Household Alcohol Research Articles

Does Household Alcohol Consumption Affect Children’s Education? Evidence from a Lower Middle-Income Country

We examine the impact of alcohol consumption on children’s educational achievement using the Vietnam Household Living Standard Surveys from 2012 to 2018. We find that alcohol consumption negatively impacts children’s schooling years and their likelihood of tertiary and higher education, while also positively affecting the lag in their school achievement. The impact is more severe in rural areas, while urban areas show no evidence. The influence of alcohol consumption varies among regions, with southern areas having a stronger effect on children’s education. Female students appear to be more affected than male students when their households consume the same amount of alcohol.

Expanding our understanding of long-term trends in alcohol abstention and consumption in England (2001-19) using two age-period-cohort approaches.

Alcohol consumption has decreased in England in recent decades, while alcohol-specific death rates have remained relatively stable. Age-period-cohort (APC) models offer the potential for understanding these paradoxical trends. This study aimed to use an APC model approach to measure long-term trends in alcohol abstention and consumption in England from 2001 to 2019. The study used grouped and proxy-variable APC models of repeat cross-sectional survey data, set in England (2001-19). Participants were residents in England aged 13 years or over who took part in the Health Survey for England. Outcome variables were alcohol abstention and consumption in units. We created nine age groups (13-15, 16-17, 18-24, 25-34, until 65-74 and 75+, reference 45-54 years), four periods (2001-04, 2005-09, 2010-14 to 2015-19, reference 2005-09) and 18 5-year birth cohorts (1915-19 to 2000-04, reference 1960-64). We proxied age effects (systolic and diastolic blood pressure), period effects (alcohol affordability, internet usage and household alcohol expenditure) and birth cohort effects (prevalence of smoking and prevalence of overweight). The odds of abstaining were considerably larger at young ages, 13-15 years [odds ratio (OR) = 5.38; 95% confidence interval (CI) = 4.50-6.43], were lowest during the first period, 2001-04 (OR = 0.83; 95% CI = 0.79-0.86) and had a U-shaped pattern by birth cohort. For units of alcohol, the incidence rate ratio (IRR) increased until age 18-24 years (IRR = 1.41, 95% CI = 1.34-1.48) and decreased afterwards, were highest during the first period, 2001-04 (IRR = 1.07; 95% CI = 1.05-1.08) and showed an inverted J-shape by birth cohort. Our proxy variable approach revealed that using blood pressure measures, alcohol affordability and prevalence of overweight as proxies resulted in APC effects that differed from our base-case model. However, internet usage, household expenditure on alcohol and smoking prevalence resulted in APC effects similar to our base-case model. The discrepancy between decreasing alcohol consumption and increasing alcohol-related deaths observed in England from 2001 to 2019 may, in part, be explained by the halt in abstention trends since 2010 and a slight consumption decline since 2001.

Socio-economic determinants of alcohol consumption for South Africa

Aims: To examine the socio-economic factors associated with alcohol consumption in South Africa.
 Design: Cross-sectional study exploring the various socio-economic factors associated with alcohol consumption in South Africa.
 Setting: South Africans older than 15 years across the country’s nine provinces.
 Participants: Adult respondents of the drinking status and alcohol intensity questions in Wave 4 of the National Income Dynamics Study (NIDS) (n=28 401).
 Measures: Alcohol, demographic, emotional, health and neighbourhood variables.
 Findings: White and Mixed Heritage (referred to as ‘Coloured’ in South Africa) adults were more likely to consume alcohol, while Indian and White adults were less likely to binge drink relative to African adults. Males with a very good self-perceived health were less likely to binge drink while males who resided in neighbourhoods where frequent alcohol and drug abuse was common, were more likely to binge drink. Females who exercised more than three times a week were also more likely to drink and binge drink. Females with a poor self-perceived health status are less likely to binge drink. Adults who smoked were more likely to drink and binge drink relative to non-smoking adults. Accounting for binge drinkers’ household size, average monthly household spending for binge drinkers was low, suggesting that binge drinkers under-reported household alcohol spending. There was evidence of drinking and binge drinking among pregnant women.
 Conclusions: With respect to binge drinking, race, gender, smoking, neighbourhood, self-perceived health, pregnancy and household alcohol spending warrant further investigation and consideration for possible future alcohol interventions in South Africa.

