Frequency Of Heavy Episodic Drinking Research Articles

Is the 21st birthday a turning point for alcohol and cannabis use? A monthly study of young adults.

An important life-course event with respect to alcohol and cannabis use is turning 21 years of age, which may be associated with increases in use of these substances due to celebrations during the month and easier access to them on and following this birthday. We examined the trajectories of alcohol and cannabis use behaviors in the months leading up to, during, and following the 21st birthday month. We also examined whether the use trajectories vary by college status and baseline levels of use. We used data from 203 young adults recruited from the Greater Seattle region who turned 21 during the course of the study. Surveys were administered each month for 24 consecutive months. Measures included the typical number of drinks per week for the past month, the frequency of heavy episodic drinking, the number of cannabis use days, and any simultaneous alcohol and cannabis use. Multilevel spline models were run that estimated linear slopes over time at four intervals: (1) up to 1 month before the 21st birthday month; (2) from 1 month before to the month of the 21st birthday; (3) from the 21st birthday month to 1 month following; and (4) from 1 month following the 21st birthday month through all following months. Alcohol use, generally, and simultaneous alcohol and cannabis use showed sharp increases from the month before the 21st birthday month to the 21st birthday month and decreases following the 21st birthday month. For cannabis use, there were significant increases in the months leading up to the 21st birthday and no other significant changes during other time intervals. Patterns differed by baseline substance use and college status. Findings from the current study have implications for the timing and personalization of prevention and intervention efforts. Event-specific 21st birthday interventions may benefit from incorporating content targeting specific hazardous drinking behaviors in the month prior to the 21st birthday.

Evaluating the Sick Quitting Hypothesis for Frailty Status and Reducing Alcohol Use Among People With HIV in a Longitudinal Clinical Cohort Study.

"Sick quitting," a phenomenon describing reductions in alcohol consumption following poor health, may explain observations that alcohol appears protective for frailty risk. We examined associations between frailty and reductions in drinking frequency among people with HIV (PWH). At six Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) sites between January 2012 and August 2021, we assessed whether frailty, measured through validated modified frailty phenotype, precedes reductions in drinking frequency. We associated time-updated frailty with quitting and reducing frequency of any drinking and heavy episodic drinking (HED), adjusted for demographic and clinical characteristics in Cox models. Among 5,654 PWH reporting drinking, 60% reported >monthly drinking and 18% reported ≥monthly HED. Over an average of 5.4 years, frail PWH had greater probabilities of quitting (HR: 1.56, 95% confidence interval [95% CI] [1.13-2.15]) and reducing (HR: 1.35, 95% CI [1.13-1.62]) drinking frequency, as well as reducing HED frequency (HR: 1.58, 95% CI [1.20-2.09]) versus robust PWH. Sick quitting likely confounds the association between alcohol use and frailty risk, requiring investigation for control.

The Interaction of Cannabis Consumption with Heavy Episodic Drinking and Alcohol-Induced Blackouts in Relation to Cannabis Use Consequences Among Recent Undergraduate College Cannabis Users

Introduction: Risky alcohol use patterns, characterized by heavy episodic drinking (HED) and alcohol- induced blackout, are prevalent in college students. However, it is not clear if experiencing HED and blackout among college-attending cannabis users heightens risk for adverse cannabis use consequences. The purpose of this study was to examine whether heavy episodic drinking and blackout episodes moderate the relationship between cannabis consumption and cannabis use consequences among college students. Methods: Undergraduate college students (n = 4331) were recruited from a Midwest University in 2021. This analysis used a subset of data from past 6-month cannabis users (n= 772; 17.8% of the full sample). Among cannabis users, 64.5% identified as female and 87.8% were White with an average age of 19.99 (SD=2.88). A linear regression was conducted with two two-way interactions of cannabis consumption and HED frequency as well as cannabis consumption and alcohol-induced blackout episodes. Results: Results showed a statistically significant positive association between cannabis consumption and cannabis use consequences (B=0.73, p<.001), adjusting for the other variables in the model. Blackout, but not HED, was a significant moderator (B=0.19, p=.003). Discussion: The findings of this study indicate that blackout experiences amplify the relationship between cannabis use and cannabis-related consequences among college students. This underscores that blackouts not only signal a risk of problematic drinking but also exacerbate the association between cannabis use and its negative consequences. Conclusion: Findings may inform college campus interventions targeting cannabis and alcohol concurrent-users who experience alcohol-induced blackouts to reduce their additional risk for cannabis-related consequences.

