Frequency Of Heavy Episodic Drinking Research Articles

Trends in older adults' alcohol use in Norway 1985-2019.

Aims:To examine the prevalence of and trends in older adults’ (60–79 years) alcohol use in Norway between 1985 and 2019.Methods:Data stem from two repeated cross-sectional surveys in the Norwegian population: Statistics Norway’s Health and Living Conditions Surveys from 1985 (N = 7799), 1995 (N = 3518) and 2005 (N = 6487), and the Norwegian Institute of Public Health’s (NIPH) annual surveys on alcohol, tobacco and drug use from 2012/2013 (N = 4047), 2014/2015 (N = 4378), 2016/2017 (N = 4264) and 2018/2019 (N = 4330). The following measures were used to examine trends in alcohol use among women and men aged 60 and older: drinking status, drinking frequency, number of drinks per occasion, and frequency of heavy episodic drinking (HED).Results:Between 1985 and 2019, there has been a substantial increase in the proportions of older adults in Norway who drink alcohol and who drink relatively often. The increase was particularly marked between 1985 and 2012/2013, and for elderly women. However, the majority of older adults drink small amounts of alcohol on typical drinking occasions, illustrating that the increased frequency of drinking is not accompanied by a corresponding increase in risky drinking.Conclusions:There has been a marked increase in alcohol use among older adults the past 30 years, particularly among older women, suggesting that the age and gender gap traditionally found in alcohol use in Norway is diminishing. Due to the lower alcohol tolerance among elderly, monitoring the changing trends in alcohol use in this group, as well as the possible consequences of these changes, is important.

Understanding the differential effect of alcohol consumption on the relation between socio-economic position and alcohol-related health problems: results from the Stockholm Public Health Cohort.

AimTo test (i) whether the harmful effects of average volume of alcohol consumption (AC) and heavy episodic drinking (HED) differ by socio‐economic position (SEP), and (ii) if so, to what extent such differential effects can be attributed to an unequal distribution of harmful levels and patterns of drinking, health, life‐style and social factors.DesignA longitudinal cohort study with baseline in 2002 or 2006, with record‐linkage to national registers.SettingStockholm County, Sweden.ParticipantsA total of 37 484 individuals, aged 25–70 years, responding to the survey in 2002 or 2006.MeasurementsThe outcome of alcohol‐related health problems was obtained from the National Patient Register and Cause of Death Register using the Swedish index diagnoses related to alcohol use. Self‐reported information on occupational class (measure of SEP), AC, HED as well as other health‐related factors were extracted from the surveys. Average follow‐up time was 13.3 years.FindingsDuring follow‐up, a total of 1237 first‐time events of alcohol‐related health problems occurred. After initial adjustments, heavy drinking appeared to be more harmful to individuals with low SEP compared with high SEP (P = 0.001). Differences in HED frequency explained the largest part of the differential effect of AC. Engaging in weekly HED was more harmful to individuals with low SEP (P = 0.031) than high SEP. Differences in AC, together with other factors, explained a large part of the differential effect of HED.ConclusionsThe greater adverse impact of alcohol consumption on health in Sweden on people with lower socio‐economic position may be largely attributable to higher prevalence of heavy episodic drinking, as well as other behavioral and social risk factors.

ELSA 2014 Cohort: Risk Factors Associated With Heavy Episodic Drinking Trajectories in Argentinean College Students.

