Initiation Of Alcohol Use Research Articles

Differences and similarities in adolescents accessing emergency care for acute alcohol intoxication in three urban regions in Italy, Belgium, and The Netherlands

Abstract Background Excessive drinking among adolescents in Western Europe is prevalent, posing significant health risks and societal costs. Early initiation of alcohol use and binge drinking are associated with adult alcohol use disorders. Collecting comprehensive data on adolescent drinking patterns is crucial for developing effective prevention strategies. Methods To gain insight into the demographic and clinical characteristics of acute alcohol intoxication (AAI), we analysed emergency department access data of adolescents aged 14-17 years presenting with AAI symptoms from 2015-2023. Three urban regions were included: the Reinier de Graaf Gasthuis in Delft (The Netherlands), eight combined hospitals in Antwerp (Belgium) and the IRCCS San Martino Hospital in Genoa (Italy). Results A total of 1841 patients with symptoms of AAI were included. The mean age of patients in the Netherlands was statistically significant younger than in Italy and Belgium (15.7 compared to 15.9 and 16.0 years old, respectively). Moreover, the blood alcohol concentration was higher in the Netherlands and Belgium compared to Italy (2.0‰ compared to 1.95‰ and 1.8‰ respectively). The distribution of sex was nearly equal in the Netherlands, while statistically significant differences were observed with a higher proportion of males in Italy (54.8%) and Belgium (56.8%). Combined drug use was lower in Belgium with 10.0%, compared to 13.4% in The Netherlands and 14.7% in Italy. The most common reason for admission was ‘reduced consciousness’ in the total population (45.2%). Conclusions This is one of the first international studies which combines data on AAI in minors. In the future, efforts should be made to establish a common European database where records of AAI can be stored and analysed more efficiently for prevention purposes.

Ecological Momentary Assessment of Alcohol Marketing Exposure, Alcohol Use, and Purchases Among University Students: Prospective Cohort Study.

The relationships between alcohol marketing exposure, alcohol use, and purchase have been widely studied. However, prospective studies examining the causal relationships in real-world settings using mobile health tools are limited. We used ecological momentary assessment (EMA) to examine both the within-person- and between-person-level effects of alcohol marketing exposure on any alcohol use, amount of alcohol use, any alcohol purchase, and frequency of alcohol purchase among university students. From January to June 2020, we conducted a prospective cohort study via EMA among university students in Hong Kong who reported current drinking. Over 14 consecutive days, each participant completed 5 fixed-interval, signal-contingent EMAs daily via a smartphone app. Each EMA asked about the number and types of alcohol marketing exposures, the amount and types of alcohol used, and whether any alcohol was purchased, all within the past 3 hours. We used 2-part models, including multilevel logistic regressions and multilevel gamma regressions, to examine if the number of alcohol marketing exposure was associated with subsequent alcohol use and alcohol purchase. A total of 49 students participated, with 33% (16/49) being male. The mean age was 22.6 (SD 2.6) years. They completed 2360 EMAs (completion rate: 2360/3430, 68.8%). Participants reported exposure to alcohol marketing in 5.9% (140/2360), alcohol use in 6.1% (145/2360), and alcohol purchase in 2.4% (56/2360) of all the EMAs. At the between-person level, exposure to more alcohol marketing predicted a higher likelihood of alcohol use (adjusted odd ratio [AOR]=3.51, 95% CI 1.29-9.54) and a higher likelihood of alcohol purchase (AOR=4.59, 95% CI 1.46-14.49) the following day. Exposure to more alcohol marketing did not increase the amount of alcohol use or frequency of alcohol purchases the following day in participants who used or purchased alcohol. At the within-person level, exposure to more alcohol marketing was not associated with a higher likelihood of alcohol use, amount of alcohol use, higher likelihood of alcohol purchase, or frequency of alcohol purchases the following day (all Ps>.05). Each additional exposure to alcohol marketing within 1 week predicted an increase of 0.85 alcoholic drinks consumed in the following week (adjusted B=0.85, 95% CI 0.09-1.61). On days of reporting alcohol use, the 3 measures for alcohol marketing receptivity were not associated with more alcohol use or purchase (all Ps>.05). By using EMA, we provided the first evidence for the effect of alcohol marketing exposure on initiating alcohol use and purchase in current-drinking university students. Our findings provide evidence of the regulation of alcohol marketing for the reduction of alcohol use and purchase among young adults.