Sexual alcohol expectancies moderate the relation between alcohol use and sexual behavior among men who have sex with men

BackgroundHIV transmission remains a significant health concern for men who have sex with men (MSM) in the United States. Heavy episodic drinking (HED) is related to increased rates of condomless anal intercourse (CAI) among MSM, though evidence suggests that this association may vary by individual difference factors. The present secondary analysis tested whether sexual alcohol expectancies (SAEs) moderate the associations between frequency of HED and anal intercourse (AI) with and without a condom among moderate-to-heavy drinking HIV- MSM. MethodsTwo hundred and forty-eight moderate-to-heavy drinking MSM completed self-report questionnaires including the Sexual Behavior Questionnaire, the Modified Daily Drinking Questionnaire, and the Sexual Alcohol Expectancies Questionnaire. ResultsNegative binomial regressions indicated that SAEs moderated the association between frequency of HED and AI with a condom, but not between the frequency of HED and condomless AI (CAI). ConclusionsThese results suggest that stronger SAEs play a role in alcohol-related sexual behavior among MSM, but do not provide evidence that SAEs are associated with increased risk for HIV transmission through CAI.

Associations between physical activity, sedentary behaviour, and alcohol consumption among UK adults: Findings from the Health Behaviours during the COVID-19 pandemic (HEBECO) study.

The COVID-19 pandemic and attendant lockdowns have had a substantial negative effect on alcohol consumption and physical activity globally. Pre-pandemic evidence in the adult population suggests that higher levels of physical activity were associated with higher levels of drinking, but it is unclear how the pandemic may have affected this. Therefore, this study aims to assess the association between alcohol consumption and physical activity in a UK cohort established during the COVID-19 pandemic. Analyses utilized data from the Health Behaviours during the COVID-19 pandemic (HEBECO) study involving 2,057 UK adults (≥18 years). Participants completed self-report measures of alcohol consumption [frequency, quantity, frequency of heavy episodic drinking (HED) and AUDIT-C score] and physical activity [moderate-vigorous physical activity (MVPA), frequency of muscle strengthening activity (MSA) and sedentary behaviour] between November 2020 and January 2021. Ordinal logistic regression models were conducted, adjusting for sociodemographic factors. Fifteen percent of the sample reported abstinence from drinking. Overall, 23.4% of participants drank ≥4 times/week, 13.9% drank more than 6 units/single drinking occasion (HED), 7.5% reported HED daily/almost daily and 4.2% scored ≥11 on AUDIT-C. MSA 3 days/week compared with no MSA was significantly associated with higher odds of alcohol frequency [OR (95 CI%) = 1.41 (1.04-1.91)], quantity [OR (95 CI%) = 1.38 (1.02-1.87)], HED [OR (95 CI%) = 1.42 (1.05-1.94)] and possible dependence [OR (95 CI%) = 1.47 (1.05-2.06)]. The association of MVPA and sedentary behaviour with drinking measures was not significant (p>0.05). In contrast with previous research, MSA rather than aerobic physical activity was associated with increased alcohol consumption during the COVID-19 pandemic. It is conceivable that during lockdown while drinking was used as a coping strategy, limited opportunities for aerobic exercise made MSA a more convenient form of physical activity. To guide public health interventions, more research is required to examine the temporal relationship between different forms of physical activity and alcohol consumption.

Mediators of effects of a digital alcohol intervention for online help-seekers: Findings from an effectiveness trial

BackgroundDigital alcohol interventions have been shown to exert effects in helping individuals reduce their drinking. However, little is known about the mechanisms which mediate such effects. The objective of this study was to estimate natural direct and indirect effects of a digital alcohol intervention. MethodsThis secondary analysis of mediated effects used data from a randomised controlled trial which included individuals with unhealthy alcohol use with access to a mobile phone aged 18 years or older in Sweden. The comparator was basic alcohol and health information. The digital intervention was centrally designed around weekly monitoring of consumption followed by feedback and tools to support behaviour change. Mediated effects were estimated using measures from 1-, 2-, and 4-months post-randomisation. Primary outcomes were total weekly consumption (TWC) and frequency of heavy episodic drinking (HED). A counterfactual framework was used to estimate three hypothesised mediators: importance, knowledge of how to change (know-how), and confidence. ResultsBetween 25/04/2019 and 26/11/2020, 2129 participants were randomised. The intervention improved know-how and confidence, which in turn mediated the effects on TWC and HED at 2- and 4-months. Analyses with imputed data were not markedly different. ConclusionsA digital alcohol intervention was found to exert effects in reducing consumption by means of improving individuals’ knowledge of how to reduce their consumption and confidence in their ability to reduce. The use of face-valid single item measures is a study limitation notwithstanding observed findings, as is attrition and lack of blinding of participants.

