Heavy Alcohol Users Research Articles

Survival after laryngectomy: a review of 133 patients with laryngeal carcinoma

Survival trends in survival for laryngeal cancer in Europe are varied. Five-year survival varied around 60-64% but numbers below 50% have been commonly reported. The aim of this study was to assess the factors influencing survival in patients with laryngeal cancer in our region. A total of 128 male and 5 female patients with larynx cancer (91 glottic and 42 supraglottic) were treated at Patras University Hospital between March 1992 and August 2004. Except 3, all were smokers and 56 (41%) heavy alcohol users. Postsurgical staging showed that most had been classified at stages III (38%) and IV (49%). By histology, 31 tumors were classified as poorly differentiated, 78 as moderately differentiated and 23 as well differentiated. All patients underwent laryngectomy with extension of the procedure where appropriate. Also, a total of 45 patients received adjuvant therapy (either chemotherapy or radiotherapy). Farmers, construction workers, professional drivers and mechanics and coffee shop and bar employees account for more than 70% of patients. Results showed that 64 (48.1%) patients died during the follow-up, 58 (43.6%) of them died from cause related to their disease. With a median follow-up of 25 months, the 5-year disease-free survival (DFS) was 53% and the 5-year overall survival (OS) was 45%. Significant prognostic factors for OS included patient age, advanced staging, heavy alcohol use and poor tumor differentiation while for DFS affected mainly by poor tumor differentiation. We conclude that the disease stage at presentation, tumor grade and alcohol consumption prove to be important predictors for the OS as well as the DFS in our series.

Effects of multisensory therapy on behaviour of adult clients with developmental disabilities; Physical leisure activities and their role in preventing dementia: a systematic review; Brief interventions for heavy alcohol users admitted to general hospital wards; The effectiveness of interventions in the prevention and management of aggressive behaviours in patients admitted to an acute hospital setting

Effects of multisensory therapy on behaviour of adult clients with developmental disabilities; Physical leisure activities and their role in preventing dementia: a systematic review; Brief interventions for heavy alcohol users admitted to general hospital wards; The effectiveness of interventions in the prevention and management of aggressive behaviours in patients admitted to an acute hospital setting

Adverse Outcomes in Alaska Natives Who Recovered From or Have Chronic Hepatitis C Infection

The factors associated with adverse outcome from hepatitis C virus (HCV) infection are incompletely understood. To determine the incidence and risk factors associated with the development of end-stage liver disease (ESLD) and liver-related death (LRD), we conducted a retrospective/prospective population-based study in a cohort of Alaska Native persons chronically infected with HCV from 1994 to 2005. We followed 960 persons prospectively for an average of 7.2 years and retrospectively for 12.1 years with data from medical records and serum samples. We compared data from subjects that were chronically infected with those who recovered from HCV infection, stratified by alcohol use. Survival models were used to examine factors associated with ESLD and LRD in chronically infected patients. During prospective follow-up, 80 (8.8%) and 47 (5.2%) patients developed ESLD and LRD, respectively. In examining incidence per 100 person-years, no difference was found among heavy alcohol users in the incidence of LRD (2.28 versus 3.50; P = .34) or ESLD (3.21 versus 5.69; P = .13) in persons with chronic HCV compared with those recovered from HCV infection. In subjects that consumed <50 g alcohol/d, the incidences of LRD were 0.77 and 0.09 (P = .01) and of ESLD were 1.58 versus 0.36 (P = .002), respectively, in subjects with chronic infection versus those that recovered. Multivariate analysis showed that older age, heavy alcohol use, and HCV genotype 3 were associated with ESLD. A history of heavy alcohol use is associated with the highest incidence of LRD and ESLD, regardless of whether patients are chronically infected or recover from HCV infection.

Peripheral Neuropathy of the Upper Extremity

In the orthopedic patient, the diagnosis of a compression neuropathy may be straightforward. However, various medical comorbidities can obscure this diagnosis. It is paramount for the practicing orthopedic surgeon to have an appreciation for the medical pathology of common axonal neuropathies to properly diagnose, treat, and refer a patient with altered sensation in the upper extremity. The prevalence of diabetes in the United States is 10%, and roughly 20% of diabetic patients have peripheral neuropathy. In addition to diabetes, 32% of heavy alcohol users present with polyneuropathy. With advancements in the treatment of human immunodeficiency virus/acquired immunodeficiency syndrome clinicians may see the long-term effects of the virus manifested as axonal neuropathies and extreme allodynia. In some regions of the world, Hansen's disease usurps diabetes as the most common cause of polyneuropathy. Based on patient demographics and social habits, Lyme disease, multiple sclerosis, and syphilis can all manifest as polyneuropathies. Understanding the common medical causes of neuropathy will aid the orthopedic surgeon in differentiating simple compression neuropathies from diseases mimicking or confounding them.

