Self-reported Alcohol Consumption Research Articles

Individual and Combined Association Between Prenatal Polysubstance Exposure and Childhood Risk of Attention-Deficit/Hyperactivity Disorder

Polysubstance use among pregnant women has increased because of the opioid epidemic and the increasing legalization of cannabis along with persistent tobacco and alcohol consumption. Previous research on prenatal substance use and the child's risk of attention-deficit/hyperactivity disorder (ADHD) has mostly focused on single-substance exposures; simultaneous examination of multiple substance use and assessment of their synergistic health consequences is needed. To assess the consequences of the use of specific substances during pregnancy, investigate whether the interaction of multiple prenatal substance exposures is associated with increases in the risk of childhood ADHD, and estimate the aggregate burden of polysubstance exposure during gestation. This cohort study analyzed data from the Boston Birth Cohort from 1998 to 2019. The sample of the present study comprised a multiethnic urban cohort of mother-child pairs who were predominantly low income. A total of 3138 children who were enrolled shortly after birth at Boston Medical Center were included and followed up from age 6 months to 21 years. Substance use during pregnancy was identified based on self-reported tobacco smoking, alcohol consumption, and use of cannabis, cocaine, or opioids in any trimester of pregnancy. Diagnostic codes for neonatal opioid withdrawal syndrome or neonatal abstinence syndrome from the International Classification of Diseases, Ninth Revision, and the International Classification of Diseases, Tenth Revision, were also used to identify opioid exposure during gestation. ADHD diagnosis in the child's electronic medical record. Among 3138 children (1583 boys [50.4%]; median age, 12 years [IQR, 9-14 years]; median follow-up, 10 years [IQR, 7-12 years]) in the final analytic sample, 486 (15.5%) had an ADHD diagnosis and 2652 (84.5%) were neurotypical. The median postnatal follow-up duration was 12 years (IQR, 9-14 years). Among mothers, 46 women (1.5%) self-identified as Asian (non-Pacific Islander), 701 (22.3%) as Hispanic, 1838 (58.6%) as non-Hispanic Black, 227 (7.2%) as non-Hispanic White, and 326 (10.4%) as other races and/or ethnicities (including American Indian or Indigenous, Cape Verdean, Pacific Islander, multiracial, other, or unknown). A total of 759 women (24.2%) reported the use of at least 1 substance during pregnancy, with tobacco being the most frequently reported (580 women [18.5%]). Cox proportional hazards models revealed that opioid exposure (60 children) had the highest adjusted hazard ratio (HR) for ADHD (2.19; 95% CI, 1.10-4.37). After including main statistical effects of all individual substances in an elastic net regression model, the HR of opioids was reduced to 1.60, and evidence of a statistical interaction between opioids and both cannabis and alcohol was found, producing 1.42 and 1.15 times higher risk of ADHD, respectively. The interaction between opioids and smoking was also associated with a higher risk of ADHD (HR, 1.17). The findings of this study suggest that it is important to consider prenatal concurrent exposure to multiple substances and their possible interactions when counseling women regarding substance use during pregnancy, the future risk of ADHD for their children, and strategies for cessation and treatment programs.

Physical Fitness, Dietary Habits and Substance Misuse: A Cross-Sectional Analysis of the Associations in 7,600 Swedish Adolescents

