Health Consequences Of Alcohol Consumption Research Articles

Later-life mortality and the repeal of federal prohibition

Despite a recent and dramatic re-evaluation of the health consequences of alcohol consumption, very little is known about the effects of in utero exposure to alcohol on long-run outcomes such as later-life mortality. Here, we investigate how state by year variation in alcohol control arising from the repeal of federal prohibition affects mortality for cohorts born in the 1930s. We find that individuals born in wet states experienced higher later-life mortality than individuals born in dry states, translating into a 3.3% increase in mortality rates between 1990 and 2004 for affected cohorts.

Interaction between drinking and dietary inflammatory index affects prostate specific antigen: a cross-sectional study

BackgroundNumerous studies have shown that the dietary inflammatory index (DII) is associated with adverse health effects. However, the relationship between DII and prostate cancer (PCa) remains controversial. Although alcohol is included in DII as a dietary factor, the various adverse health effects of alcohol consumption are not only related to inflammation. On the other hand, it has been a long-standing debate whether alcohol consumption is linked to the risk of PCa. Therefore, to clarify whether drinking affects the relationship between DII and PCa, we evaluated the correlation between DII and prostate-specific antigen (PSA) based on the National Health and Nutrition Examination Survey (NHANES) database.MethodsWe used data from the NHANES spanning from 2005 to 2010 to analyze the relationship between PCa and DII. Out of the 31,034 NHANES participants, we enrolled 4,120 individuals in our study, utilizing dietary intake data from a twenty-four-hour period to determine DII scores. Demographic data, physical and laboratory test results were collected to compare between low PSA and high PSA groups, and to calculate the odds ratio between both groups, we employed a logistic regression analysis.ResultsIn this cross-sectional investigation of PCa, drinkers and non-drinkers had different relationships between DII and PSA levels (OR: 1.2, 95% Cl: 1-1.44 vs. OR: 0.98, 95% Cl: 0.9–1.07), and DII and abstaining from alcohol were effective in reducing the incidence of PSA (p-value for significant interaction = 0.037).ConclusionThe results of our study suggest that drinking may influence the relationship between DII and PSA levels. DII is likely to be a reliable indicator for estimating PSA levels among non-drinkers, who may limit their intake of pro-inflammatory ingredients to lower the incidence and death of PCa.

Binge drinking and oral health-related quality of life in older adults: Socioeconomic position matters.

The objective of the study was to investigate whether the association between binge drinking and oral health-related quality of life (OHRQoL) differs by socioeconomic position (SEP) in Brazilian older adults. The adverse health effects of alcohol consumption disproportionately affect socioeconomically disadvantaged and older individuals. Moreover, measures of binge drinking may capture different domains of the association between alcohol misuse and health that might be independent of the traditional markers of volume or frequency of consumption. Evidence of the association between alcohol use and oral health outcomes has failed to consider binge drinking and possible effect modification by SEP. We conducted a secondary cross-sectional analysis using the baseline data from The Brazilian Longitudinal Study of Ageing (2015-2016). Effect Measure Modification analyses using multivariable Poisson regression models tested whether the association between past-month binge drinking and higher scores of the Oral Impacts on Daily Performance (OIDP) questionnaire differed in magnitude by level of household wealth and educational attainment, assessed using Relative Excess Risk due to Interaction (RERI) and simple slope test. The analytical sample comprised 8857 individuals. Participants who were from low-wealth households or with lower education and reported past-month binge drinking had 27% (95% CI: 1.16 to 1.39) and 28% (95% CI: 1.18 to 1.40) higher OIDP scores, respectively, than those not binge drinkers from higher SEP, and super-additive associations were detected (RERI for household wealth: 0.12; RERI for educational attainment: 0.14). Binge drinkers from low SEP have poorer OHRQoL. Public oral health initiatives aiming to combat binge drinking are likely to disproportionately benefit vulnerable groups.

Social, psychological and health characteristics associated with stability and change in adult alcohol consumption.