Heavy episodic drinking (HED) is highly prevalent in college students. In Argentina, there is a notable lack of longitudinal studies examining drinking trajectories. The present study identified HED trajectories in Argentinean college students during the first 3 years of college (seven waves) and examined the association between risk factors for alcohol use and HED trajectories. The sample was composed of 1,240 college students [63.1% women, aged 18–25 years (M = 19.1 ± 1.7)] who completed at least three waves (the first data collection and ≥2 follow-ups). For 3 years, participants completed seven surveys that measured HED frequency, age of drinking onset, drunkenness occurrence, trait impulsivity, family history of alcohol abuse, stressful life events, and perceived peer’s drinking. Latent Class Growth Analysis (LCGA) and Multinomial Logistic Regression (MLR) were used to identify the pattern and number of HED trajectories and to explore which risk factors better distinguished between the trajectories, respectively. Six HED trajectories were identified: Heavy Stable Frequency, Moderate Stable Frequency, Moderate Decreasing Frequency, Stable Infrequent, Decreasing Infrequent, and No-HED. Younger age of drinking onset, alcohol intoxication, greater perception of peer drinking frequency and higher levels of impulsivity (i.e., sensation seeking, lack of premeditation, and positive urgency) increased the probability of belonging to the trajectories with more frequent HED. These trajectories partially coincide with those identified in studies from other cultures. Unlike previous studies, we did not find a trajectory with increasing/ascending HED frequency. This may be related to contextual/cultural variables unique to Argentina, like differences in the age when the peak in alcohol consumption is reached or the legal minimum age to buy alcoholic beverages in this country, and the idiosyncratic elements that characterize college life in Argentina. This work represents a step forward in the identification of risk factors differentiating between different HED trajectories, and help understand changes in alcohol use during college, in an understudied population.

Depressive symptoms as a moderator of college student response to computerized alcohol intervention

BackgroundPersonalized normative alcohol feedback (PNF) is associated with decreased alcohol use among young adults. However, limited research has examined the influence of depressive symptoms on PNF efficacy. This study examined symptoms of depression as a moderator of college student response to a computerized PNF intervention for alcohol use. MethodsCollege students (N = 212, 59% female) who reported drinking in a typical week completed baseline and one-month assessments as part of a previously published intervention trial. We randomized participants to alcohol PNF (n = 153) or assessment only (n = 59). We used regression models to examine the interaction between PNF and symptoms of depression on alcohol outcomes at one-month follow-up. ResultsOne in four participants screened positive for clinically significant symptoms of depression. Depressive symptoms did not moderate intervention effects on drinking quantity. However, PNF was only associated with reduced frequency of heavy episodic drinking and lower probability of any alcohol-related consequence in the context of mild to moderate (not minimal) symptoms of depression. ConclusionsPNF is more effective than assessment alone in reducing drinking quantity, regardless of symptoms of depression. However, it may only be more effective in decreasing frequency of heavy episodic drinking and the probability of alcohol-related consequences among those experiencing mild to moderate (as opposed to minimal) symptoms of depression. Alcohol intervention trials should assess symptoms of depression and consider them in data analysis.

Event-specific drinking and protective behavioral strategy use among college students

Background Event-specific drinking occasions (e.g. holidays, special occasions, school breaks) have been associated with heavy drinking and negative alcohol-related consequences among college students. This study extends prior research by examining understudied holidays and changes in protective behavioral strategy use during these event-specific drinking occasions. Method Participants were 537 college students between the ages of 18 and 24 who retrospectively reported drinking in the past 2 weeks. Several alcohol use variables (e.g. frequency, quantity, heavy episodic drinking frequency), negative alcohol-related consequences, and protective behavioral strategies were assessed for the previous 14 days. Ten event-specific drinking occasions were coded for the 14-day reporting period. A series of Analysis of Covariance models were conducted to examine differences on alcohol use variables, negative consequences, and protective behavioral strategies for weeks that included an event-specific drinking occasion relative to a no holiday reference timeframe. Results Compared to the no holiday reference group, several event-specific drinking occasions (e.g. Labor Day, Martin Luther King Jr. Day) were associated with greater alcohol use, negative consequences, and protective behavioral strategy use. In contrast, other occasions were determined to be low-risk holidays (e.g. Veterans Day) when protective behavioral strategies were less frequently used. Some occasions (e.g. Spring Break) did not exhibit the expected clear pattern of risk. Conclusions College students’ alcohol use, negative consequences, and protective behavioral strategy use vary across event-specific drinking occasions. Determining which event-specific drinking occasions are associated with risky alcohol use and the lowest use of harm reduction strategies is important for prevention and intervention programs.

