High-risk Drinking Research Articles

대학생의 위험 음주 행동과 건강증진요인, 안전의식수준 간의 관련성

Objectives: This study analyzed the association with risk drinking behaviors, health promotion factors, and safety awareness levels among college students. Methods: The data was collected from 2,713 college students by the health and safety survey. It examined the association between health-related factors and risk drinking behavior, such as high-risk drinking, monthly binge drinking, and alcohol use disorder, by multiple logistic regression. Results: The factors affecting high-risk drinking, monthly binge drinking, and alcohol use disorder among college students were age, breakfast eating, current smoking, and life safety awareness. Risk drinking behavior was the higher rate in the group between 19~20 years old or the 1st to 2nd grade. Risk drinking behaviors were related to breakfast eating, current smoking, physical activity, and life safety consciousness level. The high rate of monthly binge-drinking rate among female students is a very remarkable result. Conclusion: Health promotion of college students is an essential task as it affects their adaptation to university life and academic achievement. It should establish campus-based university health and safety policies to prevent the risk of drinking.

The Obesity and the Metabolic Syndrome among Korean Adults: Based on National Representative Survey

Background: The obesity and metabolic syndrome (MetS) are main health issues worldwide. This study was to investigate the association of obesity and MetS.Methods: A secondary analysis was conducted using data from Korea National Health and Nutrition Examination Survey for this study. The data from 10,488 Korean adults who were 30-64 years old were utilized and the pooled weights for the stratified complex sampling were implemented in the analysis. The participants were divided into five groups based on body mass index (BMI), and waist circumference, triglyceride, high density lipid, glucose, and blood pressures were used for the MetS.Results: The prevalence of MetS was 29.8% and it was higher in highly obese adults than people who has normal weights (odds ratio, 36.9; 95% confidence interval, 25.9-52.3) after adjusting age, gender, education, income, job, smoking, high risk drinking, and physical activity. There was gradients for the MetS and the components of MetS according to BMI.Conclusions: The obesity increased the risk of MetS and its components’ prevalence. The targeted intervention to control weight need to be developed and implemented. Further researches might be also needed to evaluate the effect of the weight loss on the decreased the risk of MetS.

Sex Differences in the Relationship Between High-Risk Drinking and the Triglyceride-Glucose (TyG) Index: An Analysis Using 2013 and 2015 Korean National Health and Nutrition Examination Survey Data.

The alcohol use disorders identification test (AUDIT) was developed to evaluate excessive drinking in primary care. The triglyceride (TG) glucose (TyG) index is a novel marker used for assessing insulin resistance. We sought to document relationships between high-risk drinking according to AUDIT and the TyG index and to evaluate whether the TyG index is more correlated with high-risk drinking than TG or fasting plasma glucose (FPG). We analyzed data for 7014 participants in the 2013 and 2015 Korea National Health and Nutrition Examination Surveys. Excessive drinking risk groups were categorized according to AUDIT scores (low-risk, 0-7 in men and 0-6 in women; moderate-risk, 8-14 in men and 7-12 in women; and high-risk, ≥15 in men and ≥13 in women). In men, compared with low-risk individuals, the odds ratios (95% confidence intervals) for higher TyG index values were 1.84 (1.16-2.93) in the moderate- and 2.82 (1.86-4.30) in the high-risk groups. The correlation coefficient for the TyG index and AUDIT score was significantly higher than those for TG and FPG. No significant associations were noted in women. High-risk drinking is significantly associated with higher TyG index values in men only. The TyG index can be a novel marker for assessing high-risk drinking in men.

Association of the COVID-19 lockdown with smoking, drinking and attempts to quit in England: an analysis of 2019-20 data.

