Risky Alcohol Consumption Research Articles

Effectiveness of a brief motivational intervention in the management of risky alcohol use in primary care: ALCO-AP20 study protocol.

Motivational interviewing (MI) could be a method for minimizing alcohol-related harm. The study aims to assess the effectiveness of a brief intervention, based on a MI, in patients with risky alcohol use attended in Primary Care (PC). A cluster-randomized, two-arm parallel, multicenter, open-label, controlled clinical trial. Fifty PC healthcare professionals from the province of Córdoba (Spain) will be randomized to one of the two study groups: (1) Experimental Group (EG): MI-based approach; (2) Control Group (CG): Usual care based on health advice. EG intervention: Professionals will receive a training program focused on MI, consisting of a training workshop and the use of pre- and post-workshop questionnaires to measure knowledge and skills acquired, as well as the degree of empathy, with a videotape of the health professionals with standardized patients, before and after the workshop, and subsequent training feedback. CG intervention: Workshop on the management of risky alcohol use based on health advice; participants will also complete the pre-and post-workshop questionnaires and be videotaped. Study population: Patients ≥ 14 years old with risky alcohol consumption (28 Standard Drink Units-SDU-/week in men and 17 SDU/week in women) or excessive alcohol use (≥ 6 SDU in men or ≥ 4 SDU in women, in less than 2 h). It would be necessary to include 110 subjects/group to find a difference of 20% between the percentage of patients in abstinence between EG (37%) and CG (20%), alpha error of 5%, and statistical power of 80%. Assuming a loss rate of 5% and the cluster design effect, the number of subjects to be recruited is estimated at 197/group. The follow-up period will be 12 months. The primary outcome variables will be the self-reported alcohol use level and the Alcohol Use Disorders Identification Test (AUDIT) questionnaire score. The study aims to demonstrate the effectiveness of the motivational approach in the comprehensive treatment of the patient with risky alcohol use, improving the empathy of the healthcare professionals and strengthening the healthcare professional-patient relationship to achieve the behavioral change of the patients with this problem in primary care consultations. ClinicalTrials.gov.

Prevalence of non-alcoholic fatty liver disease and its association with lifestyle habits in adults in Chile: a cross-sectional study from the National Health Survey 2016-2017.

Non-alcoholic fatty liver disease (NAFLD) represents an excessive fat accumulation within the liver, usually associated with excess body weight. A liver biopsy is the gold standard for diagnosis, but it is inapplicable in population-based studies. In large populations, non-invasive methods could be used, which may also serve to identify potential protective factors. We aimed to (a) estimate NAFLD prevalence in the adult population in Chile by using non-invasive methods and (b) determine the association between the presence of NAFLD and lifestyle habits. The National Health Survey of Chile 2016–2017 was analysed. We included individuals aged 21–75 years, without infectious diseases nor risky alcohol consumption. NAFLD was detected by either fatty liver index (FLI; considers circulating TAG, circulating γ-glutamyl-transferase, BMI and waist circumference), lipid accumulation product (LAP; considers sex, circulating TAG and waist circumference) or their combination. Lifestyle habits were determined by questionnaires. We included 2774 participants, representative of 10599094 (9831644, 11366544) adults in Chile. NAFLD prevalence (95 % CI) was 39·4 % (36·2, 42·8) by FLI, 27·2 % (24·2, 30·4) by LAP and 23·5 % (20·7, 26·5) by their combination. The prevalence progressively increased with increasing BMI. Of note, less smoking and more moderate-vigorous physical activity and whole-grain consumption were associated with lower odds of having NAFLD, independently of BMI. At least one out of four adults in Chile is afflicted with NAFLD. Health promotion strategies focused on controlling excess body weight and promoting specific lifestyle habits are urgently required.