Many studies analyzing health effects of alcohol consumption have operationalized alcohol intake from a single baseline measure without further follow-up. Consequently, there is a lack of knowledge about stability and change in alcohol consumption over the life course and the social, psychological, lifestyle, and health characteristics associated with different alcohol consumption trajectories. The aims of the study were to describe the prevalence of different adult-life alcohol consumption trajectories among Danish men and to analyze social, psychological, lifestyle and health characteristics associated with these trajectories. For 2510 Danish men, retrospective decade-based information on alcohol consumption during life period 26-60 years was obtained in late midlife and information on individual characteristics was obtained in young adulthood, late midlife and from national hospital registries. The men were allocated to one of six a priori defined alcohol consumption trajectories. About 65% of Danish men had a stable moderate consumption, drinking 1-21 units weekly while the five other consumption trajectories were comparatively rare: 3% stable abstainers, 4.7% stable high-risk drinkers, 10.9% with increasing and 12.7% with decreasing consumption. Moderate consumption over the adult life-course was associated with the most favorable social, psychological, lifestyle and health characteristics while the other trajectories were generally associated with less favorable characteristics to varying degrees-e. g. this was the case for the stable abstaining trajectory and in particular the trajectory with decreasing consumption. The findings suggest that the majority of Danish men drink moderately in the life period from young adulthood to late midlife, and deviance from this 'normal' moderate consumption trajectory is associated with less favorable social, psychological, lifestyle and health characteristics. Some of these characteristics may influence alcohol consumption patterns, but for some of the trajectories, alcohol consumption may influence health as well as social and psychological functioning.

Molecular Alterations Caused by Alcohol Consumption in the UK Biobank: A Mendelian Randomisation Study.

Alcohol consumption is associated with the development of cardiovascular diseases, cancer, and liver disease. The biological mechanisms are still largely unclear. Here, we aimed to use an agnostic approach to identify phenotypes mediating the effect of alcohol on various diseases. Methods: We performed an agnostic association analysis between alcohol consumption (red and white wine, beer/cider, fortified wine, and spirits) with over 7800 phenotypes from the UK biobank comprising 223,728 participants. We performed Mendelian randomisation analysis to infer causality. We additionally performed a Phenome-wide association analysis and a mediation analysis between alcohol consumption as exposure, phenotypes in a causal relationship with alcohol consumption as mediators, and various diseases as the outcome. Results: Of 45 phenotypes in association with alcohol consumption, 20 were in a causal relationship with alcohol consumption. Gamma glutamyltransferase (GGT; β = 9.44; 95% CI = 5.94, 12.93; Pfdr = 9.04 × 10−7), mean sphered cell volume (β = 0.189; 95% CI = 0.11, 0.27; Pfdr = 1.00 × 10−4), mean corpuscular volume (β = 0.271; 95% CI = 0.19, 0.35; Pfdr = 7.09 × 10−10) and mean corpuscular haemoglobin (β = 0.278; 95% CI = 0.19, 0.36; Pfdr = 1.60 × 10−6) demonstrated the strongest causal relationships. We also identified GGT and physical inactivity as mediators in the pathway between alcohol consumption, liver cirrhosis and alcohol dependence. Conclusion: Our study provides evidence of causality between alcohol consumption and 20 phenotypes and a mediation effect for physical activity on health consequences of alcohol consumption.

Effects of Construal Level on Responses to Ambiguous Health Information about Alcohol Consumption

ABSTRACT Information about the health effects of alcohol consumption can be ambiguous (i.e., lacking in reliability, credibility, or adequacy) and thus may promote maladaptive health behavior. Guided by Construal Level Theory and a conceptual taxonomy of uncertainty in health care, we tested the hypothesis that manipulating construal level would promote adaptive responses to ambiguous health information. We examined the effects of ambiguous health information about alcohol on health cognitions, message responses, and intentions, as well as whether manipulating construal moderated these effects. Alcohol users (n = 135, Mag e = 20.15, 68.9% female) were randomly assigned to either a high-level or low-level construal task and then to read either an ambiguous or unambiguous health communication about the health effects of alcohol. Participants responded similarly to ambiguous health information as they did to unambiguous health information and participants in a high-level construal did not generally report differences compared with those in a low-level construal. Findings suggest that ambiguous health information might not always lead to maladaptive effects. More research is needed to examine moderators of the relationship between ambiguous health information and health outcomes, as well as to understand how and when using construal manipulations are effective in different health contexts.

