Harmful Drinking Research Articles

Non Communicable Diseases: Challenge Ahead

Non-communicable diseases (NCDs) are of long duration and generally of slow progress. The four main groups of NCDs are Cardio-vascular diseases, Cancers, Chronic Respiratory diseases and Diabetes. The NCDs kill 38 million people worldwide annually (63% of global deaths). Almost three quarters of the NCD deaths (28 million) occur in the low and middle income countries. Sixteen million deaths due to NCDs are premature, occurring before the age of 70 years; and 82% of these premature deaths occur in the low and middle income countries. These four groups of diseases account for 82% of all NCD deaths: cardiovascular diseases 17.5 million, cancers 8.2 million, chronic respiratory diseases 4 million and diabetes 1.5 million. In India, 60% of all deaths are attributable to NCDs, making them the leading cause of death- ahead of injuries and communicable, maternal, prenatal, and nutritional conditions. The NCDs account for about 40% of all hospital stays and roughly 35% of all recorded outpatient visits in India. The globalization of unhealthy life styles, which are recognized as the modifiable risk factors, like tobacco use, physical inactivity, harmful use of alcohol and unhealthy diets are the key factors that increase the risk of dying from the NCDs. The unhealthy behaviours lead to four key metabolic/ physiological changes (called the intermediate risk factors of NCDs) i.e. raised blood pressure, overweight/ obesity, raised blood glucose and dyslipidaemia that increase the risk of NCDs. The underlying determinants of NCDs mainly exist in non-health sectors, such as agriculture, urban development, education and trade. In terms of attributable deaths, the leading metabolic risk factor globally is elevated blood pressure (to which 18% of global deaths are attributed), followed by overweight and obesity and raised blood glucose. Tobacco accounts for around 6 million deaths every year and is projected to increase to 8 million by 2030. About 3.2 million deaths annually can be attributed to insufficient physical activity. In 2010, 1.7 million annual deaths from cardio vascular causes have been attributed to excess salt intake. More than 3.3 million annual deaths are attributed to harmful drinking of alcohol.

Gender inequalities in health and wellbeing across the first two decades of life: an analysis of 40 low-income and middle-income countries in the Asia-Pacific region

By adulthood, gender inequalities in health and wellbeing are apparent. Yet, the timing and nature of gender inequalities during childhood and adolescence are less clear. We describe the emergence of gender inequalities in health and wellbeing across the first two decades of life. We focused on the 40 low-income and middle-income countries in Asia and the Pacific. A measurement framework was developed around four key domains of wellbeing across the first two decades: health, education and transition to employment, protection, and a safe environment. Specific measurement constructs were then defined by considering gender indicator frameworks, the Sustainable Development Goals, indicator frameworks for child and adolescent health and wellbeing, and key stakeholder input. Available data were then mapped to define 87 indicators, subsequently populated using databases (UN agencies and the Global Burden of Diseases, Injuries, and Risk Factors Study) and nationally representative surveys. Where possible, estimates in girls were compared with boys to report relative risks. Although son preference is evident in some settings-as shown by higher than expected male-to-female sex ratios at birth in India, Vietnam, and China (all >1·10 compared with an expected ratio of 1·05) and excess mortality of girl children in some South Asian and Pacific nations-it is during early adolescence where marked gender inequalities consistently emerged. Adolescent girls face considerable disadvantage in relation to sexual and reproductive health (notably in South Asia and the Pacific), with high rates of child marriage (≥30% of women aged 20-24 years married before 18 years in Bangladesh, Nepal, and Afghanistan), fertility (≥65 livebirths per 1000 girls in Nauru, Laos, Afghanistan, Nepal, Marshall Islands, Bangladesh, Vanuatu, and Papua New Guinea), and intimate partner violence (>20% in Timor Leste, Afghanistan, Pakistan, and Myanmar). Despite educational parity in many countries, females aged 15-24 years were less likely than males to be in education, employment, or training in 17 of 19 countries for which data were available. Compared with girls, adolescent boys experienced excess all-cause mortality and substantially higher mortality due to unintentional injury, interpersonal violence, alcohol and other drugs, and suicide, and higher prevalence of harmful drinking and tobacco smoking. These findings call for a focus on gender policy and programming in later childhood and early adolescence before gender inequalities become embedded. UNICEF.