Alcohol Consumption during the Covid-19 Pandemic in India

The study examines the impact of Covid-19-induced economic stressors (such as incomes and job losses) on household alcohol consumption in India. Our analysis, based on eight waves of the Centre for Monitoring Indian Economy–Consumer Pyramids Household Survey (CMIE-CPHS) for the period January 2019–August 2021, confirms an increased consumption of alcohol during the pandemic despite supply restrictions imposed by the state. A spurt was witnessed across socioeconomic groups with varying intensities. This confirms the self-medication hypothesis and stress-response-dampening theory that households responded to the pandemic-related economic and psychological shocks by increasing the consumption of alcohol and is more significant for the poor and the marginalised. JEL Codes: D12, C23

Comparing relationships between single types of adverse childhood experiences and health-related outcomes: a combined primary data study of eight cross-sectional surveys in England and Wales

ObjectivesAdverse childhood experiences (ACEs) show strong cumulative associations with ill-health across the life course. Harms can arise even in those exposed to a single ACE type but few studies examine...

Adverse childhood experiences and sipping alcohol in U.S. children: Findings from the Adolescent Brain Cognitive Development Study

The objective of this study was to explore the relationship between accumulating adverse childhood experiences (ACEs) and sipping alcohol in a large, nationwide sample of 9-to-10-year-old U.S. children. We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study (2016–2018). Of 10,853 children (49.1 % female), 23.4 % reported ever sipping alcohol. A greater ACE score was associated with a higher risk of sipping alcohol. Having 4 or more ACEs placed children at 1.27 times the risk (95 % CI 1.11–1.45) of sipping alcohol compared to children with no ACEs. Among the nine distinct ACEs examined, household violence (Risk Ratio [RR] = 1.13, 95 % CI 1.04–1.22) and household alcohol abuse (RR = 1.14, 95 % CI 1.05–1.22) were associated with sipping alcohol during childhood. Our findings indicate a need for increased clinical attention to alcohol sipping among ACE-exposed children.

Association between caregiver and household alcohol use and child behavior problems in KwaZulu Natal, South Africa.

We explored the association between household alcohol use and behavior problems among South-African children, using data from the Asenze study, a population-based cohort of South African children and their caregivers. Household alcohol use and child behavior were assessed when children were 6-8 years old. To examine the association, we performed linear regressions. The sample included 1383 children with complete data under the care of 1251 adults. Children living in a household where self-reported caregiver alcohol use was scored as hazardous (4.6%) had higher levels of problem behavior (β = 1.94, 95% CI 0.06-3.82). There were no statistically significant associations between reported hazardous alcohol use by another member of the household (14.5%) and child problem behavior. Hazardous household alcohol use was associated with child problem behavior and this effect appeared to be mainly driven by primary caregiver use.

The COVID-19 alcohol paradox: British household purchases during 2020 compared with 2015-2019.

British supermarket-panel data suggest no increases in overall sales and purchases of alcohol following COVID-19 lockdowns, yet survey and mortality data suggest otherwise. This paper attempts to unravel the paradox. Based on purchase data of 79,417 British households from Kantar Worldpanel, we undertake controlled interrupted time series analysis of the impact of COVID-19 confinement introduced on 23rd March 2020, and variably applied during 2020, compared to purchases during 2015 to 2019 as controls. We also undertook Poisson regression analyses to estimate if changes in purchases differed by household socio-demographic and economic factors. Excess off-trade household alcohol purchases (expressed as grams of ethanol) following the introduction of confinement, were 29.2% higher (95% CI = 25.8% to 32.5%) for the post-confinement months of 2020, being larger until mid-July 2020 (37.5%, 95%CI = 33.9 to 41.26%) when pubs re-opened with restrictions, and smaller (24.6%, 95%CI = 21.6 to 27.7) thereafter. During the time of complete pub closures, and fully adjusting for no on-trade purchases, household purchases of alcohol did not change when compared with the same time period during 2015–2019 (coefficient = -0.9%, 95%CI = -5.6 to 3.8). Excess purchases from 23rd March to 31st December 2020 varied by region of Great Britain, being higher in the north of England, and lower in Scotland and Wales. Excess purchases were greater in the most deprived households, compared with the least deprived households. Excess purchases increased substantially as the amount of alcohol normally purchased by a household increased, with the top one fifth of households that normally bought the most alcohol increasing their purchases more than 17 times than the bottom one fifth of households that bought the least alcohol. That the heaviest buyers of alcohol increased their purchases the most, with some independent impact of socio-economic disadvantage, might explain why reported alcohol problems and recent alcohol-related death rates might have increased. A conclusion of this is that alcohol policy to reduce high consumption of alcohol, and the availability of help and treatment to reduce alcohol consumption become more important during extraordinary times, such as COVID lockdowns.