Adolescent alcohol use is associated with differences in the diversity and composition of the oral microbiome.

Adolescence is a sensitive stage of oral microbial development that often coincides with the initiation and escalation of alcohol use. Thus,adolescents may be particularly susceptible to alcohol-induced alterations in the oral microbiome, though minimal research has been done in this area. Understanding the connection between the oral microbiome and alcohol use during adolescence is important to understand fully the biological consequences of alcohol use to mitigate potential adverse outcomes. Saliva samples were collected from adolescents aged 17-19 who used alcohol heavily (n = 21, 52.4% female) and those who did not use alcohol or any other substances (n = 18, 44.4% female). We utilized 16S rRNA sequencing to examine differences in microbial diversity and composition between the groups. Foralpha diversity, evenness was significantly lower in the drinking group than the control group as indicated by Pielou's evenness, Shannon, and Simpson indices. There were no statistically significant findings for beta diversity. Differential abundance analyses revealed higher abundances of Rothia and Corynebacterium in the alcohol-using group using both centered-log-ratio and relative abundance normalization. These genera are known for their high capacity to convert alcohol into acetaldehyde, a toxic metabolite reported to play a role in the neurobiological effects of alcohol. An unclassified Clostridia UCG-014, Streptobacillus, Comamonas, unclassified Lachnospiraceae, and Parvimonas were also identified as significantly different between groups when using only one of the normalization techniques. This is the first study designed specifically to compare the oral microbiome of adolescents who use alcohol with that of control participants. Our findings reveal distinct alcohol-related differences in microbial composition and taxon abundance, emphasizing the importance of understanding the impact onthe oral microbiome of alcohol use during adolescence. Because the oral microbiome is malleable, this study provides foundational work for future prevention and intervention studies.

Even worse for Black girls: the longitudinal association of racial bullying with the initiation of alcohol and tobacco use.

We used Poisson's linear regression to examine the association between racial bullying (RB) and the initiation of alcohol and tobacco uses after 9 months. Two cluster-randomized controlled trials were conducted in 2019 with children in grades five (girls: 50.0%; 10 years old: 82.0%; White: 36.8%; Black: 58.7%; others: 4.5%) and seven (girls: 49.5%; 12 years old: 78.1%; White: 33.2%; Black: 60.4%; others: 6.4%) from 30 public schools in the municipality of São Paulo, Brazil. We restricted our analyses to 2 subsets of students in each grade: those who reported no lifetime alcohol use at baseline and those who reported no lifetime baseline tobacco use. At baseline, 16.2% of fifth and 10.7% of seventh graders reported suffering from RB in the 30 days before data collection. After 9 months, 14.9% of fifth graders started using alcohol and 2.5%, tobacco. Among seventh graders, the figures were 31.2% and 7.7%, respectively. RB predicted the initiation of use of alcohol (risk ratio [RR]= 1.36; 95% CI, 1.07-1.70) and tobacco (RR= 1.81; 95% CI, 1.14-2.76) among seventh graders, with race-gender differences, particularly in Black girls (alcohol: RR= 1.45; 95% CI, 1.07-1.93; tobacco: RR= 2.34; 95% CI, 1.31-3.99). School-based programs and policies must explicitly address issues related to racism and gender in alcohol and tobacco prevention strategies.

Acceptability and feasibility of a mobile behavioral economic health intervention to reduce alcohol use in adults in rural areas