Identification of harmful drinking in subjects who have had their driving license suspended due to alcohol use: a retrospective Italian study.

Early identification of Harmful Drinking (HD) is difficult, and underestimated. The aim of our retrospective study was to investigate the presence of HD in a population of subjects who had their driving license suspended due to driving under the influence of alcohol. We retrospectively recruited 979 subjects. During the first appointment (T0), clinical and laboratory characteristics of patients were evaluated, and the AUDIT questionnaire was administered. Two groups were then defined: Harmful Drinking (HD) and non-HD, and all subjects underwent a brief interview for 5-10 minutes before being assigned to a group. 95.9% of our sample were identified as non-HD, whereas 4.1% of them were HD; twenty-one (2.1%) of the HD underwent a control appointment (T1), and 17 (1.7%) of them were diagnosed with alcohol use disorder (AUD); there was a statistically significant reduction in mean daily alcohol intake (p<0.009), and in the mean values of the blood markers of HD between T0 and T1 in HD. The present study shows that 4.1%, and 1.7% of subjects presented a diagnosis of HD and AUD, respectively, and their entry in a protocol of drinking monitoring proved beneficial in reducing alcohol intake. Thus, the implementation of strict surveillance of subjects found driving under the influence of alcohol involving a network of professional figures (from police forces to specialists in alcohol addiction treatment) may help to detect and to treat subjects with HD and AUD, and to monitor their alcohol use over time.

The health behaviour of homosexual and heterosexual women in context of theory of salutogenesis

Aim of the studyComparison of the particular health behaviours and levels of sense of coherence between groups of women who have sex with women (WSW) and women who have sex only with men.Subject or material and methodsThe groups of 33 WSW and 31 women who have sex only with men were investigated. The health behaviours were studied with Inventory of Health Behaviours and the author’s survey, physical activity the Polish version of the International Physical Activity Questionnaire, the sense of coherence with SOC-29 scale. Probability of harmful or risky alcohol drinking was verified by the screening test CAGE (abbreviation from: Cut, Angry, Guilty, Empty).ResultsWomen who have sex exclusively with men scored higher than WSW in the positive mental attitude. WSW reported more frequent sexual contacts with strangers, admitted using more various psychoactive substances. WSW had lower rates of sense of comprehensibility and manageability and higher level of physical activity.DiscussionWSW and women who have sex only with men show many similarities in their health behaviour and sense of coherence. All the observed differences concern some aspects of less traditional and less healthy lifestyle and less positive mental attitude among WSW. It can be explained by a psychosocial situation and experienced minority stress in this population. Our observation coincides with the results of previous studies.ConclusionsWSW present characteristics which predispose to having more health problems, than women who have sexual contacts exclusively with men. We conclude that WSW should become receivers of special health prevention programs, adjusted to their specific needs.

Exploring views on alcohol consumption and digital support for alcohol reduction in UK-based Punjabi-Sikh men: A think aloud and interview study.