Socio-economic determinants of alcohol consumption for South Africa

Aims: To examine the socio-economic factors associated with alcohol consumption in South Africa.
 Design: Cross-sectional study exploring the various socio-economic factors associated with alcohol consumption in South Africa.
 Setting: South Africans older than 15 years across the country’s nine provinces.
 Participants: Adult respondents of the alcohol intensity and frequency questions in Wave 4 of the National Income Dynamics Study (NIDS) (n=28 401).
 Measures: Alcohol, demographic, emotional, health and neighbourhood variables.
 Findings: White and Mixed Heritage (referred to as ‘Coloured’ in South Africa) adults were more likely to consume alcohol, while Indian and White adults were less likely to binge drink relative to African adults. Males at greater risk of depression, and those who resided in neighbourhoods where frequent alcohol and drug abuse was common, were more likely to binge drink. Females who exercised more than three times a week were also more likely to drink and binge drink. Adults who smoked were more likely to drink and binge drink relative to non-smoking adults. Accounting for binge drinkers’ household size, average monthly household spending for binge drinkers was low, which suggests that binge drinkers under-reported household alcohol spending. There was evidence of drinking and binge drinking among pregnant women.
 Conclusions: Binge drinking trends related to race, gender, neighbourhood, pregnancy and household alcohol spending warrant further investigation and consideration for possible future alcohol interventions in South Africa.

Risk factors for deliberate self-harm in young people in rural Sri Lanka: a prospective cohort study of 22,000 individuals.

Over 90% of youth suicide deaths occur in low- and middle-income countries. Despite this relatively little is known about risk factors in this context. Investigate risk factors for deliberate self-harm (non-fatal) in young people in rural Sri Lanka. A prospective cohort study of 22,401 individuals aged 12-18 years with complete data on sex, student status, household asset score, household access to pesticides and household problematic alcohol use. Deliberate self-harm was measured prospectively by reviewing hospital records. Poisson regression estimated incidence rate ratios (IRRs) for the association of risk factors with deliberate self-harm. Females were at higher risk of deliberate self-harm compared to males (IRR 2.05; 95%CI 1.75 - 2.40). Lower asset scores (low compared to high: IRR 1.46, 95%CI 1.12 - 2.00) and having left education (IRR 1.61 95%CI 1.31 - 1.98) were associated with higher risks of deliberate self-harm, with evidence that the effect of not being in school was more pronounced in males (IRR 1.94; 95%CI 1.40 - 2.70) than females. There was no evidence of an association between household pesticide access and deliberate self-harm risk, but problematic household alcohol use was associated with increased risk (IRR 1.23; 95%CI 1.04 - 1.45), with evidence that this was more pronounced in females than males (IRR for females 1.42; 95%CI 1.17 - 1.72). There was no evidence of deliberate self-harm risk being higher at times of school exam stress. Indicators of lower socioeconomic status, not being in school, and problematic alcohol use in households, were associated with increased deliberate self-harm risk in young people.