Major depressive disorder as a moderator of the relationship between heavy-episodic drinking and anxiety symptoms

Background Major depressive disorder and heavy-episodic drinking are risk factors for the development of anxiety. However, the interactive effect between these constructs for predicting anxiety symptoms remains understudied. Aims This study sought to examine how major depressive disorder moderates the relationship between heavy-episodic drinking frequency and the development of anxiety symptoms in adolescence and emerging adulthood among a sample of justice-involved youth, with expectations that the salience of this relationship may differ based on life-course stage. Methods Several waves of the Pathways to Desistance study were analyzed. Poisson regression with robust standard errors was used to test the direct and interactive effects of major depressive disorder and heavy-episodic drinking frequency on anxiety symptoms at follow-up in adolescence and emerging adulthood separately. Results Results indicated that there was a significant negative interaction between major depressive disorder and heavy-episodic drinking frequency for predicting anxiety scores in both adolescence and emerging adulthood, though the results for adolescence were more robust. Conclusions These results suggest youth without major depressive disorder that engage in heavy-episodic drinking may be a priority population for treating anxiety issues, but that ceiling effects may limit the impact of the behavior on anxiety on youth with major depressive disorder.

Dose-response relationship between alcohol consumption and workplace absenteeism in Australia.

Workplace absenteeism is a burden in Australia. The estimated productivity losses due to alcohol were around $4.0 billion in 2017, with absenteeism driving 90% of these costs. We aim to determine the dose-response relationship between average daily alcohol consumption and heavy episodic drinking (HED) frequency and workplace absenteeism amongst Australian workers. We used the 2019 National Drug Strategy Household Survey of Australian employed workers aged ≥20 years to 69 years old. Respondents' average daily alcohol consumption was categorised into four: abstainers, light to moderate (1-20 g of alcohol/day), risky (>20-40 g of alcohol/day) and high-risk (>40 g of alcohol/day). HED was classified into four frequency measures (never, less than monthly, monthly, weekly). The outcome variables came from dichotomised measures of: (i) absence due to alcohol consumption; and (ii) broader sickness absence-absence due to illness or injury in the previous 3 months. Risky (adjusted odds ratio 4.74 [95% CI 2.93-7.64]) and high-risk drinking (adjusted odds ratio 6.61 [95% CI 4.10-10.68]) were linked to increased odds of alcohol-related absence. Higher HED frequency was significantly associated with alcohol-related and broader sickness absenteeism. No significant associations exist between regular alcohol consumption and broader sickness absence in fully adjusted models. Findings suggest that only HED is linked to broader sickness absence. However, there is a strong dose-response association between alcohol consumption and alcohol-related absences for both consumption measures amongst Australian workers. Population-level policies that reduce alcohol consumption to moderate level and less frequent HED might address workplace absenteeism.

Mind the gap! Gender differences in alcohol consumption among Swedish ninth graders 1989-2021.

To examine gender differences in drinking habits among Swedish ninth graders over the period 1989-2021. Annual school surveys with nationally representative samples of ninth-grade students in Sweden covering the period 1989-2021, total sample of 180,538 students. Drinking habits were measured with self-reports of frequency and quantity of use and frequency of heavy episodic drinking. Differences between genders were compared annually and differences were tested using logistic and ordinary least square regression models with cluster robust standard errors. Small gender differences in the prevalence of alcohol use during the first part of the study period were followed by an increasing gap over the past decade with girls being more likely to drink alcohol than boys. Boys consumed larger amounts of alcohol than girls during the first three decades of the studied period but no gender differences were found in later years. Binge drinking was more prevalent among boys during 1989 to 2000 but no systematic gender difference was found during the past 15 years. There used to be clear gender differences in drinking habits among ninth graders in Sweden with boys drinking more than girls. This gap has narrowed over the past three decades and among contemporary adolescents, no gender differences are found neither in binge drinking nor volume of drinking and the prevalence of drinking is even higher among girls.