<strong>Introduction:</strong> Adolescence is a period of rapid physical, psychological and social changes and a time when habits are formed. This study aimed to investigate the correlation between physical fitness, alcohol consumption, tobacco consumption and dietary habits among adolescents according to the Swedish Physical power, Mental harmony and Social capacity profile (FMS profile). <strong>Methods:</strong> Data were collected from Swedish high school students, 1st – 3rd grade (16–19 yrs), both genders, overall, 7,600 Swedish adolescents using the FMS profile, comprising physical tests and questionnaires concerning lifestyle factors (e.g. physical fitness, dietary habits, alcohol and tobacco use). Participants included in this study met the requirements of inclusion, which were having a complete set of data, e.g. had undergone all physical tests and answered all questionnaires. <strong>Results:</strong> A total of 13% self-reported cigarette smoking, while 37% self-reported alcohol consumption. Adolescents who smoked were older (t-test = 9.09,p&lt; 0.001), heavier (t-test = 4.58,p&lt; 0.001) and had greater BMI (t-test = 3.96,p&lt; 0.001). Adolescents who consumed alcohol were older (t-test = 8.78, p &lt; 0.001), heavier (t-test = 4.03,p&lt; 0.001) and taller (t-test = 3.77,p&lt; 0.001). Significant differences were found for all fitness factors, with better mobility, strength and balance in adolescents who did not smoke compared to smokers (Mann Whitney Z test = 2.77, 7.13, 5.77, respectively; allp&lt; 0.001). Regularity of meals and avoidance of sweets and cakes were less prevalent in adolescents who smoked (OR (95% CI): 0.63 (0.59–0.68), 0.71 (0.66–0.77), respectively). <strong>Conclusion:</strong> Among Swedish adolescents, tobacco and alcohol use increase with age. However, physical fitness is consistently protective against tobacco consumption, and dietary habits are mostly protective against alcohol consumption. Physical fitness and low alcohol and tobacco consumption are possible health factors.

Alcohol intake and mortality risk of COVID-19, pneumonia, and other infectious diseases: An analysis of 437191 UK biobank participants

This study aims to investigate the association between alcohol consumption and COVID-19, infectious diseases, and pneumonia mortality. This is a prospective analysis of 437,191 UK Biobank participants (age 56.3 years, 54% female). The main exposure was self-reported alcohol consumption. In addition to never and previous drinkers, we applied quartiles-based and UK guidelines-based criteria to divide current drinkers by weekly consumption into four groups. Outcomes included COVID-19, infectious diseases, and pneumonia mortality, obtained from the national death registries until May 2020. After an 11-year follow-up, compared to never drinkers, previous drinkers had higher mortality risks of infectious diseases and pneumonia (adjusted HR: 1.29 [95% CI 1.06–1.57] and 1.35 [1.07–1.70], respectively), but not COVID-19. There was a curvilinear association of alcohol consumption with infectious diseases and pneumonia mortality. Drinking within-guidelines (<14 UK units/wk) and amounts up to double the recommendation (14 to < 28 UK units/wk) was associated with the lowest mortality risks of infectious diseases (0.70 [0.59–0.83] and 0.70 [0.59–0.83], respectively) and pneumonia (0.71 [0.58–0.87] and 0.72 [0.58–0.88], respectively). Alcohol consumption was associated with lower risks of COVID-19 mortality (e.g., drinking within-guidelines: 0.53 [0.33–0.86]). Drinkers reporting multiples of the recommended alcohol drinking amounts did not have higher mortality risks of COVID-19 and other infectious diseases than never drinkers. Despite the well-established unfavorable effects on general health, we found no deleterious associations between alcohol consumption and the risk of infectious diseases, including COVID-19. Future research with other study designs is needed to confirm the causality.

FcGBP and VCAM-1 are ponderable biomarkers for differential diagnosis of alcoholic liver cirrhosis

Background/ aimsEarly diagnosis of alcoholic liver cirrhosis (ALD) and coexisting ALD and hepatitis B virus-induced cirrhosis (ALD+HBV) is primordial for an optimal management of these conditions. However, the lack of specific noninvasive biomarkers coupled with the inaccuracy of self-reported alcohol consumption make the early diagnosis of these pathologies difficult. This study aimed to identify biomarkers to diagnose ALD and differentiate ALD+HBV from HBV. MethodsProteomics mass spectrometry technique was used to identify specific proteins of ALD by contrasting serums of ALD to that of healthy subjects. The accuracy of the selected proteins in diagnosing ALD and discriminating ALD+HBV from HBV was assessed in two independent cohorts using the area under the receiver operator characteristic curve (AUROC). Results452 cirrhotic and normal subjects were enrolled in this study. The proteomic results revealed that FcGBP and VCAM-1 were the highest overexpressed proteins while comparing ALD samples to the healthy cohort. The combination of these two biomarkers had an AUROC of 0.986 (P < 0.001, sensitivity: 97.2%, specificity: 100%) in identifying ALD from the healthy cohort, and AUROC of 0.781 (P < 0.001, sensitivity: 81.8%, specificity: 77.0%) in differentiating ALD+HBV from HBV. This combination was more accurate than the combination of AST/ALT, MCV and GGT (ALD vs healthy, AUROC = 0.898; ALD+HBV vs HBV, AUROC = 0.599). The discrimination performance of this combination was further validated in another independent cohort. ConclusionFcGBP and VCAM-1 are two promising biomarkers in the diagnosis of ALD and in the differentiating of ALD+HBV from HBV subjects.