Association Between Patterns of Alcohol Use and Short-Term Risk of Suicide Attempt Among Patients With and Without Reported Suicidal Ideation.

To evaluate the association between patterns of alcohol use and short-term risk of suicide attempt among patients with and without reported suicidal ideation. Kaiser Permanente Washington electronic health record data were used to identify mental health visits (1/1/2010-6/30/2015) with documented assessments for unhealthy alcohol use (AUDIT-C) and suicidal ideation (PHQ-9 ninth question). Logistic regression fit using generalized estimating equations were used to conduct visit-level analyses, accounting for correlation between individuals' assessments. Separate models evaluated the association between (1) level of alcohol consumption and (2) frequency of heavy episodic drinking (HED), in combination with suicidal ideation (any vs none), with suicide attempt within 90 days following each visit. Primary models adjusted for age, gender, race/ethnicity and visit year. Of 59,705 visits (43,706 unique patients), 372 (0.62%) were followed by a suicide attempt within 90 days. The risk of suicide attempt was significantly higher for patients reporting suicidal ideation across all levels of alcohol consumption compared to patients reporting low-level alcohol use and no suicidal ideation, particularly high-level use (OR 9.77, 95% CI, 6.23-15.34). Similarly, risk of suicide attempt was higher for patients reporting suicidal ideation across all levels of HED relative to those reporting no HED or suicidal ideation, particularly HED monthly or more (OR 6.80, 95% CI 4.77-9.72). Among patients reporting no suicidal ideation, no associations were observed. Findings underscore the potential value of offering alcohol-related care to patient reporting suicidal ideation. Additional strategies are needed to identify suicide risk among those reporting no suicidal ideation.

The Contribution of Alcohol Use, Other Lifestyle Factors and Working Conditions to Socioeconomic Differences in Sickness Absence

Introduction: This study investigates how alcohol use contributes to the social gradient in sickness absence. Other factors assessed include lifestyle factors (smoking, physical activity and body mass index), physical and psychosocial working conditions. Methods: The study used baseline data from the Stockholm public health cohort 2006, with an analytical sample of 17,008 respondents aged 25–64 years. Outcome variables included self-reported short-term (<14 days) and register-based long-term (>14 days) sickness absence. Socioeconomic position (SEP) was measured by occupational class. Alcohol use was measured by average weekly volume and frequency of heavy episodic drinking. Negative binominal regression was used to estimate sex-specific SEP differences in sickness absence, before and after adjusting for alcohol use and the additional explanatory factors. Results: Adjusting for alcohol use attenuated the SEP differences in long-term sickness absence by 20% for men and 14% for women. Alcohol use explained a smaller proportion of the differences in short-term sickness absence. Alcohol use in combination with other lifestyle factors attenuated the SEP differences (20–35%) for both outcomes. Physical working conditions explained more than half of the gradient in long-term sickness absence, whereas psychosocial conditions had greater impact on short-term sickness absence among men. Discussion/Conclusion: Alcohol use explains a substantial proportion of the SEP disparities in long-term sickness absence among men. The effect is smaller among women and for short-term sickness absence. Our findings support the notion that physical working conditions constitute the key explanatory variable for SEP differences in long-term sickness absence, but add that psychosocial working conditions have greater impact on the gradient in short-term sickness absence among men.