Introduction and AimsWe aimed to explore UK‐based Punjabi‐Sikh men's views on: (i) alcohol consumption within the community; (ii) available support for alcohol reduction; and (iii) an evidence‐informed alcohol reduction app.Design and MethodsSemi‐structured interviews and a think aloud method were employed. Participants (n = 15) were male, aged 18–27 years, identified as Punjabi‐Sikh, were hazardous or harmful drinkers (i.e. had an Alcohol Use Disorders Identification Test‐Consumption score of ≥5) and interested in using an app to reduce drinking. Interviews were audio‐recorded, transcribed verbatim and analysed with inductive thematic analysis.ResultsSix themes were developed: (i) fear of drinking to cope; (ii) clash between religious and cultural norms (i.e. an internal conflict between important values); (iii) stigmatisation of mental health issues and lack of knowledge as barriers to help seeking; (iv) perceived usefulness of goal setting, monitoring and feedback (i.e. beliefs about the utility of the app's components for reducing drinking); (v) concerns about accessibility of the app within the Punjabi‐Sikh community; and (vi) desire for human support for continued app engagement.Discussion and ConclusionsAmong UK‐based, Punjabi‐Sikh men, clashing religious and cultural norms give rise to internal conflict about drinking. Stigmatisation of mental health issues and lack of knowledge of available support leads to reduced help seeking. Respondents believed an evidence‐informed alcohol reduction app could be useful, but were concerned about accessibility within the wider community and wanted an element of human support. The potential for a combination of digital and face‐to‐face support should be explored.

Contrasts in alcohol-related mortality in Czechia and Lithuania: Analysis of time trends and educational differences.

Introduction and Aims. Globally, Czechia and Lithuania are among the top‐ranking countries in terms of high alcohol consumption. This study highlights notable contrasts in temporal trends in alcohol‐related mortality and identifies country‐specific patterns in educational differences. Design and Methods. The study uses harmonised cause‐of‐death series from the Human Cause of Death Database. Mortality disparities by education were assessed using census‐linked mortality data. Directly standardised death rates were used to estimate levels of national and group‐specific mortality. Relative and absolute mortality differences by education were assessed by range‐type measures (Poisson regression mortality ratios and rate differences) and Gini‐type measures. Results. Between 1994–1995 and 2016, the absolute difference between Czechia and Lithuania in terms of alcohol‐related age‐standardised death rates (per 1 000 000) decreased from 450 for males and 130 for females to 76 in males and 11 in females. In both countries, alcohol‐related mortality was markedly higher among persons of lower education levels. Lithuanian males experienced the highest absolute inequalities measured by rate difference between the low and high educated (740 per million), while Lithuanian females showed the most pronounced relative inequalities (6.70‐fold difference between low and high educated). The corresponding figures were less than half for Czechia. Discussion and Conclusions. Reducing educational disparities in alcohol‐related mortality within both countries would have a substantial impact on overall levels. Policies aimed at targeting the lowest priced and illegal alcohols and reducing levels of harmful drinking should be a priority, especially in Lithuania.

Patterns and temporal change of psychopathological symptoms among inpatients with alcohol use disorder undergoing a twelve-step based treatment

BackgroundPatients diagnosed with Alcohol Use Disorder (AUD) present an increased risk for experiencing severe internalizing and externalizing symptoms. Involvement in twelve-step based treatment programs, such as the Minnesota Model (MM), can contribute to improvement of an individual’s psychopathological symptom profile. The present study’s main objective was to examine profiles and change trajectories of psychopathological symptoms of AUD subgroups during an eight-week long period of MM treatment attendance. MethodInpatients with AUD (N = 303) who attended MM treatment programs participated in the present study. Latent Class Growth Analysis (LCGA) was used to evaluate the psychopathological symptom change trajectories assessed by using the Brief Symptom Inventory (BSI). Multiple comparisons and multinomial logistic regression were performed to validate the subgroups. ResultsThree subgroups were identified: low severity (48.5%), moderate severity (35.2%), and high severity (16.2%) symptomatic subgroups. The moderate severity class demonstrated the largest effect in terms of symptoms decrease. Higher severity classes showed significantly higher rates of harmful alcohol drinking and drinking motives. ConclusionsThe present study identified three severity-based subgroups which indicate that psychopathology sits on a spectrum of severity among AUD patients. The findings highlight the associations between AUD and internalizing symptoms, negative reinforcement drinking motives, and the symptomatic improvement that can occur among those participating in MM treatment programs.

The Portuguese alcohol industry: friend or foe of public health authorities?

