Regular Alcohol Use Research Articles

The Impact of Parenting Styles on Adolescent Alcohol Use: The TRAILS Study

Aims: To investigate the influence of parenting styles (overprotection, emotional warmth, and rejection) in early adolescence on regular alcohol use in late adolescence. Methods: We analyzed data from the first three waves (mean ages: 11.09, 13.56, and 16.27 years, respectively) of a population-based prospective cohort study of 2,230 adolescents, conducted between 2001 and 2007. Adolescents reported on parental overprotection, emotional warmth, and rejection (T1). Regular alcohol use was defined as six and seven glasses or more a week for girls and boys, respectively. We further assessed family socioeconomic status, parental divorce, parental alcohol use, educational level of the adolescent, and alcohol use at baseline. Results: Parental overprotection had the strongest relationship to regular alcohol use: adolescents who perceived more parental overprotection were at increased risk of developing regular alcohol use, even after adjustment for several confounders. Rejection was not related to adolescents’ alcohol use and, after adjustment for the other variables, neither was emotional warmth. Conclusion: Overprotective parenting is a determinant of future regular adolescent alcohol use and therefore health professionals should pay particular attention to those adolescents who have overprotective parents. The role of adolescent characteristics in the relationship between overprotection and alcohol use deserves further study.

Abstract 9864: Depression Inhibits the Positive Effects of Exercise and Light-to-Moderate Alcohol Consumption on C-Reactive Protein Levels

Introduction: Light to moderate alcohol consumption and exercise are associated with lower cardiovascular mortality and levels of high sensitivity C-reactive protein (hsCRP), a predictor of cardiovascular risk. In contrast, depression is associated with higher cardiovascular risk and hsCRP. We tested the hypothesis that depression attenuates the positive effects of exercise and alcohol consumption on hsCRP. Methods: Data were collected on 225 adult men and women (18-65 yrs, 45% women, 40% minorities). The Beck Depression Inventory (BDI) was administered the same day blood samples were collected for hsCRP. BDI scores > 9 indicated depression. The following was used to classify alcohol consumption: never/former (< 1 drink in past 12-months), infrequently (1-3 drinks/month), occasionally (1-7 drinks/week), and regularly (2 drinks/day). Multivariate models were used to test the interaction effects on log-transformed CRP. Results: Depression was noted in 20% of participants. Adjusting for a number of coronary risk factors, depression attenuated the effect of exercise on hsCRP (p = .043). Among those who exercised (n = 184), hsCRP was higher in depressed versus non-depressed subjects (p = .005). No gender differences were noted. Depression also attenuated the effect of alcohol consumption on hsCRP in men but not women (p = .006). Among women who abstained (n = 29), those who were depressed exhibited higher hsCRP compared to non-depressed women (p = .03). Depression did not affect hsCRP in women who drank. In non-depressed men (n = 102), drinkers exhibited lower hsCRP relative to non-drinkers (p < .05). In depressed men (n = 19), however, the positive effect of alcohol consumption was not observed. This was most notable among men who reported occasional and regular alcohol use (n= 55), where depressed men exhibited significantly higher hsCRP than non-depressed men (p = .005). Conclusions: Independent of cardiovascular risk factors, current depression inhibits the positive effects of exercise on hsCRP. In men, but not women, depression also attenuates the effect of light-to-moderate alcohol intake on hsCRP. Combined, these data suggest the potential for depression to attenuate the health benefits of cardioprotective factors.

Patterns of Alcohol and Tobacco Use in Cambodia

Few studies have considered whether the habitual use of tobacco in Southeast Asia is part of an established pattern of addiction that includes regular alcohol use. As part of a national survey of adult tobacco use in Cambodia (n = 13 988), we found that men who smoked were 2 times more likely to have drank alcohol in the past week (odds ratio = 2.53, 95% confidence interval = 2.10-3.03). By age 18 to 25 years, 47% of male smokers drank alcohol, and this pattern of alcohol and tobacco use increased to >55% through the fifth decade. Women using smokeless tobacco with betel quid were more likely to be alcohol drinkers (odds ratio = 1.49, 95% confidence interval = 1.12-1.98). Past week's drinking declined by late middle age and was associated with lower education and being currently married; the behavior was lower in some ethnic groups (ie, Cham). Our findings indicate an important association between alcohol and tobacco use, and raise the possibility that reducing alcohol consumption can be an important component of tobacco control.

