Prevalence Of High-risk Drinking Research Articles

An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking

BackgroundAlthough alcohol use disorder can complicate depression management, there is no standard process for assessing AUD symptoms (i.e., AUD diagnostic criteria) in primary care for patients who screen positive for depression. This study characterizes the association between depressive symptoms and high-risk drinking reported by primary care patients on screening measures in routine care. Then, using data from a novel clinical program, this study characterizes the association between depressive symptoms and AUD symptoms reported by primary care patients with high-risk drinking via an Alcohol Symptom Checklist.MethodsIn this cross-sectional study, electronic health record data were obtained from patients who visited 33 Kaiser Permanente Washington primary care clinics between 03/2018 and 02/2020 and completed depression (PHQ-2) and alcohol consumption (AUDIT-C) screening measures as part of routine care (N = 369,943). Patients who reported high-risk drinking (AUDIT-C scores 7–12) also completed an Alcohol Symptom Checklist where they reported the presence or absence of 11 AUD criteria as defined by the DSM-5 (N = 8,184). Generalized linear models estimated and compared the prevalence of high-risk drinking (AUDIT-C scores 7–12) and probable AUD (2–11 AUD symptoms on Alcohol Symptom Checklists) for patients with and without positive depression screens.ResultsPatients who screened positive for depression had a 131% higher prevalence of high-risk drinking than those who screened negative (5.2% vs. 2.2%; p < 0.001). Among patients with high-risk drinking, positive depression screens were associated with a significantly higher prevalence of probable AUD (69.8% vs. 48.0%; p < 0.001), with large differences in the prevalence of probable AUD observed with increasing PHQ-2 scores (e.g., probable AUD prevalence of 37.6%, 55.3% and 65.2%, for PHQ-2 scores of 0, 1, and 2, respectively). Although the overall prevalence of high-risk drinking was higher for male patients, similar patterns of association between depression screens, high-risk drinking, and AUD symptoms were observed for male and female patients.ConclusionsPatients with positive depression screens are more likely to have high-risk drinking. Large percentages of patients with positive depression screens and high-risk drinking report symptoms consistent with AUD to healthcare providers when given the opportunity to do so using an Alcohol Symptom Checklist.

Patterns of high-risk drinking among medical students: A web-based survey with machine learning.

Prior studies have found increased rates of alcohol consumption among physicians and medical students. The present study aims to build machine learning (ML) models to identify patterns of high-risk drinking (HRD), including alcohol use disorder, within this population. We analyzed data collected through a web-based survey among Brazilian medical students. Variables included sociodemographic data, personal information, university status, and mental health. Stratification for HRD was carried out based on the AUDIT-C scores. Three ML algorithms were used to build classifiers to predict HRD among medical students: elastic net regularization, random forest, and artificial neural networks. Model interpretation techniques were adopted to assess the most influential predictors for models' decisions, which represent potential factors associated with HRD. A total of 4840 medical students were included in the study. The prevalence of HRD was 53.03%. The three ML models built were able to distinguish individuals with HRD from low-risk drinking (LRD) with very similar performance. The average AUC scores in the cross-validation procedure were around 0.72, and this performance was replicated in the test set. The most important features for the ML models were the use of tobacco and cannabis, monthly family income, marital status, sexual orientation, and physical activities. This study proposes that ML models may serve as tools for initial screening of students regarding their susceptibility for at-risk drinking or alcohol use disorder. In addition, we identified several key factors associated with HRD that could be further investigated and explored for preventive and assistance measures.

Moderators of changes in smoking, drinking and quitting behaviour associated with the first COVID-19 lockdown in England.