Abstract The influence of the alcohol industry is considered one of the most important obstacles to the implementation of policies that aim to tighten alcohol control. However, to our knowledge, our research is the first one to document the influence of the alcohol industry in the country, despite a 6.8% prevalence of alcohol use disorders and alcohol not featuring in the current National Health plan. We performed a qualitative thematic analysis of information available on websites and social media pages of trade associations, charities funded by the alcohol industry, government, universities and media material. This analysis was based on the “Policy Dystopia” framework, dividing the strategies we found as either instrumental (action-based) and discursive (argument-based). Overall, out of the 198 written records, 56% were instrumental and 44% discursive. The alcohol industry's representatives are part of the executive commission of the national task force responsible for consulting on policies regarding alcohol. We also found evidence of extensive community involvement through cooperation with security forces, among others. Also, after a discussion by the Portuguese Parliament of a possible increase in taxation of alcoholic beverages, a trade association delivered a study it had ordered from a consultancy company refuting any increase. Trade associations also claimed stricter control measures were not necessary in southern European countries, such as Portugal, and they were only appropriate for countries with more harmful drinking patterns. When referring to health risks causes by alcohol consumption, the association with breast cancer was only found once with misleading language describing it as “chest cancer”. This research has shown several tactics employed by the alcohol industry in Portugal and, as such, helped counteract some arguments used by the industry. This can enable the implementation of more effective control policies. Key messages Public health authorities should document the industry’s tactics in order to implement effective control policies regarding alcohol and other substances. There is a need for audits of health information made public by the alcohol industry.

Prevalence of Hangover Resistance According to Two Methods for Calculating Estimated Blood Alcohol Concentration (eBAC).

Hangover resistance may be linked to an increased risk of continuing harmful drinking behaviours as well as involvement in potentially dangerous daily activities such as driving while hungover, mainly due to the absence of negative consequences (i.e., hangover symptoms) the day after alcohol consumption. The aim of this study was to examine the occurrence of claimed alcohol hangover resistance relative to estimated blood alcohol concentration (eBAC). A total of 1198 participants completed an online survey by answering questions regarding their demographics, alcohol consumption and occurrence of hangover. Two methods were used to calculate eBAC, one based on the modified Widmark Equation (N = 955) and the other from an equation averaging the total body water (TBW) estimates of Forrest, Watson, Seidl, Widmark and Ulrich (males only) (N = 942). The percentage of participants who claimed to be hangover resistant decreased rapidly with increasing eBAC and only a small number of hangover resistant drinkers remained at higher eBACs. Comparisons of the eBACs calculated by the two methods revealed significantly higher BACs when using the modified Widmark equation. These findings suggest that additional research for eBAC calculations is needed to improve accuracy and comprehensiveness of these equations for future alcohol hangover research.

The prevalence and factors associated with alcohol use disorder among people living with HIV/AIDS in Africa: a systematic review and meta-analysis

BackgroundAlcohol use disorder (AUD) in HIV/AIDS patient’s decreases adherence and effectiveness of medications and help-seeking to HIV/AIDS care and treatment. This study, therefore, assessed the average 1 year prevalence and associated factors of alcohol use disorder in HIV/AIDS patients.MethodsWe did an electronic data search on PubMed, Scopus, EMBASE, Psych-INFO libraries, African index Medicus and African Journals Online (AJOL). Google scholar was also investigated for non-published articles. The reference lists of published articles were also reviewed. The stata-11meta-prop package was employed. Subgroup and sensitivity analyses were done. Cochran’s Q-statistics and the Higgs I2 test were used to check heterogeneity. Publication bias was evaluated with Egger’s test and funnel plots.ResultsOf 1362 articles identified using the search strategies; only 22 studies were included in the final analysis. The average 1 year prevalence of AUD was 22.03% (95% CI: 17.18, 28.67). The average prevalence of AUD in South Africa (28.77%) was higher than in Uganda (16.61%) and Nigeria (22.8%). The prevalence of AUD in studies published before 2011, 2011–2015, and after 2015 was found to be 13.47, 24.93, and 22.88% respectively. The average prevalence of AUD among studies with a sample size > 450 was 16.71% whereas it was 26.46% among studies with a sample size < 450. Furthermore, the average prevalence of hazardous, harmful, and dependent drinking was 10.87, 8.1, and 3.12% respectively. Our narrative analysis showed that male sex, cigarette smoking, family history of alcohol use, missing ART medication, mental distress, khat chewing, low CD4 count, and low income were among the associated factors for AUD in people with HIV AIDS. On quantitative meta-analysis for associated factors of AUD, the AOR of being male, Cigarette smoking and khat chewing were 5.5, 3.95, and 3.34 respectively.ConclusionThe average 1 year prevalence of AUD in HIV/AIDs patients was high and qualitatively factors such as being Male, cigarette smoking, and khat chewing were associated with it. Therefore, clinical services for people living with HIV/AIDS should integrate this public health problem. Policymakers should also develop guidelines and implementation strategies for addressing this problem.