Age trends in alcohol use behavior patterns among U.S. adults ages 18–65

IntroductionAlthough much of the work on risky alcohol use behaviors, such as heavy drinking, focuses on adolescence and young adulthood, these behaviors are associated with negative health consequences across all ages. Existing studies on age trends have focused on a single alcohol use behavior across many ages, using methods such as time-varying effect modeling, or a single age period with many behaviors, using methods such as latent class analysis. This study integrates aspects of both modeling approaches to examine age trends in alcohol use behavior patterns across ages 18–65. MethodsData from the National Epidemiologic Survey on Alcohol and Related Conditions-III were used to identify past-year alcohol use behavior patterns among a nationally representative sample of U.S. adults (n = 30,997; 51.1% women; 63.5% White Non-Hispanic) and flexibly estimate nonlinear trends in the prevalences of those patterns across ages 18–65. ResultsFive patterns were identified: Non-Drinkers, Frequent Light Drinkers, Infrequent Heavy Episodic Drinkers, Frequent Heavy Episodic Drinkers, and Extreme Drinkers. Pattern prevalences were allowed to vary flexibly across the entire age range. Prevalences of the Infrequent Heavy Episodic and Extreme Drinkers peaked around ages 22–24, but peaked for Frequent Heavy Episodic Drinkers around age 49. Non-Drinkers were most prevalent across all ages except during the early 20 s when Extreme Drinkers were more prevalent. Around ages 24–30, the Non-, Frequent Light, and Extreme Drinkers were approximately equally prevalent. ConclusionsThe approach used here holds promise for understanding characteristics associated with behavior patterns at different ages and long-term age trends in complex behaviors.

Sociodemographics, lifestyle factors and health status indicators associated with alcohol consumption and related behaviours: a Brazilian population-based analysis

ObjectivesTo investigate how various alcohol-drinking behaviours are associated with sociodemographics, lifestyle factors and health status indicators in Brazil. Study designThis study is based on a household survey of 53,034 adults aged 18 + years from all 26 Brazilian capitals and the Federal District conducted in 2017. MethodsSex-stratified relationships were modelled using logistic regressions and controlled for capital-specific effects. Main outcome measures included regular alcohol use, weekly alcohol use, heavy episodic drinking (HED), frequent HED and drinking and driving. ResultsOverall (unadjusted) prevalence of regular alcohol consumption is 41%. Among drinkers, approximately 70% drink on a weekly basis, and 46% are heavy episodic drinkers. Among this latter group, close to 44% are frequent heavy episodic drinkers (i.e. at least four times in a month). Among regular drinkers who also are drivers, the prevalence of drinking and driving is 28%. These prevalences are considerably higher in men. The relationships investigated vary by drinking behaviour and sex, with some factors consistently associated with various behaviours, when present. Population (men or women) at greatest risk include (largely) younger individuals (up to 700% increase in odds) who are single or divorced, those who are less health conscious and watch television or use mobile devices during leisure time 4 + hours per day and do not have diabetes. For drinking and driving, the additional risk factors include speeding behaviour, the use of mobile devices while driving and HED. Education, race/ethnicity and other health status indicators are differently associated with various drinking behaviours. For women, in particular, the results also show differences in odds of up to 360% and 1430% across cities for frequent HED and drinking and driving, respectively. Similarly, indigenous women are at greatest risk of weekly alcohol use and HED. ConclusionsHED and drinking and driving are problematic, as the association with other factors suggests a clustering of risky behaviours that may exacerbate the consequences of drinking behaviours.

Dangerous Liaisons: The Role of Hookups and Heavy Episodic Drinking in College Sexual Victimization.

Heavy episodic drinking (HED) and hookups increase college women's vulnerability to sexual victimization. We examined whether the effect of HED on first year college sexual victimization severity was mediated via hookups, that is, casual sexual encounters between individuals not in a relationship. We also tested the hypothesis that greater sexual limit-setting would attenuate the positive effect of hookups on sexual victimization. Freshman women (N = 335) were recruited by e-mail to complete an online survey regarding their college drinking and sexual experiences. The effect of HED frequency on sexual victimization was completely mediated via hookups. There was a significant indirect path from HED to victimization via alcohol-involved hookups; the path through sober hookups was not significant. We found some support for the hypothesis that sexual limit-setting reduced the impact of hookups on sexual victimization severity. Findings suggest the importance of targeting sexual behavior, which frequently occurs in conjunction with drinking, as a way of preventing college sexual victimization.

