Responsible Alcohol Use Research Articles

Mother needs a bigger “helper”: A critique of “wine mom” discourse as conformity to hegemonic intensive motherhood

Abstract“Wine mom” discourse encourages American women to self‐deprecatingly bond over the stressors of parenting and touts alcohol use as necessary means for coping and escapism. Before the added stress of the COVID‐19 pandemic, whereby alcohol sales and consumption increased in the United States, rates of heavy drinking and alcohol‐related illnesses among US women have been steadily increasing. Exceeding the clinical markers of responsible alcohol use, “wine mom” discourse normalizes an inextricable link between alcohol misuse and expectations of (White, middle‐class) motherhood. Online communities and businesses emphasize “wine mom” discourse for self‐acceptance and bonding in response to the impossible demands of hegemonic motherhood. In this critique of “wine mom” discourse, we argue that although alcohol consumption is commonly touted as self‐care, this messaging operates in toxic ways that harms women and reinforces patriarchy. Applying Merton's strain theory, we argue that “wine mom” trends and related discourse encompass a harmful form of conformity, if not false resistance, to the strain of flawed cultural goals and lacking institutionalized supports for American mothers. We call for true rebellion, emphasizing positive discourse as well as structural changes and policy reforms to dismantle patriarchal barriers and hegemonic motherhood constraints to better support American families.

Gender and Craft Beer: Participation and Preferences in Pennsylvania

Gender roles and stereotypes relating to alcohol use and consumption have been widely studied. Most of this research has focused on how gender roles influence consumption patterns and binge drinking, or identifying double-standards associated with the act of drunkenness (which has historically been associated with masculinity). While binge drinking and inebriation have obvious negative consequences, responsible use of alcohol remains an important part of contemporary life and is worth studying from a variety of perspectives. The craft beverage industry has grown tremendously in the U.S. over the last two decades, and several sources suggest that this growth is likely to continue. Consumption of craft beverages is an important component of travel and tourism and, for some, may even represent the primary reason for leisure travel. This paper examines gender differences in participation and attitudes towards craft beer among Pennsylvania craft beer patrons. More specifically, it examines how gender relates to craft beer consumption/participation, beer-related travel and tourism, social worlds engagement, knowledge, economic activity, psychological involvement, and support for brewery engagement with environmental activism and localism in contemporary society. Data were collected from patrons of 11 different craft beer venues in Pennsylvania. Though more similarities than differences were found between men and women, results suggested that males make up the majority of craft beer consumers and are more committed to craft beer drinking both behaviorally and psychologically. However, an examination of current trends suggests that female participation in the craft beer world is increasing. Further, there appears to be a commitment to environmental activism and localism among many craft breweries, which has been positively received by both male and female patrons (but perhaps to a greater degree by females). Implications for the craft beverage industry and future researchers are discussed.

Preparing for the Holidays: Rethinking Drinking

Health professionals should assist patients to plan for responsible alcohol use. Department Editor Denise G. Link, PhD, WHNP-BC, FAAN, FAANP, is a clinical professor at the Arizona State University College of Nursing and Health Innovation, Phoenix, AZ, who would like to hear your ideas for future columns, can be reached at .

CONSEQUENCES OF ALCOHOL ABUSE/DEPENDENCE IN BRAZIL: DISABILITY-ADJUSTED LIFE YEARS (DALY)

This study estimated the burden of alcohol use in Disability-Adjusted Life Years (DALY) for Brazil. The measures of DALY combines the measures of Years of Life Lost (YLL) and Years Lived with Disability (YLD), based on methodology of the Global Burden of Disease (GBD) and were presented using the rate of 1:10,000. Alcohol use was defined by ICD-10 F10-F10.9. We used outpatient treatment, admissions and mortality data and the disability weights specific for alcohol according with GBD to calculate the DALY-relevant measures. The total value of DALY in Brazil due to the alcohol use was 32.05, similar to what we observed in YLD total value [31.60] and different of the measure of the YLL total value [0.45]. There is important difference in DALY’s value between gender, being the biggest at the age group 40-44 [158.10 male and 34.03 female]. The biggest loss of DALY’s total value is at the 44 age group with 158.01 years. The impact of the DALY due to alcohol use represents the need to refine existing actions in prevention and treatment, seeking the search for better strategies that promote more responsible alcohol use and decrease individual and social harms.