AimTo estimate changes in smoking, drinking and quitting behaviour from before to during the first COVID‐19 lockdown in England, and whether changes differed by age, sex or social grade.DesignRepresentative cross‐sectional surveys of adults, collected monthly between August 2018 and July 2020.SettingEngland.ParticipantsA total of 36 980 adults (≥ 18 years).MeasurementsIndependent variables were survey month (pre‐lockdown: August–February versus lockdown months: April–July) and year (pandemic: 2019/20 versus comparator: 2018/19). Smoking outcomes were smoking prevalence, cessation, quit attempts, quit success and use of evidence‐based or remote cessation support. Drinking outcomes were high‐risk drinking prevalence, alcohol reduction attempts and use of evidence‐based or remote support. Moderators were age, sex and occupational social grade (ABC1 = more advantaged/C2DE = less advantaged).FindingsRelative to changes during the same time period in 2018/19, lockdown was associated with significant increases in smoking prevalence [+24.7% in 2019/20 versus 0.0% in 2018/19, adjusted odds ratio (aOR) = 1.35, 95% confidence interval (CI) = 1.12–1.63] and quit attempts (+39.9 versus –22.2%, aOR = 2.48, 95% CI = 1.76–3.50) among 18–34‐year‐olds, but not older groups. Increases in cessation (+156.4 versus –12.5%, aOR = 3.08, 95% CI = 1.86–5.09) and the success rate of quit attempts (+99.2 versus +0.8%, aOR = 2.29, 95% CI = 1.31–3.98) were also observed, and did not differ significantly by age, sex or social grade. Lockdown was associated with a significant increase in high‐risk drinking prevalence among all socio‐demographic groups (+39.5 versus –7.8%, aOR = 1.80, 95% CI = 1.64–1.98), with particularly high increases among women (aOR = 2.17, 95% CI = 1.87–2.53) and social grades C2DE (aOR = 2.34, 95% CI = 2.00–2.74). Alcohol reduction attempts increased significantly among high‐risk drinkers from social grades ABC1 (aOR = 2.31, 95% CI = 1.78–3.00) but not C2DE (aOR = 1.25, 95% CI = 0.83–1.88). There were few significant changes in use of support for smoking cessation or alcohol reduction, although samples were small.ConclusionsIn England, the first COVID‐19 lockdown was associated with increased smoking prevalence among younger adults and increased high‐risk drinking prevalence among all adults. Smoking cessation activity also increased: more younger smokers made quit attempts during lockdown and more smokers quit successfully. Socio‐economic disparities in drinking behaviour were evident: high‐risk drinking increased by more among women and those from less advantaged social grades (C2DE), but the rate of reduction attempts increased only among the more advantaged social grades (ABC1).

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.

Are population trends in high-risk alcohol consumption in smokers associated with trends in quit attempts and quit success? A time-series analysis

ObjectivesMonthly changes in the prevalence of high-risk drinking and smoking in England appear to be positively correlated. This study aimed to assess how far monthly changes in high-risk drinking were...

Is the use of e-cigarettes for smoking cessation associated with alcohol consumption? A population-level survey of successful quitters in England

ObjectiveTo examine associations between the use of e-cigarettes for smoking cessation and levels of alcohol consumption, high-risk drinking, and attempts to cut down alcohol consumption compared with use of nicotine replacement therapy (NRT) or no aid. MethodsCross-sectional survey of adults (≥16 years) in England. The sample included a total of 961 people who had quit smoking with the use of either e-cigarettes (n = 425), NRT (n = 116), or no aid (n = 421) within the past year and were still abstinent at the survey. Drinking behaviour was assessed with the AUDIT. ResultsMean (SD) alcohol consumption among those who quit smoking with e-cigarettes, NRT, and no aid was 7.78 (13.41), 7.12 (13.85), and 5.55 (8.70) units/week, respectively. The prevalence of high-risk drinking was 43.3% (n = 184), 32.2% (n = 37), and 36.8% (n = 155), respectively. Among high-risk drinkers, the prevalence of attempts to cut down alcohol consumption was 22.3% (n = 41), 18.9% (n = 7), and 27.7% (n = 43), respectively. After adjustment for covariates, those who quit with e-cigarettes had significantly higher alcohol consumption than those who quit unaided (B = 1.69, 95%CI 0.21–3.17), but there was no significant difference relative to those who quit with NRT. Differences in high-risk drinking and attempts to cut down were not significant, but Bayes factors indicated the data were insensitive (range: 0.47–0.95). ConclusionsRecent ex-smokers who used e-cigarettes to help them quit consumed around two more units of alcohol each week than those who quit unaided, but their alcohol consumption was similar to those who quit with NRT. Data on differences in high-risk drinking and attempts to cut down alcohol consumption among high-risk drinkers were inconclusive.