Does Participation in Sports Influence the Prevalence of and Initiation into Multiple Substance Misuse in Adolescence? A Two-Year Prospective Analysis.

Concurrent smoking and harmful drinking (CSHD) in adolescence is an important public health and social problem, while participation in sports is considered as being protective against CSHD. This study aimed to prospectively evaluate the influence of various facets of sports participation on the prevalence of and initiation into CSHD of adolescents. Participants were adolescents from southern Croatia (n = 711, 43.6% females, 16 years of age at study baseline), who were tested at baseline and at follow-up (two years later). Variables included gender, age, sports factors (participation in individual and team sports, sport experience, competitive success, intensity of involvement in sports), and CSHD. The CSHD prevalence did not increase significantly over the course of the study (from 5.6% to 7.5%, p > 0.05). Binomial logistic regression with age and gender as covariates suggested that team sports participation correlated to CSHD prevalence at baseline, and follow-up, with higher risk for CSHD among those adolescents who quit team sports (OR = 9.18 and 2.68, 95%CI = 2.04–22.26 and 1.05–6.83 for baseline and follow-up, respectively), and those never involved in team sports (OR = 9.00 and 3.70, 95%CI = 2.07–39.16 and 1.57–8.72 for baseline and follow-up, respectively). A higher risk of CSHD at baseline was seen among those adolescents who were involved in sports for longer (OR = 1.66, 95%CI = 1.16–2.38). The results are discussed in the context of the fact that the study included adolescents at the age of rigid sports selection (the transition from youth to professional-level sports). Since the majority of participants began CSHD at an earlier age, further studies in subjects of a younger age range are warranted.

Harmful drinking occurs in private homes in some high- and middle-income alcohol markets: Data from the International Alcohol Control Study.

To describe how for some high- and middle-income countries, the total volume of alcohol, including volume consumed in harmful drinking occasions, is distributed across drinking locations in each country. Population surveys of drinkers were conducted as part of the International Alcohol Control Study in New Zealand, Australia, Vietnam and Thailand. Consumption data were collected using a beverage- and location-specific measure that also allows for the measurement of unrecorded alcohol. In the high-income countries, the percentage of absolute alcohol consumed in harmful drinking occasions was 44% in New Zealand and 51% in Australia. In the middle-income countries, the proportions were 55% in Vietnam and 66% in Thailand. The vast majority of alcohol was consumed in private homes (67% or above in all four countries). Private homes were also the location where the highest percentage of alcohol was consumed in harmful drinking occasions (range 33% in New Zealand to 44% in Vietnam). Unrecorded/untaxed alcohol was of considerable importance for heavier drinking occasions in private homes in Vietnam. Bars and nightclubs were more likely locations for harmful drinking in the high-income countries relative to the middle-income countries. As the majority of alcohol consumed in each country, including in harmful drinking occasions, was consumed in private homes, these findings make take-away alcohol a focus for alcohol policy including trading hour and pricing policies. Unrecorded alcohol was also of considerable importance in Vietnam, highlighting the importance of the policy responses being developed to address unrecorded alcohol.

