Self-reported Alcohol Use Research Articles

The Impact of Self-Reported Alcohol, Tobacco, and Recreational Drug Use during Pregnancy on Adverse Pregnancy Outcomes in First-Time Mothers.

The objective of this study was to derive profiles of alcohol, tobacco, and recreational drug use during pregnancy for first-time mothers with latent class growth analysis (LCGA) and determine the association of these classes with the risk of adverse pregnancy outcomes (APO). A secondary analysis of a prospective cohort of Nulliparous Outcomes in Pregnancy: Monitoring Mothers-to-Be was conducted in eight medical centers across the United States from September 30, 2010, to September 23, 2013. Self-reported use of any alcohol, tobacco, or recreational drugs in the 1 month prior to the visit was assessed at up to four visits throughout pregnancy, and APOs included a composite of preterm birth, hypertensive disorder of pregnancy (HDP), small for gestational age (SGA) infant, or stillbirth, and each adverse outcome separately. Four latent classes were identified from the LCGA for 10,031 nulliparous pregnant women that were on average 26.9 years old (standard deviation [SD] = 5.7) and mostly non-Hispanic White (59.7%). Classes included consistent tobacco users (N = 517, 5.2%), nonusers (N = 8,945, 89.2%), alcohol users (N = 500, 5.0%), and a combination of alcohol/tobacco/drug users (N = 69, 0.7%). Logistic regression demonstrated that the class of tobacco users was more likely to have an APO (odds ratio [OR] = 1.48, 95% confidence interval [CI] = 1.22-1.81), preterm birth (OR = 1.53, 95% CI = 1.15-2.02), and SGA (OR = 1.79, 95% CI = 1.36-2.35) relative to the class of nonusers. The class of alcohol users was more likely to have HDP (OR = 1.37, 95% CI = 1.11-1.70) and less likely to have preterm birth (OR = 0.59, 95% CI = 0.38-0.90) and SGA (OR = 0.61, 95% CI = 0.40-0.93) compared to nonusers. Trajectories of substance use are associated with APOs; thus, interventions to mitigate the use when encountered early in pregnancy are warranted. · Four classes of substance use were identified.. · Tobacco users were at a higher risk of APO and alcohol users were at higher risk of HDP.. · Mitigation strategies are warranted to reduce APO..

Friends, attachment and substance use in adolescence

Friends' alcohol and drug use is one of the best-known social predictors of substance use in adolescence and can be explained by two main mechanisms: socialization (being influenced by one's friends' substance use) and peer selection (choosing friends who have similar substance use habits). In this study, we first examined the bidirectional relations between 182 adolescents' and their friends' self-reported alcohol and cannabis use frequency from ages 14 to 16. Then, we tested the moderating role of the participants' attachment-related avoidance and anxiety, measured using the Attachment Scale Questionnaire, in how these relations unfold between ages 15 and 16. Cross-lagged models with interaction analyses supported both mechanisms for both substances, but selection was stronger. However, attachment moderated only socialization; Socialization of alcohol use was stronger for non-avoidant adolescents while socialization of cannabis use was stronger for preoccupied adolescents. These results may have implications for improving prevention and intervention.

Digital Health Screening in People With HIV in Uganda to Increase Alcohol Use Reporting: Qualitative Study on the Development and Testing of the Self-administered Digital Screener for Health.

BackgroundAlcohol consumption is a critical driver of the HIV epidemic worldwide, particularly in sub-Saharan Africa, where unhealthy alcohol use and HIV are prevalent. Brief alcohol interventions are effective in reducing alcohol use; however, they depend on effective screening for unhealthy alcohol use, which is often underreported. Thus, there is a need to develop methods to improve reporting of unhealthy alcohol use as an essential step toward referral to brief alcohol interventions. Self-administered digital health screeners may improve reporting.ObjectiveThis study aimed to develop and test a digital, easy-to-use self-administered health screener. The health screener was designed to be implemented in a busy, underresourced HIV treatment setting and used by patients with varying levels of literacy.MethodsWe conducted a qualitative study at the Immune Suppression Syndrome (ISS) Clinic of Mbarara Regional Referral Hospital in Uganda to develop and test a digital self-administered health screener. The health screener included a training module and assessed behaviors regarding general health, HIV care, and mental health as well as sensitive topics such as alcohol use and sexual health. We conducted focus group discussions with clinicians and patients with HIV of the Mbarara ISS Clinic who consumed alcohol to obtain input on the need for and content, format, and feasibility of the proposed screener. We iteratively revised a tablet-based screener with a subset of these participants, piloted the revised screener, and conducted individual semistructured in-depth interviews with 20 participants who had taken part in our previous studies on alcohol and HIV, including those who had previously underreported alcohol use and with low literacy.ResultsA total of 45 people (n=5, 11% clinicians and n=40, 89% Mbarara ISS Clinic patients) participated in the study. Of the patient participants, 65% (26/40) were male, 43% (17/40) had low literacy, and all (40/40, 100%) had self-reported alcohol use in previous studies. Clinicians and patients cited benefits such as time savings, easing of staff burden, mitigation of patient-provider tension around sensitive issues, and information communication, but also identified areas of training required, issues of security of the device, and confidentiality concerns. Patients also stated fear of forgetting how to use the tablet, making mistakes, and losing information as barriers to uptake. In pilot tests of the prototype, patients liked the feature of a recorded voice in the local language and found the screener easy to use, although many required additional help and training from the study staff to complete the screener.ConclusionsWe found a self-administered digital health screener to be appealing to patients and clinicians and usable in a busy HIV clinic setting, albeit with concerns about confidentiality and training. Such a screener may be useful in improving reporting of unhealthy alcohol use for referral to interventions.