Prevalence of Alcohol and Tobacco Use among Men and Women in Namibia.

Namibia is known to have a high prevalence of tobacco smoking and alcohol consumption. Individuals who smoke are more likely to drink, and vice versa. It was reported that the individual rewarding effect of drinking and smoking were reported to be higher than when they are used at the same time. In this study our objective was to examine the individual and combined prevalence of drinking and smoking and investigate their sociodemographic correlates among adolescent and adult men and women in Namibia. This study was based on data from Namibia Demographic and Health Survey (NDHS 2013). Sample population were 14,185 men and women aged between 15 and 64 years. Self-reported tobacco smoking and alcohol consumption patterns were the outcome variables. Data were analysed using complex sampling techniques to account for survey design. Bivariate and multivariate techniques were used to measure the association between drinking and smoking with the sociodemographic factors. The prevalence of alcohol and tobacco use was, respectively, 53.1% (51.5–54.6) and 8.8% (8.1–9.5), and that of both drinking and smoking was 6.9% (6.3–7.6). In the regression analysis, several sociodemographic factors were found to be significantly associated with alcohol and tobacco use including age, area of residence, religion and educational status. Overall, women had higher rates of drinking alcohol; however, men had higher rates of engaging in high risk drinking. Men and women who reported drinking alcohol had, respectively, 2.57 and 4.60 times higher odds of smoking. Findings suggest that the prevalence of drinking was higher than that of smoking, with men having higher prevalence of high risk drinking. Men and women who drink alcohol were more likely to be smokers. The prevalence of both alcohol and tobacco use showed important sociodemographic patterns which need to be taken into consideration in designing prevention and intervention programs. Strategic tobacco control and smoking cessation approaches should pay particular attention to alcohol users.

The prevalence of and factors associated with high-risk alcohol consumption in Korean adults: The 2009-2011 Korea National Health and Nutrition Examination Survey.

BackgroundThe consequences of alcohol consumption on health outcomes are largely determined by two separate, but related, dimensions of drinking: the total volume of alcohol consumed and the pattern of drinking. Most epidemiological studies focus on the amount of alcohol consumed and do not consider the pattern of drinking.ObjectivesThis study evaluated the prevalence of and factors associated with high-risk and heavy alcohol drinking in Korean adults.MethodsThis study analyzed 15,215 of the 28,009 participants in the 2009–2011 Korea National Health and Nutrition Examination Survey (KNHANES). High-risk alcohol drinking was defined as Alcohol Use Disorders Identification Test (AUDIT) scores ≥16, which provides a framework for intervention to identify hazardous and harmful drinking patterns as the cause of alcohol-use disorders, according to World Health Organization guidelines.ResultsThe prevalence of high-risk drinking was 15.1%, with the highest prevalence of 17.2% in middle-aged adults (45–64 years). In men, the prevalence of high-risk alcohol drinking was 23.7%, with the highest prevalence found in middle-aged adults. In women, the prevalence of high-risk alcohol drinking was 4.2%, with the highest prevalence found in younger adults. Men had higher weighted mean AUDIT scores than women (10.0 vs. 4.0, P<0.001), and age was negatively associated with the AUDIT score (P<0.001). Elementary school graduates had higher mean AUDIT scores than senior high school (P = 0.003) or college (P<0.001) graduates. Regarding occupation, clerical support workers (P = 0.002) and service and sales workers (P<0.001) had higher mean AUDIT scores than managers and professionals. Logistic regression analyses of high-risk alcohol drinking using sex, age, education level, number of family members, household income, and occupation as covariates was performed. Women had a lower risk of high-risk alcohol drinking (odds ratio (OR) 0.14, 95% CI: 0.13–0.16, P<0.001) than men. Regarding age, compared to control subjects aged 19–29 years, adults aged 60–69 and older than 70 years had 0.67- (95% CI: 0.51–0.89, P = 0.005) and 0.29-fold (95% CI: 0.20–0.70, P<0.001) lower risks, respectively, of high-risk alcohol drinking, whereas adults aged 30–59 had an increased risk of high-risk alcohol drinking. Using elementary school graduates as controls, senior high school (OR: 0.70, 95% CI: 0.55–0.87, P = 0.002) and college (OR: 0.54, 95% CI: 0.42–0. 70, P<0.001) graduates had lower risks of high-risk alcohol drinking. Regarding occupation, compared to managers and professionals as controls, service and sales workers had a greater risk of high-risk alcohol drinking (OR: 1.36, 95% CI: 1.07–1.73, P = 0.011). The number of family members and household income did not influence high-risk alcohol drinking.ConclusionsIn a representative sample of Korean adults, the prevalence of high-risk alcohol drinking was 15.1%, with the highest prevalence of 28.3% found in middle-aged men (45–64 years). This study suggests that younger age, male sex, low education level, and service and sales workers are at risk for a high-risk drinking pattern.