BackgroundAt-risk alcohol use is associated with increased adverse health consequences, yet is undertreated in healthcare settings. People residing in rural areas need improved access to services; however, few interventions are designed to meet the needs of rural populations. Mobile interventions can provide feasible, low-cost, and scalable means for reaching this population and improving health, and behavioral economic approaches are promising. MethodsWe conducted a pilot randomized controlled trial focused on acceptability and feasibility of a mobile behavioral economic intervention for 75 rural-residing adults with at-risk alcohol use. We recruited participants from a large healthcare system and randomized them to one of four virtually-delivered conditions reflecting behavioral economic approaches: episodic future thinking (EFT), volitional choice (VC), both EFT and VC, or enhanced usual care control (EUC). The intervention included a telephone-delivered induction session followed by two weeks of condition-consistent ecological momentary interventions (EMIs; 2x/day) and ecological momentary assessments (EMAs; 1x/day). Participants completed assessments at baseline, post-intervention, and two-month follow-up, and provided intervention feedback. ResultsAll participants completed the telephone-delivered session and elected to receive EMI messages. Average completion rate of EMAs across conditions was 92.9%. Among participants in active intervention conditions, 89.3% reported the induction session was helpful and 80.0% reported it influenced their future drinking. We also report initial alcohol use outcomes. DiscussionThe behavioral economic intervention components and trial procedures evaluated here appear to be feasible and acceptable. Next steps include determination of their efficacy to reduce alcohol use and public health harms.

FARESHARE: An open-source apparatus for assessing drinking microstructure in socially housed rats

Social factors have been shown to play a significant and lasting role in alcohol consumption. Studying the role of social context on alcohol drinking is important to understand the factors that contribute to the initiation or maintenance of casual and problematic alcohol use, as well as those that may be protective. A substantial body of preclinical research has shown that social environment such as housing conditions and social rank plays an important role in alcohol consumption and preference, though the extent of these effects have been obfuscated by methodological differences and technical challenges. Robust individual differences in alcohol intake in socially housed animals are difficult to track when animals share a common fluid source. Commercial solutions are prohibitively expensive and are limited by proprietary software and hardware (including caging systems). Here we describe FARESHARE, an affordable, open-source solution for tracking fluid consumption in socially housed rats. The device uses RFID and custom hardware to individually measure and record each rat’s fluid consumption and licking microstructure. Each bout is also timestamped such that the circadian effects of drinking behaviour may be analysed. We provide a validation showing the operation of the device in a two-bottle-choice alcohol-drinking paradigm over a nine-day period in four group-housed female rats. We show that FARESHARE is able to capture traditional measures such as daily intake and preference, as well as circadian effects, microstructure, and individual variations in drinking.

Use and co-use of alcohol and cannabis following physical pain in the daily life of community adults engaged in regular substance use.

Alcohol and cannabis are often perceived as pain-relieving. However, minimal work has examined whether people use and co-use these substances following pain in daily life. Forty-six adults reporting weekly use of alcohol and/or cannabis completed a 60-day ecological momentary assessment protocol, answering at least four daily reports on their alcohol and cannabis use and pain (nassessments = 10,769 over 2,656 days). We examined whether self-reported pain so far that day (cumulative-average pain) was associated with subsequent alcohol and cannabis use and same-occasion co-use. Models also addressed whether associations differed for initiating versus continuing a use episode. Hypotheses were preregistered. A multinomial multilevel model found that cumulative-average pain was associated with a greater likelihood of same-occasion co-use in the continuation phase but not the initiation phase, compared to no use (OR = 1.48,95% CI [1.06, 2.06], p = .023) and alcohol use (OR = 1.52, CI [1.03, 2.26], p = .037). Cumulative-average pain was largely not associated with alcohol-only and cannabis-only use. After alcohol use, greater pain was associated with cannabis use (OR = 1.37, CI [1.11, 1.70], p = .004), but not the reverse. Secondary analyses found greater previous-occasion (not cumulative) pain was associated with initiation of alcohol use and number of drinks, and initiation and continuation of cannabis use, but not number of cannabis hits. Although not all hypotheses were supported, pain was associated with subsequent substance use in this sample engaged in regular substance use and not recruited for chronic pain. Cumulative pain may be particularly related to alcohol-cannabis same-occasion co-use, which may increase the risk of substance use-related problems over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Genetic and environmental influence on alcohol intent and alcohol sips among U.S. children-Effects across sex, race, and ethnicity.