Хвороби системи кровообігу як проблема профілактичної медицини (огляд літератури та власні дослідження)

In review the modern data about risk factors of developments of cardiovascular system diseases are summarized. The main attentions have given to modified factors. Among them the most essential are: smoking, the regular use of alcohol in the doses exceeding limit, low physical activity or excessive (professional) physical activity, irrational diet, an unbalance of microelements-nutrients, including the reduced content in a ration of manganese, ferrous, zinc, nickel, vanadium, selenium, copper, the smooth water with the reduced content of calcium, water with the excessive content of sodium, cadmium and lead. The negative influence of atmospheric factors, such as non-periodic oscillations of atmospheric pressure, high air humidity, temperature diversions, on a state of persons with meteorological sensitivity and cardiovascular diseases is marked. Exogenous factors of antihazard are generalized; on their bottom organizational principles and shapes of embodying of circulation system diseases prophylaxis are offered, which will to reduce a level of a case rate of the population on 30 %, and frequency of relapses of cardiovascular infringements in 1,6–2 times.

Drinking and driving in southeastern Brazil: Results from a roadside survey study

ObjectiveThe objective of this study is to present data from a roadside survey study on drinking and driving and alcohol consumption in southeastern Brazil. MethodsA cross-sectional roadside survey study using a questionnaire and breathalyzer data is the method used to determine the prevalence of drinking and driving and to examine whether socio-demographic characteristics and drivers' behavior, attitude and alcohol consumption predicted positive blood alcohol content (BAC). The data were gathered from 2005 to 2007 through roadside surveys conducted on high volume public roads in four cities in southeastern Brazil. A total of 4182 randomly selected drivers took part in the research. Of these drivers, 3488 (83.4%) completed the questionnaire and agreed to take a breath test. ResultsOverall, 24.6% of drivers had a detectable blood alcohol concentration (BAC) and 15.9% had a BAC above the legal limit (0.6g/l) at the time of the study. Logistic regression controlling for locale (city), sex, age and marital status was used to predict whether each driver would present a positive breath test. Socio-demographic characteristics, driving behaviors and attitudes, and alcohol consumption patterns were included as predictors. These analyses indicated that those who believed drinking and driving was a serious offense were about two-thirds as likely to have a positive breath test, and that drivers reporting a pattern of regular alcohol use were three times as likely to have a positive breath test. ConclusionsThese findings indicate that drinking and driving is relatively common in Brazil, and that it occurs considerably more frequently than similar surveys suggest, is the case in other countries.

Veränderungen im Tabak-, Alkohol- und Cannabiskonsum von Jugendlichen im Zeitraum von 2002 bis 2010 in Deutschland

So far, little is known about long-term trends in the use of psychoactive substances by adolescents in Germany. However, these results are urgently required for a target-orientated prevention. The aim of the present study is to analyse age- and gender-specific prevalences and trends in tobacco, alcohol und cannabis use among young people in Germany from 2002 to 2010.Data were obtained from the German part of the WHO collaborative study "Health Behaviour in School-aged Children (HBSC)" conducted in 2002, 2006, and 2010. The analysis is based on 11 917 students aged 13 and 15 years. Age- and gender-specific trend analyses were done using log binomial regression models.The prevalences of regular tobacco and alcohol use among 13- and 15-year-olds decreased from 2002 to 2010, independent of gender. A similar effect was found for repeated drunkenness and for the 12-month prevalence of cannabis use. In 2010 about 15% of the 15-year-olds consumed tobacco and alcohol at least once a week, 30% reported 2 or more episodes of drunkenness and 11% used cannabis in the last 12 months. The corresponding values for 13-year-olds with a prevalence of 3-5% on average are considerably lower.Following an increase over the 1990s the HBSC data shows a strong decrease in the use of psychoactive substances over the last 8 years which can be interpreted as a success of recent preventive efforts. However, noticeable is a clear flattening of the decrease from 2006 to 2010. This underlines that preventive actions must continue play a central role in health policy and practice.