Associations Between Heavy Episodic Drinking, Drinking While Gambling, and Risky Gambling

Introduction: Understanding how patterns of drinking are associated with risky gambling in Australia is needed to inform an effective approach to minimise harm. Methods: This cross-sectional questionnaire study reports on 2,704 subsampled participants who completed survey questions about their patterns of drinking. With logistic regressions, we examined whether frequency of heavy episodic drinking (HED) and alcohol use while gambling were associated with risky gambling while controlling for sociodemographic variables. Results: Occasional HED and monthly HED were associated with any gambling (versus no gambling), but frequent HED was not significantly associated with gambling. The opposite pattern was found when predicting risky gambling. Occasional HED (i.e. less than monthly) was not significantly associated, but a higher frequency of HED (at least weekly) was associated with a higher likelihood of risky gambling. Drinking alcohol while gambling was associated with risky gambling, over and above HED. The combination of HED and use of alcohol while gambling appeared to significantly increase the likelihood of risky gambling. Conclusions: The association of HED and alcohol use while gambling with risky gambling highlights the importance of preventing heavy alcohol use among gamblers. The links between these forms of drinking and risky gambling further suggests that individuals who engage in both activities are specifically prone to gambling harm. Policies should therefore discourage alcohol use while gambling for example by prohibiting serving alcohol at reduced prices or to gamblers who show signs of being affected by alcohol and informing individuals of the risks associated with alcohol use while gambling.

Country-level determinants of gender differences in major depression and alcohol use disorder

Abstract Background Major depressive disorder (MDD) and alcohol use disorder (AUD) are leading causes of disease burden in Europe, with MDD disproportionately affecting women and AUD being more prevalent among men. However, it is unclear how country-level political and socio-cultural characteristics contribute to gender differences in these conditions. Methods Data for 30,416 participants from 16 countries were obtained from the 2014 European Social Survey. Depressive symptoms were ascertained using the 8-item CES-D scale, and alcohol use was assessed with items on past-year alcohol use frequency and quantity, as well as frequency of heavy episodic drinking. Country-level data for attitudes to gender equality, needs-adjusted public social expenditure, and other covariates came from the 2012 International Social Survey Programme and the OECD. Modified Poisson and linear regression with log link examined additive and multiplicative interactions of country-level characteristics with gender for MDD, AUD, and their specific symptoms/dimensions. Results Public social expenditure was not associated with gender differences in MDD (CES-D>10), but with greater differences in the prevalence of the loneliness and sadness symptoms; support for gender equality was associated with smaller differences in loneliness (p < 0.05). For AUD, there was evidence of increased alcohol use frequency and quantity among women, and decreased frequency and quantity among men associated with support for gender equality, resulting in lower gender differences in predicted probabilities (from 23% to 5% across exposure levels; p < 0.001). Heavy episodic drinking was strongly positively associated with support for gender equality among women (p < 0.001), but not among men. Conclusions Country-level characteristics appear to exert differential impact on the prevalence of AUD and certain psychological symptoms of MDD among men and women in Europe. Pending replication, future research should examine underlying mechanisms. Key messages

Efficacy of screening and brief intervention for hazardous alcohol use in patients with mood disorders: A randomized clinical trial from a psychiatric out-patient clinic in India.

To determine the efficacy of individual-based, face-to-face screening and brief intervention (SBI) for hazardous alcohol use among treatment-seeking outpatients with mood disorders. It was a parallel-group, single-blind, randomized controlled trial of 84 participants who met the selection criteria for hazardous alcohol use, defined by alcohol use disorder identification test (AUDIT) score 8-19. Participants were randomly allocated to either SBI or general advice group. Both groups had received a standard care for mood disorders. The outcome was assessed after 3 months. The primary outcome was a change in the mean AUDIT score and the secondary outcomes were a change in frequency of heavy episodic drinking and stages of motivation. Majority (60%) had major depressive episodes. There was no significant difference in baseline demography and clinical variables between the groups. Both intention to treat and per-protocol analyses showed a small but significant effect of SBI on mean AUDIT score. Age, baseline AUDIT, and motivation did not moderate the effect. SBI was associated with a significant decrease in the frequency of heavy drinking and improvement in stages of motivation. SBI among patients with mood disorders had a small but significant effect on alcohol use.