Effectiveness of a practice change intervention in reducing alcohol consumption in pregnant women attending public maternity services

BackgroundThe aim of this study was to examine the effect of a practice change intervention to support the implementation of guideline-recommended care for addressing alcohol use in pregnancy on self-reported alcohol use during pregnancy.MethodsA randomized, stepped-wedge controlled trial in three clusters (sectors) within the Hunter New England Local Health District (NSW, Australia). We evaluated a practice change intervention that supported the introduction of a new model of care for reducing alcohol use in pregnancy, consistent with local and international guidelines, and implemented in random order across the sectors. Each week throughout the study period, pregnant women who attended any public antenatal services within the previous week, for a 27–28 or 35–36 week gestation visit, were randomly sampled and invited to participate in the survey. The intended intervention for all women was Brief advice (to abstain from alcohol and information about potential risks). Women identified as medium-risk alcohol consumers using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) were to be offered referral to a phone coaching service, and women identified as high-risk were to be offered referral to a Drug and Alcohol Service. Rates of self-reported alcohol use (AUDIT-C risk level and special occasion drinking) were summarized and compared in groups of women pre-intervention and post-intervention using multivariable logistic regression.ResultsSurveys were completed by 1309 women at pre-intervention and 2540 at post-intervention. The majority of women did not drink during pregnancy (pre-intervention: 89.68%; post-intervention: 90.74%). There was no change in the proportion of women classified as No risk from drinking (AUDIT-C score = 0) or Some risk from drinking (AUDIT-C score ≥ 1) pre- or post-intervention (p = 0.08). However, a significant reduction in special occasion drinking was observed (pre-intervention: 11.59%; post-intervention: 8.43%; p < 0.001).ConclusionsSpecial occasion drinking was reduced following implementation of guideline-recommended care. Failure to change other patterns of alcohol use in pregnancy may reflect barriers to implementing the model of care in antenatal care settings and the need to address other social determinants of alcohol use.Trial registrationAustralian and New Zealand Clinical Trials Registry (registration number: ACTRN12617000882325; date: 16 June 2017).

Cell Phone Availability and Usage for mHealth and Intervention Delivery to Persons Living With HIV in a Low-Resource Setting: Cross-sectional Study.

BackgroundHIV/AIDS is now a manageable chronic illness owing to effective antiretroviral therapy (ART), which involves routine follow-up care, including regular physical visits to the clinic. In the recent past, and in wake of the COVID-19 pandemic, there has been increased need for virtual care and intervention delivery, a modality known as mobile health (mHealth), which includes cell phone–delivered services for medical and public health practice.ObjectiveHere we describe cell phone use and its relationship with alcohol use in a cohort of persons living with HIV and latent tuberculosis (TB).MethodsWe performed a cross-sectional analysis of baseline data from a cohort of persons living with HIV and latent TB in HIV care in southwestern Uganda. We estimated proportions of cell phone and text message use and evaluated their associations with alcohol use—a common modifiable behavior among persons living with HIV. Cell phone use (primary outcome) was defined as owning a cell phone that is turned on at least half of the day. Any alcohol use was defined as any self-reported alcohol use in the prior 3 months or a phosphatidylethanol (an alcohol biomarker) level of ≥8 ng/mL.ResultsA total of 300 participants (median age 40 years; n=146, 48.7% male) were included in the analysis. Most (n=267, 89.0%) participants had access to a phone and of them, 26 (9.7%) shared the phone with someone else. In total, 262/300 (87.3%) of participants owned a cell phone that is turned on at least half of the time; the majority (n=269, 89.7%) rarely or never sent text messages, and over two-thirds (n=200, 66.9%) rarely or never received text messages. Most (n=214, 71.3%) had any alcohol use in the prior 3 months. In adjusted analyses, any alcohol use was not significantly associated with cell phone use (adjusted odds ratio [aOR] 0.48, 95% CI 0.18-1.25; P=.13) or sending (aOR 0.82, 95% CI 0.28-2.37; P=.71) or receiving (aOR 1.31, 95% CI 0.70-2.47; P=.40) text messages.ConclusionsThere is hope that mHealth interventions in this population can be carried out using cell phones owing to their popularity; however, the interventions may need to employ methods that do not rely on the sending and receiving of text messages only.