AimTo examine changes in smoking, drinking and quitting/reduction behaviour following the COVID‐19 lockdown in England.Design/settingMonthly cross‐sectional surveys representative of the adult population in England, aggregated before (April 2019–February 2020) versus after (April 2020) lockdown.ParticipantsA total of 20 558 adults (≥ 16 years).MeasurementsThe independent variable was the timing of the COVID‐19 lockdown (before versus after March 2020). Dependent variables were: prevalence of smoking and high‐risk drinking, past‐year cessation and quit attempts (among past‐year smokers), past‐year attempts to reduce alcohol consumption (among high‐risk drinkers) and use of evidence‐based (e.g. prescription medication/face‐to‐face behavioural support) and remote support [telephone support/websites/applications (apps)] for smoking cessation and alcohol reduction (among smokers/high‐risk drinkers who made a quit/reduction attempt). Covariates included age, sex, social grade, region and level of nicotine and alcohol dependence (as relevant).FindingsThe COVID‐19 lockdown was not associated with a significant change in smoking prevalence [17.0% (after) versus 15.9% (before), odds ratio (OR) = 1.09, 95% CI = 0.95–1.24], but was associated with increases in quit attempts [39.6 versus 29.1%, adjusted odds ratio (ORadj) = 1.56, 95% CI = 1.23–1.98], quit success (21.3 versus 13.9%, ORadj = 2.01, 95% CI = 1.22–3.33) and cessation (8.8 versus 4.1%, ORadj = 2.63, 95% CI = 1.69–4.09) among past‐year smokers. Among smokers who tried to quit, there was no significant change in use of evidence‐based support (50.0 versus 51.5%, ORadj = 1.10, 95% CI = 0.72–1.68) but use of remote support increased (10.9 versus 2.7%, ORadj = 3.59, 95% CI = 1.56–8.23). Lockdown was associated with increases in high‐risk drinking (38.3 versus 25.1%, OR = 1.85, CI = 1.67–2.06), but also alcohol reduction attempts by high‐risk drinkers (28.5 versus 15.3%, ORadj = 2.16, 95% CI = 1.77–2.64). Among high‐risk drinkers who made a reduction attempt, use of evidence‐based support decreased (1.2 versus 4.0%, ORadj = 0.23, 95% CI = 0.05–0.97) and there was no significant change in use of remote support (6.9 versus 6.1%, ORadj = 1.32, 95% CI = 0.64–2.75).ConclusionsFollowing the March 2020 COVID‐19 lockdown, smokers and high‐risk drinkers in England were more likely than before lockdown to report trying to quit smoking or reduce alcohol consumption and rates of smoking cessation and use of remote cessation support were higher. However, high‐risk drinking prevalence increased post‐lockdown and use of evidence‐based support for alcohol reduction by high‐risk drinkers decreased with no compensatory increase in use of remote support.

Alcohol Consumption in China Before and During COVID-19: Preliminary Results From an Online Retrospective Survey.

Background: Alcohol is an important aspect of Chinese culture, and alcohol use has been traditionally accepted in China. People with stress, anxiety, and depression may use more alcohol. More people reported symptoms of anxiety and depression during the outbreak of COVID-19. Thus, people may drink more alcohol during the outbreak of COVID-19 than before COVID-19.Methods: An online retrospective survey was conducted on a total sample of 2,229 participants. Drinking behaviors before and during COVID-19, current risky drinking and hazardous drinking, and the association between high-risk drinking and mental health problems (depression, anxiety, and stress) were assessed via self-reported measures on the Alcohol Use Disorders Identification Test (AUDIT) and the 21-item Depression Anxiety Stress Scales (DASS−21).Results: This study found that, compared with before COVID-19, alcohol consumption was slightly decreased during COVID-19 (from 3.5 drinks to 3.4 drinks, p = 0.035) in the overall sample. Most (78.7%) alcohol drinkers were males. Before and during COVID-19, males consumed more drinks per week (4.2 and 4.0 vs. 1.3 and 1.2 drinks), had a higher percentage of heavy drinking (8.1 and 7.7% vs. 4.4 and 2.7%), and more drinking days per week (2.1 and 2.1 vs. 1.0 and 0.9 days). Males also had more risky drinking (43.2 vs. 9.3%) and hazardous drinking (70.2 vs. 46.6%) than female counterparts. This study also found that high-risk drinking predicted anxiety in females.Conclusions: This study suggests a slight reduction in alcohol consumption during COVID-19. However, hazardous drinking is common, especially among male alcohol drinkers. Males consumed more alcohol, had more risky and hazardous drinking than female counterparts both before and during COVID-19. Public health policy makers should pay more attention to developing effective, population-based strategies to prevent harmful alcohol consumption.

Susceptibility to interference between Pavlovian and instrumental control is associated with early hazardous alcohol use.