Effects of Issue Involvement and Framing of a Responsible Drinking Message on Attitudes, Intentions, and Behavior

To decrease the prevalence and the amount of alcohol consumption among students, health messages advocating responsible alcohol behavior can be used. However, it is unclear whether responsible drinking messages are most effective when they use a gain frame, presenting the advantages of responsible drinking, or a loss frame, presenting the disadvantages of irresponsible drinking. This study tests the effects of framing and the moderating role of involvement with the issue of responsible drinking. A three-wave, between-subjects, experimental study was conducted, in which participants (N = 90) were exposed to either a gain- or loss-framed message about responsible drinking behavior at Wave 2. At all three waves, attitudes, intentions and behavior toward responsible drinking were measured. Results showed that for participants with low issue- involvement, a gain frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a loss frame did not have any effects for them. For participants with high issue involvement, a loss frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a gain frame did not have an effect on attitude and only a delayed effect on intention. However, there were no effects of frame and issue involvement on adhering to the guideline of responsible alcohol use and average drinking behavior.

Alcohol use, working conditions, job benefits, and the legacy of the "Dop" system among farm workers in the Western Cape Province, South Africa: hope despite high levels of risky drinking.

This study describes alcohol consumption in five Western Cape Province communities. Cross-sectional data from a community household sample (n = 591) describe the alcohol use patterns of adult males and females, and farm workers vs. others. Data reveal that men were more likely to be current drinkers than women, 75.1% vs. 65.8% (p = 0.033); farm laborers were more likely to be current drinkers than individuals in other occupations 83.1% vs. 66.8% (p = 0.004). Group, binge drinking on weekends was the norm; men were more likely to be binge drinkers in the past week than women 59.8% vs. 48.8% (p = 0.086); farm workers were more likely to binge than others 75.0% vs. 47.5% (p < 0.001). The legacy of “Dop” contributes to current risky drinking behaviors. Farm owners or managers were interviewed on 11 farms, they described working conditions on their farms and how the legacy of “Dop” is reflected in the current use of alcohol by their workers. “Dop” was given to farm workers in the past on six of the 11 farms, but was discontinued for different reasons. There is zero tolerance for coming to work intoxicated; farm owners encourage responsible use of alcohol and assist farm workers in getting help for alcohol problems when necessary. The farm owners report some positive initiatives, were ahead of the movement to provide meaningful wages, and provide other important amenities. Further research is needed to assess whether progressive practices on some farms will reduce harmful alcohol use.

Segmenting and Targeting American University Students to Promote Responsible Alcohol Use: A Case for Applying Social Marketing Principles

The current study contributes to the social marketing literature in the American university binge-drinking context in three innovative ways. First, it profiles drinking segments by “values” and “expectancies” sought from behaviors. Second, the study compares segment values and expectancies of two competing behaviors, that is, binge drinking and participation in alternative activities. Third, the study compares the influence of a variety of factors on both behaviors in each segment. Finally, based on these findings and feedback from eight university alcohol prevention experts, appropriate strategies to promote responsible alcohol use for each segment are proposed.

Chronic liver disease and hepatic encephalopathy: Clinical profile and outcomes

Hepatic encephalopathy (HE) is an important neuropsychiatry complication of liver disease causing significant morbidity and mortality worldwide. Efforts at improving the outcome have resulted in development of new strategies in the management given the background of new insights in the pathogenesis of this disease entity. Understanding the disease profile including precipitants as well as prognostic factors will contribute in this regard as new strategies are yet to be widely applied. The aim of this report is to document the profile of patients with HE, the precipitants, prognostic factors as well as the scope of the burden associated with it. In this prospective study, all patients managed for HE from January to December 2008 were recruited. A questionnaire was used to extract their basic demographics, clinical features noting any possible precipitants, complications, management protocol as well as outcome. A total of 21 subjects (11 females and 10 males) within the age range of 16-83 years were seen during the period under review. (mean age 57.9 ± 13). There was no significant difference in the mean ages of males and females. Two patients had acute encephalopathy, while others had acute-on chronic encephalopathy. The risk factors for liver disease included significant alcohol ingestion, hepatitis B virus infection, and previous jaundice, while other complications of liver disease noted were deepening jaundice, ascites, bleeding tendencies, and renal failure. The identified precipitants for HE were sepsis 6 (29%), electrolyte inbalance 3 (14%), gastrointestinal bleed 5 (24%), drugs (5%), and possible malignant transformation 6 (29%). Focus of sepsis was bacterial peritonitis in two cases. Majority of our patients (61%) came during advanced stage of liver disease (Child-Pugh class C). Length of hospital stay ranged from 1 to 7 weeks and a mortality of 48% was observed. Predictors of mortality were a history of significant alcohol ingestion, previous blood transfusion, Hepatitis B and C infections, and severe liver dysfunction on presentation (Child-Pugh class C). HE is associated with a high mortality rate and this scenario is associated with a history of previous blood transfusion, Hepatitis B and C infections, and severe liver dysfunction on presentation. Measures to reduce the burden of viral Hepatitis B and C, safe blood transfusion, and responsible use of alcohol should be promoted. Screening of those at risk of encephalopathy (liver disease patients) with a psychometric test of good predictability should be part of their routine evaluation in daily practice so as to detect cases of latent encephalopathy. Intensive care facilities and necessary personnel should be provided.