Personalized Approach Bias Modification Smartphone App ("SWIPE") to Reduce Alcohol Use Among People Drinking at Hazardous or Harmful Levels: Protocol for an Open-Label Feasibility Study.

BackgroundAlcohol accounts for 5.1% of the global burden of disease and injury, and approximately 1 in 10 people worldwide develop an alcohol use disorder. Approach bias modification (ABM) is a computerized cognitive training intervention in which patients are trained to “avoid” alcohol-related images and “approach” neutral or positive images. ABM has been shown to reduce alcohol relapse rates when delivered in residential settings (eg, withdrawal management or rehabilitation). However, many people who drink at hazardous or harmful levels do not require residential treatment or choose not to access it (eg, owing to its cost, duration, inconvenience, or concerns about privacy). Smartphone app–delivered ABM could offer a free, convenient intervention to reduce cravings and consumption that is accessible regardless of time and place, and during periods when support is most needed. Importantly, an ABM app could also easily be personalized (eg, allowing participants to select personally relevant images as training stimuli) and gamified (eg, by rewarding participants for the speed and accuracy of responses) to encourage engagement and training completion.ObjectiveWe aim to test the feasibility and acceptability of “SWIPE,” a gamified, personalized alcohol ABM smartphone app, assess its preliminary effectiveness, and explore in which populations the app shows the strongest indicators of effectiveness.MethodsWe aim to recruit 500 people who drink alcohol at hazardous or harmful levels (Alcohol Use Disorders Identification Test score≥8) and who wish to reduce their drinking. Recruitment will be conducted through social media and websites. The participants’ intended alcohol use goal (reduction or abstinence), motivation to change their consumption, and confidence to change their consumption will be measured prior to training. Participants will be instructed to download the SWIPE app and complete at least 2 ABM sessions per week for 4 weeks. Recruitment and completion rates will be used to assess feasibility. Four weeks after downloading SWIPE, participants will be asked to rate SWIPE’s functionality, esthetics, and quality to assess acceptability. Alcohol consumption, craving, and dependence will be measured prior to commencing the first session of ABM and 4 weeks later to assess whether these variables change significantly over the course of ABM.ResultsWe expect to commence recruitment in August 2020 and complete data collection in March 2021.ConclusionsThis will be the first study to test the feasibility, acceptability, and preliminary effectiveness of a personalized, gamified ABM intervention smartphone app for hazardous or harmful drinkers. Results will inform further improvements to the app, as well as the design of a statistically powered randomized controlled trial to test its efficacy relative to a control condition. Ultimately, we hope that SWIPE will extend the benefits of ABM to the millions of individuals who consume alcohol at hazardous levels and wish to reduce their use but cannot or choose not to access treatment.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000638932p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000638932pInternational Registered Report Identifier (IRRID)PRR1-10.2196/21278

Gambling problems among military personnel after deployment

Military and veteran populations may exhibit heightened vulnerability to gambling problems; however, there is scant relevant evidence outside the US, and few studies of transition periods, including return from operational deployment. The aim of this study was thus to highlight the extent, risk-factors, and implications of gambling problems among current members of the Australian Defence Force (ADF) following deployment to the Middle East Area of Operations (MEAO). It involved analyses of data from n = 1324 ADF personnel who deployed between 2010 and 2012, and completed surveys within four months of returning to Australia. The Problem Gambling Severity Index (PGSI) identified Problem Gambling (PG: PGSI ≥5) and At-Risk Gambling (ARG: PGSI 1–4), alongside measures of Depression (PHQ-9), Posttraumatic Stress Disorder (PCL-C), alcohol use problems (AUDIT), distress (K10), and post-deployment stressors. Analyses indicated that 7.7% of personnel reported at least some gambling problems post-deployment, including 2.0% that were distinguished by PG, and 5.7% indicating ARG. These figures were comparable to conditions including probable depression and alcohol dependence, while levels of any gambling problems were high relative to harmful drinking. Higher levels were observed among personnel who were aged 18–24, reported 0–4 years of military service, served in the Army, and comprised Non-Commissioned Officers/Other Ranks. There were strong associations with gambling problems and various indicators of mental health and wellbeing, and self-reported post-deployment difficulties. The findings indicate that gambling problems are salient concerns for some Australian military personnel post-deployment, and highlight the need for increased recognition and responses to these problems.