Pavlovian-to-instrumental transfer (PIT) tasks examine the influence of Pavlovian stimuli on ongoing instrumental behaviour. Previous studies reported associations between a strong PIT effect, high-risk drinking and alcohol use disorder. This study investigated whether susceptibility to interference between Pavlovian and instrumental control is linked to risky alcohol use in a community sample of 18-year-old male adults. Participants (N=191) were instructed to 'collect good shells' and 'leave bad shells' during the presentation of appetitive (monetary reward), aversive (monetary loss) or neutral Pavlovian stimuli. We compared instrumental error rates (ER) and functional magnetic resonance imaging (fMRI) brain responses between the congruent and incongruent conditions, as well as among high-risk and low-risk drinking groups. On average, individuals showed a substantial PIT effect, that is, increased ER when Pavlovian cues and instrumental stimuli were in conflict compared with congruent trials. Neural PIT correlates were found in the ventral striatum and the dorsomedial and lateral prefrontal cortices (lPFC). Importantly, high-risk drinking was associated with a stronger behavioural PIT effect, a decreased lPFC response and an increased neural response in the ventral striatum on the trend level. Moreover, high-risk drinkers showed weaker connectivity from the ventral striatum to the lPFC during incongruent trials. Our study links interference during PIT to drinking behaviour in healthy, young adults. High-risk drinkers showed higher susceptibility to Pavlovian cues, especially when they conflicted with instrumental behaviour, indicating lower interference control abilities. Increased activity in the ventral striatum (bottom-up), decreased lPFC response (top-down), and their altered interplay may contribute to poor interference control in the high-risk drinkers.

High-Risk Drinking in Midlife Before Versus During the COVID-19 Crisis: Longitudinal Evidence From the United Kingdom

IntroductionEmerging evidence suggests that the COVID-19 pandemic and associated lockdown restrictions may have influenced alcohol consumption. This study examines changes in high-risk alcohol consumption from before to during the COVID-19 crisis in an established cohort of middle-aged British adults.MethodsParticipants consisted of 3,358 middle-aged adults from the 1970 British Cohort Study who completed the Alcohol Use Disorders Identification Test for detecting hazardous drinkers in primary care settings in 2016–2018 (when aged 46–48 years) and May 2020 (aged 50 years). Multivariable logistic regression analysis was used to examine changes in high-risk drinking (scores of ≥5), and multinomial regression was used to compare responses with individual test items in 2016–2018 and May 2020.ResultsAmong middle-aged British adults, high-risk drinking increased by 5.2 percentage points from 19.4% to 24.6% (p<0.001) between 2016–2018 and May 2020. The increase in high-risk drinking was not moderated by sex, marital status, educational attainment, the presence of a chronic illness, or the year the baseline survey was completed. The prevalence of drinking ≥4 times a week doubled from 12.5% to 26% from before to during the pandemic (p<0.001), and there was also evidence of an increase in the frequency of being unable to stop drinking.ConclusionsThis study provides evidence linking the COVID-19 crisis and associated lockdown restrictions to an increase in high-risk drinking patterns and particularly frequent drinking in British adults. Potential long-term changes in drinking habits should be monitored following the emergence of the COVID-19 pandemic.

Patterns of change in cardiovascular risks of Korean male workers: a 10-year cohort analysis using the National Health Insurance Service–National Sample Cohort (NHIS-NSC) 2.0 database

ObjectiveHealth behaviour is one of the major determinants of cardiovascular diseases in working population. This study was tried to investigate the trend of cardiovascular health level, the relationship between continuous...

Impact of Minimum Unit Pricing on Alcohol-Related Emergency Department Attendances in Scotland: A Natural Experiment Study