Identifying Potential Predictors of High-Quality Oral Anticoagulation Assessed by Time in Therapeutic International Normalized Ratio Range: A Prospective, Long-Term, Single-Center, Observational Study

BackgroundThe efficacy and risks of oral anticoagulation are largely associated with maintaining the quality of anticoagulation control. Nevertheless, few studies have addressed which factors, if any, are associated with this control. ObjectiveThis study aimed to identify predictors of high-quality oral anticoagulation. MethodsA prospective observational study enrolled all adult patients on intended long-term oral anticoagulation attending a public anticoagulation clinic. Patients with high-quality anticoagulation, defined as percentage of time in therapeutic international normalized ratio (INR) range (TTR) ≥66%, were compared with those with poor anticoagulation control (TTR <66%). Measures included cognitive, psychological, and relevant behavioral factors, in addition to traditionally implicated ones, such as age, comorbidity, and concurrent medications. ResultsParticipation was requested from all 233 patients followed up at the anticoagulation clinic. Eighty-six did not meet the inclusion criteria (49 due to intended anticoagulation duration <90 days, 37 due to the need for a caregiver responsible for medications). A total of 147 patients were enrolled, of whom 13 (8.8%) were lost to follow-up. Therefore, data were analyzed from 134 patients (mean [SD] age, 55 [14.2] years [range, 19–87 years]), who were followed up for a mean (SD) duration of 272 (87) days. The total mean TTR was 64.7%, which is comparable to values achieved in clinical trials. The good-control group had 61 patients (45.5%) (mean TTR, 77.7% [8.5%]) and the poor-control group had 73 patients (54.5%) (mean TTR, 50.4 [11.7%]). On multivariate logistic regression analysis, high-quality anticoagulation was independently associated with regular vitamin K intake, expressed by its variability in daily dosage (odds ratio [OR] = 0.79; 95% CI, 0.64–0.98); male sex (OR = 2.41; 95% CI, 1.06–5.49); duration of anticoagulation treatment >2 months (OR = 3.23; 95% CI, 1.25–8.36); presence of family support (OR = 3.32; 95% CI, 1.16–9.48); functional and cognitive ability to take medications as prescribed, defined as good medication management capacity (MMC; as assed using the Drug Regimen Unassisted Grading Scale) (OR = 4.18; 95% CI, 1.63–10.68); and no regular use of alcohol (OR = 8.59; 95% CI, 1.45–51.09). ConclusionsThe data suggest that independent predictors of high-quality oral anticoagulation included regular vitamin K intake, male sex, duration of anticoagulation treatment >2 months, presence of family support, good MMC, and no regular alcohol use. These findings may help clinicians to decide whether to start anticoagulation in intermediate-risk patients, to identify patients who will require closer attention on their anticoagulation management, and to direct their efforts to improve the quality of oral anticoagulation.

PMO-219 Higher than expected false negative CLO test in patients not taking PPI associated with regular alcohol intake and absence of endoscopic gastritis

IntroductionH pylori has a prevalence of around 40%–50% in the UK.1 Rapid urease test (CLO test) is commonly used in the endoscopy units around the UK to detect H pylori....

Altered Expression of Cytokine Signaling Pathway Genes in Peripheral Blood Cells of Alcohol Dependent Subjects: Preliminary Findings

Preclinical and clinical studies have implicated changes in cytokine and innate immune gene-expression in both the development of and end-organ damage resulting from alcohol dependence. However, these changes have not been systematically assessed on the basis of alcohol consumption in human subjects. Illumina Sentrix Beadchip (Human-6v2) microarrays were used to measure levels of gene-expression in peripheral blood in 3 groups of subjects: those with alcohol dependence (AD, n = 12), heavy drinkers (HD; defined as regular alcohol use over the past year of at least 8 standard drinks/wk for women and at least 15 standard drinks/wk for men, n = 13), and moderate drinkers (MD; defined as up to 7 standard drinks/wk for women and 14 standard drinks/wk for men, n = 17). Four hundred and thirty-six genes were differentially expressed among the 3 groups of subjects (false discovery rate corrected p-value < 0.05). Two hundred and ninety-one genes differed between AD and MD subjects, 240 differed between AD and HD subjects, but only 6 differed between HD and MD subjects. Pathway analysis using DAVID and GeneGO Metacore(®) software showed that the most affected pathways were those related to T-cell receptor and Janus kinase-Signal transducer and activator of transcription (JAK-Stat) signaling. These results suggest the transition from heavy alcohol use to dependence is accompanied by changes in the expression of genes involved in regulation of the innate immune response. Such changes may underlie some of the previously described changes in immune function associated with chronic alcohol abuse. Early detection of these changes may allow individuals at high risk for dependence to be identified.