Alcohol consumption and alcohol-related problems during the COVID-19 pandemic: a narrative review.

To summarise publications reporting on alcohol consumption and alcohol-related problems during the Coronavirus disease 2019 (COVID-19) pandemic in a narrative review. ProQuest, Web of Science and Google Scholar were searched for articles published in 2020. This search used two terms: 'alcohol' and 'COVID'. Reference lists of articles were reviewed to identify additional articles. There is growing concern around an increase in alcohol intake and alcohol-related harms. These concerns are related to the impact of excessive alcohol consumption in a person with COVID-19 and/or with alcohol use disorder, as well as with a potential increase in the prevalence of harmful drinking, alcohol use disorder, withdrawal symptoms, intimate partner violence, harm to children, suicide, mental health problems and non-communicable diseases. The need for assessing alcohol use and providing adequate advice during the pandemic have been highlighted. The time for action is now, and all necessary measures to prevent an increase in alcohol-related problems should be adopted. At the same time, healthcare services should also prepare for such potential increase, while adapting to the exceptional circumstances presented by the pandemic, such as physical distancing.

Alcohol Use Disorder and Determinant of Alcohol Dependence among Vocational Students in the Northeast of Thailand

Background: Alcohol-related deaths currently comprise 3.2% of all global mortality and alcohol consumption is the 3rd leading health risk factors among Thais after unsafe sex and smoking. This research aimed to determine the pattern of alcohol use disorders and investigate factors associated with alcohol dependence among vocational students in the Northeast of Thailand. Method: This cross-sectional study was conducted among 1,006 vocational students who were multistage random sampling from five provinces of the Northeast of Thailand to response to a self-administrated structured questionnaire. The Alcohol Use Disorder Identification Test in Thai version was used to identify prevalence of hazardous, harmful, alcohol dependence as well as some specific consequences of harmful drinking. Multiple logistic regression was performed to identify factors associated with alcohol dependence. Result: Among the total of 1,006 vocational students, more than a quarter was hazardous drinkers (26.34%; 95%CI: 23.64 -29.18), 13.72 % (95%CI:11.65 -15.99) were harmful drinker and 11.43% (95%CI: 9.53- 13.56) were alcohol dependence. Factors that were associated with alcohol dependence among vocational students were; stayed in dormitory (adj.OR=2.78; 95%CI: 1.62-4.75), used to drink and drive (adj.OR=2.21; 95%CI:1.64-2.97), studying in higher vocational program (adj.OR=2.04;95%CI: 1.55- 2.69), were tobacco user (adj.OR=1.77; 95%CI: 1.23-2.55), never been arrested for drink driving (adj.OR=1.76; 95%CI: 1.24- 2.49), used to access to advertisement on alcoholic beverages from radio or television (adj.OR=1.48; 95%CI: 1.10- 1.99), university did not comply to implement no alcohol advertisement and consumption measures (adj.OR=1.47; 95%CI: 1.10-1.95), had good attitude toward drinking alcohol (adj.OR=1.44; 95%CI: 1.09- 1.90) when controlling other covariates. Conclusion: Almost half of the vocational students had alcohol use disorders, and more than ten percent suffering alcohol dependence. Peer factors, advertisement, other risk behaviors, poor law enforcement as well as personal attitude were associated with alcohol dependence among vocational students in the Northeast of Thailand.