Assessing alcohol use in situ: Correlates of self-report vs. objective alcohol consumption

Associations between self-report and objective measurement of young adult alcohol use are weakened by excessive consumption levels; therefore, associations between correlates of alcohol use and consumption likely also differ by alcohol measurement. This study examined the extent to which correlates of heavy drinking measured via self-report are also indicators of heavy drinking measured objectively. Data were collected from 164 bar patrons (54% male; 73% White, 12% Black, 15% Other; 15% Hispanic) as they exited the bar. Participants completed an intercept survey including self-reported measures of drinking, demographics, and social-environmental factors. A breath alcohol concentration (BrAC) reading was also obtained using a handheld breathalyzer device. Correlations between two self-reported outcomes, number of drinks consumed prior to and at the bar, and BrAC were significant among those in the lowest quartile of BrAC readings, but largely non-significant at moderate and high BrAC levels. Intention to get drunk that night was a robust predictor of alcohol consumption across self-reported outcomes and BrAC. Social factors (presence of drinking peers, witnessing drunk others) were predictive of self-reported alcohol use but not BrAC. AUDIT-C score was the only additional alcohol behavior predictive of objectively measured alcohol use. Self-reported outcomes and BrAC, as well as their association with key correlates, diverge at high levels of intoxication, when preventive intervention is most needed. Implications for further research and alcohol prevention practice are discussed.

Development of an algorithm to classify primary care electronic health records of alcohol consumption: experience using data linkage from UK Biobank and primary care electronic health data sources

ObjectivesDevelop a novel algorithm to categorise alcohol consumption using primary care electronic health records (EHRs) and asses its reliability by comparing this classification with self-reported alcohol consumption data obtained from...

Longitudinal Patterns of Alcohol Use Following Traumatic Brain Injury in an Active Duty and Young Veteran Military Sample: A VA TBI Model Systems Study.

To describe alcohol use among younger military active duty service members and veterans (SMVs) in the first 5 years after traumatic brain injury (TBI) and examine whether differential alcohol use patterns emerge as a function of brain injury severity and active duty service at time of injury. Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRCs). In total, 265 SMVs enrolled in the VA Traumatic Brain Injury Model Systems (TBIMS) PRC national database. Participants sustained a TBI of any severity level; received inpatient care at a PRC within 1 year of injury; were younger than 40 years; and completed survey interviews or questionnaires regarding their pre- and postinjury alcohol use for at least 3 of 4 time points (preinjury, postinjury years 1, 2, and 5). Self-reported alcohol use, defined as amount of weekly consumption and endorsement of binge drinking. Participant information related to demographics, injury, TBI severity, active duty status, mental health treatment, and FIM (Functional Independence Measure) total scores was also obtained to examine impact of these as covariates in the analyses. Alcohol use generally increased following an initial period of reduced consumption for SVMs with moderate-to-severe TBI. Individuals with mild TBI showed an opposite trend, with an initial period of increased use, followed by a decline and return to baseline levels in the long term. However, alcohol use did not significantly differ over time within this subsample after adjusting for covariates. The current study identified longitudinal alcohol use among a young, military/veteran cohort with a history of TBI, an at-risk population for problematic alcohol use. Patterns of self-reported alcohol consumption suggest the time frame of 2 to 5 years postinjury may be a critical window of opportunity for further intervention to maintain lowered levels of alcohol use, particularly among SVMs with moderate-to-severe TBI.

Post-treatment effects of topiramate on alcohol-related outcomes: A combined analysis of two placebo-controlled trials.