Is Drinking with Parents Associated with High-Risk Drinking among Adolescents?

Background/Aims: What are the implications of drinking with parents (DWP) on adolescents' drinking behavior? We expanded the meagre body of research on this controversial issue by assessing the association between the frequency of DWP and adolescent high-risk drinking, taking a number of parental factors into account. Method: Data stemmed from a subsample of 14-17-year-old current drinkers (n = 7,616) who participated in a cross-sectional Norwegian school survey (response rate: 84%). Results: One in four reported DWP during the past year. The higher the frequency of DWP, the higher was the prevalence of high-risk drinking. Parental drunkenness, permissive alcohol-related parenting, and indicators of suboptimal parenting more generally also correlated with DWP. After controlling for these confounders, only frequent DWP remained significantly associated with high-risk drinking. Conclusions: DWP was related to adolescent high-risk drinking, yet the association was in part attributable to parents' drinking and parenting style. The risk of involvement in high-risk drinking was about the same for adolescents reporting no DWP and infrequent DWP, while it was significantly elevated among those reporting frequent DWP. This study thus demonstrated that the frequency of DWP matters and that parents who drink with their adolescent children differ from other parents in important ways.

PWE-262 Prevalence of harmful, hazardous or dependent drinking in hospital inpatients on a single day using audit questionnaire

IntroductionDeaths from alcoholic liver disease have increased dramatically. Currently, 24% of UK adults are said to drink in a harmful or hazardous manner. The government strategy to combat alcohol mortality...

Why is high-risk drinking more prevalent among men than women? evidence from South Korea

BackgroundIt is important to identify and quantify the factors that affect gender differences in high-risk drinking (HRD), from both an academic and a policy perspective. However, little is currently known about them. This study examines these factors and estimates the percentage contribution each makes to gender differences in HRD.MethodsThis study analyzed information on 23,587 adults obtained from the Korea National Health and Nutrition Surveys of 1998, 2001, and 2005. It found that the prevalence of HRD was about 5 times higher among men (0.37) than women (0.08). Using a decomposition approach extended from the Oaxaca-Blinder method, we decomposed the gender difference in HRD to an "overall composition effect" (contributions due to gender differences in the distribution of observed socio-economic characteristics), and an "overall HRD-tendency effect" (contributions due to gender differences in tendencies in HRD for individuals who share socio-economic characteristics).ResultsThe HRD-tendency effect accounted for 96% of the gender difference in HRD in South Korea, whereas gender differences in observed socio-economic characteristics explained just 4% of the difference. Notably, the gender-specific HRD-tendency effect accounts for 90% of the gender difference in HRD.ConclusionWe came to a finding that gender-specific HRD tendency is the greatest contributor to gender differences in HRD. Therefore, to effective reduce HRD, it will be necessary to understand gender differences in socioeconomic characteristics between men and women but also take notice of such differences in sociocultural settings as they experience. And it will be also required to prepare any gender-differentiated intervention strategy for men and women.