Alcohol use trajectories across the life course: Influences of childhood predictors and consequences for late-life health

BackgroundThe cumulative, negative health effects of alcohol consumption are exacerbated in older adulthood. We used a ‘life course epidemiology’ approach to explore how alcohol use trajectories develop across the lifespan, what early life events influence these trajectories and their associations with late-life health. MethodsSurvey data combined with retrospective life course history interviews were collected from 749 non-lifetime alcohol abstainer adults aged 61–81 years (51 % female).Frequency and quantity items of the AUDIT-C assessed alcohol use across each decade of life. Early life factors were childhood socioeconomic status, parental health behaviours, and age of drinking onset. Health outcomes were alcohol-related conditions. ResultsLatent class growth analysis yielded two life course trajectories for women: consistently infrequent, low quantity drinking (Group 1: 48 %) and increasingly frequent, low quantity drinking (Group 2: 52 %). Men showed three trajectories: consistently infrequent, low quantity drinking (Group 3: 36 %); increasingly frequent, low quantity drinking (Group 4: 51 %); and drinking with increasing frequency and quantity until midlife, after which consumption gradually declined (Group 5: 13 %). Better childhood socioeconomic status was associated with Groups 2 and 4. Later drinking onset was associated with Groups 1 and 3. Parental alcohol misuse, early drinking initiation and childhood socioeconomic adversity were predictive of Group 5. Those in Group 5 were five-to-seven times more likely to have alcohol-related comorbidities. ConclusionsEarly life experiences influence life course hazardous alcohol use. Interventions across the life course, from childhood, when drinking may be initiated, through to older adulthood, when sensitivity to alcohol increases, are needed.

Evaluating Undergraduate Alcohol Health Literacy and Education Efficacy

This study examined the U.S. undergraduate students’ knowledge of the long-term health effects of alcohol consumption. It also examined the efficacy of alcohol education programs at informing students of health effects and influencing drinking behavior. A national online questionnaire was distributed to collect self-reported data from students. Findings indicate that student knowledge of the health risks of alcohol consumption is poor. Around half of undergraduate students are aware that alcohol is associated with some negative health effects, but far fewer are aware of alcohol’s specific health risks. Additionally, findings reaffirm that alcohol consumption and binge drinking remain common behaviors among students, and suggest that, despite widespread adoption, alcohol education programs are not very effective at reducing alcohol consumption. Most research participants reported that knowledge of negative long-term health effects of alcohol consumption was unlikely to influence their drinking behavior.

The Scottish case: minimum unit pricing for alcohol

Abstract There have been longstanding social and public health concerns about the levels of harmful alcohol consumption in Scotland. The Alcohol (Minimum Pricing) (Scotland) Act 2012 targets all alcohol sold through licensed premises in Scotland by ensuring it cannot be sold below a set minimum unit price. The pricing policy is currently set at 50p per unit of alcohol. Following a legal challenge and a vote in the Scottish Parliament, minimum unit pricing was implemented in Scotland on 1 May 2018. The aim of the Scottish alcohol policy has been to reduce the adverse public health consequences of alcohol consumption. It has also been identified as a potential measure for reducing health inequalities since alcohol-related harms are strongly socially patterned. The Scottish alcohol policy is important case to consider for a number of reasons. First, the nature of the policy differs. Rather than the introduction of a variable floor price, which may encourage switching in consumption from one product to another to maintain alcohol intake, minimum unit pricing introduces a price threshold that is uniform across all alcohol products. Second, minimum unit pricing is being introduced into a competitive commercial environment with strong vested interests, rather than a government-controlled monopoly. Third, the policy has been framed as a public health intervention, rather than primarily for revenue-raising reasons. Research on its development and evaluation will be considered to inform broader discussions on policy advocacy. Here we show a visualisation of the minimum unit pricing policy network to highlight how the public health community could work in more coordinated manner to support alcohol policy interventions.

