation) using Cox proportional hazards models. The potential for alcohol consumption and other risk factors (including smoking and body-mass index [BMI]) mediating social patterning was explored in separate regression models. Reverse causation was tested by comparing change in area deprivation over time.Findings50 236 participants (21 777 men and 28 459 women) were included in the analytical sample, with 429 986 person-years of follow-up. Low socioeconomic status was associated consistently with strikingly raised alcohol-attributable harms, including after adjustment for weekly consumption, binge drinking, BMI, and smoking. Evidence was noted of effect modification; for example, relative to light drinkers living in advantaged areas, the risk of alcohol-attributable admission or death for excessive drinkers was increased (hazard ratio 6·12, 95% CI 4·45–8·41 in advantaged areas; and 10·22, 7·73–13·53 in deprived areas). We found little support for reverse causation.InterpretationDisadvantaged social groups have greater alcohol-attributable harms compared with individuals from advantaged areas for given levels of alcohol consumption, even after accounting for different drinking patterns, obesity, and smoking status at the individual level.FundingMedical Research Council, NHS Research Scotland, Scottish Government Chief Scientist Office.

Changes in wine consumption are influenced most by health: results from a population survey of South Australians in 2013

Changes in wine consumption are influenced most by health: results from a population survey of South Australians in 2013 Creina S Stockley,1 Anne W Taylor,2 Alicia Montgomerie,2 Eleonora Dal Grande2 1The Australian Wine Research Institute, 2Population Research &amp; Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, SA, Australia Aims: Individuals change their wine consumption over their life course, and mean volume typically declines with increasing age. Research on the reasons individuals change their consumption has primarily focused on youth/the young, but not on older adults. This study&rsquo;s aim was to ascertain changes in wine consumption over a 12-month period in Australians at different ages and what influenced these changes.Methods: As part of the Spring 2013 South Australian Health Omnibus Survey, persons (n=2,908) aged 15 years and over who had most recently had a birthday in the selected household were interviewed in their home by trained interviewers. Of these, 48.9% were males and their mean age was 46.3 (standard deviation 18.9) years.Results: Regular, light&ndash;moderate wine consumers were generally stable in the amount of wine they drank over a 12 month period, particularly those aged 55 years and older. They generally cited health (48.0%) as a reason for decreasing their wine consumption. Those who usually consumed three to four standard drinks on days they drank wine were also more likely to give health (54.3%) as a reason for decreasing their consumption, as were heavy wine consumers (57.7%). The 25- to 34-year age-group was more likely to have decreased (36% vs 26%) their wine consumption in the last 12 months. The 15- to 24-year age-group was most likely to have increased (28% vs 10%) their wine consumption in the last 12 months. Health was most cited as the reason for decreasing this consumption, while family and friends were most cited as the reason for increasing this consumption.Conclusion: In this representative population of South Australians, the wine consumption of previously identified at-risk groups for both short- and long-term harms, ie, youth and older adults, as well as excessive and heavy drinkers, was most influenced by health, family and friends, and employment. Keywords: alcohol, wine, consumption, changes

Should GPs prescribe vitamin B compound strong tablets to alcoholics?

Many medicine management committees are advising their GPs not to prescribe vitamin B compound strong tablets to alcoholics as they believe it is not recommended by the National Institute for Health and Care Excellence (NICE). The NICE guidelines for the management of alcohol problems that they quote do not discuss the use of vitamin B supplements other than thiamine (vitamin B1).1,2 This is not surprising because the clinical guideline is advising about the prevention and treatment of Wernicke–Korsakoff syndrome (WKS) in which just thiamine and not other B vitamin deficiency is implicated. There are many other diseases that can be caused by other B vitamin deficiency. B vitamins are a group of chemically different water-soluble co-factors, co-enzymes, and precursors that are important for many metabolic processes. A range of B vitamin deficiencies have been reported in chronic excessive and regular alcohol drinkers, and …