Background: Minimum Unit Pricing (MUP) was introduced in Scotland at 50p per unit (8g) of alcohol on 1st May 2018 to reduce alcohol consumption and associated harms. We assessed its impact on alcohol-related emergency department (ED) attendances, drinking patterns, and having an alcohol-related diagnosis amongst ED attendees. Methods: We used a natural experiment approach to compare outcomes between Scotland (intervention group) and England (comparison group). Two EDs in Scotland and two in England were recruited for one baseline and two post-intervention waves. Research nurses considered all attendees for interview, and recorded reasons for not interviewing attendees. The primary outcome was alcohol-related attendances among all recorded attendees. Secondary outcomes included alcohol-related diagnosis, binge drinking and high-risk drinking, and tested for differential effects across socioeconomic groups. Difference-in-difference regression models adjusted for age, sex and baseline covariates. Findings: 12,207 participants were recruited in Scotland and 11,248 in England. The odds ratio for an alcohol-related attendance was 1.14 (95% CI 0.90-1.44) after the introduction of MUP in Scotland relative to England, after controlling for covariates. It is estimated that an additional 1.0% (95% CI -0.7% to 2.7%) of the ED attendances were alcohol-related than would have been the case in the absence of MUP. Meanwhile, the odds for an attendee having at least one alcohol-related diagnosis increased after MUP (OR=1.25, 95%CI 1.00-1.57). There was no evidence of substantive differences in the majority of other secondary outcomes after the introduction of MUP in Scotland, or of differential effects across socioeconomic groups. Interpretation: We found no evidence that MUP impacted on alcohol-related ED attendances.

The Effects of Alcohol Drinking and Environmental Cadmium Exposure on Hypertension in the Korean Adults: Data Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2013

Background/Aim Hypertension is a common disease found in one-third of Korean adults. Although previous studies have reported that high-risk drinking and cadmium exposure are risk factors for hypertension, most of these studies were limited to small populations or occupational workers exposed to a high concentration. Several studies that presented the joint effect of combined exposure of alcohol drinking and cadmium exposure on hypertension were also mainly conducted on animal experiments. This study will verify the individual effects of alcohol drinking and cadmium in the body and the joint effect of their co-exposure on hypertension in the general population.Methods We analyzed data from 6,795 Korean adults who had been randomly assigned to the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2013. Multiple linear and logistic regression analysis was conducted to estimate the association of alcohol drinking and blood cadmium concentration with blood pressure and odds ratio (OR) for hypertension.Results After adjusting for age, sex, smoking status, monthly income, education level, body mass index, stress level, physical activity, sodium intake, and the energy intake, ORs for hypertension comparing the group with high-risk alcohol drinking versus the group who did not was 1.67 (95% CI: 1.34, 2.06). In the same model, ORs for hypertension comparing the highest versus the lowest blood cadmium quartiles were 1.46 (95% CI: 1.15, 1.86), increasing significantly as cadmium concentration increased (p for trend &lt;0.001). The results of logistic regression analysis for the additive scale of joint effects, ORs for interaction term was 0.64 (95% CI: 0.14, 1.14, p-value=0.011).Conclusions This study supports the hypothesis that alcohol drinking and environmental cadmium exposures at levels currently observed in the Korea may increase the risk of hypertension. Our findings support efforts to reduce alcohol drinking and environmental cadmium exposure to prevent hypertension in the general population effectively.

Changing Patterns of Alcohol Use and Probability of Unsuppressed Viral Load Among Treated Patients with HIV Engaged in Routine Care in the United States.

We examined HIV viral load non-suppression ([Formula: see text] 200 copies/mL) subsequent to person-periods (3-18months) bookended by two self-reports of alcohol use on a standardized patient reported outcome assessment among adults in routine HIV care. We examined the relative risk (RR) of non-suppression associated with increases and decreases in alcohol use (relative to stable use), stratified by use at the start of the person-period. Increases in drinking from abstinence were associated with higher risk of viral non-suppression (low-risk without binge: RR 1.16, 95% CI 1.03, 1.32; low-risk with binge: RR 1.35, 95% CI 1.11, 1.63; high-risk: RR 1.89, 95% CI 1.16, 3.08). Decreases in drinking from high-risk drinking were weakly, and not statistically significantly associated with lower risk of viral non-suppression. Other changes in alcohol use were not associated with viral load non-suppression. Most changes in alcohol consumption among people using alcohol at baseline were not strongly associated with viral non-suppression.

Individual and Contextual Factors Associated With Hazardous Drinking in Spain: Evidence From a National Population-Based Study.