Comorbid smoking and risky alcohol consumption: impact on mental health and quality of life during the Covid-19 pandemic

Comorbid smoking and risky alcohol consumption: impact on mental health and quality of life during the Covid-19 pandemic

Comportamientos excesivos e intermitentes: diferencias en el consumo de alcohol e ingesta en forma de atracón entre adultos jóvenes de áreas rurales y urbanas

Introduction: Drug abuse and binge eating have been characterized as part of the so-called intermittent excessive behaviors, which share common neurobiological pathways. University students come from very different areas to access higher education, for example, rural environments, where some habits, education, and recreational options differ from those of people who grew up in the city. Contextual cues are crucial in the development of drug addic- tion, but little is known about the role that the living area where individuals grew up has on the development of intermittent excessive behaviors, such as binge eating and binge drinking. Objective: The main aim of this study was to explore the prevalence and comorbidity of alcohol consumption and binge eating behaviors in young adults (18-30 years), considering the living area where they grew up. Method: For this purpose, the AUDIT and the Binge Eating Scale were employed in a sample of 2461 undergraduates. Results: The results showed a significant propor- tion presenting a risky alcohol consumption pattern and a reduced proportion of people presenting binge eating behaviors. Interestingly, in both cases, there was a significant difference between groups, where rural students were more vulnerable to risky alcohol consumption and to developing maladaptive eating patterns.

"Appagalo" a Customized Mobile Health Intervention (mHealth) for Smoking Cessation in Women: A Randomized Controlled Trial.

Almost 30% of Chilean women report cigarette smoking with important repercussions on their health. Design and test a mobile phone intervention for smoking cessation in young women. A mobile application (app) was created using the best available evidence and consumer input. Its effectiveness was assessed through a randomized clinical trial. Women 18 to 44years old from middle-class neighborhoods in Santiago, Chile. Inclusion criteria were intention to quit cigarette smoking in the following month and having a smartphone cell phone. Women with positive screening for risky alcohol consumption were excluded. App with content to support cigarette smoking cessation over 6 months. The control arm included an app that delivered general messages to promote permanence in the study. Telephone follow-up was performed at 6 weeks, and at 3 and 6 months after randomization. No smoking in the past 7days at 6weeks from enrolment. Intention-to-treat analysis was carried out using SPSS 17.0 with a significance level set at .05. 309 women entered the study. Mean number of cigarettes smoked in a day was 8.8. 58.6% of the participants (n = 181) completed the follow-up for the primary outcome. With intention-to-treat analysis, 9.7% of participants in the intervention group reported not having smoked any cigarettes in the last 7days vs 3.2% in the control group (RR 2.98 CI 95% 1.11-8.0, P = .022). Additionally, 12.3% vs 1.9% of the participants in the intervention group and control group reported continuous abstinence at 6weeks, respectively (RR 6.29 95% CI 1.9-20.8, P < .001). Continuous abstinence was also significant at 6 months (P-value of .036). The "Appagalo" app is an effective tool to support smoking cessation in young women. It is a simple mHealth alternative for smoking cessation that can contribute to improving women's health in the Americas and worldwide.

Susceptibility to liver damage in women due to risky alcohol consumption

Susceptibility to liver damage in women due to risky alcohol consumption

A Biopsychosocial Approach to Examining Alcohol Consumption among Youth during the COVID-19 Pandemic

This study investigated the relationship between biopsychosocial characteristics (age, sex, self-rated health, mental health, parental socio-economic status, family support, teacher support, peer support) and alcohol consumption (weekly alcohol consumption in the past three months, drunkenness in the past three months, and binge drinking in the past month) in adolescents during a crisis event. The study consisted of 1019 Israeli students aged 11–18. Questionnaires were distributed to the students between May and July 2021 during school. Teacher support among those who presented weekly alcohol consumption and drunkenness in the past three months was lower than in those who did not present such behavior. The effects of parental support differed only for drunkenness behavior, with those who engaged in drunken behavior presenting significantly less parental support. Our findings suggest that teacher support and mental health are the two major factors in preventing risky alcohol consumption behavior during a crisis, such as the COVID-19 pandemic, among adolescents.

Prevalences of cardiometabolic risk and lifestyle factors in young parents: evidence from a German birth cohort study