Building a social marketing Strategy to reduce alcohol-related harm in France

Abstract Background Alcohol use ranks among the top three risk factors in France, leading to about 40 000 deaths annually. French health authorities wished to renew the public health message about alcohol consumption and build a social marketing Strategy to lower the social and health consequences of alcohol consumption in France. Objectives Two main steps were followed: 1) gathering a group of experts to provide up-to-date low-risk drinking guidelines, 2) building, testing and implementing a social marketing Strategy based on this expertise. Results In 2017, the group of experts established low-risk drinking Guidelines based on both scientific evidence and socially acceptable risks for the French population. They suggested to increase awareness on alcohol-related harm as well as on the new Guidelines. In 2018, a social marketing Strategy was set up by Santé publique France, the French national public health Agency. Qualitative and quantitative pretests allowed to develop understandable and potentially effective communication materials consisting of the following message: “To protect your health, no more than 2 alcoholic drinks a day, and not every day”. A web-based brief intervention to assess a person’s alcohol consumption was developed, based on a previous tool whose effectiveness had been demonstrated. In 2019, the Campaign was launched: health professionals were informed at first, followed by a national mass media Campaign that was broadcasted for 3 weeks, targeting the general population (TV, radio, press, the Internet). Conclusions It is the first time in France that such a global Strategy is set up to promote an alcohol harm reduction message. A robust evaluation is in progress but this structured approach seems feasible and reproducible abroad. Key messages In France, an alcohol harm reduction Strategy has been built up and implemented, based on scientifically-established Guidelines. The social marketing campaign is rigorously evaluated to assess its impact and portability.

Examining the Sexual Health Consequences of Alcohol Consumption Among Black Gay and Bisexual Men.

Black men who have sex with men (MSM) are disproportionately affected by HIV infection. Efforts are needed to understand correlates of HIV risk among this group. Alcohol consumption may have a role in HIV transmission given its association with condomless sex. This study aimed to examine the association between alcohol consumption (i.e., drinking before/during sex and levels ofalcohol use problems) and condom use during lifetime, past 6months, and the event (i.e., a specific sexual episode) level. Black MSM (N=102) reported sexual behavior and condom use for lifetime, past 6months, and the most recent condom and condomless sex events. The Alcohol Use Disorders Identification Test (AUDIT) determined alcohol use problems. Ordinal and binary regression analyses analyzed associations between AUDIT scores and condomless sex (receptive and insertive). AUDIT scores were associated with a greater likelihood of condomless sex (lifetime receptive sex: OR=1.06, p<0.05; past 6months insertive sex: odds ratio [OR]=1.09, p<0.01). At the event level, there was no greater likelihood of drinking during last condomless sex as compared to last condom sex, χ2 (1)=0.18, p=0.39. There was evidence that an increase in alcohol use problems was associated with a greater likelihood of risky sexual behavior. Drinking before/during sex was not related to condom use. These findings contribute to understanding the nuanced relationship between alcohol use and sexual risk.

Valentin Magnan and Sergey Korsakov: French and Russian pioneers in the study of alcohol abuse

ABSTRACTThis study focuses on two outstanding psychiatrists: the Frenchman Valentin Magnan (1835–1916) and the Russian Sergey Korsakov (1854–1900). Their international renown is primarily associated with their investigations into health consequences of alcohol consumption; they were pioneers in this field, and happened to know each other well. The similarities and differences are shown in social and scientific approaches adopted by these two scientists. In his work, Magnan focused mainly on absinthe and epilepsy; he considered alcoholism to be a hereditary mental disorder. Korsakov, after a period of work in Paris under Magnan’s guidance, represented a more modern generation and was advancing fundamental ideas on the nature of psychoses and merging clinical features, somatic, psychological, and social factors. Although Magnan has practically disappeared from the current literature on alcoholism, Korsakov is still clearly present today.