Topiramate reduces drinking and alcohol-related problems and is increasingly being used to treat alcohol use disorder (AUD). In a randomized controlled trial (RCT) of topiramate, rs2832407, a single nucleotide polymorphism (SNP) in the GRIK1 gene moderated topiramate's effects (Study 1). However, a second RCT (Study 2) did not replicate the SNP's moderating effect during treatment. The current analysis combines data from these two studies to examine topiramate's effects on alcohol-related outcomes and on its pharmacogenetic moderation during a 6-month post-treatment period. This analysis includes 308 individuals with problematic alcohol use (67% male; mean age = 51.1; topiramate: 49%, placebo: 51%). It uses generalized linear mixed models to examine changes in self-reported alcohol consumption and alcohol-related problems and concentrations of the liver enzyme γ-glutamyltransferase. The report combines published 3- and 6-month follow-up data from Study 1 with similar, unpublished data from Study 2. Despite robust effects of topiramate on drinking during treatment, the overall multivariate medication effects on outcomes during 3- and 6-month follow-up were not significant (p = 0.08 and p = 0.26, respectively). The moderating effect of the SNP on primary treatment outcomes was also not significant during either follow-up period (p = 0.13 and p = 0.16, respectively). However, during the 3-month post-treatment period, drinks per day was significantly lower in the topiramate group than the placebo group in the rs2832407*CC-genotype group. The robust effects of topiramate on alcohol-related outcomes during treatment diminish substantially once the medication is discontinued. Research is needed both to determine the optimal treatment duration and to identify clinically useful pharmacogenetic moderators of topiramate for treating AUD.

Exploring the Association Between Social Support and Hazardous Alcohol Use Among Persons Living with HIV in South Western Uganda.

Hazardous alcohol use and psychological distress are common among persons living with HIV (PLWH). In Uganda, HIV prevalence is 6.2% with average pure alcohol consumption per capita of 9.8 L. Social support may mitigate hazardous alcohol use. In a cohort of 443 PLWH, we measured social support using the Duke-UNC functional social support scale and self-reported alcohol consumption using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), augmented by phosphatidylethanol (PEth). We examined the association between low social support and hazardous alcohol use using multiple logistic regression models. 30% had low social support and 44% had hazardous alcohol use (AUDIT-C ≥ 3 for women and ≥ 4 for men and/or PEth ≥ 50ng/mL). We did not detect an association between low social support and hazardous alcohol use. Social support may play no role or a minimal role in preventing PLWH from hazardous alcohol use.

Improving Estimates of Alcohol-Attributable Deaths in the United States: Impact of Adjusting for the Underreporting of Alcohol Consumption

Self-reported alcohol consumption in U.S. public health surveys covers only 30%-60% of per capita alcohol sales, based on tax and shipment data. To estimate alcohol-attributable harms using alcohol-attributable fractions, accurate measures of total population consumption and the distribution of this drinking are needed. This study compared methodological approaches of adjusting self-reported survey data on alcohol consumption to better reflect sales and assessed the impact of these adjustments on the distribution of average daily consumption (ADC) levels and the number of alcohol-attributable deaths. Prevalence estimates of ADC levels (i.e., low, medium, and high) among U.S. adults who responded to the 2011-2015 Behavioral Risk Factor Surveillance System (BRFSS; N = 2,198,089) were estimated using six methods. BRFSS ADC estimates were adjusted using the National Alcohol Survey, per capita alcohol sales data (from the Alcohol Epidemiologic Data System), or both. Prevalence estimates for the six methods were used to estimate average annual alcohol-attributable deaths, using a population-attributable fraction approach. Self-reported ADC in the BRFSS accounted for 31.3% coverage of per capita alcohol sales without adjustments, 36.1% using indexed-BRFSS data, and 44.3% with National Alcohol Survey adjustments. Per capita sales adjustments decreased low ADC prevalence estimates and increased medium and high ADC prevalence estimates. Estimated alcohol-attributable deaths ranged from approximately 91,200 per year (BRFSS unadjusted; Method 1) to 125,200 per year (100% of per capita sales adjustment; Method 6). Adjusting ADC to reflect total U.S. alcohol consumption (e.g., adjusting to 73% of per capita sales) has implications for assessing the impact of excessive drinking on health outcomes, including alcohol-attributable death estimates.