BackgroundStudies show that parents significantly impact their children’s health through their cardiometabolic risk profile and health behavior. There is only little information about the prevalence of cardiometabolic risk factors and lifestyle factors among new parents yet. The aims of this study are therefore to evaluate the prevalences of cardiometabolic risk factors in parents of infants in Germany and to examine their lifestyle and health behavior.MethodsIn the KUNO-Kids health study, an ongoing birth cohort, parents (n = 930 mothers and 769 fathers) were asked about cardiometabolic risk factors (obesity/hypertension/type 2 diabetes mellitus) and lifestyle factors (dietary/sports/smoking habits/alcohol consumption) during the first year after the birth of their children via questionnaires. Chi-square as well as fisher exact tests were conducted to analyse associations between lifestyle factors and cardiometabolic risk factors.Results34.2% of mothers and 58.5% of fathers were overweight or obese. In 11.8% of the families, at least one parent suffered from hypertension, in 2.4% from type 2 diabetes mellitus. One year after delivery, 8.5% of mothers were smoking, 6.9% showed a risky alcohol consumption (> 10 g/d). 16.0% of fathers were smoking 4 weeks after childbirth, 10.7% showed risky alcohol consumption (> 20 g/d). 21.6% of mothers carried out sports activity for more than 2 h a week then. Parental hypertension was linked to a higher prevalence of risky alcohol consumption, obesity to a lower prevalence of daily fruits consumption.ConclusionsCardiometabolic risk factors were widespread among new parents with obesity and overweight having the highest prevalences. A considerable number of parents also practiced an unhealthy lifestyle showing that there is potential for improvement to promote the healthy development of their children.

Prevalence and Predictors of Increased and Hazardous Alcohol Consumption in a Cohort of Older South Australian Men during COVID-19 Restrictions

Background: Increasing levels of risky alcohol consumption in older men observed in many countries, combined with trends for increased alcohol-related misuse by men during COVID, indicate a need to examine alcohol use by older men during the pandemic. Aim: To examine the prevalence and predictors of increased and hazardous alcohol consumption in older South Australian men during COVID-19 restrictions. Method: Data collected in the latest (eighth) wave of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) cohort study were interrogated. Participants were 746 community-dwelling older men (mean age 69 years) who completed a self-report survey on mental health, coping, COVID-related worries, and alcohol consumption during pandemic restrictions. Alcohol-related items asked about changes to overall consumption (analysed as increased vs. decreased/same) and number of standard drinks per occasion (analysed as &lt;5 drinks [not hazardous consumption] vs. 5+ drinks [hazardous]). Two hierarchical binary logistic regressions were conducted to explore predictors of increased and hazardous alcohol intake. Results: Eight percent of men reported increased alcohol intake and nine percent reported hazardous alcohol consumption during COVID-19 restrictions. Being in a younger age group (‘younger old’; OR=0.46, 95%CI=1.03, 2.28), having mild to severe depressive symptoms (OR=1.39, 95%CI=1.10, 5.05), and greater concern about becoming sick with COVID-19 (OR=1.52, 95%CI=1.03, 2.28) were predictive of increased alcohol consumption during restrictions. Younger age group (OR=0.46, 95%CI=0.34, 0.62) and greater concern about becoming sick with COVID-19 (OR=1.67, 95%CI=1.13, 2.51) were also predictive of hazardous alcohol consumption during this time. Discussion: Men participating in longitudinal health study follow-ups may be less inclined to engage in unhelpful coping behaviours such as problematic alcohol use. Clinicians should regularly screen older men for risky alcohol consumption; a particular focus on screening ‘younger old’ men, those with more significant concerns around COVID-19, and those with depression symptoms may be warranted.

Health, wellbeing, and the impact of Corona in older adults in Dresden, Germany: the LAB60+ study

Abstract Introduction As the proportion of older people increases, it is necessary to evaluate their health and well-being to identify measures to promote healthy ageing. Moreover, the COVID-19 pandemic has impacted older adults’ health- not just through the infection itself, but also due to infection protection ordinances. Methods LAB60+ is a population-based cross-sectional study investigating, among other things, the physical and mental health of older adults. Residents of Dresden aged 60 years and older were invited to participate in the first half of 2021. Participants answered questions on their habits, health status and wellbeing, using, among others, the Short Form-8 Health Survey and the WHO wellbeing index. Results 2399 people participated in the study (40% response). Participants assessed their physical health similar to the German population. The most common chronic conditions were hypertension (54%), chronic pain (32%) and osteoarthritis (31%). 42% of the participants were overweight and 20% were obese. One-fifth did not engage in physical activity: this number increased with age and decreased socioeconomic status. Participants reported lower levels of wellbeing compared to the German population (58 vs. 67 pts.). One-third had higher levels of depressiveness and half reported an increase in their experienced loneliness due to the pandemic. 34% participated in risky alcohol consumption, but it did not markedly change during the pandemic. The greatest negative impact of the pandemic on health behaviors was physical activity: more than one-third exercised less compared to the time before the pandemic. Conclusions Physical health was comparable to the German population, while depressivity was higher, perhaps due to the pandemic. Age-appropriate interventions should especially target an increase in physical activity. It is important to take measures to reduce the possible negative effects of the pandemic, such as increased loneliness or reduced physical activity. Key messages • This is the first study on health and wellbeing on older adults (60+ years) in the city of Dresden, Germany. • The COVID-19 pandemic had a high impact on older adults’ physical activity and loneliness.