Heavy drinking (HD) and binge drinking (BD) exhibit marked differences in their relationships with contextual-level factors imbedded in geographical areas of residence. The objective is to identify sociodemographic factors, both at the individual and at the contextual level, associated with these 2 main hazardous consumption patterns. Cross-sectional study using data from the 2011 to 2012 National Health Survey in Spain. The sample included 21,007 individuals ≥15years of age. HD was defined as an alcohol intake of ≥40g/d in men and ≥24g/d in women. BD was defined as the consumption in the previous month of ≥6 alcoholic drinks (men) or ≥5 drinks (women) within 4 to 6hours. Individual-level variables included sociodemographic factors, urban/rural residence, smoking, and perceived social support. Contextual-level variables covered percentage of population with no schooling, unemployment rate, and hospitality industry-related economic activity, all at the census tract level. We analyzed data using multilevel logistic regression and calculated areas under the curve (AUC). Being male, smoking, high-income, and low perceived social support were associated with both hazardous drinking patterns. Younger individuals were at higher risk for BD but at lower risk for HD. BD was more common among rural than urban dwellers (odds ratios [OR]=1.35; 95% CI: 1.05 to 1.72), whereas HD was less likely in participants residing in areas with high unemployment rates (OR=0.62; 95% CI: 0.41 to 0.93). HD was more likely in census tracts with higher levels of hospitality industry activity (OR=1.74; 95% CI: 1.20 to 2.54). The AUC increased substantially for both HD and BD when the census tract variable was entered in the respective models (reaching 89.5 and 93.3%, respectively). Except for age, both drinking patterns have similar associations with individual-level variables but disparate links to contextual-level indicators. In both cases, accounting for area of residence substantially increased the ability to discriminate between high-risk drinkers from nonhazardous alcohol consumers.

Intersection of familial risk and environmental social control on high-risk drinking and alcohol dependence in a US national sample of adults

BackgroundEffects of a family history of alcoholism may be moderated by area-level social control factors. We examine whether increased neighborhood alcohol availability (low social control environment) or increased presence of religious adherents in the county (high social control environment) interact with family history in relation to alcohol outcomes. MethodsWeighted data from 12,686 adult drinkers (51% male; mean age 44; 80% White, 9% Black, 11% Hispanic) in three US National Alcohol Surveys were linked with data on area-level off-premise alcohol availability and adherence to religions with strong prohibitions against drinking. Family history density had four levels (family history negative, extended family only, first-degree relative(s) only, high family density). Dichotomous outcomes were past-year high-risk drinking and alcohol dependence. Logistic regression models with interaction terms assessed whether associations of family history with alcohol outcomes differed significantly by area-level social control. Stratified models assessed differences by sex and by race/ethnicity. ResultsIn the full sample, effects of first-degree relatives and high family density on high-risk drinking strengthened as alcohol availability increased. This was replicated in the subsample of women and suggested in relation to dependence among men and Black drinkers. For White drinkers, higher religious social control reduced effects of first-degree relatives on high-risk drinking. ConclusionsLow social control—in particular, greater density of off-premise alcohol outlets—appears to exacerbate effects of a family history of alcoholism on high-risk drinking. Policy makers should consider differential benefits of decreasing alcohol availability for people from high-risk families to reduce high-risk drinking and alcohol problems.

Older Physicians’ Reporting of Psychological Distress, Alcohol Use, Burnout and Workplace Stressors

Most of the published data on the psychological health of physicians has focused on the youngest members of the profession. The aims of this analysis were to determine how psychological morbidity changes across the career cycle. We report data from the cross-sectional National Mental Health Survey of Doctors and Medical Students, conducted in Australia. Age differences in psychological distress, suicidal ideation, alcohol use, burnout, workplace, and personal stressors were examined for younger (40 years and younger), middle aged (41-60), and older (61+) physicians. A total of 10,038 physicians responded. Older physicians reported significantly less psychological distress, burnout and suicidal ideation than younger and middle aged colleagues, findings that were maintained after adjusting for sex and excluding trainees. There were no group differences in overall alcohol use and high risk drinking. On multivariate analysis, the largest contributor to psychological distress in older physicians was a past history of mental disorder. There was a decline across age groups in the endorsement as "very stressful" of work-life conflict and work-anxiety stressors such as fear of making mistakes. Older physicians were least likely to feel very stressed by all workplace stressors. The better psychological health of older physicians highlights the need to consider physician health according to age and career stage. Apart from the decline in work stressors, in particular work-life conflict, there may be a survivor effect such that physicians who practice into older age have developed greater resilience and professional maturation.