NASCAR-related philanthropy and the distilled spirits sponsor category

The National Association for Stock Car Racing, Inc. (NASCAR) has a long history with its roots in distilled spirits. While NASCAR has a long association with beer sponsors, distilled spirits sponsors were unwelcome until 2004. Since then, a number of spirits brands have sponsored the NASCAR federation, driver teams and individual races. NASCAR requires its sponsoring spirits brands dedicate 20% of their budgets to promoting responsible alcohol use. However, how does NASCAR’s corporate charitable foundation look when subjected to the same standard required of its spirits sponsors? The NASCAR Foundation’s philanthropic giving relative to alcohol programmes is examined for the first two years of distilled spirits sponsorships. This research concludes that The NASCAR Foundation does not meet the standard it requires of its sponsoring partners.

Good governance and social responsibility in the South African wine industry

The paper reviews the institutional structure or strategic framework, the Wine Industry Transformation Charter and Scorecard, adopted on 31 July 2007, through which good governance and social responsibility programmes are fostered, implemented and monitored in the South African wine industry. In other words, the paper outlines how the wine industry seeks to foster social change through integrated socioeconomic support structures, as based on the Wine Industry Plan (WIP). The wine charter and scorecard components are a representation of good governance in the industry, whereas the social capital development approach is the focus of social responsibility programmes in the wine industry. The seven components of the wine transformation charter are: (i) ownership, (ii) management/control, (iii) employment equity, (iv) skills development, (v) enterprise development, (vi) preferential procurement, and (vii) rural development, land reform and poverty alleviation. Five areas that constitute the programmes of social responsibility are: (i) the responsible alcohol use, (ii) rural development and poverty alleviation, (iii) security of tenure, (iv) land, and (v) sectoral determination. The implications for the agri-food sector and conclusions are provided.

Good idea, bad idea: A study of young adults’ opinions on anti-drunken driving campaigns

Social marketing campaigns intend to persuade specific target groups to accept, modify, or abandon certain attitudes and behaviour, in order to protect society. The negative consequences of alcohol abuse in South Africa have led various associations to run social marketing campaigns, including ArriveAlive, DriveAlive, ARA (Industry Association for Responsible Alcohol Use), and programmes by the Ministry of Transport. Fear appeals are widely used in these campaigns and the purpose of this study is to investigate the role of fear appeals on behavioural intent. A qualitative pilot study was done by conducting an in-depth focus group with students from a university in South Africa. Respondents were exposed to and discussed nine fear appeal television advertisements (three low, three medium and three with a high level of fear appeal), to gauge the impact of the level of fear appeal. Qualitative content analysis revealed several themes on the execution of television advertisements thought by the young adults to have an impact on their age group: realism, visuals and sound, shock, language and attention. Low fear appeal advertisements were criticised by respondents as having no impact. Differences in personal relevance influenced respondents at medium and high level. Based on the results, a quantitative study was conducted.

Referrals for Alcohol Use Problems in an Overseas Military Environment: Description of the Client Population and Reasons for Referral

Being stationed in an overseas installation has been associated with increased risk for alcohol use problems. Okinawa is a unique overseas environment that often challenges service members with separation from family and friends, limited resources and recreational activities, a high rate of deployment, and restrictive local laws. Single, young, male services members in the junior ranks are at increased risk for poor coping, particularly relying on alcohol use. Maladaptive alcohol use places them at increased risk for engaging in illegal behavior and other negative consequences that subsequently lead them to be referred for an evaluation for alcohol use problems. Alcohol use problems negatively affect health, safety, morale, and mission readiness. Findings from this study strongly suggest that prevention and wellness programs should target young service members in the junior ranks for training on responsible alcohol use, alcohol use problems, and basic coping for improved impact on health and mission readiness.