The interaction of adverse childhood experiences and gender as risk factors for depression and anxiety disorders in US adults: a cross-sectional study

BackgroundExposure to adverse childhood experiences (ACEs) and being female are distinct risk factors for having a major depressive episode (MDE) or an anxiety disorder (AD) in adulthood, but it is unclear whether these two risk factors are synergistic. The purpose of this study was to determine whether exposure to ACEs and being female are more than additive (synergistic) in their association with MDE and AD in US adults.MethodsWe pooled cross-sectional survey data in the Midlife in the United States study from two nationally-representative cohorts of English-speaking US adults. Data from the first cohort were collected in 2004–2006 and from the second in 2011–2014. Data from both cohorts included the 12-month prevalence of MDE and AD (generalized anxiety disorder or panic disorder) assessed with the Composite International Diagnostic Interview Short Form, gender (here termed female and male), and the count of five categories of exposure to ACEs: physical, sexual, or emotional abuse; household alcohol or substance abuse; and parental separation or divorce.ResultsOf the 5834 survey respondents, 4344 (74.5%) with complete data on ACEs were included in the analysis. Mean (SD) age was 54.1 (13.8) years and 53.9% were female. The prevalences of MDE, AD, and exposure to 3–5 categories of ACEs were 13.7, 10.0, and 12.5%, respectively. After adjusting for covariates (age, race, and current and childhood socioeconomic disadvantage), for those with both risk factors (female and 3–5 ACEs) the prevalence of MDE was 26.9%. This was 10.2% (95% CI: 1.8, 18.5%) higher than the expected prevalence based on the additive associations of the two risk factors. The adjusted prevalence of AD among females with 3–5 ACEs was 21.9%, which was 11.4% (95% CI: 4.0, 18.9%) higher than the expected prevalence.ConclusionsFor both MDE and AD, there was synergy between the two risk factors of exposure to ACEs and being female. Identification and treatment of MDE and AD may benefit from understanding the mechanisms involved in the synergistic interaction of gender with ACEs.

Identification of Associated Factors and Prediction for the Level of Intimate Partner Violence against Women in Sri Lanka

Intimate partner violence (IPV) can be defined as a serious social problem rapidly increasing in Sri Lanka as same as in other countries in the world. The Sri Lanka Demographic and Health Survey (SLDHS) 2016 revealed that 17% of married women age 15-49 in Sri Lanka have become victims of IPV. The objectives of this study were to determine the factors associated with IPV against women in Sri Lanka and to develop an appropriate regression model and feedforward neural network (FNN) to predict the Violence Index which describes the level of IPV against women in the country. The data records of 2494 ever-married women that have experienced IPV were considered from Sri Lanka Demographic and Health Survey 2016. The Violence Index was estimated using Multiple Correspondence Analysis. Gamma regression analysis revealed that religion, education level of the woman, husband’s occupation, woman’s married time, the age difference between husband and wife, Empowerment Indicator, enough money for daily household expenses, and household alcohol consumption were significantly associated with IPV against women. The optimum FNN consists of one hidden layer with 3 neurons provided a better prediction on the Violence Index with the minimum mean squared error for the testing set. Based on the prediction accuracy, the FNN was found to be better than the gamma regression model. The findings of this study would support an effort to develop the current policies and implement prevention programs against IPV in Sri Lanka.

A Systematic Review of Household and Family Alcohol Use and Childhood Neurodevelopmental Outcomes in Low- and Middle-Income Countries

Childhood exposure to alcohol misuse by household adults has been related to childhood developmental delay, cognitive impacts, mental illness, and problem behaviours. Most evidence comes from high income countries. This systematic review only included studies from low- and middle-income countries (LMICs). Five databases were searched from 1990–2020. Twenty-eight studies of children 0–12 years were included, with 42,599 participants from 11 LMICs. The most common outcome was behavioural problems/disorders (19 studies). Despite varying study designs, this review found that alcohol misuse by household members in LMICs is associated with adverse child neurodevelopmental outcomes, although casual inferences cannot be drawn in the absence of well conducted prospective studies. Statistically significant correlations were described between parental alcohol misuse and child emotional and behavioural difficulties, cognitive delay, and risky behaviours. In future, prospective cohort studies are recommended, with adjustment for confounders.

Washington's privatization of liquor: effects on household alcohol purchases from Initiative 1183.