Inhaling alcohol vapour or mist: An international study of use, effects and harms

ObjectivesTo determine the prevalence, patterns of use and consequences of inhaling alcohol vapour or mist. DesignCross-sectional survey recruiting an international non-probability sample of people who use alcohol and other drugs as part of the annual Global Drug Survey (GDS). SettingOnline questionnaire translated into 19 languages. Participants110,557 people took part in GDS2020 and 88,124 completed a question about inhaling alcohol in the last 12 months. The focus of this study is GDS2020 respondents who reported inhaling alcohol mist/vapour from a balloon in the last 12 months. Main outcomesLast 12-month use of alcohol vapour, onset duration, intensity of effects, value for money compared with alcohol, and incidence of falls/injuries. ResultsA total of 803 people reported the use of alcohol vapour in the last 12 months, with 51% of the sample coming from 3 countries: Australia, Denmark and England. Two-thirds were male, and they were more likely to be under 25. 45.7% reported that they were a bit/very drunk before they inhaled alcohol. 51.3% reported that the effects lasted for less than 5 mins. Both the intensity of effect and perceived value for money showed a normal distribution on a 10-point scale. 12.7% of respondents reported falling/injuring themselves. ConclusionInhaling alcohol vapour appears to be more common amongst younger, higher-risk drinkers. The rapid onset of action and inability to titrate consumption to effect is a risk for acute injury. We consider that alcohol is harmful enough through oral consumption without adding to the risk of injury by offering such a potentially risky additional administration method.

Peer-Led Training to Reduce Alcohol Misuse and Related Harm among Greek-Affiliated Students

Background High-risk alcohol use on college campuses is a significant public health concern, especially among students in fraternities and sororities. Alcohol harm-reduction programs that include protective behavioral strategies (PBSs) provide a promising approach to curb drinking among students, yet results have been inconsistent among high-risk drinkers. Purpose: To evaluate the impact of a harm-reduction, peer-led training program called “Voice of Reason” (VOR) on alcohol knowledge and behaviors among students in Greek chapters. Methods: We conducted two studies with students directly trained in VOR (Study 1: N = 118; Study 2: N = 53) and with students in affiliated Greek chapters (Study 1: N = 1363; Study 2: N = 1446). Study 1 included 13 chapters and Study 2 included 15 chapters. Results: Results of analyses across both studies showed that among those directly trained in VOR, there were pre-post increases in alcohol knowledge, medical amnesty law awareness, talking with friends about PBS, use of PBS, and intentions to use PBS, as well as pre-post decreases in drinking and driving and riding with drinking drivers. In addition, VOR had an impact on students in affiliated chapters, indicating an increase in medical amnesty law awareness and a decrease in the number of drinks consumed on a typical day. Conclusions: Overall, results provide some early evidence of VOR impact, while also demonstrating the challenge of changing normative drinking behaviors among high-risk college students. Ongoing research is needed to assess the effectiveness of VOR, especially after successive implementations with the same chapters.

Comparing responses to public health and industry-funded alcohol harm reduction advertisements: an experimental study

ObjectivesConduct a head-to-head experimental test of responses to alcohol harm reduction advertisements developed by alcohol industry Social Aspects/Public Relations Organisations (SAPROs) versus those developed by public health (PH) agencies. We...

High-risk lifestyle and all-cause mortality in older Australians with stroke: A data linkage study

Abstract Background Stroke prevention via lifestyle modification is a public health priority in developed countries. Few studies have examined the association of high-risk lifestyle factors with long-term mortality of stroke survivors. Therefore, this study aims to explore the effect of key lifestyle factors on all-cause mortality after stroke. Methods Sample is derived from the 45 and Up Study, the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. The lifestyle data in the 45 and Up Study between 2006 to 2015 were linked with data from the NSW Registry of Births, Deaths and Marriages, NSW Cause of Death Unit Record File, and NSW Admitted Patient Data Collection by the Centre for Health Record Linkage. We defined a high-risk lifestyle as no vigorous exercise, smokers, or &amp;gt; 10 alcoholic drinks/week. Multivariate Cox regression model is used to examine the effect of high-risk lifestyle on survival using 10-year all-cause mortality as the main outcome, adjusted for key confounders. Results We analysed information on 8410 adults with a stroke event occurring prior to the baseline 45 and Up Study, and 31% of them died in 10 years. 6219 participants were identified as having a high-risk lifestyle at baseline. Being a current smoker and without vigorous exercise were associated with 41% (95% CI: 16%, 73%) and 52% (95% CI: 30%, 78%) increase in the likelihood of death in 10 years, respectively. However, high-risk alcohol drinking was not significantly associated with survival. Of note, having cardiovascular-related comorbidities showed greater risks of mortality (HR range, 3.6-7.2). Conclusions High-risk lifestyle factors were associated with an increased risk of long-term all-cause mortality, suggesting that enhancing public health initiatives to promote 'healthy' lifestyle behaviours can be of great benefit to stroke survivors. Key messages It is essential for stroke survivors to maintain a healthy lifestyle to delay all-cause mortality. Stroke survivors with high-risk lifestyle may be associated with increased likelihood of death if they have comorbidities such as diabetes and hypertension.