Comparing Alcohol Use of Pre-COVID-Era and COVID-Era Cohorts of Mandated College Student Drinkers

Studies report mixed findings on the effect of the COVID-19 pandemic on college student alcohol consumption. However, the impact of pandemic restrictions on students referred to an intervention following a campus alcohol violation has not yet been studied. The current study examined alcohol use behaviors and perceived drinking norms among mandated student cohorts enrolled in the pre-COVID-19 era (fall 2019) and COVID-19 era (fall 2020). Participants (N = 228) completed measures focused on alcohol use and associated behaviors. Analytic models controlled for participant age and entailed negative binomial regressions for count outcomes and analyses of covariance for normally distributed continuous outcomes. COVID-era cohort students reported fewer drinks, pregaming occasions (i.e., drinking before a social occasion such as a sports event), and drinks while pregaming. Frequency of heavy episodic drinking (HED) remained consistent between groups; however, the peak number of drinks during HED was significantly lower in the COVID-era group, as were Alcohol Use Disorders Identification Test scores and alcohol-related consequences. Perceived peer norms for frequency and quantity were significantly higher in the COVID-era group. Regression confirmed a significant impact of norms on both frequency and quantity of alcohol use in both cohorts. Mandated college students during the COVID-19 pandemic consumed less alcohol, engaged in less pregaming, consumed fewer drinks while pregaming, and reported fewer negative alcohol consequences than a cohort from the previous year. In this campus case study of residential students who violate campus alcohol policy, COVID restrictions were associated with reduced overall quantity and risky practices.

Impacts on anxiety symptoms and alcohol consumption among people with disabilities and family caregivers in Latin America and the Caribbean during the first wave of the COVID-19 pandemic

ObjectivesThe aim of this study was to analyse associations between the COVID-19 pandemic, alcohol consumption and anxiety symptoms among people with self-reported disabilities and family caregivers in Latin America and the Caribbean. Study designCross-sectional study with secondary data analysis of the ‘Alcohol Use during the COVID-19 pandemic in Latin America and the Caribbean’, a Web-based cross-sectional survey conducted by the Pan American Health Organisation between March and June 2020. MethodsDescriptive analyses were conducted on the individual, social environment characteristics, COVID-19 infection, quarantine compliance, anxiety symptoms (measured by Generalized Anxiety Disorder Scale [GAD-7]) and change in frequency of heavy episodic drinking during the pandemic. Multinomial logistic regression was used to analyse associations among individuals with self-reported disabilities with anxiety symptoms and change in frequency of heavy episodic drinking during the pandemic. ResultsFamily caregivers were more compliant with COVID-19 restrictive measures than individuals with and without disabilities. The majority of participants with disabilities did not change their drinking patterns during the pandemic (64.3%); however, 28.1% reported increased consumption. People with disabilities were 2.17 times more likely to have severe anxiety symptoms than no anxiety symptoms between March and June 2020 in Latin America and the Caribbean. ConclusionsThis study observed a higher prevalence of the maintenance of heavy episodic drinking behaviour during the early phase of the pandemic in people with disabilities and family caregivers than in people without self-reported disabilities in Latin America and the Caribbean. People with disabilities showed more severe anxiety symptoms than those without disabilities, highlighting the need to develop inclusive health and quality-of-life policies to mitigate the effects of the pandemic in this vulnerable population.

The Declining Trend in Adolescent Drinking: Do Volume and Drinking Pattern Go Hand in Hand?

Traditionally, adolescent drinking cultures differed between Nordic and Mediterranean countries; the former being characterised by low volume and relatively frequent heavy episodic drinking (HED). Across these drinking cultures, we examined the associations between alcohol volume and HED with respect to (i) secular trends at the country level and (ii) individual-level associations over time. The data stem from the European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted among 15–16-year-olds in Finland, Iceland, Norway, Sweden, France and Italy, employing six cross-sectional surveys from 1999 to 2019 (n = 126,126). Both consumption volume and HED frequency decreased in all Nordic countries and displayed a curvilinear trend in France and Italy. In all countries, consumption volume and HED correlated highly over time at the country level. At the individual level, the correlation was positive but with a varying magnitude over time and between countries. In 1999/2003, the alcohol volume–HED correlation was significantly higher in the Nordic compared to the Mediterranean countries but became significantly weaker in Finland, Norway and Sweden and remained stable in France, Iceland and Italy during the period. In conclusion, while trends in consumption volume and drinking patterns went hand in hand at the aggregate level, the association at the individual level weakened over time in several Nordic countries, along with the substantial decline in adolescent drinking since 2000.