Abstract 2316: Benefits Of Clinical Trial Participation For Risk Factor Control: Experience From The SPS3 Study

Objective: To assess for unplanned effects of trial participation as measured by changes in smoking, alcohol use, and exercise. Background: Trial effect is a non-specific element of trial participation that has been difficult to quantify. Recent trials are beginning to measure this with promising results. The SPS3 study tests the effects of antiplatelet therapy and intensive blood pressure control on stroke recurrence and cognitive decline. The protocol does not mandate interventions for modifying lifestyle behaviors but local study investigators provide guidance for these changes at their discretion. This provides an opportunity to evaluate a “trial effect”, beyond the study interventions. Design/Methods: SPS3 subjects who completed at least one 3-month visit were included (n=2935). Definitions used by CDC for risk factors were applied to SPS3. Hypothesis tests were performed to determine differences between SPS3 group at baseline and general population (CDC, n=210000). Kaplan-Meier plots were used to determine time from baseline to behavior changes. Log-rank tests were performed to determine influence of age, gender, education, and ethnicity in risk factor outcomes. Results: At baseline, smoking status was comparable between SPS3 and CDC groups (19.9%, 20.6% respectively); alcohol use was significantly lower (27.9%, 52% respectively); and exercise was comparable (50.8%, 48.8% respectively). Of the 583 smokers at baseline; 323 (55%) stopped while 152 (47%) restarted over the mean follow-up of 36 months. Of the 820 regular alcohol users at baseline, 536 (65%) stopped while 278 (52%) restarted again. Of the 1444 who did not exercise at least 3 times per week at baseline, 1209 (84%) started while 855 (71%) stopped again. There were no significant differences in these three health behaviors by age, gender, education, or race. A marginally significant effect by age was observed related to alcohol. Subjects ≤64 yr old at baseline were more likely to stop regular alcohol use than those &gt;64 (p=0.054). Conclusion: Independent of the study intervention, SPS3 participants significantly modified their health behaviors. Our findings suggest that it is important to address trial effect and its impact on the outcomes.

Fall-related traumas in urgent care centers

OBJECTIVE:To identify the scope and the characteristics of fall-related traumas in urgent care centers in Sergipe, Brazil and to verify potential associations among the following variables: gender, age, and where the event occurred.METHOD:This descriptive, cross-sectional study with a quantitative approach was conducted in the urgent care centers of two public referral hospitals in the state of Sergipe, Brazil. The data collection was conducted in November 2010, after approval was obtained from the Human Research Ethics Committee, through a structured interview with a sample of 509 fall victims.RESULTS:Most of the participants were male, between 0 and 19 years old, single, with no impairments or preexisting diseases, nor regular use of medication or alcohol. The victims were brought to the hospital by ambulance and were accompanied. Most events occurred at home, were same-level falls, and most frequently resulted from slipping and tripping during recreational activities with a subsequent fracture, contusion or sprain. Most victims were discharged from the hospital after care delivery. Statistically significant associations were found between place of fall and age and gender.CONCLUSION:There is a high incidence of seeking out care in urgent care centers due to falls, which constitutes a severe public health problem that affects both genders in different age groups. The adoption of preventive measures aimed to reduce such events is urgently required.