Alcohol consumption and alcohol home delivery laws during the COVID-19 pandemic

Background: Alcohol consumption in the U.S. is a public health problem that has been exacerbated by the COVID-19 pandemic. Relatedly, many states have responded to COVID-19 by relaxing their alcohol laws, making it possible for adults to have alcohol delivered to their homes. This study sought to understand the impact of allowing alcohol home delivery on self-reported adult alcohol consumption in the US. Methods: In May 2020, we surveyed a convenience sample of U.S. adults over 21 years of age recruited through social media and listservs. Eight hundred and thirty-two participants completed the online survey: 84% were female, 85% were White, and 72% were between the ages of 26 and 49. Results: Twenty-one percent of participants who consumed alcohol in the past month had at least some alcohol delivered, with 60% having it delivered from liquor stores, restaurants, or bars. The remainder of the participants purchased the alcohol in-person or owned it pre-COVID-19. Participants who reported having alcohol delivered also reported consuming more drinks (β = 13.3; 95% CI [8.2, 18.4]; p < .000) and drinking on more days (β = 5.0; 95% CI [2.9, 7.0]; p < .000) over the past month than participants who obtained alcohol through other methods. Participants who had alcohol delivered were nearly two times more likely to report engaging in binge drinking than those who obtained alcohol through other methods (OR = 1.96; 95% CI [1.3, 3.1]; p = .003). Conclusions: Obtaining alcohol through home delivery was associated with greater alcohol consumption including binge drinking. As states consider permanently allowing alcohol home delivery, it is important to consider the potential public health implications.

Hazardous alcohol consumption and problem drinking in Norwegian and Russian women and men: The Tromsø Study 2015-2016 and the Know Your Heart study 2015-2018.

Harmful use of alcohol is a worldwide public health concern. Cultural differences may affect responses to questions on alcohol problems, making international comparisons difficult. We aimed to compare self-reported alcohol consumption and problem drinking between Norwegian and Russian populations. We used data from women and men aged 40-69 years participating in the Tromsø Study seventh survey (Tromsø7, N=17646, participation 65%), Tromsø (2015-2016), Norway, and the Know Your Heart study (KYH, N=4099, participation 51%), Arkhangelsk and Novosibirsk (2015-2018), Russia. Alcohol consumption and problem drinking were measured by the Alcohol Use Disorders Identification Test (AUDIT) via questionnaires (Tromsø7) and interviews (KYH). We compared AUDIT scores and components between populations, by sex. Non-drinking was more commonly reported in KYH compared with Tromsø7 (men 15.5% versus 4.9%, women 13.3% versus 7.3%). In men, hazardous consumption (41.4% versus 31.5%) and problem drinking (24.8% versus 19.6%) was higher in KYH compared with Tromsø7, but opposite for women (6.5% versus 12.0%, and 2.3% versus 5.8%). KYH men were less likely to report problem drinking behaviours than Tromsø7 men, with the exception of needing a drink first thing in the morning (13.2% versus 2.4%). KYH women consistently reported less consumption and problem drinking than Tromsø7 women. We found between-study differences in hazardous drinking, but in men these were lower than suggested by differences in country-level statistics on alcohol consumption and alcohol-related health-harms. Study sample selection, stronger social desirability bias effects in the Russian samples, and cultural differences in responding could have affected the results.

Examining Sex Differences in Associations between Pain and Alcohol Use among College Student-Athletes

Background: College student-athletes are a high-risk population for both pain and alcohol use. Although a growing literature indicates that pain motivates alcohol consumption, no studies have tested associations between pain and alcohol in college student-athletes. Methods and Results: Among National Collegiate Athletic Association Division I student-athletes at a large public university (N = 65; 48% Female), nearly all student-athletes (97%) reported alcohol use and 65% reported pain due to an athletic injury. Pain intensity was positively associated with greater motivation to reduce drinking prior to receiving a brief alcohol intervention. Among females, pain intensity was associated with lower self-reported alcohol consumption. Among male athletes, pain-related interference was associated with greater alcohol-related problems and lower perceived ability to deal with alcohol-related situations. Conclusion: Results provide initial evidence that pain may be important to consider when addressing alcohol use among student-athletes.