Declining Trend in Adolescent Alcohol Use: Does It Have Any Significance for Drinking Behaviour in Young Adulthood?

Since 2000, adolescent alcohol use has declined substantially in many high-income countries, particularly in Northern Europe. This study examined whether birth cohorts in Norway who experienced different levels of alcohol consumption in mid-adolescence differed in drinking behaviour when they reached young adulthood. We analysed data from annual population surveys in Norway (2012–2021). The analytic sample comprised data from respondents aged 20–29 years (N = 5266), and we applied four birth cohorts (i.e., 1983–1987, 1988–1992, 1993–1996 and 1997–2001). We applied age categories with two- and five-year intervals and tested whether drinking frequency, heavy episodic drinking (HED) and usual number of drinks per drinking occasion during the past 12 months differed by birth cohort in age-specific strata. Possible cohort differences within age groups were tested using Pearson’s Chi square. There were no statistically significant differences between cohorts with respect to drinking frequency or HED frequency. However, the youngest cohort had fewer drinks per occasion when in their early 20s compared to older cohorts. This study showed that birth cohorts who differed substantially in levels of alcohol consumption in mid-adolescence, only to a little extent differed in drinking behaviour in young adulthood.

Factors associated with an increase in alcohol consumption among users of online social networks in Russia in the early months of the COVID-19 pandemic

IntroductionThe various restrictions and physical distancing introduced inRussia in early months of COVID-19pandemic could have a particular impact on people who use alcohol and create new needs for prevention and treatment of associated disorders.ObjectivesThe study was aimed at assessing changes in alcohol consumption among users of online social networks in Russia.MethodsDuring June-September 2020,1518 adult users (18+) of the most popular social networks in Russia (Odnoklassniki, VKontakte,Facebook, Twitter), completed an anonymous online survey regarding alcohol use changes in the first months of COVID-19 pandemic. Binary logistic regression was used to estimate associations of increased alcohol consumption with socio-demographic and pandemic-related factors.Results35.4%of men and 25.6%of women increased their frequency of drinking; 24.9%of men and 17.7%of women increased their typical one-time volume of alcohol consumption,and 28.5% of men and 27.9% of women increased frequency of heavy episodic drinking in the early months of pandemic. After mutual adjustment of independent variables,age18-29 years(OR=1.710;95%CI 1.002-2.917), very strong restrictions of everyday life(3.127; 1.011-9.675)and severe negative consequences in relation to professional or financial situation due to spread ofSARS-CoV-2 (2.247; 1.131-4.465) were positively associated with increase in frequency of drinking. The odds of increase in frequency of heavy episodic drinking were more than twice higher(2.329; 1.001-5.428) among those who experienced severe negative consequences to their professional/financial situation.Higher typical frequency,larger one-time volume of alcohol use,and higher frequency of heavy episodic drinking before pandemic were positively associated with increase of alcohol consumption in early months of pandemic.ConclusionsTimely monitoring of changes in alcohol consumption during pandemic can allow prevention of alcohol-related disorders, including mental disorders, among users of online social networks.DisclosureNo significant relationships.

Changes in Use of Tobacco and Alcohol During the COVID-19 Pandemic

IntroductionThe survey assessed changes in tobacco, alcohol and other substance use during the COVID-19 pandemic.ObjectivesThe survey was carried out in Moscow and Nizhegorodskaya Oblast in December, 2020 - February, 2021 and included 650 medical organizations’ employees and 344 individuals with harmful alcohol or other substances use.MethodsThe instrument included ASSIST, Kessler-10 and IES-R tests modified for self-reporting about different pandemic periods.ResultsAmong medical workers 36.8% smoked last 12 months; during the COVID-19 pandemic 13% maintained usual cigarette smoking level, 2.4% increased smoking during incidence rises. 71.2% drank alcohol last 12 months; during incidence rises 20.4% drank as usual, 15.0% drank less frequently; 2.4% increased frequency of drinking, 1.8% volumes on drinking days, 1.3% frequency of heavy episodic drinking. In harmful substance use group 61.9% smoked last 12 months; during COVID-19 incidence rises 40% kept their usual level of smoking; 13.4% increased their smoking during the first and 8.7% during the second ‘wave’ of the pandemic. 90.1% drank alcohol last 12 months; during incidence rises 49% kept drinking as usual, 20% reduced drinking and 17.3% increased drinking frequency, 21.0% volumes on drinking days, 16.4% heavy episodic drinking frequency. Wastewater-based epidemiology analysis performed in Moscow Oblast location demonstrated significant increase during COVID-19 pandemic, compared to same period 2 years earlier: inhaled nicotine use by average of 40%, ethanol consumption by average of 49%.ConclusionsChanges in cigarette smoking and alcohol use during the COVID-19 pandemic had significant variation. Increases were more likely to occur during the pandemic ‘waves’ among individual from harmful users’ group.DisclosureNo significant relationships.