Alcohol intent (the susceptibility to initiating alcohol use) and alcohol sips (the initiation of alcohol) in youth are a multifactorial puzzle with many components. This research aims to examine the connection between genetic and environmental factors across sex, race and ethnicity. Data was obtained from the twin hub of the Adolescent Brain Cognitive Development (ABCD) study at baseline (2016-2018). Variance component models were conducted to dissect the additive genetic (A), common (C) and unique environmental (E) effects on alcohol traits. The proportion of the total alcohol phenotypic variation attributable to additive genetic factors is reported as heritability (h2). The sample (n = 1,772) included an approximately equal male-female distribution. The 886 same-sex twin pairs were 60.4% dizygotic (DZ), 39.6% monozygotic (MZ), 65.4% non-Hispanic Whites, 13.9% non-Hispanic Blacks, 10.8% of Hispanics with a mean age of 121.2 months. Overall, genetic predisposition was moderate for alcohol intent (h2 = 28%, p = .006) and low for alcohol initiation (h2 = 4%, p = 0.83). Hispanics (h2 = 53%, p < .0001) and Blacks (h2 = 48%, p < .0001) demonstrated higher alcohol intent due to additive genetic factors than Whites (h2 = 34%, p < .0001). Common environmental factors explained more variation in alcohol sips in females (c2 = 63%, p = .001) than in males (c2 = 55%, p = .003). Unique environmental factors largely attributed to alcohol intent, while common environmental factors explained the substantial variation in alcohol initiation. Sex and racial/ethnic disparities in genetic and environmental risk factors for susceptibility to alcohol initiation can lead to significant health disparities. Certain populations may be at greater risk for alcohol use due to their genetic and ecological factors at an early age.

Associations of childhood poly-adversity with alcohol problems among undergraduates: adolescent alcohol use trajectories and drinker self-schema

Objective Undergraduate drinking is associated with childhood adversity, early alcohol experience, and drinker self-schema. However, the pathway linking childhood adversity to undergraduate drinking problems remains undefined. This study aimed to identify the effects of childhood poly-adversity on the sequelae of adolescent alcohol-use trajectory, drinker self-schema, and alcohol problems among undergraduates. We also examined whether adolescent alcohol-use trajectory and drinker self-schema mediated the effects of childhood poly-adversity on undergraduate alcohol problems. Methods Baseline data from an ongoing prospective study, which included 851 first- and second-year full-time college students in Taiwan, were used. An anonymous online questionnaire was administered. Results The results showed that low poly-adversity and high poly-adversity were associated with the mean of initial alcohol use frequency during adolescence and further alcohol problems at college than those with no adversity. High poly-adversity was also associated with the increase in alcohol use frequency during adolescence. Both initial and increase in alcohol use frequency were associated with higher drinker self-schema scores and further alcohol problems. The indirect effects of high poly-adversity on undergraduate alcohol problems were mediated through adolescent alcohol-use trajectories and drinker self-schema. Conclusion Findings suggest that early identification of childhood poly-adversity and interventions to decrease adolescent drinking may prevent the formation of drinker self-schema and reduce undergraduate drinking problems.

Adolescent intermittent ethanol (AIE) produces lasting, sex-specific changes in rat body fat independent of changes in white blood cell composition.

Early initiation of alcohol use during adolescence, and adolescent binge drinking are risk factors for the development of alcohol use disorder later in life. Adolescence is a time of rapid sex-dependent neural, physiological, and behavioral changes as well as a period of heightened vulnerability to many effects of alcohol. The goal of the present studies was to determine age-related changes in blood (leukocyte populations) and body composition across adolescence and early adulthood, and to investigate whether adolescent intermittent ethanol (AIE) exposure would alter the trajectory of adolescent development on these broad physiological parameters. We observed significant ontogenetic changes in leukocyte populations that were mirrored by an age-related increase in cytokine expression among mixed populations of circulating leukocytes. Despite these developmental changes, AIE did not significantly alter overall leukocyte numbers or cytokine gene expression. However, AIE led to sex-specific changes in body fat mass and fat percentage, with AIE-exposed male rats showing significantly decreased fat levels and female rats showing significantly increased fat levels relative to controls. These changes suggest that while AIE may not alter overall leukocyte levels, more complex phenotypic changes in leukocyte populations could underlie previously reported differences in cytokine expression. Coupled with long-term shifts in adipocyte levels, this could have long-lasting effects on innate immunity and the capacity of individuals to respond to later immunological and physiological threats.

The application of target trials with longitudinal targeted maximum likelihood estimation to assess the effect of alcohol consumption in adolescence on depressive symptoms in adulthood.