Peripheral Neuropathy of the Upper Extremity: Medical Comorbidity That Confounds Common Orthopedic Pathology

In the orthopedic patient, the diagnosis of a compression neuropathy may be straightforward. However, various medical comorbidities can obscure this diagnosis. It is paramount for the practicing orthopedic surgeon to have an appreciation for the medical pathology of common axonal neuropathies to properly diagnose, treat, and refer a patient with altered sensation in the upper extremity. The prevalence of diabetes in the United States is 10%, and roughly 20% of diabetic patients have peripheral neuropathy. In addition to diabetes, 32% of heavy alcohol users present with polyneuropathy. With advancements in the treatment of human immunodeficiency virus/acquired immunodeficiency syndrome clinicians may see the long-term effects of the virus manifested as axonal neuropathies and extreme allodynia. In some regions of the world, Hansen's disease usurps diabetes as the most common cause of polyneuropathy. Based on patient demographics and social habits, Lyme disease, multiple sclerosis, and syphilis can all manifest as polyneuropathies. Understanding the common medical causes of neuropathy will aid the orthopedic surgeon in differentiating simple compression neuropathies from diseases mimicking or confounding them.

A synergy between action‐research and a mixed methods design for improving services and treatment for family members of heavy alcohol and drug users

AbstractOur project first explored the patterns of disempowerment within 113 Italian families facing the problem of a heavy alcohol or drug user in the family. It then provided therapeutic interventions for the members of a further fifty‐two families, and thirdly, as a part of the diffusion of the results, it provided brief training for 1,011 professionals supplying services for those suffering from alcohol and drug addiction. Research undertaken in the UK, Mexico and Australia (Copello, Templeton, &amp; Velleman, 2006; Orford et al., 2005a; Orford, Templeton, Velleman, &amp; Copello, 2005b; Velleman &amp; Templeton, 2003) on the impact of substance misuse on families, and on the development of effective interventions to assist those families, supplied the models for this participatory research in Italy.This article discusses the mobilization of health professionals in developing a participatory project within a cross‐cultural framework, focusing on research that involved more than 70 researchers and other professionals all over Italy. Research team discussions, peer validation of gathered data and reflexivity all had a significant role. The paper illustrates various issues, which are often not explicitly mentioned in research reports, related to recruitment, cooperation between researchers, interactions between researchers and participants, information about decision‐making and the actual modalities of execution of the project. Moreover, the careful descriptions of qualitative research principles within the action research approach and a mixed methods design should enhance the research competencies of psychologists and social scientists involved in the community. Copyright © 2009 John Wiley &amp; Sons, Ltd.

The social context of homeless women's alcohol and drug use

Background Substance use poses a significant threat to the health of women, and homeless women are more likely to use alcohol and drugs than other women. Addressing risk factors in this population requires a focus on the social context of substance use among homeless women. Methods Participants were 445 homeless women who were randomly sampled and interviewed in shelter settings about the characteristics of their personal networks. Binomial logistic regressions predicted days of binge drinking and of using marijuana, crack, cocaine, and methamphetamine or other amphetamines in the past 6 months. Results Homeless women with a greater proportion of heavy alcohol users in their personal networks had greater odds of engaging in binge drinking, and women with a greater proportion of drug users in their networks had greater odds of using marijuana, cocaine, crack, and methamphetamine or other amphetamines. Women with a greater proportion of individuals in their networks that they had met in school or through work had lower odds of marijuana, cocaine, and crack use. Conclusions Findings suggest the importance of structural solutions in addressing homeless women's alcohol and drug use, including greater access to treatment and recovery support for alcohol and drug problems as well as depression, and enhancing employment and educational opportunities for homeless women.