The role of conduct disorder in the association between ADHD and alcohol use (disorder). Results from the Netherlands Mental Health Survey and Incidence Study-2

BackgroundMuch is unclear about the association between attention-deficit/hyperactivity disorder (ADHD) and alcohol use (disorder). Research on this subject is hindered by the role of conduct disorder (CD). We investigate whether (1) childhood ADHD is associated with higher prevalence and earlier onset of alcohol initiation, regular alcohol use and alcohol use disorder (AUD) (2) CD mediates or modifies this association. MethodsData were derived from the baseline assessment of the Netherlands Mental Health Survey and Incidence Study-2, a general population study. ADHD and CD were assessed among respondents aged 18–44 (n=3309). ADHD, CD, and alcohol use (disorder) were assessed using the Composite International Diagnostic Interview 3.0. ResultsLifetime prevalence was 2.9% for ADHD, 5.6% for CD, 94.3% for alcohol initiation, 85.7% for regular alcohol use and 19.0% for AUD; mean ages of onset were 6.7, 11.5, 14.8, 16.7 and 19.2 years, respectively. After correction for gender and age, ADHD was associated with a higher prevalence of all three stages of alcohol use, but not with earlier onset of these stages. The association between ADHD and prevalence of AUD was fully explained by a mediating role of CD. CD did not modify the associations between ADHD and prevalence and onset of alcohol use (disorder). ConclusionsThe mediating role of CD in the association between ADHD and AUD suggests a developmental pathway from ADHD to CD and subsequent AUD. Early interventions in children with ADHD may prevent CD and subsequent onset of AUD.

Alcohol Use Among Latinos: A Comparison of Pre-Immigration, Post-Immigration, and US Born Latinos

US born Latinos have higher rates of alcohol use than Latino immigrants. Yet, little is known about drinking patterns of Latinos before their immigration to the US This exploratory study compares the past month regular, binge, and heavy alcohol use patterns of Latino immigrants prior to immigration with that of post-immigration and US born Latinos. Data on past month alcohol use prior to immigration was collected from 516 recent adult Latino immigrants. Results were compared with US born and post-immigration Latinos using national aggregate data. Alcohol use patterns among Latino immigrants prior to immigration were similar to that of US born Latinos. Alcohol use patterns were lower among Latinos after immigration when compared to pre-immigration and US born Latinos. This study provides a foundation for further exploration of the drinking patterns of Latinos in the US before they immigrated to this country. Findings suggest more research is needed to uncover the underlying factors associated with the higher rates of alcohol use among Latinos prior to their immigration when compared to alcohol use patterns of post-immigration Latinos.

Patterns of substance use in adolescents attending a mental health department

This study aimed to describe patterns of substance use in adolescents initiating mental health treatment and analyse factors associated with a high-risk pattern of substance use differentially by gender. Two hundred and thirty-seven 12- to 17-year-old new patients in an urban public mental health service were prospectively recruited and evaluated using semi-structured interviews and standardized questionnaires to obtain socio-demographic, psychopathological, family, school and substance use data. The most prevalent primary diagnoses among males were attention deficit disorder and conduct disorder, while among females they were eating disorders, affective and conduct disorders. Substance use disorder was diagnosed as follows: cannabis in 10.1% of the sample, alcohol in 3.4% and other drugs in 0.4%. A pattern of substance use with high risk of developing problems (at least regular use of alcohol or occasional use of cannabis or other illegal drugs) was found in 48.9% of the sample. After adjusting for age in the multivariate logistic regression, this pattern of risky use of drugs was found to be associated with Youth Self-Report scales of thought problems, delinquent and aggressive behaviour, in both genders. Altered family structure, having had to repeat a school grade and Youth Self-Report attention problems were only significantly associated with risky drug consumption in females. The high prevalence of risky and problematic substance use in adolescents entering mental health treatment warrants early systematic screening and specific preventive and therapeutic interventions, addressing mental health psychoeducation and motivation to avoid drugs, as well as differential associated risk factors for males and females.

The cost-effectiveness of community-based screening for oral cancer in high-risk males in the United States: a Markov decision analysis approach.