Time-varying confounding is a common challenge for causal inference in observational studies with time-varying treatments, long follow-up periods, and participant dropout. Confounder adjustment using traditional approaches can be limited by data sparsity, weight instability, and computational issues. The Nicotine Dependence in Teens Study is a prospective cohort study, and we used data from 21 data collection cycles carried out from 1999 to 2008 among 1294 students recruited from 10 high schools in Montreal, Quebec, Canada, including follow-up into adulthood. Our aim in this study was to estimate associations of timing of alcohol initiation and cumulative duration of alcohol use with depression symptoms in adulthood. Based on the target trials framework, we defined intention-to-treat and as-treated parameters in a marginal structural model with sex as a potential effect-modifier. We then used the observational data to emulate the trials. For estimation, we used pooled longitudinal target maximum likelihood estimation, a plug-in estimator with double-robust and local efficiency properties. We describe strategies for dealing with high-dimensional potential drinking patterns and practical positivity violations due to a long follow-up time, including modifying the effect of interest by removing sparsely observed drinking patterns from the loss function and applying longitudinal modified treatment policies to represent the effect of discouraging drinking.

Frequency of high risk behaviour in patients with alcohol dependence syndrome: a cross sectional study

Background: Alcohol use and high-risk behaviour has been shown to have an association. Severity of alcohol dependence has an association with frequency of risk-taking behaviour. Objectives were to evaluate the frequency of high risk behaviour in alcohol dependence syndrome and to find any correlation between psychosocial variables and high risk behaviour. Methods: 100 individuals with ICD 10 diagnosis of alcohol dependence syndrome were studied using semi structured interview. High risk behaviour was assessed using violent risk appraisal guide and deliberate self-harm inventory. The age of onset of initiation of alcohol use and dependence and severity of alcohol dependence syndrome were assessed and analyzed by frequency and Chi square test. Results: In 100 subjects with alcohol dependence syndrome, 4 (17.4%) and 7 (30.4%) of subjects with severe dependence had road traffic accidents and risky sexual and violent behaviour respectively. There was a statistically significant association between age of onset, age of dependence and high-risk behaviour. Conclusions: The present study concluded that most individuals with alcohol dependence syndrome had high risk behaviour. Road traffic accident was the most common followed by risky sexual and violent behaviour. There was a significant association between severity of alcohol dependence and high risk behaviour.

Patterns of simultaneous and nonsimultaneous use of cannabis and alcohol among American Indian adolescents

Background American Indian (AI) adolescents report earlier initiation and higher rates of cannabis and alcohol use compared to their non-AI peers. Simultaneous cannabis and alcohol (SCA) use is increasingly common. A primary goal of our research was to identify profiles of cannabis and alcohol use, including SCA use, among AI adolescents using latent class analysis (LCA). Method Data from 1,673 7th–12th grade students attending 45 reservation-area schools throughout the United States who reported using alcohol and/or cannabis in the past year were used to identify the latent classes. Multinomial logistic regression analysis determined associations of sex, grade, and multiethnicity to class membership. Results A four-class solution was found: (1) SCA-Heavier Use (16.1%); (2) SCA-Lighter Use (25.2%); (3) Primarily Cannabis Use (33.3%); and (4) Primarily Alcohol Use (25.4%). Multinomial regression showed higher grade, identifying as multiethnic, and being female were associated with higher likelihood of membership in the SCA class. Conclusion AI adolescents were more likely to be classified in the Primarily Cannabis Use class as compared to all other classes. Characterizing profiles of use may help identify those engaging in risky or co-use and help researchers and clinicians better understand how AI adolescents engage with alcohol and marijuana.

Investigating the associations of age of initiation and other psychosocial factors of singular alcohol, tobacco and marijuana usage on polysubstance use: analysis of a population-based survey in Jamaica

ObjectivesThis study aimed to examine concurrent polysubstance use of alcohol, tobacco and marijuana and determine correlations with access to marijuana, friend and familial drug use habits, risk perception and the...

A case series of substance abuse among urban slum population during the COVID 19 pandemic.