The associations between alcohol intake and cardiometabolic risk in African-origin adults spanning the epidemiologic transition

BackgroundCardiometabolic (CM) risk affects approximately 25% of adults globally, and is diagnosed by meeting 3 out of 5 of the following CM risk factors: elevated blood pressure, high triglycerides, elevated blood sugar, low high-density lipoprotein (HDL) level, and abdominal obesity. Adults with CM risk are approximately 22% more likely to have higher mortality rates, and alcohol consumption may be associated with higher CM risk. While previous studies have investigated this potential connection, the majority of them did not include African-origin adults. Therefore, the study aimed to explore the association between alcohol intake and CM risk in 5 African-origin cohorts, spanning the epidemiologic transition in Ghana, South Africa, Jamaica, Seychelles and the United States of America.MethodsMeasurements included clinical measures for CM risk and self-reported alcohol consumption. Each participant was categorized into one of three drinking categories: non-drinker, light drinker (1–3 drinks daily for men and 1–2 drinks daily for women) and heavy drinker (4 or more drinks every day for men and 3 or more drinks per day for women). Using non-drinker status as the reference, the association between alcohol consumption status and prevalence of each of the five CM risk factors and overall elevated CM risk (having 3 out of 5 risk factors) was explored, adjusting for site, age and sex. Associations were explored using logistic regression and significance was determined using odds ratios (OR) and 95% confidence intervals.ResultsNeither light nor heavy drinking was associated with increased odds for having higher CM risk compared to nondrinkers (OR = 1.05, p = 0.792 and OR = 1.11, p = 0.489, respectively). However, light drinking was associated with lower odds for having low high density lipoproteins (HDL) cholesterol (OR = 0.69, p = 0.002) and increased risk for high triglycerides (OR = 1.48, p = 0.030). Heavy drinking was associated with elevated blood pressure (OR = 1.59, p = 0.002), high triglycerides (OR = 1.73, p = 0.006) and decreased risk of low HDL-cholesterol (OR = 0.621, p < 0.0005). Finally, country-specific analyses indicated that the relationship between heavy drinking and elevated CM risk varied widely across sites.ConclusionWhile several CM risk factors were associated with alcohol consumption, the associations were inconsistent and varied widely across five international cohorts of African-origin. Future studies should focus on understanding the individual site-related effects.

Association between alcohol and bone mineral density in a Mendelian randomization study: the Dong-gu study.

Many previous studies have reported a positive relationship between alcohol and bone mineral density (BMD). However, the causality between alcohol and BMD has not been fully evaluated. This study enrolled 8892 participants from the Dong-gu study. Mendelian randomization (MR) using two-stage least-squared regression was used to evaluate the association between the genetically predicted amount of alcohol consumption per day and BMD. The aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as instrumental variables for alcohol consumption. Age, smoking history, and BMI were adjusted in the multivariate model. Self-reported alcohol consumption was positively related to total hip and lumbar spine BMD in both sexes. In multivariate Mendelian randomization analysis, the genetically predicted amount of alcohol consumption was positively associated with both total hip and lumbar spine BMD in men. Total hip BMD and lumbar spine BMD increased by 0.004g/cm2 (95% confidence interval [CI] 0.002-0.007) and 0.007g/cm2 (95% CI 0.004-0.011) with doubling of alcohol consumption. However, in women, genetically predicted alcohol consumption was not significantly associated with BMD. In our MR study, genetically predicted alcohol consumption was positively associated with BMD in men. This result suggests that the association between alcohol consumption and BMD is causal.

Epigenetic Analyses of Alcohol Consumption in Combustible and Non-Combustible Nicotine Product Users