The Prevalence of Injury of Any Type in an Urban Emergency Department Population

National estimates of injury prevalence in the Emergency Department (ED) are based on medical record review and vary considerably. By using a more robust approach to surveillance, we (1) determine the prevalence of injury of any type in an urban ED population and (2) explore the association between violence-related injury and personal characteristics of injury victims. This cross-sectional study was performed at an urban level I trauma center from June to August, 2005. We prospectively screened 4,246 consecutive ED patients for injury during a randomized schedule of shifts totaling 336 hours. The ED record of each injured patient was reviewed to catalogue injury type and intent (International Classification of External Causes of Injury, Short Form) as well as to estimate injury severity (New Injury Severity Score). We interviewed noncritically injured, adult patients who provided consent to collect demographic (race, income, and education) and personal information (substance abuse, domestic violence, handgun ownership, and homelessness). We sought independent associations between these variables and violence-related injury in an exploratory analysis using multivariate logistic regression. Injury contributed to 1,036 of 4,246 ED visits (24.4%, 95% confidence interval [CI], 23.1-25.7%). Eleven percent of injured patients were admitted to the hospital and two patients died in the ED. The majority of patients (75%) suffered minor injury. Among the 434 injured patients consenting to interview, the prevalence of established injury risk factors, such as substance use or handgun ownership, varied by gender. The adjusted odds of violence-related injury among this subset of patients were increased for males (odds ratio [OR], 2.22; 95% CI, 1.17-4.23), patients with an annual income less than $5,000 (OR, 2.85; 95% CI, 1.64-4.97), those reporting a history of domestic violence (OR, 2.69; 95% CI, 1.43-5.07), and heavy alcohol users (OR, 1.79; 95% CI, 1.01-3.19). One in four ED visits to this urban, county hospital is due, at least in part, to injury. Patient characteristics associated with violence-related injury may generate hypotheses for further study.

Sleep architecture in adolescent marijuana and alcohol users during acute and extended abstinence

This study examined sleep changes following cessation of marijuana and alcohol use during late adolescence. Twenty-nine heavy marijuana and alcohol users and 20 matched controls were studied during a 28-day monitored abstinence period. Sleep was examined as a function of prior substance use during Nights 1–2 and Nights 27–28. On Night 2, percent rapid eye movement sleep was predicted by past month alcohol use, whereas percent slow wave sleep was predicted by marijuana intake. By Night 28, neither alcohol nor marijuana use predicted any sleep architecture measure. However, on Night 28, indices of period limb movements (PLMs) in sleep were predicted by marijuana and alcohol intake. Results indicate that in adolescents: (1) cessation of heavy marijuana and alcohol use may influence sleep; (2) most sleep abnormalities abate within several weeks of abstinence; and (3) PLMs may increase following abstinence.

Life success of males on nonoffender, adolescence‐limited, persistent, and adult‐onset antisocial pathways: follow‐up from age 8 to 42

A random sample of 196 males, drawn from the Jyväskylä Longitudinal Study of Personality and Social Development, was divided into four groups of offenders using information from government registers of convictions between ages 21 and 47, from local police registers searched at age 21, from a Self-Report Delinquency Scale administered at age 36, from a Life History Calendar for ages 15-42, and from personal interviews at ages 27, 36, and 42. The groups were: persistent offenders (offences before and after age 21; 29% of the men); adolescence-limited offenders (offences before age 21; 27%); adult-onset offenders (offences after age 21; 16%); and nonoffenders (28%). The profile of the persistent offenders included many characteristics of antisocial personality and problems of social and psychological functioning at all ages. In childhood and adolescence, the adolescence-limited offenders tended to display higher self-control than the other offenders indicated by less negative emotionality and higher constraint. In early middle age, they were well established in terms of work and marriage, but they differed from the nonoffenders in higher neuroticism, aggressiveness, and psychosomatic symptoms as did the other offender groups. The adult-onset offenders displayed an emotionally unstable personality, and in adulthood, they tended to be heavy users of alcohol. Parental SES did not differentiate the groups, but the parents of the persistent offenders tended to use alcohol heavily, and the social capital of the family tended to be low compared with the other groups.