Washington Initiative 1183 (I-1183), a 2012 law that privatized liquor retail sales and distribution in Washington State, USA, has had two opposing effects on liquor purchases: it has increased access to liquor and imposed new fees on retailers and distributors. This study aimed to estimate the effect of I-1183 on monthly alcohol purchases during the post-I-1183 period (June 2012-December 2014) compared with the pre-I-1183 period (January 2010-May 2012). DIFFERENCES-IN-DIFFERENCES STUDY: Setting and participants The study included households participating in the Nielsen Consumer Panel Dataset living in metropolitan and surrounding areas in Washington State and 10 control states. Measurements Outcomes were alcohol purchases by type (ounces of liquor, wine, beer and total alcohol or ethanol). Findings I-1183 was associated with a 6.34-ounce (P<0.001) and a 2.01-ounce (P<0.001) increase in monthly liquor and ethanol purchases, respectively, per household in the post-policy period spanning 31months compared with monthly purchases in control states. In a longitudinal subgroup analysis, low and moderate alcohol purchasers increased monthly purchases of ethanol and high purchasers decreased purchases of ethanol. Conclusions Enacting 'Washington Initiative 1183', a law that privatized sale and distribution of liquor and imposed new fees on retailers and distributors, appears to have been associated with an approximate 82% increase in monthly liquor purchases and 26% increase in monthly ethanol purchases by households in metropolitan and surrounding areas in Washington State, USA.

Immediate impact of minimum unit pricing on alcohol purchases in Scotland: controlled interrupted time series analysis for 2015-18

ObjectiveTo assess the immediate impact of the introduction of minimum unit pricing in Scotland on household alcohol purchases.DesignControlled interrupted time series analysis.SettingPurchase data from Kantar Worldpanel’s household shopping panel for...

Determinants of Household Alcohol and Tobacco Expenditures in Turkey

In line with the recommendation by the World Health Organization (WHO), prices are used as policy instruments in many countries in discouraging the consumption of alcohol and tobacco products. Due to the complexity in the interplay of the household sociodemographic and economic factors in these countries, the effectiveness of price-related intervention tends to be limited in scope and unsustainable. We aim at determining the key factors in the spending decisions and the levels of spending on alcohol and tobacco products using a multivariate sample selection model, estimated with recent survey data collected by the Turkish Statistical Institute. We identify a number of sociodemographic and economic factors related to the excessive use of these products in the country. These findings can inform policy deliberation in curbing the use of alcohol and tobacco products.

Does retirement affect alcohol expenditure? Evidence from urban Chinese older adults in 2002-2009

Exploiting China’s mandatory retirement policy, we used fuzzy regression discontinuity design to estimate the effect of retirement on household alcohol expenditure among urban Chinese older adults ages 50–70. Drawing on data from the Urban Household Survey of China Statistics Bureau for the period of 2002–2009, we found that having a retired male household head significantly reduced total household expenditure on alcohol by 32%. After breaking down by different types of alcohol, we found that the retirement effect was largely driven by expenditure on liquor. We explored two potential mechanisms that may explain the retirement effect. The first mechanism relates to decreased disposable income after retirement and the second mechanism involves reduced demand of social drinking after retirement. Our findings suggest that the urban Chinese older adults experience substantial change in such health behavior as drinking as they retire. This has important public policy implications as China is facing a severe challenge of rapid population aging.

Does retirement affect alcohol expenditure? Evidence from urban Chinese older adults in 2002-2009

Exploiting China’s mandatory retirement policy, we used fuzzy regression discontinuity design to estimate the effect of retirement on household alcohol expenditure among urban Chinese older adults ages 50–70. Drawing on data from the Urban Household Survey of China Statistics Bureau for the period of 2002–2009, we found that having a retired male household head significantly reduced total household expenditure on alcohol by 32%. After breaking down by different types of alcohol, we found that the retirement effect was largely driven by expenditure on liquor. We explored two potential mechanisms that may explain the retirement effect. The first mechanism relates to decreased disposable income after retirement and the second mechanism involves reduced demand of social drinking after retirement. Our findings suggest that the urban Chinese older adults experience substantial change in such health behavior as drinking as they retire. This has important public policy implications as China is facing a severe challenge of rapid population aging.