Measuring health literacy and its associations with health behaviors of adolescents in Germany

Abstract Background The questionnaire “Measurement of Health Literacy Among Adolescents Questionnaire” (MOHLAA-Q) was developed and validated in a multi-stage process to measure generic health literacy among 14- to 17-year-olds. The MOHLAA-Q combines subjective and objective measurements, consisting of four scales. The instrument was applied to explore associations between generic health literacy and different health behaviors among adolescents in Germany. The data should contribute to the age-appropriate development of health promotion interventions. Methods We carried out a nationwide cross-sectional online survey with 1,235 adolescents aged 14-17 years in Germany in 2019. Data on generic health literacy were collected using the four scales of the MOHLAA-Q and data on health behaviors were collected using single established single-item questions on sports, diet, alcohol consumption, and smoking. Bivariate and multiple analyses were performed for investigating associations between generic health literacy and health behaviors, adjusted for age, gender, education and self-efficacy. Results Not consuming fruit and vegetables daily was associated with lower health literacy levels in all examined scales. Doing no sports as well as smoking showed positive associations with low levels in “health-related communication and interaction skills” and “attitudes toward one's own health and health information”. No associations were found between risky alcohol consumption and health literacy. Conclusions The results indicate that strengthening health literacy should be part of health promotion activities for increasing physical activity and healthy diet among adolescents. The MOHLAA-Q allows us to identify which specific dimensions of health literacy might be addressed in order to promote different health behaviors.

Relationship Between Depression and Risky Alcohol Consumption in Women: the Mediating Role of Coping Styles and Age.

Women are more likely to use alcohol as a coping strategy for psychological distress, with higher rates of comorbidity with depression being found in those with an alcohol use disorder. The objective of this study was to analyze changes in problematic alcohol consumption and depression during the COVID-19 lockdown, and to establish a predictive model based on age. A total of 1889 women aged 18–64 years (M = 36.14) participated. The Patient Health Questionnaire was applied for depression, the Alcohol Use Disorders Identification Test–Short Version for alcohol, and active and avoidant coping were considered. In the period prior to the pandemic, depression and avoidant coping were good predictors of alcohol consumption in women, regardless of age. During lockdown, this predictive capacity was only maintained in women aged 35–64 years. In the mediational models, differences were observed according to age. For women aged 18–34 years, depression was the predictor variable of problematic alcohol consumption, but for women aged 35–64 years it was the avoidant coping style, which is the predominant style in women of this age with clinical depression. The relevance of age in the combined treatments of depression and problematic alcohol consumption is highlighted, and training in active coping strategies is suggested.

Alcohol consumption and mental health conditions: Insights from a South Australian population survey to inform policy and practice

ObjectiveAmong individuals with a mental health condition co‐occurring alcohol use disorders are common, but less is known about alcohol consumption in excess of recommended drinking guidelines. This study investigated the prevalence of lifetime risky drinking (>2 drinks daily) and single occasion risky drinking (>4 drinks on one occasion) among individuals with mental health conditions of different severities. MethodsData from representative cross‐sectional population surveys among South Australians aged ≥15 years (n=11,761) were utilised. Logistic regression models assessed associations between risky alcohol consumption, presence of a mental health condition and demographic characteristics. ResultsPrevalence of lifetime risky drinking was greater among both males and females with a mental health condition (p>0.001). Single occasion risky drinking was more prevalent among males with a severe mental health condition (p=0.01). Adjusted logistic regressions showed that only females with a mental health condition had greater odds of exceeding lifetime risky drinking levels (OR=1.39, CI 1.11 to1.75). ConclusionsThere are sex‐specific relationships between risky alcohol consumption and mental health conditions. Implications for public healthRisky alcohol consumption, in excess of guidelines, is of concern among those with a mental health condition and requires attention at an individual and population level.

Peer-led interventions to reduce alcohol consumption in college students: A scoping review.