Preventing High-Risk Drinking among College Students: A Social Marketing Case Study

Investigators implemented a social marketing intervention to reduce alcohol consumption at a large university in the southeastern United States. The objective was to decrease high-risk drinking and drinking and driving and to change the perception that alcohol use increases sexual opportunities among college students. Formative research revealed that high-risk college students associate undesirable social consequences with excessive drinking (e.g., embarrassing oneself, annoying peers, offending the other sex, or burdening friends). An intervention was developed in which the product was avoiding the social stigma associated with excessive alcohol consumption. Promotional materials illustrating the social repercussions associated with excessive alcohol use and promoting the advantages of moderating one's drinking were disseminated in popular student venues; price was raised by increased law enforcement; and place was addressed by providing alcohol-free alternative activities. Evaluation included a time-series design in which students completed an anonymous online standard alcohol and drug survey and reviewing campus records of drinking under the influence (DUI) citations, alcohol-related judicial violations, and emergency department transports for alcohol overdose. Self-reported high-risk drinking, drinking and driving, and the perception that alcohol facilitates sexual opportunity rates decreased 33%, 45%, and 21%, respectively. DUI violations, alcohol-related judicial violations, and student transports to the emergency department for alcohol overdose decreased 13%, 28%, and 37%, respectively. Programmatic goals and objectives were met. Social marketing interventions appear to be a promising and cost-effective means to reduce high-risk drinking and the associated consequences among college students. Addressing social ramifications appears to be more motivating than conveying the prevalence of high-risk drinking.

Alcohol drinking patterns by gender, ethnicity, and social class in Bahia, Brazil.

To study patterns of alcohol consumption and prevalence of high-risk drinking. A household survey was carried out in a sample of 2,302 adults in Salvador, Brazil. Cases of High-Risk Drinking (HRD) were defined as those subjects who referred daily or weekly binge drinking plus episodes of drunkenness and those who reported any use of alcoholic beverages but with frequent drunkenness (at least once a week). Fifty-six per cent of the sample acknowledged drinking alcoholic beverages. Overall consumption was significantly related with gender (male), marital status (single), migration (non-migrant), better educated (college level), and social class (upper). No significant differences were found regarding ethnicity, except for cachaça (Brazilian sugarcane liquor) and other distilled beverages. Overall 12-month prevalence of high-risk drinking was 7%, six times more prevalent among males than females (almost 13% compared to 2.4%). A positive association of HRD prevalence with education and social class was found. No overall relationship was found between ethnicity and HRD. Male gender and higher socioeconomic status were associated with increased odds of HRD. Two-way stratified analyses yielded consistent gender effects throughout all strata of independent variables. The findings suggest that social and cultural elements determine local patterns of alcohol-drinking behavior. Additional research on long-term and differential effects of gender, ethnicity, and social class on alcohol use and misuse is needed in order to explain their role as sources of social health inequities.

Estimated alcohol-caused deaths in Australia, 1990-97.

The purpose of the study was to provide updated estimates of alcohol-caused mortality rates in Australia between 1990 and 1997, making adjustments for changes in the prevalence of high-risk alcohol use estimated on the basis of per capita alcohol consumption (PCAC). Deaths wholly and partially attributable to high-risk alcohol consumption were extracted from the Australian Bureau of Statistics Mortality Datafile (1990-1997) and multiplied by specific aetiological fractions, which in turn were adjusted by changes in the prevalence of high-risk alcohol use estimated on the basis of annual changes in PCAC. The yearly trends in age-standardized rates of estimated alcohol-caused deaths were compared with those using (i) aetiological fractions unadjusted for changes in PCAC, and (ii) wholly alcohol-caused conditions only (thus requiring no application of aetiological fractions). The age-standardized rates of all alcohol-caused deaths among males aged 15+ years declined from 1990 (4.01/10,000) to 1993 (3.19/10,000) and decreased far more slowly up to 1997 (3.15/10,000) - 16% overall. For females, these rates declined steadily from 1990 (1.75/10,000) to 1997 (1.33/10,000) - 19% overall. Similar patterns in time trends were noted for estimated alcohol-caused death rates calculated as in (i) and (ii). However, the proportional decreases in rates (21.6% for males; 24.0% for females) would have been underestimated by 16% (males) and 19% (females) if the alcohol aetiological fractions had not been adjusted to take account of the estimated annual changes in the prevalence of high-risk drinking. The declines in estimated alcohol-caused death rates were more pronounced than the 9% decline in PCAC, and were due mainly to decreasing death rates for stroke (men and women), alcoholic liver cirrhosis and road injuries (men only). When aetiological fractions are used to measure temporal trends in estimated alcohol-caused death rates from official mortality statistics, they should account for annual changes in the prevalence of high-risk drinking. Such changes in prevalence can be deduced from yearly fluctuations in PCAC.