The 2004 US Preventative Services Task Force (USPSTF) guidelines do not recommend routinely screening adults for oral cancer given no proven mortality reduction. A large cluster-randomized controlled screening trial in Kerala, India, in 2005, however, reported a significant reduction in mortality for screened male tobacco and/or alcohol users. In the United States, office-based screening efforts targeting males of high risk (regular use of tobacco and/or alcohol) have been unsuccessful due to poor attendance. Given the newfound screening mortality benefit to this high-risk subpopulation, we sought to ascertain the cost-effectiveness threshold of a yearly, community outreach screening program for males more than 40 years regularly using tobacco and/or alcohol. Markov decision analysis model; societal perspective. A literature search was performed to determine event probabilities, health utilities, and cost parameters to serve as model inputs. Screen versus No-Screen strategies were modeled using assumptions and published data. The primary outcome was the difference in costs and quality-adjusted life-years (QALYs) between the two cohorts, representing the potential budget for a screening program. One-way sensitivity analysis was performed for several key parameters. The No-Screen arm was dominated with an incremental cost of $258 and an incremental effectiveness of -0.0414 QALYs. Using the $75,000/QALY metric, the maximum allowable budget for a screening program equals $3,363 ($258 + $3,105) per screened person over a 40-year time course. Given the significant health benefits and financial savings via early detection in the screened cohort, a community-based screening program targeting high-risk males is likely to be cost-effective.

Sensitive Periods for Adolescent Alcohol Use Initiation: Predicting the Lifetime Occurrence and Chronicity of Alcohol Problems in Adulthood

This study examined the association between age at alcohol use onset and adult alcohol misuse and dependence by testing the sensitive-period hypothesis that early adolescence (11-14) is a vulnerable period of development during which initiating alcohol use is particularly harmful. Data came from a longitudinal panel of 808 participants recruited in 1981. Participants were followed through age 33 in 2008 with 92% retention. Onset of alcohol use before age 11 (late childhood), when compared with initiation during early adolescence, was related to an increased chronicity of adult alcohol dependence, even after accounting for sociodemographic controls and other substance use in adolescence. The present study finds no evidence that early adolescence is a particularly sensitive period for the onset of alcohol use. Findings related to the onset of regular alcohol use and the chronicity of alcohol dependence suggest that the onset of regular drinking before age 21 is problematic, but no one adolescent period is more sensitive than others. Specifically, although all age groups that started drinking regularly before age 21 had a greater rate of alcohol dependence in adulthood, initiation of regular use of alcohol at or before age 14 was not related to greater chronicity of alcohol dependence than the initiation of regular use of alcohol in middle or late adolescence. The findings suggest the importance of delaying the onset of alcohol use through prevention efforts as early as the elementary grades. In addition, prevention efforts should focus on preventing the onset of regular drinking before age 21.

P01-36 - Alexithymia and drinking motivations among male patients with alcohol dependency

ObjectiveThe aim of this study was to investigate the relationship between alexithymia and drinking motivations among male patients with alcohol dependency.MethodParticipants were 136 male patients consecutively admitted to an alcohol dependency treatment unit. The Toronto Alexithymia Scale (TAS-20) and the Drinking Motives Questionnaire—Revised (DMQ-R) were administered to all participants.ResultsIn alexithymic group (N = 44, 32.4%) duration of education was lower, whereas current age, age onset of regular alcohol use, marital and employment status did not differ between groups. Scores of drinking motives and severity of general psychopathology were higher in alexithymic group. Alexithymia total and factors of alexithymia (other than thirth factor) were positively correlated with drinking motives. TAS- difficulty in identifing feelings was significant covariant for enhancement, coping and confirmity motives, whereas TAS- difficulty in describing feelings was significant covariant for only confirmity motives in MANCOVA analysis.ConclusionsThese suggest that drinking motives may be a mediator in the relationship between alexithymia alcohol dependence.

Gravidez e Diabetes Gestacional: uma combinação prejudicial à função sexual feminina?