Risky alcohol consumption among college students is a significant public health issue. In the college setting, students can collaborate in the implementation of peer-led interventions. To date, evidence of peer-led programmes in reducing harmful alcohol consumption in this population is inconclusive. The aim of the current scoping review is to provide a broad overview by systematically examining and mapping the literature on peer-led interventions for preventing risky alcohol consumption by college students. The specific aims were to (1) identify the underlying focus of the interventions and assess their (2) effectiveness and (3) feasibility. A comprehensive search was conducted in PubMed, PsycINFO, CINAHL, Cochrane Library, Web of Science, DART-Europe, RCAAP, Trove and ProQuest. The inclusion criteria were peer-led interventions that exclusively addressed alcohol consumption, college students as the target population and interventional studies (randomised controlled trials, quasi-experimental studies, systematic reviews and meta-analyses of interventions). The methodological quality of the articles was evaluated. From 6654potential studies, 13 were included. Nine interventions were described within these studies: Voice of Reason programme, Brief Advice sessions, Peer Theatre, Alcohol Education programme, Perceptions of Alcohol Norms intervention, Motivational Intervention, Alcohol Skills Training programme, Lifestyle Management Class and the Brief Alcohol Screening and Intervention for College Students. Only the last showed significant reductions in three of the four outcome measures: quantity and frequency of drinking, estimated peak blood alcohol concentration and alcohol-related consequences. It did not significantly decrease the number of heavy-drinking episodes. Peer interventions may be effective in preventing alcohol use among college students, although the evidence is weak and scarce. Further research is needed to strengthen the findings about peer-led interventions.

Risk and protective factors for mental ill-health in elite para- and non-para athletes

ObjectiveTo apply a socioecological approach to identify risk and protective factors across levels of the “sports-ecosystem,” which are associated with mental health outcomes among athletes in para-sports and non-para sports. A further aim is to determine whether para athletes have unique risks and protective factor profiles compared to non-para athletes.MethodsA cross-sectional, anonymous online-survey was provided to all categorized (e.g., highest level) athletes aged 16 years and older, registered with the Australian Institute of Sport (AIS). Mental health outcomes included mental health symptoms (GHQ-28), general psychological distress (K-10), risky alcohol consumption (AUDIT-C) and eating disorder risk (BEDA-Q). Risk and protective factors across multiple levels of the socioecological model, including individual, microsystem, exosystem and macrosystem level factors were assessed via self-report.ResultsA total of 427 elite athletes (71 para and 356 non-para athletes) participated in the study. No significant differences in the rates of mental health problems were observed between para and non-para athletes. Both differences and similarities in risk and protective factor profiles were found across the multiple levels of the sports-ecosystem. Weak evidence was also found to support the hypothesis that certain risk factors, including experiencing two or more adverse life events in the past year, sports related concussion, high self-stigma, inadequate social support and low psychological safety conferred a greater risk for poorer mental health outcomes for para athletes in particular.ConclusionRisk factors occurring across various levels of the sports ecosystem, including individual, interpersonal and organizational level risk factors were found to be associated with a range of poorer mental health outcomes. The association between mental ill-health and certain risk factors, particularly those at the individual and microsystem level, appear to be greater for para athletes. These findings have important implications for policy and mental health service provision in elite sports settings, highlighting the need for more nuanced approaches to subpopulations, and the delivery of mental health interventions across all levels of the sports ecosystem.

Alcohol use and family-related factors among Spanish university students: the unHicos project

BackgroundDuring adolescence and youth there are relevant changes in the consolidation, gain or loss of consumption habits and lifestyles and the family factors has a fundamental role to development these habits. The study of the consumption of toxins, such as alcohol intake, is crucial at this stage due to the repercussions that said consumption presents in adulthood. Therefore, the objective of our study was to evaluate the associations between alcohol consumption patterns and related family factors (family functioning, family history of alcohol consumption) in Spanish university students.MethodsObservational, descriptive, cross-sectional, multicenter study, carried out in first-year university students from 11 Spanish universities. Through an online questionnaire, alcohol consumption (risky consumption and intensive consumption or binge drinking), family functioning and history of alcohol in the family were evaluated.Risky alcohol consumption and binge drinking were assessed using the AUDIT test, and family functioning was assessed using the family APGAR questionnaire. A descriptive analysis of the data was performed, as well as the Chi-Square test and Student's T-Test, and non-conditional logistic regression models were carried out to examine this association.ResultsThe prevalence of risky alcohol consumption identified in the 10,167 respondents was 16.9% (95% CI = 16.2–17.6), and that of BD was 48.8% (95% CI = 47.9–48.8). There is a significant association between risky alcohol consumption and family functioning in students of both sexes, with greater consumption in the face of severe dysfunctional support (men OR = 1.72; p < 0.001 and women OR = 1.74; p < 0.001) and family history of consumption (p = 0.005). Regarding the binge drinking pattern, no statistically significant differences were observed.ConclusionsRisky alcohol consumption in university students is associated with dysfunctional family support, unlike the binge drinking pattern, where there is no such association.The findings of this study show the importance of creating prevention programs focused on the family approach in university students, which include alcohol screening in the population with a family history of this substance, and greater social support from health services.