Text Messaging Interventions for Reducing Alcohol Consumption Among Harmful and Hazardous Drinkers: Protocol for a Systematic Review and Meta-Analysis.

BackgroundMobile phone-based interventions have become popular for lifestyle behavior change, particularly the use of text messaging as it is a technology ubiquitous in mobile phones. Reviews and meta-analyses of digital interventions for reducing harmful and hazardous use of alcohol have mainly focused on Web-based interventions; thus, there is a need for a body of evidence to guide health practitioners, policy makers, and researchers with respect to the efficacy of available text messaging interventions.ObjectiveThe aim of this systematic review and meta-analysis is to assess the effectiveness of text messaging interventions for reducing the amount of alcohol consumed among harmful and hazardous drinkers; this is compared to receiving no, minimal, or unrelated health information. Specifically, we ask the following questions: (1) Can interventions consisting of only text messages be effective in reducing alcohol consumption compared to no intervention or a minimal or unrelated intervention? (2) Can interventions consisting of only text messages be effective in reducing the prevalence of risky drinking compared to no intervention or a minimal or unrelated intervention?MethodsSeveral databases will be searched, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, the Conference Proceedings Citation Index, ClinicalTrials.gov, OpenGrey, among others. Reports of studies that evaluate text messaging interventions for reducing the amount of alcohol consumed will be included. Primary outcomes of interest will be weekly alcohol consumption and frequency of heavy episodic drinking. The Cochrane Collaboration Risk of Bias tool will be used to assess bias in reports, and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the quality of the body of evidence. A narrative review will be presented, and a meta-analysis will be conducted in case of homogeneity among included studies.ResultsThe systematic review has not yet begun but is expected to start in May of 2019; publication of the final review and meta-analysis is expected at the end of 2019.ConclusionsThe technology for text messaging is ubiquitous in mobile phones; thus, the potential reach of interventions utilizing this technique is great. However, there are no meta-analyses to date that limit the scope to the use of text messaging interventions for alcohol consumption reduction. Therefore, the proposed systematic review and meta-analysis will help health practitioners, policy decision makers, researchers, and others to better understand the effects of these interventions.International Registered Report Identifier (IRRID)PRR1-10.2196/12898

Gambling among Swedish youth: Predictors and prevalence among 15- and 17-year-old students.

Background:Gambling among adolescents is a growing public health concern in Sweden as in many other countries. Excessive gambling has been found to be associated with a wide range of negative consequences such as financial problems, strained relationships, criminal behaviour, depression, and an elevated risk for suicide. Research suggests a link between alcohol consumption and gambling, particularly among male gamblers. There are nevertheless gaps in the available knowledge pertaining to school-aged students in Sweden.Aim:The purpose of this study is to investigate predictors of gambling and frequent gambling among Swedish students in Grade 9 and Grade 11 (ages 15 and 17 years).Data and method:Data on gambling and alcohol consumption were obtained from the Swedish Council on Information and Other Drugs yearly school surveys (n = 4763) in Grade 9 and Grade 11 (n = 3720). Poisson regression models have been applied to estimate the association between less frequent and frequent gambling with the predictors of gender, family and school satisfaction, school situation, and alcohol and drug use.Results:Gambling among Swedish students is a highly gendered activity: boys gamble more and more frequently than girls. Having consumed alcohol was associated with both less frequent and more frequent gambling among Grade 9 students while controlling for other variables. In Grade 9, heavy episodic drinking was only associated with less frequent gambling, not with frequent gambling. Among Grade 11 students, both alcohol consumption and heavy episodic drinking was associated with less frequent gambling but heavy episodic drinking was only associated with frequent gambling. Moreover, drug use was associated with less frequent gambling in Grade 11. Skipping classes was the only school factor that was found to be associated with less frequent gambling (Grade 11). Such factors as family satisfaction and two measurements of economic situation were not associated with gambling at all.