Male alcohol use and unprotected sex with non-regular partners: Evidence from wine shops in Chennai, India

Background In India, heterosexual transmission accounts for approximately 80% of the spread of HIV, the virus that causes AIDS. Male alcohol use and its putative association with sexual risk are explored to inform HIV prevention interventions. Methods A survey of 1196 male patrons of wine shops or bars was conducted from August 2002–January 2003 as part of an ongoing HIV prevention trial in Chennai city in south India. In the analysis, we explored associations between covariates related to sexual behavior and alcohol use and our outcome of unprotected sexual intercourse with non-regular partners among men. Results Nearly half (43%) of the respondents reported any unprotected sex with non-regular partners and 24% had four or more recent sexual partners. Over 85% reported using alcohol at least 10 days a month (17% reported drinking everyday). During a typical drinking day, 49% reported consuming five or more drinks. Alcohol use before sex was reported by 89% of respondents. Unprotected sex with non-regular partners was significantly higher among unmarried men (OR =3.25), those who reported irregular income (OR = 1.38), who used alcohol before sex (OR = 1.75) and who had higher numbers of sexual partners (OR = 14.5). Conclusions Our findings suggest that future HIV prevention interventions in India might consider discussing responsible alcohol use and its possible role in sexual risk. These interventions should particularly consider involving unmarried men and weigh the role of structural factors such as access to income in developing prevention messages.

HIV among pregnant women in Moshi Tanzania: the role of sexual behavior, male partner characteristics and sexually transmitted infections

BackgroundWomen continue to be disproportionately affected by HIV in Tanzania, and factors contributing to this situation need to be identified. The objective of this study was to determine social, behavioral and biological risk factors of HIV infection among pregnant women in Moshi urban, Tanzania. In 2002 – 2004, consenting women (N = 2654), attending primary health clinics for routine antenatal care were interviewed, examined and biological samples collected for diagnosis of HIV and other sexually transmitted/reproductive tract infections.ResultsThe prevalence of HIV was 6.9%. The risk for HIV was greater among women whose male partner; had other sexual partners (adjusted odds ratio [AOR], 15.11; 95% confidence interval [CI], 8.39–27.20), traveled frequently (AOR, 1.79; 95% CI, 1.22–2.65) or consumed alcohol daily (AOR, 1.68; 95% CI, 1.06–2.67). Other independent predictors of HIV were age, number of sex partners, recent migration, and presence of bacterial vaginosis, genital ulcer, active syphilis and herpes simplex virus type 2.ConclusionDevelopment of programs that actively involve men in HIV prevention is important in reducing transmission of HIV in this population. Further, interventions that focus on STI control, the mobile population, sexual risk behavior and responsible alcohol use are required.

Strategy for a public health initiative at regional level—the example of Bavaria

The authors introduced a new public health initiative in Bavaria. The initiative called Gesund.Leben.Bayern. (Healthy Living in Bavaria) applies a complementary promotion-prevention approach to the settings of daily living. The priorities for the Bavarian initiative are based on specific Bavarian epidemiological data and the Bavarian situation, and reflect WHO recommendations, including those contained in the World Health Report 2002. The initiative includes four priorities for public cofinancing and recognition: freedom from tobacco smoke, responsible use of alcohol, availability and choice of healthy nutrition and sufficient physical exercise opportunities, and health promotion at the workplace. A specific aspect of the Bavarian initiative is the requirement for explicit evaluation, aiming at generating new evidence of adequacy, success and cost-effectiveness of different prevention and promotion approaches. First steps have been taken: gearing up for participation and shaping the strategy; setting up a programme secretariat; building criteria for evidence, self reporting and evaluation into the application form; gearing up for scientific support; and setting an example of good practice. Bavaria is embarking on an evidence-based, focused and participative approach to health promotion and disease prevention that aims at improving the participants’ health and quality of life.

‘White liquor hits black livers’: meanings of excessive liquor consumption in South Africa in the second half of the twentieth century

Four years into South Africa's first democracy, the African National Congress Youth League, with the help of the liquor industry's Social Aspects of Alcohol Committee 1 1 Social Aspects of Alcohol Committee (SAAC), initiated by the South African Breweries, was reconstituted as Association of Responsible Alcohol Use (ARA) in 1998. drafted a policy to prevent substance abuse in black communities. They declared that alcohol was ‘often not used in a socially acceptable way’. Concerned not so much with post-apartheid policy as with making sense of what socially acceptable alcohol usage might mean, this article explores narratives of alcohol use and abuse in South Africa in the second half of the twentieth century. It demonstrates that while multiple understandings of excess in alcohol consumption were articulated, those notions tied to particular constructions of racial difference prevailed. Ideas pairing drinking habits with race were given effect by state institutions. By tying drinking habits to ‘race’ and by locating ‘race’ in a social hierarchy, state institutions determined access to liquor and welfare services. By naturalising Africans as heavy drinkers, the state justified its sale of liquor to African men while denying the need for rehabilitation in the event of alcoholic dependence. By placing ‘coloured’ closer to ‘white’ in its racial order, the apartheid state found cause to extend limited rehabilitation services to those designated ‘coloured’. 2 2 The Population Registration Act (1950) designated as ‘Coloured’, those individuals who were neither ‘white’ viz. of European ancestry, nor black viz. black African. By tying liquor revenues to apartheid administration, the ruling regime exonerated its policy of excluding blacks from the retail liquor trade even after lifting prohibition in 1962. This policy encouraged rampant illicit liquor dealing, created a social environment in which alcoholic excess, particularly after 1976, reached new proportions and generated new and dangerous meanings of socially acceptable drinking. Against the grain of these dominant discourses of racially designated meanings of drinking, African people forged a more complex set of practices and meanings not rendered any clearer by the ANC Youth League's discourse of acceptable and unacceptable usage.