Prices, alcohol use initiation and heavy episodic drinking among Chilean youth.

AimsTo examine the association between alcohol prices and age of initiation of alcohol use and the association between age of alcohol use initiation and heavy episodic drinking (HED) among adolescents in Chile.DesignWe estimated discrete‐time hazard models using retrospective data and generalized ordered probit models with repeated cross‐sectional data.SettingChile.ParticipantsA total of 248 336 urban youth who attended secondary school between 2003 and 2015 and self‐reported ever having tried alcohol.MeasurementsWe created drinking histories from self‐reported responses of age, age of alcohol use initiation and year/month of survey. From two self‐reported responses, we created a four‐category ordinal variable of heavy episodic drinking: none, one to two, three to nine and more than 10 HED episodes in the past 30 days. We constructed a monthly measure of real alcohol prices using the all‐items and alcohol component of the Consumer Price Index compiled by Chile's statistical agency, the Instituto Nacional de Estadísticas.FindingsFirst, we found negative, statistically significant and policy‐meaningful associations between alcohol prices and the age of alcohol use initiation. The estimated price elasticity of delay was −0.99 [95% confidence interval (CI) = –1.30, −0.69]. A 10% increase in real alcohol prices was associated with delayed alcohol use initiation of approximately 6.6 months. Secondly, we found that youth who had started drinking alcohol at a later age had statistically significant and substantially lower probabilities of having reported HED during the previous month. For example, youth who started drinking at 16 were 4.9 (95% CI = 4.2–5.6) percentage points more likely to have reported no HED in the previous month relative to youth who started drinking alcohol when aged 12 years or younger.ConclusionsIncreasing the price of alcohol products may delay alcohol initiation among young people in Chile. Chilean youth who start drinking alcohol later may engage in less harmful drinking practices.

Burden of disease attributable to alcohol use and its counter measure in China

Harmful drinking causes serious consequences to social security as well as physical and mental health of the general public. The Global Burden of Disease Study (2017) showed that the number of alcohol-related deaths in China in 2017 was 1.82 times higher than that in 1990, and the population attributable fraction increased by 44.13%. The burden of disease caused by drinking alcohol had been increasing. By comparing with the comprehensive intervention strategy of restricting harmful drinking put forward by the World Health Organization, we suggest that the current interventions that need to be improved in China should include several aspects below: (1) strengthening the control of alcohol production, marketing and circulation, (2) restricting the availability of alcohol products for minors through enterprise self-discipline, laws and regulations, parents and school health education, (3) bridging gaps in appropriate techniques and services for alcohol restriction/abstinence in the health care system, (4) providing services such as rapid screening of alcohol dependence and short abstinence interventions, (5) strengthening restrictions on alcohol advertising especially in new media (e.g., online and social media) marketing practices for alcohol products, (6) conducting scientific research and evaluation on alcohol tax-related issues, and (7) regularly reviewing alcohol prices related to inflation and income levels.

Drinking in denial: a cross-sectional analysis of national survey data in Ireland to measure drinkers’ awareness of their alcohol use

ObjectivesIreland has high per capita alcohol consumption and also has high levels of problematic drinking patterns. While it is accepted that patterns of alcohol consumption in Ireland are a cause...

Debate on Selection Criteria for Liver Transplantation for Alcoholic Hepatitis: Tighten or Loosen?

Although liver transplantation (LT) for alcohol-associated liver disease (ALD) is a well-accepted practice, LT for severe alcoholic hepatitis (AH) remains controversial due to concerns about the limited organ supply and the risk of return to harmful drinking. Recognizing an increasing body of favorable evidence, a convergence of practice guideline recommendations from leading hepatology and gastroenterology societies have suggested that the length of abstinence should not be a sole criterion for LT selection and, thus, that LT may be considered in carefully selected severe AH patients with favorable psychosocial profiles not responding to medical therapy. We sought to examine this new consensus in greater detail, debating whether candidate selection criteria for LT in AH should be tightened or loosened.