Longitudinal assessment of heavy alcohol use and incapacitated sexual assault: A cross-lagged analysis

Researchers have argued there are bidirectional associations between heavy alcohol use and sexual assault; however, research in this area is inconclusive due to methodological differences, particularly in study design. The purpose of this study is to clarify the longitudinal associations between heavy alcohol use and incapacitated sexual assault among first-year college women, accounting for hypothesized autoregressive effects within each construct over their first year of college. A sample of 483 women completed regular surveys that assessed a range of health behaviors, including alcohol use and sexual behavior, during their first year of college. We used cross-lagged analyses to examine prospective associations between incapacitated sexual assault and heavy alcohol use (frequency of heavy episodic drinking and peak blood alcohol content). There were significant autoregressive effects, such that women who were engaging in heavier alcohol use as they entered college continued to be heavier alcohol users throughout their first year, and women with a history of assault at college entry were at greater risk for assault during their first year of college. There was a significant cross-lagged effect from precollege incapacitated assault to first-semester alcohol use after controlling for pre-college alcohol use. There were no significant cross-lag paths from alcohol use to subsequent incapacitated assault. Women with a history of incapacitated sexual assault engaged in heavier drinking during their transition to college, but heavy alcohol use did not predict subsequent assault risk.

The Relationship Between Parent Drinking and Adolescent Drinking: Differences for Mothers and Fathers and Boys and Girls

Background: Gender differences in the relationship between parent drinking and adolescent drinking are poorly understood. As parental alcohol use is a primary early exposure to alcohol for adolescents, it is important to understand how consequences may differ for adolescent males and females. Objectives: The aim of this paper was to examine gender differences in the relationship between mother’s and father’s heavy episodic drinking, and its combination, and adolescent drinking. Methods: The sample included 2,800 14–15 year olds (48.9% female) living in two-parent households from the Longitudinal Study of Australian Children. The adolescent outcome measure was having had an alcoholic drink in the past year. Mothers and fathers self-reported their frequency of heavy episodic drinking. Covariates included parents’ education, smoking, non-English-speaking background, and symptoms of psychological distress. Logistic regression was used to examine the hypotheses. Results: After adjustment for covariates, both mothers’ and fathers’ heavy episodic drinking significantly increased the likelihood of adolescent drinking. Moreover, fathers’ heavy drinking was more strongly related to adolescent drinking for girls. However, there were no gender differences in the relationship between mothers’ drinking and adolescent drinking, and the combination of mothers’ and fathers’ drinking was not more risky than heavy drinking in either parent alone. Conclusions: Parent heavy episodic drinking is a risk factor for adolescent drinking, after controlling for potential confounding variables. Results suggest that girls may be especially vulnerable to parent heavy drinking in early adolescence. This variation should be considered in the design and evaluation of family-based interventions to prevent adolescent drinking.

Homophobic Bullying and Sexual Minority Youth Alcohol Use: Do Sex and Race/Ethnicity Matter?

Sexual minority youth (SMY) are more likely to use alcohol than their heterosexual peers, yet a lack of research on within-group differences and modifiable mechanisms has hindered efforts to address alcohol use disparities. The purpose of the current study was to examine differences in the mediating role of homophobic bullying on the association between sexual orientation identity and drinking frequency and heavy episodic drinking frequency by sex and race/ethnicity. We used data from a subsample of 20,744 youth in seven states from the 2015 Youth Risk Behavior Survey, a population-based data set of 9-12th grade high school students in the United States. We included youth who self-identified as male or female; heterosexual, lesbian/gay, bisexual, or unsure of their sexual orientation identity; and White, Black, or Latino. Within-group comparisons demonstrated that SMY alcohol use disparities were concentrated among Latino bisexual and unsure youth. All subgroups of SMY at the intersection of race/ethnicity and sex were more likely than their heterosexual counterparts to report homophobic bullying. Homophobic bullying mediated alcohol use disparities for some, but not all, subgroups of SMY. Homophobic bullying is a serious risk factor for SMY alcohol use, although youths' multiple identities may differentiate degrees of risk. Sexual orientation identity-related disparities in alcohol use among Latino, bisexual, and unsure youth were not fully attenuated when adjusted for homophobic bullying, which suggests that there may be additional factors that contribute to rates of alcohol use among these specific subgroups of SMY.