Alcohol and tobacco use are highly comorbid and exacerbate the associated morbidity and mortality of either substance alone. However, the relationship of alcohol consumption to the various forms of nicotine-containing products is not well understood. To improve this understanding, we examined the relationship of alcohol consumption to nicotine product use using self-report, cotinine, and two epigenetic biomarkers specific for smoking (cg05575921) and drinking (Alcohol T Scores (ATS)) in n = 424 subjects. Cigarette users had significantly higher ATS values than the other groups (p < 2.2 × 10−16). Using the objective biomarkers, the intensity of nicotine and alcohol consumption was correlated in both the cigarette and smokeless users (R = −0.66, p = 3.1 × 10−14; R2 = 0.61, p = 1.97 × 10−4). Building upon this idea, we used the objective nicotine biomarkers and age to build and test a Balanced Random Forest classification model for heavy alcohol consumption (ATS > 2.35). The model performed well with an AUC of 0.962, 89.3% sensitivity, and 85% specificity. We conclude that those who use non-combustible nicotine products drink significantly less than smokers, and cigarette and smokeless users drink more with heavier nicotine use. These findings further highlight the lack of informativeness of self-reported alcohol consumption and suggest given the public and private health burden of alcoholism, further research into whether using non-combustible nicotine products as a mode of treatment for dual users should be considered.

Association of Prenatal Exposure to Maternal Drinking and Smoking With the Risk of Stillbirth

Prenatal smoking is a known modifiable risk factor for stillbirth; however, the contribution of prenatal drinking or the combination of smoking and drinking is uncertain. To examine whether prenatal exposure to alcohol and tobacco cigarettes is associated with the risk of stillbirth. The Safe Passage Study was a longitudinal, prospective cohort study with data collection conducted between August 1, 2007, and January 31, 2015. Pregnant women from Cape Town, South Africa, and the Northern Plains region of the US were recruited and followed up throughout pregnancy. Data analysis was performed from November 1, 2018, to November 20, 2020. Maternal consumption of alcohol and tobacco cigarettes in the prenatal period. The main outcomes were stillbirth, defined as fetal death at 20 or more weeks' gestation, and late stillbirth, defined as fetal death at 28 or more weeks' gestation. Self-reported alcohol and tobacco cigarette consumption was captured at the recruitment interview and up to 3 scheduled visits during pregnancy. Participants were followed up during pregnancy to obtain delivery outcome. Of 11663 pregnancies (mean [SD] gestational age at enrollment, 18.6 [6.6] weeks) in 8506 women for whom the pregnancy outcome was known by 20 weeks' gestation or later and who did not terminate their pregnancies, there were 145 stillbirths (12.4 per 1000 pregnancies) and 82 late stillbirths (7.1 per 1000 pregnancies). A total of 59% of pregnancies were in women from South Africa, 59% were in multiracial women, 23% were in White women, 17% were in American Indian women, and 0.9% were in women of other races. A total of 8% were older than 35 years. In 51% of pregnancies, women reported no alcohol or tobacco cigarette exposure (risk of stillbirth, 4 per 1000 pregnancies). After the first trimester, 18% drank and smoked (risk of stillbirth, 15 per 1000 births), 9% drank only (risk of stillbirth, 10 per 1000 pregnancies), and 22% smoked only (risk of stillbirth, 8 per 1000 pregnancies). Compared with the reference group (pregnancies not prenatally exposed or without any exposure after the first trimester), the adjusted relative risk of late stillbirth was 2.78 (98.3% CI, 1.12-6.67) for pregnancies prenatally exposed to drinking and smoking, 2.22 (98.3% CI, 0.78-6.18) for pregnancies prenatally exposed to drinking only after the first trimester, and 1.60 (98.3% CI, 0.64-3.98) for pregnancies prenatally exposed to smoking only after the first trimester. The adjusted relative risk for all stillbirths was 1.75 (98.3% CI, 0.96-3.18) for dual exposure, 1.26 (98.3% CI, 0.58-2.74) for drinking only, and 1.27 (98.3% CI, 0.69-2.35) for smoking only compared with the reference group. These results suggest that combined drinking and smoking after the first trimester of pregnancy, compared with no exposure or quitting before the end of the first trimester, may be associated with a significantly increased risk of late stillbirth.