Joint Effect of Alcohol Consumption and Educational Level on Alcohol-related Medical Events: A Danish Register-based Cohort Study.

Alcohol-related mortality is more pronounced in lower than in higher socioeconomic groups in Western countries. Part of the explanation is differences in drinking patterns. However, differences in vulnerability to health consequences of alcohol consumption across socioeconomic groups may also play a role. We investigated the joint effect of alcohol consumption and educational level on the rate of alcohol-related medical events. We pooled seven prospective cohorts from Denmark that enrolled 74,278 men and women age 30-70 years (study period, 1981 to 2009). We measured alcohol consumption at baseline using self-administrated questionnaires. Information on highest attained education 1 year before study entry and hospital and mortality data on alcohol-related medical events were obtained through linkage to nationwide registries. We performed analyses using the Aalen additive hazards model. During follow-up (1,085,049 person-years), a total of 1718 alcohol-related events occurred. The joint effect of very high alcohol consumption (>21 [>28] drinks per week in women [men]) and low education on alcohol-related events exceeded the sum of their separate effects. Among men, we observed 289 (95% confidence interval = 123, 457) extra events per 100,000 person-years owing to education-alcohol interaction (P < 0.001). Similarly, among women, we observed 239 (95% confidence interval = 90, 388) extra events per 100,000 person-years owing to this interaction (P < 0.001). High alcohol consumption is associated with a higher risk of alcohol-related medical events among those with low compared with high education. This interaction may be explained by differences in vulnerability and drinking patterns across educational groups.See video abstract at, http://links.lww.com/EDE/B267.

Predictors and outcomes of drinkers' use of protective behavioral strategies.

While protective behavioral strategies (PBSs) have the potential to reduce alcohol-related harm, there is a lack of understanding of the factors influencing adults' use of these strategies. The present study assessed the frequency of enactment of a range of PBSs among Australian adults and identified factors associated with their use and the implications for alcohol harm minimization. A sample of 2,168 Australian drinkers (1,095 males and 1,073 females) recruited via a web panel provider completed an online survey that included items relating to quantity and frequency of alcohol consumption, beliefs about the health consequences of alcohol consumption, use of 5 specific PBSs (e.g., counting drinks and eating while drinking), and demographic characteristics. In general, use of these PBSs was negatively associated with overall alcohol consumption. However, usage rates were relatively low, especially among the heaviest drinkers. Refusing unwanted drinks and alternating between alcoholic and nonalcoholic beverages were identified as especially important strategies in the Australian context, accounting for a substantial proportion of the variance in alcohol consumption. Greater efforts to increase awareness and use of PBSs are warranted. In particular, the results suggest that information relating to the importance of refusing unwanted drinks and alternating between alcoholic and nonalcoholic beverages should be actively disseminated to the drinking public. In addition, the reliance on specified numbers of standard drinks in national drinking guidelines suggests encouraging drinkers to count their drinks should be a further focus of interventions given low reported prevalence of this behavior. (PsycINFO Database Record

Actual and predicted prevalence of alcohol consumption during pregnancy in the WHO African Region.

To estimate the prevalence of alcohol consumption and binge drinking during pregnancy among the general population in the World Health Organization (WHO) African Region, by country. First, a comprehensive systematic literature search was performed to identify all published and unpublished studies. Then, several meta-analyses, assuming a random-effects model, were conducted to estimate the prevalence of alcohol consumption and binge drinking during pregnancy among the general population for countries in the WHO African Region with two or more studies available. Lastly, for countries with less than two studies or no known data predictions were obtained using regression modelling. The estimated prevalence of alcohol consumption during pregnancy among the general population ranged from 2.2% (95% confidence interval [CI]: 1.6-2.8%; Equatorial Guinea) to 12.6% (95% CI: 9.9-15.4%; Cameroon) in Central Africa, 3.4% (95% CI: 2.6-4.3%; Seychelles) to 20.5% (95% CI: 16.4-24.7%; Uganda) in Eastern Africa, 5.7% (95% CI: 4.4-7.1%; Botswana) to 14.2% (95% CI: 11.1-17.3%; Namibia) in Southern Africa, 6.6% (95% CI: 5.0-8.3%; Mauritania) to 14.8% (95% CI: 11.6-17.9%; Sierra Leone) in Western Africa, and 4.3% (95% CI: 3.2-5.3%; Algeria) in Northern Africa. The high prevalence of alcohol consumption and binge drinking during pregnancy in some African countries calls for educational campaigns, screening and targeted interventions for women of childbearing age.