Alcohol’s harm from strangers drinking in Lithuania

ABSTRACTThe main aim of this study was to evaluate the prevalence of alcohol’s harm from strangers (AHS) drinking and its association with demographic and alcohol use variables. Method: A representative national survey was conducted using face-to-face interviews with Lithuanian residents aged 18 years and over (n = 1000) in 2014. Descriptive statistics and logistic regression were applied. Findings: The most frequent forms were the least severe types of harm: “disturbance of rest at night” (40.7%) and “afraid to meet drunk people on the street” (38.8%). Less frequent form was the most severe harm — “physically injured” (4.3%). The possibility to experience AHS according to the regression analyses is 0.453 times higher for women, 1.373 for urban residents, and 2.205 for excessive drinkers in comparison to moderate drinkers. The possibility of AHS is 11.452 times higher for those who drink “several times a month or more often,” 6.363 “at least once per month,” and 3.473 “less than once per month” in comparison with abstainers. Conclusions: Being women, living in urban areas, and frequent and excessive alcohol use all increase AHS risk. Stricter alcohol regulation and targeted intervention strategies are needed to prevent harmful alcohol use and AHS.

Endothelial function is impaired in relation to alcohol intake even in the case of light alcohol consumption in Asian men; Flow-mediated Dilation Japan (FMD-J) Study

BackgroundHeavy drinking should be a predictor of endothelial dysfunction. However, there is little information on the effects of light to moderate alcohol consumption on endothelial function. The purpose of this study was to estimate the effects of dose-dependent alcohol consumption on endothelial function. MethodsWe measured flow-mediated vasodilation (FMD) in 2734 men aged 21–81years who provided information on alcohol intake at 3 general hospitals. The subjects were divided into 5 groups; non-drinkers (0g/week), light drinkers (>0 to 140g/week), moderate drinkers (>140 to 280g/week), heavy drinkers (>280 to 420g/week), and excessive heavy drinkers (>420g/week). ResultsFMD showed a gradual decrease in accordance with alcohol consumption in the entire study population (non-drinkers, 6.6±3.4%; light drinkers, 6.2±3.0%; moderate drinkers, 6.0±3.0%; heavy drinkers, 5.5±2.9%; excessive heavy drinkers, 5.3±3.0%; P<0.001). There was a significant difference in FMD between the light alcohol drinker group and the non-drinker group (P=0.015). After adjustment for other risk factors, the odds of having FMD in the lowest quartile was found to be significantly increased in the 4 drinker groups than in the non-drinker group: light (OR, 1.38; 95% CI, 1.10 to 1.75), moderate (OR, 1.36; 95% CI, 1.01 to 1.82), heavy (OR, 2.05; 95% CI, 1.46 to 2.87), excessive (OR, 2.04; 95% CI, 1.43 to 2.89). ConclusionThese findings suggest that FMD is impaired in relation to alcohol consumption and that FMD is significantly smaller even in light alcohol drinkers than in non-drinkers. Alcohol intake per se may be harmful for vascular function.

Alcohol Electronic Screening and Brief Intervention: A Community Guide Systematic Review.

Excessive drinking is responsible for one in ten deaths among working-age adults in the U.S. annually. Alcohol screening and brief intervention is an effective but underutilized intervention for reducing excessive drinking among adults. Electronic screening and brief intervention (e-SBI) uses electronic devices to deliver key elements of alcohol screening and brief intervention, with the potential to expand population reach. Using Community Guide methods, a systematic review of the scientific literature on the effectiveness of e-SBI for reducing excessive alcohol consumption and related harms was conducted. The search covered studies published from 1967 to October 2011. A total of 31 studies with 36 study arms met quality criteria and were included in the review. Analyses were conducted in 2012. Twenty-four studies (28 study arms) provided results for excessive drinkers only and seven studies (eight study arms) reported results for all drinkers. Nearly all studies found that e-SBI reduced excessive alcohol consumption and related harms: nine study arms reported a median 23.9% reduction in binge-drinking intensity (maximum drinks/binge episode) and nine study arms reported a median 16.5% reduction in binge-drinking frequency. Reductions in drinking measures were sustained for up to 12 months. According to Community Guide rules of evidence, e-SBI is an effective method for reducing excessive alcohol consumption and related harms among intervention participants. Implementation of e-SBI could complement population-level strategies previously recommended by the Community Preventive Services Task Force for reducing excessive drinking (e.g., increasing alcohol taxes and regulating alcohol outlet density).