The COVID 19 pandemic stuck the world already burdened with numerous diseases. The approach toward controlling the pandemic disturbed the healthcare delivery system and also aggravated the already existing problems of malnutrition, unemployment, economic inequalities, decreased routine immunization services, and substance abuse. Six individuals with multiple substance use histories were identified and in depth interviews were conducted in an urban slum under the field practice area of a medical college. Common features were identified and reported. The age of initiation of alcohol and tobacco use was found to be in the early adolescence period (10-14 years). Chronic substance abuse causes poor health, an economic burden on families, and domestic violence. Lack of self esteem due to unemployment, decreased social interaction, and multiple failed attempts at abstinence were the shared features among dependents. Measures employed during the COVID 19 pandemic to contain the virus have caused unanticipated adverse effects on health, finance, and social life. A holistic approach would play a pivotal role rather than reactionary and momentary interventions.

Family ties: examining family functioning and alcohol use among American Indian youth

PurposeThis study aims to examine a second-order latent variable of family functioning built from two established protective factors for American Indian (AI) youth, i.e. family cohesion and parental monitoring. This study then examines if family functioning is related to alcohol use frequency or age of initiation for AI youth. Additionally, this study examines if family functioning served as a moderator for the risk factor of peer alcohol use.Design/methodology/approachData came from the 2021 Our Youth, Our Future survey. Participants were 4,373 AI adolescents from Grades 6–12 across the contiguous USA. Structural equation modeling (SEM) was used to test the latent variable of family functioning. Structural paths and interaction terms between peer use and family functioning were added to the SEM to explore direct and moderating effects.FindingsFamily cohesion and parental monitoring were best represented by a second-order latent variable of family functioning, which was related to later initiation and lower alcohol use frequency.Practical implicationsThe findings regarding the initiation of alcohol use may be applicable to prevention programs, with family functioning serving as a protective factor for the initiation of alcohol use. Programs working toward alcohol prevention may be best served by focusing on family-based programs.Originality/valueThe latent variable of family functioning is appropriate for use in AI samples. Family functioning, which is an inherent resilience factor in AI communities, was shown to be protective against harmful alcohol use behaviors.

The Effectiveness of a Novel Public Health Campaign to Reduce Parental Provision of Alcohol

Abstract Background Parental provision of alcohol to children is common despite being associated with negative outcomes, including earlier initiation of alcohol use and riskier drinking behaviours. Parental provision can be particularly problematic because it suggests to children that their parents have permissive attitudes to underage alcohol use. This study evaluated the ‘I need you to say no’ mass media public health campaign implemented by the Mental Health Commission in Western Australia (Nov 2018 - Feb 2022). The campaign adopted a novel approach by depicting adolescent children asking their parents to say ‘no’ if they ask for alcohol, alongside information challenging beliefs that provision behaviours are safe and commonplace. Methods Parents in Western Australia (n = 297) were surveyed in March 2022 to examine campaign recognition, perceptions of the campaign, and behaviours enacted due to seeing the campaign. Descriptive analyses were conducted. Two generalised linear models were also run to identify variables associated with positive campaign perceptions and behaviours enacted due to the campaign. Results The campaign was recognised by 4 in 5 parents and was rated by 70+% as being clear, memorable, and believable. Two-thirds of parents reported that the campaign made them concerned about underage drinking and less likely to supply alcohol to minors. Half the sample reported talking to their children about alcohol as a result of seeing the campaign. Perceptions of the campaign did not differ according to demographic characteristics, suggesting the campaign achieved widespread approval across demographic subgroups. Positive perceptions of the campaign were associated with enacting more of the examined harm reduction behaviours (B = .43, p = .002). Conclusions A novel campaign discouraging parental provision of alcohol resonated with parents and motivated harm reduction behaviours. Such campaigns have the potential to reduce alcohol-related harms among underage people. Key messages • A campaign advising parents to not provide alcohol to children was well received. • Such campaigns can challenge permissive attitudes to parental alcohol provision and promote harm-reduction behaviours.