The relationship between labour market categories and alcohol use trajectories in midlife

Background and aimsStudies on the role of labour market position and change in alcohol use during midlife are scarce and their results are inconclusive mainly due to their failure to...

Addressing alcohol health harms through non-health sector policies in English local government: a systematic overview, legal analysis, and case study

BackgroundMany key determinants of alcohol health harms lie outside the health sector and are affected by non-health sector policies. Public health practitioners tackling alcohol health harms need to work effectively with non-health sectors. Understanding how health can be addressed through non-health policies will improve the public health response to alcohol harms in England. We aimed to identify the barriers to and opportunities for implementation of population-level health interventions in English local government that effectively address alcohol health harms. MethodsWe used a three-stage research design. First, an overview of systematic reviews identified effective population-level interventions addressing alcohol-related health harms. 6775 articles were retrieved from Medline, Embase, Cochrane, Social Policy and Practice, DARE, Campbell, and NICE database searches, supplemented by screening of references of included reviews and contacting key experts to identify missed and unpublished reviews. 10% of articles were independently dual screened with the remainder screened individually after reconciling all classification disagreements. Systematic reviews were included if they were published since 2002, assessed the effectiveness of population-level interventions, and reported quantitative outcomes on alcohol use or related harm. Two reviewers independently assessed the included reviews' quality using the AMSTAR criteria. Second, a legal and policy analysis established the legislative framework governing English local authority alcohol control policies, identifying opportunities to enact effective policies to address alcohol health harms. Third, case studies were done in two local authorities to understand how local factors affected the choice and implementation of alcohol control policies. Data were obtained through non-audio recorded qualitative interviews with local government staff, work shadowing, documentary analysis of reports and external-facing communications, and quantitative analysis of administrative data. Findings52 systematic reviews were identified. The evidence base showed a pattern of support for regulatory or statutory enforcement interventions over local non-regulatory approaches. Interventions with proven effectiveness that are especially relevant to English local authority intervention include limiting alcohol outlet density and opening hours and increasing alcohol prices. By contrast, the legal and policy analysis showed that licensing decisions in England that might control local alcohol availability and affordability should be framed around non-health arguments. Licensing committees need data that relate to a specific premises or local geography, limiting how much aggregate population health indices can be used to justify policy choices. Nevertheless, alcohol health harms can be addressed by developing sufficiently detailed local health evidence; designing special policy areas to address cumulative effect; aligning local planning policy with licensing; and cross-sector collaborations—in particular with licensing, planning, the police, and community safety—such as joint needs assessments and strategies to tackle alcohol harms. The legal framework and local government operating practices do, however, make interventions that address the immediate harms associated with alcohol intoxication more feasible to implement in non-health sectors than those that tackle chronic overconsumption. Case study findings suggest that local government practitioners perceive that policy decisions relate to the priorities of a range of constituencies that might not align with health concerns. InterpretationOpportunities exist to address local health consequences of alcohol consumption through English local government policies. Public health practitioners wishing to engage with non-health sectors will benefit from understanding how other sectors define evidence in terms of relevance and validity, how legislation constrains and enables their practice and policy, and whose priorities shape policy choices. FundingNational Institute for Health Research (NIHR)'s School for Public Health Research (SPHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