Dimensions of Problem Drinking among Young Adult Restaurant Workers

Background: Nationwide surveys identify food service workers as heavy alcohol users. Objectives: This article analyzes dimensions and correlates of problem drinking among young adult food service workers. Methods: A telephone survey of national restaurant chain employees yielded 1,294 completed surveys. Results: Hazardous alcohol consumption patterns were seen in 80% of men and 64% of women. Multivariate analysis showed that different dimensions of problem drinking measured by the AUDIT were associated with workers' demographic characteristics, smoking behaviour, and job category. Conclusions and Scientific Significance: These findings offer evidence of extremely high rates of alcohol misuse among young adult restaurant workers.

Correlates of alcohol use among methadone-maintained adults

This prospective study ( n = 190) examined correlates of alcohol use from baseline data of a longitudinal trial conducted among moderate and heavy alcohol users receiving methadone maintenance therapy (MMT). The sample included MMT clients who were 18–55 years of age, and were receiving MMT from five large methadone maintenance clinics in the Los Angeles area. Half of the sample was heavy drinkers and nearly half (46%) reported heroin use. Using a structured questionnaire, correlates of heavy alcohol use included White and Hispanic ethnicity, and fair or poor physical health combined with older age (≥50 years). We also found that MMT clients who were younger than 50 years, regardless of health status, were more likely to be heavy drinkers. Compared with moderate alcohol consumers, a greater number of heavy alcohol users also experienced recent victimization. To optimize MMT, alcohol screening should be part of routine assessment and alcohol treatment should be made available within MMT programs. Moreover, special consideration should be provided to the most vulnerable clients, such as the younger user, those with a long-term and current history of heavy drug use, and those victimized and reporting fair or poor health. In addition, promoting attention to general physical and mental health problems within MMT programs may be beneficial in enhancing health outcomes of this population.

Relationships among Sociodemographic Markers, Behavioral Risk, and Sexually Transmitted Infections in U. S. Female Marine Corps Recruits

The purpose of this study was to examine the effect of sociodemographic factors and constructs derived from the Information, Motivation, and Behavioral Skills (IMB) model on sexually transmitted infections (STIs) and a composite STI risk score in female Marine Corps recruits. Data were collected in 1999 to 2000 through self-administered questionnaires and laboratory-confirmed tests of STIs. Logistic regression analyses were used to assess factors associated with sexual risk and STIs. Recruits with the highest STI risk scores were younger, single, had high STI knowledge, less positive condom attitudes, perceptions of higher STI risk, perceived that sex is more likely and enjoyable under the influence of alcohol, and were heavy alcohol and drug users before recruit training entry. Recruits diagnosed with STIs had higher STI risk scores, had last sexual partners who were non-Caucasian, and resided in rural locations before recruit training entry. A significant proportion of young women entering the Marine Corps present with STIs and/or recent sexual behavior that put them at risk for acquiring STIs despite high group means for prevention skills. Deficiencies in STI/human immunodeficiency virus knowledge and motivation to reduce risk (denoted by negative attitudes toward condom use and acceptance of the connection between sex and substance use) are possible targets for intervention.

Expanding the Role of Health Services Research as a Tool to Reduce the Public Health Burden of Alcohol Use Disorders

The public and private cost of “heavy alcohol use”1 is estimated to be more than 187 billion in lost productivity, health care and criminal justice expenditures, and other costs. This does not include the emotional and psychological costs to family, friends, and the community. Investments by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) have led to a number of important advances in pharmacological and behavioral treatments for alcohol disorders. Yet, there continues to be a significant gap between research findings and progress in community-based care. Additionally, limited capacity, a lack of acknowledged standards, and a separation between the specialty substance use treatment sector and general medical practice contribute to this gap. As part of its ongoing efforts to encourage translation from clinical research to practice, NIAAA undertook a review of its alcohol related health services research program for the purpose of creating a vision for the next 10 yr that is sensitive to the changing needs of both the clinical and research communities. Central to the development of a new research agenda is a reconceptualization of alcohol use and misuse along a continuum that takes into account quantity and frequency of use as well as the consequences from “heavy use” and misuse of alcohol. This public health approach recommends a number of high priority areas to expand and improve the system of care for “heavy alcohol users” who may be at-risk or who may have developed an alcohol use disorder. These recommendations include research on dissemination and implementation of evidence-based practices, and improving access and utilization to care for individuals who are “heavy users.” The paper concludes by outlining some of the steps taken by NIAAA to further the continuing development of alcohol health services research. 1 The terms heavy alcohol use(rs), which are often used in the literature, are an unscientific taxonomy which is bounded (culture, time, and place, etc.) and which inadvertently homogenizes a heterogeneous population of alcoholic beverage consumers and patterns of use. Editor's note.