Relationship between mood disorders and substance involvement and the shared genetic liabilities: A population-based study in Taiwan

BackgroundThis study explored the phenotypic association of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BPD), with a range of substance involvement, including lifetime experience and age at initiation of tobacco, alcohol, and betel nut use. Additionally, we elucidated polygenic risk score (PRS) association. MethodsIn total, 132,615 community participants were recruited from the Taiwan Biobank. Genome-wide genotyping data were available for 106,806 unrelated individuals, and the PRS for MDD and BPD was calculated. The significance of mood disorders and PRSs associated with substance involvement were evaluated using a linear/logistic regression model with adjustment for potential confounders. Sex differences were assessed. ResultsMDD and BPD were associated with regular alcohol consumption, drinking cessation, tobacco smoking, smoking cessation, betel nut chewing, and earlier onset of drinking. BPD was associated with an earlier onset of smoking. MDD PRS was associated with regular alcohol use (odds ratio [OR] per standard deviation increase in PRS = 1.03, p = 0.018), alcohol cessation (OR = 1.05, p = 0.03), regular tobacco use (OR = 1.08, p < 0.0001), and betel nut chewing (OR = 1.06, p < 0.0001), whereas BPD PRS was not associated with substance use. Phenotypic association strengths between MDD/BPD and regular drinking/smoking and the polygenic association between MDD PRS and regular smoking were larger in females than in males. LimitationsRetrospective self-reported MDD/BPD diagnoses and substance involvement. ConclusionsMood disorders were associated with a range of substance involvement. Shared genetic architecture contributed to the co-occurrence of MDD and substance involvement. These findings may help design prevention and cessation strategies for substance use.

Prevalence, associated factors, and reasons for the initiation of alcohol use among female college students during the COVID-19 pandemic: A mixed-methods study from urban Bengaluru, India

BackgroundFemale alcohol users are increasing in recent days. Social isolation during the COVID-19 pandemic would have worsened the situation. Hence, we aimed to determine the prevalence and reasons for the initiation of alcohol use among college students during the pandemic. MethodsWe conducted a cross-sectional analytical study and qualitative in-depth interviews among female college students from medical, engineering and arts & science streams. WHO-AUDIT questionnaire was used to identify alcohol use and patterns. ResultsA total of 1111 students participated. The prevalence of alcohol use was 28.3% (95% CI 25.6–31.0). Of them, harmful use and alcohol dependency were 3.5% (95% CI 2.5–4.8) and 2.5% (95% CI 1.7–3.6), respectively. Age (APR = 4.95, p=<0.001), family history of alcohol (APR = 1.60, p=<0.001), friends consuming alcohol (APR = 1.53, p=<0.001) and tobacco use (APR = 1.70, p=<0.001) were associated with alcohol use. Mothers’ education (APR = 3.06, p = 0.043), family history of alcohol (APR = 2.53, p = 0.008) and type of college (APR = 2.65, p = 0.010) were associated with harmful use/dependency. Social influence, college and family environment were the main reason for the initiation of alcohol use. ConclusionHigh prevalence of alcohol use among female college students emphasizes the need for alcohol use prevention interventions in colleges.

24-month outcomes of an eHealth universal program for students and parents to prevent adolescent alcohol use: A cluster randomized controlled trial in schools

BackgroundParents play a critical role in delaying adolescent initiation of alcohol and other drug use. However, the majority of prevention programs focus on adolescents only. This study tested the acceptability and effectiveness of an eHealth universal program for students and parents to prevent adolescent alcohol use. MethodsA cluster randomized controlled trial (RCT) was conducted between 2018 and 2020 with students from one grade level (aged 12–14 years) from 12 Australian secondary schools randomly allocated to the intervention or control conditions. Students accessed a web-based program in class and parents accessed the program online at their convenience. Data were collected via online questionnaires from students (N = 572) and parents (N = 78) at baseline, and 12- and 24- months post baseline. Multilevel, mixed effects regression models were used to analyse student data. FindingsMore students in the control group reported having at least one standard alcoholic drink and engaging in heavy episodic drinking in the previous 12 months at both 12- and 24-month follow up compared to students in the intervention, however, these differences were not statistically significant. Students in the intervention group reported greater increases in alcohol-related knowledge, compared to the control students. Qualitative data from parents indicated that they found the program useful, however, the number of parents who enrolled in the research study (13.9 %) was low. Parent engagement increased following implementation of an interactive parent/adolescent homework task. ConclusionsSmall sample size, low prevalence of alcohol use and parental engagement, and relatively short follow-up period may have contributed to lack of observed intervention effect, other than on alcohol-related knowledge. Parents who engaged with the program found it useful, however, implementation strategies that encourage parent-child interaction and communication may increase parent engagement for future programs.