Nutraceutical strategies for ameliorating the toxic effects of alcohol

Rodent studies reveal that oxidative stress, much of it generated via induction/activation of NADPH oxidase, is a key mediator of a number of the pathogenic effects of chronic ethanol overconsumption. The highly reactive ethanol metabolite acetaldehyde is a key driver of this oxidative stress, and doubtless works in other ways to promote alcohol-induced pathology. Effective antioxidant measure may therefore be useful for mitigating the adverse health consequences of alcohol consumption; spirulina may have particular utility in this regard, as its chief phycochemical phycocyanobilin has recently been shown to function as an inhibitor of certain NADPH oxidase complexes, mimicking the physiological role of its chemical relatives biliverdin/bilirubin in this respect. Moreover, certain nutraceuticals, including taurine, pantethine, and lipoic acid, may have the potential to boost the activity of the mitochondrial isoform of aldehyde dehydrogenase, ALDH-2, accelerating conversion of acetaldehyde to acetate (which arguably has protective health effects). Little noticed clinical studies conducted nearly three decades ago reported that pre-ingestion of either taurine or pantethine could blunt the rise in blood acetaldehyde following ethanol consumption. Other evidence suggests that lipoic acid may function within mitochondria to maintain aldehyde dehydrogenase in a reduced active conformation; the impact of this agent on ethanol metabolism has however received little or no study. Studies evaluating the impact of nutracetical strategies on prevention of hangovers – which likely are mediated by acetaldehyde – may represent a quick, low-cost way to identify nutraceutical regimens that merit further attention for their potential impact on alcohol-induced pathology. Measures which boost or preserve ALDH-2 activity may also have important antioxidant potential, as this enzyme functions physiologically to protect cells from toxic aldehydes generated by oxidant stress.

Alkoholavholdende – en risikogruppe?

Abstinence from alcohol has been associated with higher mortality than a moderate consumption of alcohol. However, there is evidence to indicate that the abstainers constitute a select group which is exposed to various psychosocial risk factors. A population-based sample (N=1978) from the study Young in Norway - longitudinal was followed with repeated surveys from their teens until approaching the age of 30. This data set was linked to various registries. The collection of data included their use of alcohol, social integration and symptoms of anxiety and depression, as well as sexual behaviour. Data on receipt of social benefits were collected from registries. At age 21, altogether 211 individuals (10.7%) had remained abstinent from alcohol throughout their entire lives. At age 28, their number had fallen to 93 individuals (4.7%). At age 21, abstinence was associated with weak networks of friends, loneliness and a higher likelihood of not yet having had a sexual debut. At age 28, the abstainers also reported a higher prevalence of symptoms of anxiety and depression. They were also more frequent recipients of social benefits. Abstinence from alcohol in adulthood is associated with psychosocial problems and weak integration. These may introduce confounding factors in studies of the health effects of alcohol consumption.

Relatively drunk: subjective intoxication and estimated health consequences of alcohol consumption are conditional on the presence of less intoxicated individuals, not level of intoxication

According to the relative rank hypothesis (RRH), the magnitudes of sensory stimuli are estimated relative to their rank among related comparators. This study assessed the RRH in social drinkers and tested whether rank breath alcohol concentration is a better predictor of subjective alcohol risk estimates. The design was a cross-sectional alcometer street survey. Data from 1997 respondents (mean age, 26.96 years; 61.86% male) were used in analyses. Data were collected from five night-time economies characterized by excessive alcohol use. Prospective respondents were randomly approached to complete a short survey, including perceptions of the long-term health effects of their current state of intoxication and their self-perceived drunkenness, with those who consented to participate providing a breathalyzer score. Alcometer score was ranked according to other respondents and by discrete reference groups. Those whose breath alcohol content ranked high in their reference group reported that they felt more drunk and that they perceived the negative health consequences of alcohol misuse as more likely. No effect of breath score or social norm was observed. Our results generalize fundamental psychophysical theory and indicate that attitudes are spontaneous and relative to context; and that manipulating the social context in which alcohol is served—for example, by including more sober individuals—would increase perceived intoxication and increase the perceived likelihood of alcohol-related poor health. This is contrary to assumptions indicating attitudes are stable and informed by perceived social norms or absolute levels of consumption.