Cultural aspects of alcohol use (Part 2)

This is the second of a two‐part article on cultural aspects of alcohol use. Part I introduced the primary and secondary characteristics of culture and the current information on drinking patterns of selected ethnocultural groups. Part 2 includes other selected primary and secondary characteristics of culture such as age, gender, religious affiliation, education, socioeconomic status, and sexual orientation. The article concludes with measures whose effectiveness has been questionable in promoting responsible alcohol use and includes some proven and new recommendations.

Substance use among Dutch dental students

The objectives were to assess the prevalence of substance use among Dutch dental students and to determine their attitudes about substance use and its consequences. In association with a national study of drug use among US dental students, a questionnaire was translated from English into Dutch and administered to dental students at two dental schools in The Netherlands. Students received an anonymous 115-item questionnaire in the fall of 1996. Alcohol was the students' drug of choice for lifetime (95%), past year (94%) and past month (88%) use. No significant correlations were found between alcohol use and gender, schools, and years in dental education. In the past month, 58% of students reported drinking on 5 or more days; 53% had 5 or more drinks on the same occasion, 20% had 5 or more drinks on the same occasion on 5 or more days; and 17% reported getting drunk at least monthly. Prevalence rates for past month use of tobacco was 24% and marijuana, 4%. Male students smoked twice as much as females, with significant differences found for all three periods of use (X2>19.00, P<0.01). When asked whether their schools offered policies and education programs on alcohol and other drugs, 52% of students reported that these were not available. Dental schools should develop effective programmes to educate students about responsible use of alcohol and other licit and illicit drugs. Schools should also inform students about their susceptibilities to substance abuse and dependency.

Interactive Multimedia Preventive Alcohol Education: An Evaluation of Effectiveness with College Students

A self-selected sample of 4695 university and college students participated in a short-term evaluation of an interactive CD-ROM addressing harm reduction for alcohol use. The CD-ROM (Alcohol 101) uses a mix of video, text, music, graphics, and animation elements to present behavioral change strategies for safe and responsible use of alcohol. Student learning about alcohol as measured by self-report was generally in the desired direction and supportive of the impact of the CD-ROM on understanding of the physiological impact of alcohol and the range of behavioral options for pacing consumption and helping friends in potential peril.

Alcohol and Heart Disease

Any advice about the consumption of alcohol must take into account not only the complex relation between alcohol and cardiovascular disease but also the well-known association of heavy consumption of alcohol with a large number of health risks.1 One approach would be to recommend no consumption of alcohol. However, a large number of recent observational studies have consistently demonstrated a reduction in coronary heart disease (CHD) with moderate consumption of alcohol.2 3 Any prohibition of alcohol would then deny such persons a potentially sizable health benefit. This advisory examines the complex relation between alcohol and coronary heart disease and offers recommendations for the responsible use of alcohol. Many beverages contain alcohol in varying amounts, necessitating standardization of the quantity of alcohol contained in various drinks. In general, the amount of absolute alcohol in grams is determined by the number of beverages consumed per day times the amount of alcohol in each beverage. In general, a 12-ounce bottle of beer, a 4-ounce glass of wine, and a 1 1/2-ounce shot of 80-proof spirits all contain the same amount of alcohol (one half ounce). Each of these is considered a “drink equivalent.”4 Recent studies have tried to determine whether specific beverages have unique protective or deleterious effects. The interpretation of this research is complex because one person often consumes several types of beverages. A large number of observational studies have consistently demonstrated a J-shaped relation between alcohol consumption and total mortality .5 This relation appears to hold in men and women who are middle aged or older.6 7 8 9 The lowest mortality occurs in those who consume one or two drinks per day.10 In teetotalers or occasional drinkers, the rates are higher than in those consuming one or two drinks per day. In persons …