Gaudibilidad (moduladores del disfrute) y consumo riesgoso y perjudicial de alcohol en adolescentes

Introduction: in a recent study, it has been reported that adolescents who presented risky and harmful alcohol consumption show lower levels of gaudiebility (enjoyment modulators) than their consuming peers, but without risk. But in this study a one-factor gaudiebility scale for adults was used, and recently a new scale for children and adolescents has been published that is multifactorial (consistent with the construct). Objective: to study the relationship between the level of gaudiebility and the risky and harmful consumption of alcohol in adolescence using a new scale that presents adequate construct validity. Method: a sample of 464 adolescents (53.7% women) with a mean age of 15.99 (SD = 1.29), with risky and harmful consumption of alcohol and consumption without risk, was used. The GSCA (Gaudiebility Scale for Children and Adolescents) and AUDIT (Alcohol Use Disorders Identification Test) were administered. Results: the group with risky and harmful alcohol consumption did not show a mean in the level of gaudiebility (or with the factors) different from that observed in the group with non-risky alcohol consumption. Only the interest factor of the GSCA scale showed a negative and significant correlation with risky and harmful alcohol consumption, but this was very low. Discussion and conclusions: research suggests that the level of gaudiebility in adolescence is not a risk factor for an adolescent to present a risky and harmful consumption of alcohol. In future research, it is proposed to study the relationship between alcohol dependence and gaudiebility.

A Systematic Review of Common Drunkorexia Measures: Examining Gender Differences across Scales

ABSTRCT Background Drunkorexia includes calorie restriction, excessive exercise, and/or purging in combination with alcohol consumption. Exploring drunkorexia by gender could inform potential intervention to address varying rates of drunkorexia, blood alcohol concentrations, and alcohol-related consequences. Purpose The purpose of this systematic review is to examine potential gender differences in drunkorexia among college students. Methods Search engines were used to find studies utilizing college students (2012–2021) and drunkorexia measures, resulting in 22 studies. Results Weighted mean scores and independent-sample t-tests of subscales for both the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS) and Drunkorexia Motives and Behaviors Scale (DMBS) showed no significant differences between females and males. Discussion The lack of difference indicates the need to consider diet, purging, and exercise as separate drunkorexia control techniques as opposed to one drunkorexia construct and indicates trends by gender may have evolved over the last decade. Translation to Health Education Practice Understanding the unique direct and secondhand health effects of drunkorexia by gender might assist in counteracting negative alcohol consequences potentially exacerbated by drunkorexia (e.g., overdose, injuries, death), and inform multiple CHES® and MCHES® areas of responsibilities and competencies to improve interventions to reduce risky alcohol consumption among college students.

Effectiveness of Varenicline and Cytisine for Alcohol Use Reduction Among People With HIV and Substance Use