B-PO05-165 ALCOHOL CONSUMPTION AND RISK OF BRADYARRHYTHMIAS: DATA FROM THE UK BIOBANK

There is a paucity of evidence for the role of alcohol consumption on the risk of bradyarrhythmias. Using prospective cohort data from the UK Biobank, we characterised associations of total and beverage-specific alcohol consumption with incident bradyarrhythmias. Self-reported alcohol consumption from a baseline questionnaire was calculated as standard drinks (8g alcohol) per week. Past and never drinkers and those with a history of bradyarrhythmias were excluded. Bradyarrhythmias were defined as a pacemaker insertion or abnormalities in rate/rhythm resulting in a pathologically slow ventricular response. Incident events were assessed through hospitalisation and death records. Consumption was modelled as restricted cubic splines in multivariate Cox regression models and corrected for regression dilution bias. The cohort consisted of 385,670 participants with 4,246 incident bradyarrhythmias over a median (IQR) follow-up duration of 8.0 (7.3-8.6) years. Participants consuming greater amounts of alcohol were younger, more likely male, of white ethnicity, and largely more comorbid. Associations of total and beverage-specific alcohol consumption and bradyarrhythmia risk are shown in the Figure. Disaggregation demonstrated similar associations for alcohol consumption with different bradyarrhythmia outcomes. Amongst current drinkers, alcohol consumption appears to have a protective association with bradyarrhythmia risk. Red and white wine intake was associated with lower risk compared to beer, cider and spirits. Further investigation is required into the biologic mechanisms behind these findings.

Health-related lifestyle and dropout from a web-based physical activity intervention trial in older adults: A latent profile analysis.

Selective study dropout limits manifestation and detection of intervention effects and is a major challenge in behavioral intervention studies. Engaging in health-risk behaviors might make individuals especially dropout-vulnerable. Thus, this theory-based study's aim was to identify health-related lifestyle profiles affecting dropout in a web-based physical activity intervention trial targeting older adults. The 12-week intervention trial was conducted between 2016 and 2018 in Germany. Baseline lifestyle profiles consisting of self-reported physical activity, sedentary behavior, alcohol consumption, fruit and vegetable intake, nocturnal sleep, and social activity were assessed with questionnaires and investigated in 589 individuals. The risk of study dropout related to health-related lifestyle profile was tested with Poisson regression in 571 individuals (96.9%). Latent profile analysis identified four latent health-related lifestyle profiles: socially inactive (n = 23, 3.9%), slightly unhealthy (n = 449, 75.2%), health-promoting (n = 81, 13.8%), and highly physically active lifestyle (n = 36, 6.1%). Profiles differed significantly by sex, stage of behavior change, and subjective health. Compared with the average of all profiles, statistically significant study dropout adjusted risk ratios (aRR) were 1.91 for the socially inactive lifestyle, and aRR = 0.73 for the slightly unhealthy lifestyle. There were no statistically significant effects for the highly physically active lifestyle (aRR = 0.94) and the health-promoting lifestyle (aRR = 0.76) on study dropout. This study highlights the relevance of accounting for the correlation between health-related lifestyle profiles and study participation of older adults in physical activity interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

B-PO02-004 TOTAL AND BEVERAGE-SPECIFIC ALCOHOL CONSUMPTION AND INCIDENT ATRIAL FIBRILLATION

Although binge drinking and moderate-to-high alcohol consumption are risk factors for developing atrial fibrillation (AF), the impact of low alcohol consumption remains controversial. Using prospective cohort data from the UK Biobank, we characterised the associations of alcohol consumption with incident AF. Self-reported alcohol consumption from a baseline questionnaire was calculated as standard drinks (8g alcohol) per week. Non-drinkers and those with a history of AF were excluded. Incident AF was assessed through hospitalisation and death records. Consumption was modelled as restricted cubic splines in multivariate Cox regression models and corrected for regression dilution bias. The cohort consisted of 381,236 participants with 11,538 incident AF events over a median (IQR) follow-up duration of 7.9 (7.3-8.6) years. Participants consuming greater amounts of alcohol were younger, more likely male, of white ethnicity, and largely more comorbid. Associations for total and beverage-specific alcohol consumption with risk of AF are shown in the Figure. When included in the analysis, past drinkers but not never drinkers appeared to have a greater risk of AF compared to current drinkers (HR 1.15, 95% CI 1.05-1.26 and HR 1.03, 95% CI 0.94-1.13 respectively). Spirit consumption in females was associated with greater AF risk, though no other significant gender interactions were observed. Amongst current drinkers, low alcohol consumption up to 7 standard drinks/week was not associated with increased AF risk. Red and white wine intake was associated with lower AF risk in comparison to beer, cider and spirits.