Childhood and adolescent predictors of heavy drinking and alcohol use disorders in early adulthood: a longitudinal developmental analysis

To identify childhood and adolescent factors differentiating heavy alcohol users in early adulthood from more moderate users or abstainers. Low-income participants followed from birth to age 28 years. A total of 178 adults (95 males) who were first-born children of low-income mothers recruited in Minneapolis, Minnesota, during their third trimester of pregnancy. Maternal hostility (24/42 months), externalizing and internalizing behavior problems (9 years), peer acceptance and academic achievement (12 years), maternal alcohol use and participants' drinking behavior (16 years), quantity of alcohol use per occasion (19, 23 and 26 years), alcohol use disorders (28 years). For men: (i) higher amounts of alcohol consumption at age 16 increased the odds of being a heavy drinker compared to an abstainer (age 19) and a moderate drinker (ages 23 and 26); (ii) lower achievement scores at age 12 and having a mother who drank more when the participant was age 16 increased the odds of being a heavy drinker compared to moderate drinker (age 26). Higher levels of externalizing behavior problems at age 9 and drinking more when the participants were age 16 increased the odds that men would have a current alcohol use disorder at age 28. For women: (i) drinking more at age 16 increased the odds of being a heavy drinker compared to being either an abstainer or a moderate drinker (age 26); (ii) having higher levels of achievement at age 12 increased the odds of being a heavy drinker compared to an abstainer at age 23. Adolescent alcohol use mediated the relation between externalizing behavior at age 9 and alcohol use at age 26 for women. Problem drinking may be the result of a long-term developmental process wherein childhood externalizing behavior problems sets a pathway leading to heavy drinking during and after adolescence.

Psychiatric Comorbidity Related to Alcohol Use Among Adolescents

Introduction: Alcohol use is apparently related to high prevalences of psychiatric comorbidity, although scientific studies focusing the problem among adolescents are still lacking. Objective: To evaluate the performance of adolescents with different patterns of alcohol use on screening instruments for psychiatric disorders. Method: Forty-one adolescents seeking assistance for alcohol-related problems were compared to a nonclinical sample of 43 adolescents. These 84 users were divided in three sub-groups according to pattern of recent alcohol intake. All subjects responded to validated versions of screening scales for mental disorders. Comparison of groups was held through Analysis of variance (ANOVA). Results: Self Report Questionnaire (SRQ) aims to evaluate the presence of mental disorders. Heavy users presented significant higher scores than the other groups (p < .05) and half of them presented a psychiatry diagnosis. The same was observed for the CES-D. Using the cut-off, 76.9% of daily-users adolescents were considered depressive. In the Beck Anxiety Inventory the same was observed and 50.0% of those adolescents who drank daily could be considered at risk of presenting anxiety disorders. Conclusion: We detected higher prevalences of mental disorders among heavy alcohol users. This reinforces the importance of detailed diagnostic investigation of patients.

OC182: Can prenatal ultrasound detect the effects of in‐utero alcohol exposure?

Objectives: To develop ultrasound parameters for the early detection of alcohol-mediated fetal somatic and CNS maldevelopment. Maternal alcohol ingestion during pregnancy may lead to fetal alcohol spectrum disorder (FASD) which encompasses a broad range of structural abnormalities including growth impairment, cardiac and CNS abnormalities. Developmental and behavioral abnormalities parallel such structural defects. Early detection of fetuses at risk of FASD would allow earlier interventions. Methods: We performed a longitudinal prospective study from 2004 to 2006 in two sites in Ukraine. Women were screened for alcohol use using TWEAK and AUDIT questionnaires. We compared the fetuses of pregnant women with moderate-to-heavy alcohol consumption during pregnancy to those of women who drank little or no alcohol. Ultrasound evaluation of growth and specific measurements of intracranial structures including occipital frontal diameter (OFD), transverse cerebellar diameter (TCD), caval calvarial distance (CCD), outer orbital diameter (OOD), intraorbital diameter (IOD) and orbital diameter were performed during the second and third trimesters. Data from alcohol-exposed and a similar number of control fetuses were compared using ANOVA. Results: From 6745 screened subjects 84 heavy alcohol users were identified in the second trimester; 47 of these were available for comparison in the third trimester. Mothers who drank were significantly more likely to be single, use tobacco and be of lower socioeconomic status compared to controls. Significant ultrasound findings are given below, comparing exposed to control subjects using ANOVA (NS, not significant).