Cigarette smoking and risky alcohol consumption co-occur and are undertreated. Nicotine receptor partial agonists and nicotine replacement therapy (NRT) treat smoking but are unproven for alcohol, and clinical trials rarely include individuals with HIV, substance use, and mental health conditions. To compare the effects on drinking and smoking of nicotinic acetylcholine receptor partial agonists varenicline and cytisine with those of NRT. This 4-group randomized, double-blinded, placebo-controlled clinical trial was conducted from July 2017 to December 2020 in St Petersburg, Russia. Included participants were 400 individuals with HIV who engaged in risky drinking (≥5 prior-month heavy-drinking days [HDDs]) and daily smoking; they were followed up for 12 months after enrollment. Data were analyzed from May 2021 through June 2022. Participants received alcohol and tobacco counseling, 1 active medication, and 1 placebo in 1 of 4 groups: active varenicline and placebo NRT (group 1), placebo varenicline and active NRT (group 2), active cytisine and placebo NRT (group 3), or placebo cytisine and active NRT (group 4). The primary outcome was number of prior-month HDDs at 3 months. Secondary outcomes included biochemically validated abstinence from alcohol at 3 months and smoking at 6 months. Among 400 participants (263 [65.8%] men; mean [SD] age, 39 [6] years), 97 individuals (24.3%) used opioids and 156 individuals (39.1%) had depressive symptoms. These individuals had a mean (SD) CD4 count of 391 (257) cells/mm3, smoked a mean (SD) of 21 [8] cigarettes/d, and reported a mean (SD) of 9.3 (5.8) HDDs in the prior 30 days. At 3 months, the mean (SD) number of HDDs was decreased vs baseline across all groups (group 1: 2.0 [3.8] HDDs vs. 9.5 [6.1] HDDs; group 2: 2.1 [4.3] HDDs vs 9.3 [5.7] HDDs; group 3: 1.5 [3.3] HDDs vs 8.9 [5.0] HDDs; group 4: 2.4 [5.2] HDDs vs 9.6 [6.3] HDDs). There were no significant differences at 3 months between groups in mean (SD) HDDs, including group 1 vs 2 (incident rate ratio [IRR], 0.94; 95% CI, 0.49-1.79), 3 vs 4 (IRR, 0.60; 95% CI, 0.30-1.18), and 1 vs 3 (IRR, 1.29; 95% CI, 0.65-2.55). There were no significant differences at 6 months between groups in smoking abstinence, including group 1 vs 2 (15 of 100 individuals [15.0%] vs 17 of 99 individuals [17.2%]; odds ratio [OR],0.89; 95% CI, 0.38-2.08), 3 vs 4 (19 of 100 individuals [19.0%] vs 19 of 101 individuals [18.8%]; OR, 1.00; 95% CI, 0.46-2.17), and 1 vs 3 (OR, 0.79; 95% CI, 0.35-1.78). Post hoc analyses suggested lower mean (SD) HDDs (eg, at 3 months: 0.7 [1.8] HDDs vs 2.3 [4.6] HDDs) and higher alcohol abstinence (eg, at 3 months: 30 of 85 individuals [35.3%] vs 54 of 315 individuals [17.1%]) among those who quit vs continued smoking. This study found that among individuals with HIV who engaged in risky drinking and smoking, varenicline and cytisine were not more efficacious than NRT to treat risky drinking and smoking but that behavior change rates were high in all groups. ClinicalTrials.gov Identifier: NCT02797587.

Prevalence and Correlates of Mental Health Symptoms and Well-Being Among Elite Sport Coaches and High-Performance Support Staff

BackgroundThere is growing understanding of mental health needs in elite athletes, but less is known about the mental health of coaches and support staff who work within elite sport settings. This study examined the prevalence and correlates of mental health symptoms in elite-level coaches and high-performance support staff (HPSS) and compared rates against published elite athlete samples. A cross-sectional, anonymous, online survey was administered to coaches and HPSS working in Australia’s high-performance sports system. Main outcomes were scores on validated measures of psychological distress, probable ‘caseness’ for a diagnosable psychological condition, alcohol consumption and sleep disturbance.ResultsData were provided by 78 coaches (mean age = 46.4 years, 23.8% female) and 174 HPSS (mean age = 40.0 years, 56.7% female). Overall, 41.2% of the sample met probable caseness criteria, 13.9% reported high to very high psychological distress, 41.8% reported potential risky alcohol consumption and 17.7% reported moderate to severe sleep disturbance, with no statistically significant differences between coaches and HPSS. The most robust correlates of psychological distress and probable caseness were dissatisfaction with social support and dissatisfaction with life balance, while poor life balance was also associated with increased alcohol consumption and poor social support with sleep disturbance. Coaches and HPSS reported similar prevalence of mental health outcomes compared to rates previously observed in elite athletes, with the exception of higher reporting of alcohol consumption among coaches and HPSS.ConclusionsElite-level coaches and HPSS reported levels of psychological distress and probable caseness similar to those previously reported among elite-level athletes, suggesting that these groups are also susceptible to the pressures of high-performance sporting environments. Screening for mental health symptoms in elite sport should be extended from athletes to all key stakeholders in the daily training environment, as should access to programs to support mental health and well-being.