Changes in alcohol consumption in the Russian Federation during the first months of the COVID-19 pandemic

IntroductionExcessive alcohol consumption is a known risk factor for various mental health disorders and can exacerbate the already high burden of COVID-19 pandemic on mental health.On the other hand, the COVID-19 pandemic itself can adversely affect alcohol consumption and thus contribute to alcohol-related problems, including mental health problems.ObjectivesThis study was aimed to assess changes in alcohol consumption that may have occurred as a result of the COVID-19pandemic and determine associated factors among population of Russian Federation.MethodsBy distributing a link to take part in an anonymous online survey,changes in volume and frequency of alcohol use,and frequency of heavy episodic drinking(6 or more servings of alcohol at a time)in the first months of COVID-19pandemic were assessed. 819respondents from Russia:321 men and 498women, submitted their responses during May-July,2020. Associations between changes in alcohol use were assessed in a univariate analysis with socio-demographic factors,alcohol use over the previous 12months,stress, individual perceptions of changes in daily and social life and other negative consequences of pandemic.The statistical significance of associations was assessed using the Pearson’sχ2 test.ResultsIndividuals with initially higher alcohol consumption increased their alcohol use, while those who drank less, decreased alcohol use even more during pandemic (p<0.05). Severe restrictions of social/everyday life were associated with more frequent alcohol use and in larger volumes (p<0.001). Negative professional/financial consequences of pandemic and stress were associated with increase of typical drinking volume (p<0.001), more frequent alcohol use (p<0.001)and heavy episodic drinking (p<0.05).ConclusionsThe COVID-19 pandemic could have increased health inequalities in Russia through changes in alcohol consumption.DisclosureNo significant relationships.

Effectiveness of a digital intervention versus alcohol information for online help-seekers in Sweden: a randomised controlled trial

BackgroundThe ubiquity of Internet connectivity, and widespread unmet needs, requires investigations of digital interventions for people seeking help with their drinking. The objective of this study was to test the effectiveness of a digital alcohol intervention compared to existing online resources for help seekers.MethodsThis parallel randomised controlled trial included 2129 risky drinkers with access to a mobile phone and aged 18 years or older. Randomised sub-studies investigated consent procedures and control group design. Simple computerised randomisation was used. Participants were aware of allocation after randomisation; research personnel were not. The digital intervention was designed around weekly monitoring of alcohol consumption followed by feedback and tools for behaviour change. Primary outcomes were total weekly consumption (TWC) and frequency of heavy episodic drinking (HED), measured 2 and 4 months post-randomisation.ResultsBetween 25/04/2019 and 26/11/2020, 2129 participants were randomised (intervention: 1063, control: 1066). Negative binomial regression was used to contrast groups, with both Bayesian and maximum likelihood inference. The posterior median incidence rate ratio (IRR) of TWC was 0.89 (95% CI = 0.81;0.99, 98.2% probability of effect, P-value = 0.033) at 2 months among 1557 participants and 0.77 (95% CI = 0.69;0.86, > 99.9% probability of effect, P-value < 0.001) at 4 months among 1429 participants. For HED, the IRR was 0.83 (95% CI = 0.75;0.93, > 99.9% probability of effect, P-value = 0.0009) at 2 months among 1548 participants and 0.71 (95% CI = 0.63;0.79, probability of effect > 99.9%, P-value < 0.0001) at 4 months among 1424 participants. Analyses with imputed data were not markedly different.ConclusionsA digital alcohol intervention produced self-reported behaviour change among online help seekers in the general population. The internal and external validity of this trial is strong, subject to carefully considered study limitations arguably inherent to trials of this nature. Limitations include higher than anticipated attrition to follow-up and lack of blinding.Trial registrationThe trial was prospectively registered (ISRCTN48317451).