To compare the sexual function of healthy adult pregnant women with that of gestational diabetes patients (GDM) in the third trimester. This cross-sectional study enrolled two groups of women managed antenatal care clinics. Inclusion criteria were: maternal age .20 years, gestational age at least 28 weeks, being in a heterosexual relationship with the same partner for at least 6 months, and being able to read. We excluded women with a medical recommendation for sexual abstinence due to clinical or obstetric disorders; hypertension controlled through medications; pregnancy resulting from rape; absent or sexually unavailable partner in the last month; hospital admission in the last month; use of vaginal creams in the last 30 days; multiple pregnancy, regular use of alcohol or illicit drugs or use of medications that can interfere with sexual function. Eighty-seven patients fulfilled the selection criteria and were included in the study. The Sexual Quotient . Feminine Version (QS-F) questionnaire was used to assess sexual function. Student's t and χ² tests were used to compare differences between groups and p<0.05 was considered significant. The mean gestational age of the participants was 34 weeks. There were no significant differences in the mean QS-F scores between groups (62.5 healthy vs 62.8 GDM women, p=0.9). Approximately half the participants (47 and 47.5% of the healthy and GDM women, respectively, p=0.9) had total scores up to 60, indicative of dysfunction in one of the assessed domains (desire, sexual satisfaction, arousal, orgasm, dyspareunia and vaginismus). The prevalence of sexual dysfunction was high among women in the third trimester of pregnancy and did not differ significantly between healthy women and women with GDM.

Temporal sequence of incident cigarette, coffee, and alcohol use among AA participants

Background: Cigarettes and coffee are widely used psychoactive substances among alcoholics. Due to the devastating public health impact of alcohol use disorders, it is important to determine if using cigarettes or coffee may influence alcoholism. Previous studies indicate that cigarette smoking is associated with progression of alcohol dependence, but the effects of coffee drinking have yet to be investigated. Objectives: To retrospectively determine the temporal sequence of incident cigarette, coffee, and alcohol use and attributed subjective effects in AA participants. Methods: Volunteers at all Nashville open-AA meetings (n = 289 [126 women], completion rate = 94.1%) were administered a Lifetime Drinking History modified to also include lifetime cigarette and coffee consumption, as well as coffee consumption and effects questions, the Fagerstrom Test for Nicotine Dependence, and the Smoking Effects Questionnaire. Results: Average ages (years) at first regular use of alcohol, cigarettes, and coffee were 15.4 (IQR: 13.0–18.0), 16.7 (IQR: 13.0–18.5), and 18.5 (IQR: 14.0–23.5), respectively. In a subset who used all three substances (n = 236;102 women) alcohol consumption preceded cigarette smoking (p < .001) and coffee drinking (p < .001), and cigarette smoking preceded coffee drinking (p < .001); these relationships did not differ by gender. Conclusions: Recovering alcoholics started regular alcohol consumption prior to cigarette smoking and coffee drinking. Scientific Significance: In AA participants, coffee does not precede initiation of regular smoking or alcohol drinking as might be anticipated for a gateway drug.

DRD2 and DRD4 in relation to regular alcohol and cannabis use among adolescents: Does parenting modify the impact of genetic vulnerability? The TRAILS study

AimsThe aims of the present study were to determine the direct effect of DRD2 and DRD4, as well as their interaction with parenting (i.e. rejection, overprotection and emotional warmth), on the development of regular alcohol and cannabis use in 1192 Dutch adolescents from the general population. MethodsInformation was obtained by self-report questionnaires. Perceived rejection, overprotection and emotional warmth were assessed at age 10–12. Regular alcohol and cannabis use were determined at age 15–18 and defined as the consumption of alcohol on 10 or more occasions in the past four weeks, and the use of cannabis on 4 or more occasions in the past four weeks. Models were adjusted for age, sex, parental alcohol or cannabis use, and externalizing behavior. ResultsCarrying the A1 allele of the DRD2 TaqIA polymorphism, or the 7 repeat DRD4, was not directly related to regular alcohol or cannabis use. In addition, adolescent carriers of these genetic risk markers were not more susceptible to the influence of less optimal parenting. Main effects for parenting indicated that overprotection increased the risk of regular alcohol use, whereas the risk of cannabis use was enhanced by parental rejection and buffered by emotional warmth. ConclusionsOur findings do not support an association between DRD2/DRD4 and regular alcohol and cannabis use in adolescents. Given the substance-specific influences of rejection, overprotection and emotional warmth, these parenting factors might be promising candidates for prevention work.