Cognitive impairment in Aboriginal people with heavy episodic patterns of alcohol use.

With chronic alcohol abuse, cognitive studies suggest that progressive cognitive decline may precede more serious and irreversible neurological syndromes. The early detection of cognitive impairment may therefore aid in the prevention of permanent brain damage. Despite the devastating consequences of alcohol abuse among Aboriginal Australians, the effects on brain function have never been studied in this population and a lack of appropriate assessment tools has prevented the development of such research. To determine the impact of long-term and heavy episodic alcohol use on cognitive function in Aboriginal people. Cross-sectional comparing heavy episodic alcohol users with non-alcohol users. Two remote Aboriginal communities in north-east Arnhem Land, northern Australia. The control group consisted of 24 non-drinkers (15 males, nine female) and the heavy episodic group consisted of 20 people (19 males, one female) who had been drinking alcohol in a heavy episodic style (median 14 drinks per occasion) for a mean of 8.9 years (SD = 5.0). Interview to obtain demographic information, substance abuse history and symptoms of mental health and wellbeing, together with a computerized cognitive assessment battery (CogState Ltd). Compared with non-drinkers, heavy episodic drinkers showed reduced psychomotor speed (P = 0.04) and reduced accuracy when performing tasks of attention (P = 0.045), working memory (P = 0.04), implicit memory (P = 0.03) and associate learning and memory (P = 0.001). Specific cognitive abnormalities that suggest frontostriatal abnormalities and have been observed in association with chronic alcoholism in other populations were observed among Aboriginal Australians who were heavy episodic alcoholic users.

Implications of Cannabis Use and Heavy Alcohol Use on HIV Drug Risk Behaviors in Russian Heroin Users

Cannabis and heavy alcohol use potentially increase HIV transmission by increasing risky drug behaviors. We studied 404 subjects entering treatment for heroin dependence, in St. Petersburg, Russia. We used the HIV Risk Assessment Battery (RAB) drug subscale to measure risky drug behavior. Although all heavy alcohol users had risky drug behaviors, their drug RAB scores did not differ from non-heavy alcohol users in unadjusted or adjusted analyses. Cannabis use was significantly associated with drug RAB scores in unadjusted analyses (mean difference 1.7 points) and analyses adjusted for age, sex, and employment (mean difference 1.3 points). When also adjusting for stimulant use, the impact of cannabis use was attenuated and no longer statistically significant (mean difference 1.1 points). Because of the central role of risky drug behaviors in the Russian HIV epidemic, it is important to understand how the use of multiple substances, including cannabis and alcohol, impacts risky drug behaviors.

Vitamin and Mineral Supplement Use among US Medical Students: A Longitudinal Study

Objective To provide data on medical students’ multivitamin and calcium supplement use during medical school. Design Medical students were anonymously surveyed at three time points: freshman orientation, orientation to wards, and during senior year. Subjects Medical students (n=2,316) at 16 US medical schools (response rate=80.3%). Outcome Measures Prevalence and correlates of multivitamin and calcium supplement use throughout medical school. Statistical Analyses χ 2 tests with associated P values, and logistic regression with associated odds ratios and confidence intervals. Results Half of medical students surveyed used multivitamins, and 19% used calcium supplements, at least once per week as freshmen. Consumption of calcium, but not multivitamin, supplements increased during subsequent years ( P=0.0001) and both supplements were more commonly used by women ( P<0.0003). Of 970 students tracked across all three time points, 14% of women, compared with only 2% of men ( P<0.0001), took calcium at all three time points. Using multivariate models, we found that medical students were more likely to use multivitamins if they exercised regularly, had children, were underweight, or were women who were not heavy users of alcohol ( P<0.0001 to P<0.05). Similarly, students who were women, underweight, exercised regularly, or had a personal or family history of osteoporosis were more likely to consume supplemental calcium ( P<0.0001 to P=0.04). Conclusions Medical students of all types used supplements at moderate rates, and women used supplements more commonly and consistently than did men. Medical students, especially nonunderweight and nonexercising students, may be particularly important targets for messages regarding appropriate and adequate vitamin/mineral use.