Obesity, Diabetes, Coffee, Tea, and Cannabis Use Alter Risk for Alcohol-Related Cirrhosis in 2 Large Cohorts of High-Risk Drinkers.

Sustained high alcohol intake is necessary but not sufficient to produce alcohol-related cirrhosis. Identification of risk factors, apart from lifetime alcohol exposure, would assist in discovery of mechanisms and prediction of risk. We conducted a multicenter case-control study (GenomALC) comparing 1,293 cases (with alcohol-related cirrhosis, 75.6% male) and 754 controls (with equivalent alcohol exposure but no evidence of liver disease, 73.6% male). Information confirming or excluding cirrhosis, and on alcohol intake and other potential risk factors, was obtained from clinical records and by interview. Case-control differences in risk factors discovered in the GenomALC participants were validated using similar data from 407 cases and 6,573 controls from UK Biobank. The GenomALC case and control groups reported similar lifetime alcohol intake (1,374 vs 1,412 kg). Cases had a higher prevalence of diabetes (20.5% (262/1,288) vs 6.5% (48/734), P = 2.27 × 10-18) and higher premorbid body mass index (26.37 ± 0.16 kg/m2) than controls (24.44 ± 0.18 kg/m2, P = 5.77 × 10-15). Controls were significantly more likely to have been wine drinkers, coffee drinkers, smokers, and cannabis users than cases. Cases reported a higher proportion of parents who died of liver disease than controls (odds ratio 2.25 95% confidence interval 1.55-3.26). Data from UK Biobank confirmed these findings for diabetes, body mass index, proportion of alcohol as wine, and coffee consumption. If these relationships are causal, measures such as weight loss, intensive treatment of diabetes or prediabetic states, and coffee consumption should reduce the risk of alcohol-related cirrhosis.

The impact of an alcohol policy change on developmental trajectories of youth alcohol use: examination of a natural experiment in Canada.

In 2015, the Liquor Control Board of Ontario (LCBO) authorized sale of alcohol in some Ontario grocery stores. This research evaluates the impact of the new policy on alcohol use patterns of youth in a quasi-experimental setting with two control groups. The sample consists of 2267 grade 9 students attending 60 secondary schools across Ontario (n = 56) and Alberta (n = 4), who provided 4-year linked longitudinal data (2013-2014 to 2016-2017) inthe COMPASS study. The study used the frequency of drinking and the frequency of binge drinking to characterize alcohol use behaviours. Latent transition analysis found four statuses of alcohol use: abstainer, periodic drinker, low-risk drinker, and high-risk regular drinker. The new policy had no negative impact among periodic and low-risk drinkers, but the risk of transitioning from the abstainer (lowest risk status) to high-risk regular drinker (highest risk status) among the exposed cohort was 1.71 times greater post-policy than pre-policy change, compared with those of Ontario-unexposed (0.50) and Alberta-unexposed cohorts (1.00). The probability of sustaining high-risk drinking among the exposed cohort increased by a factorof 1.76, compared with 1.13-fold and 0.89-fold among the Ontario-unexposed and Alberta-unexposed cohorts, respectively. Youth are more likely to transition from abstinence to high-risk regular drinking, and high-risk regular drinkers are more likely to maintain their behaviours in the jurisdictions exposed to the latest change in LCBO policy authorizing grocery stores to sell alcohol. When formulating policy interventions, youth access to alcohol should be considered in orderto reduce their harmful alcohol consumption.