Effectiveness of a Text Messaging-Based Intervention Targeting Alcohol Consumption Among University Students: Randomized Controlled Trial.

BackgroundExcessive drinking among university students is a global challenge, leading to significant health risks. However, heavy drinking among students is widely accepted and socially normalized. Mobile phone interventions have attempted to reach students who engage in excessive drinking. A growing number of studies suggest that text message–based interventions could potentially reach many students and, if effective, such an intervention might help reduce heavy drinking in the student community.ObjectiveThe objective of this study was to test the effectiveness of a behavior change theory–based 6-week text message intervention among university students.MethodsThis study was a two-arm, randomized controlled trial with an intervention group receiving a 6-week text message intervention and a control group that was referred to treatment as usual at the local student health care center. Outcome measures were collected at baseline and at 3 months after the initial invitation to participate in the intervention. The primary outcome was total weekly alcohol consumption. Secondary outcomes were frequency of heavy episodic drinking, highest estimated blood alcohol concentration, and number of negative consequences attributable to excessive drinking.ResultsA total of 896 students were randomized to either the intervention or control group. The primary outcome analysis included 92.0% of the participants in the intervention group and 90.1% of the control group. At follow-up, total weekly alcohol consumption decreased in both groups, but no significant between-group difference was seen. Data on the secondary outcomes included 49.1% of the participants in the intervention group and 41.3% of the control group. No significant between-group difference was seen for any of the secondary outcomes.ConclusionsThe present study was under-powered, which could partly explain the lack of significance. However, the intervention, although theory-based, needs to be re-assessed and refined to better support the target group. Apart from establishing which content forms an effective intervention, the optimal length of an alcohol intervention targeting students also needs to be addressed in future studies.Trial RegistrationInternational Standard Randomised Controlled Trial Number ISRCTN95054707; http://www.isrctn.com/ISRCTN95054707 (Archived by WebCite at http://www.webcitation.org/70Ax4vXhd)

Prevention of Underage Drinking on California Indian Reservations Using Individual- and Community-Level Approaches.

To evaluate combined individual- and community-level interventions to reduce underage drinking by American Indian/Alaska Native (AI/AN) youths on rural California Indian reservations. Individual-level interventions included brief motivational interviewing and psychoeducation for Tribal youths. Community-level interventions included community mobilization and awareness activities, as well as restricting alcohol sales to minors. To test effects, we compared 7 waves of California Healthy Kids Survey data (2002-2015) for 9th- and 11th-grade AI/AN and non-AI/AN students in intervention area schools with California AI/AN students outside the intervention area (n = 617, n = 33 469, and n = 976, respectively). Pre- to postintervention mean past 30-day drinking frequency declined among current drinkers in the intervention group (8.4-6.3 days) relative to comparison groups. Similarly, heavy episodic drinking frequency among current drinkers declined in the intervention group (7.0-4.8 days) versus the comparison groups. This study documented significant, sustained past 30-day drinking or heavy episodic drinking frequency reductions among AI/AN 9th- and 11th-grade current drinkers in rural California Indian reservation communities exposed to multilevel interventions. Public Health Implications. Multilevel community-partnered interventions can effectively reduce underage alcohol use in this population.

Association of belief in the "firewater myth" with strategies to avoid alcohol consequences among American Indian and Alaska Native college students who drink.