Abstract 5259: Cancer incidence in relation to body fatness in China: Evidence from a large population-based cohort study

Abstract Body fatness has been associated with several cancers in developed countries, but little is known in China. The purpose of this study was to examine the association between body fatness and cancer incidence, with different anthropometric measures, and compare their predicting values. Between June 2004 and July 2008, the China Kadoorie Biobank (CKB) study recruited 0.5 million adults aged 30-79 years from 10 geographically diverse areas across China, and followed up until December, 2015. Body-mass index (BMI), body fat percentage (BFP), waist circumference (WC), and waist-to-hip ratio (WHR) were measured at baseline. Cox regression yielded adjusted hazard ratios (HRs) associating incidence of all cancers and 15 site-specific cancers with different anthropometric measures, adjusting for education level, marital status, annual household income, alcohol consumption, smoking status and physical activity, and stratifying by age at risk, sex, and region. We compared the ability of cancer risk prediction between different anthropometric measures through a receiver operating characteristic (ROC) analysis. Among 508,362 participants, the overall mean (SD) BMI was 23.66 (3.38) kg/m2, 31.11% of men and 34.24% of women were overweight or obesity (BMI≥25.0kg/m2), and 4.41% of men and 4.26% of women were underweight (BMI&amp;lt;18.5kg/m2). 21,474 incident cancers were identified over an average of 8.94 years of follow-up. Each 5 kg/m2 increase in BMI was associated with an increased risk of endometrial (HR, 2.01; 95% CI, 1.72 to 2.35), postmenopausal breast (HR, 1.29; 95% CI, 1.18 to 1.40), colorectal (HR, 1.17; 95% CI, 1.10 to 1.25) and cervical (HR, 1.15; 95% CI, 1.03 to1.29) cancer, whereas it was associated with a reduced risk of oesophageal (HR, 0.73; 95% CI, 0.67 to 0.79), lung (HR, 0.78; 95% CI, 0.74 to 0.82), liver (HR, 0.85; 95% CI, 0.79 to 0.92), and stomach (HR, 0.88; 95% CI, 0.82 to 0.94) cancer. BMI was the best risk prediction measure for postmenopausal breast and endometrial cancer, whereas BFP were the best for oesophageal, lung, liver and stomach cancer, and WC and WHR did for colorectal cancer. BMI is related to the incidence of several cancers in China. Obesity and overweight, as well as underweight, contribute to the cancer incidence in China. Other anthropometric measures may add information for cancer-specific risk prediction. Citation Format: Lu Wang, Guangfu Jin, Canqing Yu, Jun Lv, Yu Guo, Zheng Bian, Ling Yang, Yiping Chen, Zhibin Hu, Feng Chen, Zhengming Chen, Liming Li, Hongbing Shen. Cancer incidence in relation to body fatness in China: Evidence from a large population-based cohort study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5259.

By-product Originating from Artisan Distillers of Rice Alcohol in Northern Vietnam: Production, Use and Nutrient Value for Smallholder Pig Raising

The objective of this study was to investigate by-product production originating from artisan distillers of rice alcohol and its use as pig feed in three provinces (Hai Duong, Hung Yen and Bac Giang) of Northern Vietnam. A total of 120 rice alcohol producers classified by production scales (30 producers for Large-L, 45 producers for Medium-M and 45 producers for Small-S) were interviewed from January to August 2015. Additionally, sixty-three rice distiller’s by-product samples were collected from the study areas to determine their daily nutrient content according to one week storage time. The annual dry matter feedstuff production was estimated to 4.8, 3.0 and 2.1 tons per household for L, M and S scales, respectively (p<0.001). Swine herd size increased with the scale of household alcohol production (p<0.05). The proportion of rice distiller’s by-product in diet of swine lowered when turning from pregnant to lactating sows, and varied in fattening pigs. Rice distiller’s by-product was rich in high quality crude protein, copper and lactic acid but poor in dry matter. Its nutritive value remained stable over a week under ambient conditions. In conclusion, rice distiller’s by-product provides significant and stable amounts of nutrients in northern vietnamese pig production.