Belief in an American Indian/Alaska Native (AI/AN) specific biological vulnerability (BV) to alcohol problems (aka the "firewater myth") is associated with worse alcohol outcomes among AI/AN college students who drink, despite also being associated with greater attempts to reduce drinking. The current study examined how belief in a BV may have affected how 157 AI/AN college students who drink (a) attempted to moderate their alcohol use and avoid alcohol-related problems using abstinence-based and harm reduction strategies, and (b) attitudes toward these strategies as a means of addressing alcohol problems. Contrary to our hypotheses, belief in a BV was not found to be associated with use of harm reduction strategies or with how effective students believed these strategies to be. However, greater belief in a BV was associated with lower self-efficacy for the use of harm reduction strategies among more frequent heavy episodic drinkers. This is concerning, as the use of harm reduction strategies was associated with less frequent heavy episodic drinking in this sample. In contrast, belief in a BV was positively associated with the use of abstinence-based strategies and with how effective these strategies were perceived to be. However, for individuals with average or greater belief in a BV, abstinence-based strategies were associated with greater alcohol consequences. The results suggest that for AI/AN students who drink, belief in a BV may be influencing the strategies used to moderate alcohol use and avoid alcohol-related harm, as well as attitudes toward these strategies, in ways that do not appear helpful. (PsycINFO Database Record

Heavy Episodic Drinking Is Associated With Poorer Bone Health in Adolescent and Young Adult Women.

Osteoporosis is a costly bone disease characterized by low bone mineral density (BMD) that primarily affects postmenopausal women. One factor that may lead to osteoporosis is a failure to reach peak bone mass (PBM) in early adulthood. In older adults and animal models, heavy episodic drinking (HED) has been found to predict failure to reach PBM. However, this relationship has yet to be investigated in adolescent human females. Female college students (N = 87; 60% White) reported age at menarche, hormonal contraceptive use, physical activity, smoking habits, and HED history via an online survey and then received a dual energy x-ray absorptiometry bone scan to assess both lean body mass and BMD at the lumbar spine. Frequent HED (having four or more drinks within 2 hours on 115 or more occasions since the start of high school, which is approximately equal to 1.6 episodes per month over this period) was associated with decreased vertebral BMD even when variables most commonly associated with bone health (lean body mass, physical activity, age at menarche, smoking, and oral contraception use) were controlled for. However, early HED initiation (beginning HED at age 15 years or younger) was not significantly related to BMD. This is the first study to assess the impacts of early HED initiation and frequent HED during adolescence on the bone health of young women. Results suggest frequency of HED before reaching PBM, but not age at initiation, may be negatively related to skeletal health during young adulthood. These findings encourage research into the association between HED and BMD in late adolescence.

Drinking Patterns of College- and Non-College-Attending Young Adults: Is High-Intensity Drinking Only a College Phenomenon?

ABSTRACTBackground: Young adults report the heaviest drinking of any age group, and many are at risk for experiencing an alcohol use disorder. Most research investigating young adult drinking has focused on single indicators of use. Using multiple dimensions of consumption, such as federal guidelines for daily/weekly drinking and engagement in drinking at twice the binge threshold (“high-intensity drinking”) to characterize drinking behavior could illuminate drinking patterns linked with harms. Objectives: We used a person-centered approach to examine latent classes of drinkers from a national sample of young adults. Further, we compared classes on college status. Methods: We used 2012–2013 data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)-III. We included past-year drinkers aged 18–22 years (n = 2213). Latent classes were estimated based on drinking frequency, daily/weekly drinking, frequency of heavy episodic drinking (4+/5+ drinks for women/men), frequency of high-intensity drinking (8+/10+ drinks), and intoxication frequency. Results: Five latent classes were identified: Occasional, Light Drinkers (30%), Regular Drinkers (6%), Infrequent Drinkers with Occasional Binging (10%), Frequent Drinkers with Occasional Binging (22%), and High-Intensity Drinkers (32%). Although membership in the two riskiest classes were more common among college-attenders, odds of being a High-Intensity Drinker relative to the second riskiest class was not significantly different for college- and non-college-attending young adults. Conclusions/Importance: As high-intensity drinking does not appear to be a drinking pattern unique to college-attenders and non-college-attenders are less likely to mature out of heavy drinking patterns, intervention efforts are needed for this at-risk age group.