Is Alcohol Consumption Associated with a Lower Risk of Cardiovascular Events in Patients Treated with Statins? An Observational Real-World Experience.

Alcohol consumption has long been associated with cardiovascular (CV) benefit, but it also has adverse potential. Statins are currently widely used for CV prevention. We evaluated whether alcohol use is associated with lower CV risk in patients on statins. We searched Intermountain Medical Center cardiac catheterization laboratory medical records for patients with a prescription history of statin use or non-use and a self-report of alcohol use or non-use. Alcohol and statin prescription data were available together with long-term (mean [SD], 4.4 [2.4] years) major adverse CV events (MACE, including death, myocardial infarction, stroke, and heart failure hospitalizations) in 1701 patients at primary and 3266 patients at secondary CV risk. MACE rates were lower for primary prevention alcohol users than non-users not on statins (adjusted hazard ratio [adj-HR] 0.50 (95% CI 0.33, 0.78, p = 0.002), but not for those on statins (adj-HR 0.84, CI 0.54, 1.32, p = 0.45). MACE rates for secondary prevention were not reduced by alcohol consumption either in statin non-users or users (adj HR 1.18, CI 0.85, 1.64, p = 0.33; adj HR 1.08, CI 0.87, 1.35, p = 0.45, respectively). These findings, together with other recent supportive studies, can help inform personal choices in alcohol consumption and professional society recommendations for CV prevention.

Online randomised factorial trial of electronic Screening and Brief Intervention for alcohol use in pregnancy: a study protocol

IntroductionApproximately 1 in 7 pregnant women in the USA report past-month alcohol use. Strong evidence connects prenatal alcohol exposure with a range of adverse perinatal outcomes, including the spectrum of...

Correlates of high phosphatidylethanol (PEth) levels and their concordance with self-reported heavy alcohol consumption among men who have sex with men who binge drink alcohol.

Heavy alcohol use, including binge drinking, is associated with high morbidity and mortality among men who have sex with men (MSM). Self-reported alcohol measures may lead to inaccurate estimates due to recall and social desirability biases. Objective alcohol biomarkers like phosphatidylethanol (PEth) can be used to corroborate self-report and could help to inform treatment approaches and research strategies for alcohol using MSM. From 2015 to 2020, alcohol using MSM ≥18 years were enrolled in a randomized controlled trial evaluating the efficacy of naltrexone in reducing binge drinking. Using this trial's baseline data, we applied multivariable logistic regression to identify the correlates of high PEth levels (i.e., ≥87 ng/ml) and concordance between PEth levels and self-reported heavy drinking. Of 118 MSM, 64% had PEth levels ≥87 ng/ml and 72% had PEth levels that were concordant with self-reported heavy alcohol use. Factors significantlyassociated in separate models with elevated PEth levels were income ≥$60,000 (adjusted odds ratio [aOR]=4.09; 95% CI=1.13 to 14.82), being employed (aOR=4.04; 95% CI=1.45 to 11.32), episodic cannabis use (aOR=4.63; 95% CI=1.27 to 16.92), and any alcohol/substance use prior to or during anal intercourse (aOR=2.52; 95% CI=1.08 to 5.90). Living with HIV was associated with significantly lower odds of elevated PEth levels (aOR=0.23; 95% CI=0.09 to 0.61). Factors associated with significantly higher concordance between PEth levels and self-reported heavy alcohol use included at least weekly use of poppers (aOR=6.41; 95% CI=1.27 to 32.28) and polysubstance use (aOR=2.53; 95% CI=1.02 to 6.27). Living with HIV was associated with lower odds of concordance (aOR=0.36; 95% CI=0.14 to 0.97). PEth may enhance the detection of heavy drinking among MSM, including the identification of subpopulations that may benefit from targeted alcohol reduction interventions. However, PEth values for MSM living with HIV showed modest concordance with self-reported alcohol use and may need to be supplemented with additional biomarkers or evaluated against a different cutoff.

Gender Differences in Prevalence and Risk Factors Associated With Substance Use in 50- to 65-Year-Old Jamaicans.

The purpose of this study was to evaluate gender-specific differences in prevalence and risk factors for alcohol, tobacco, and marijuana use among 50- to 65-year-old Jamaicans. We performed secondary analysis of the 2016 Jamaica National Drug Use Prevalence Survey. The dependent variables were self-reported use of tobacco, alcohol, and marijuana in the 30 days before the survey. The independent variables included general, socioeconomic, and community characteristics and concomitant substance use. Gender-stratified multiple Poisson regressions were conducted. The survey included 1,099 individuals aged 50-65 years; 50.3% were men. Reported use was significantly higher in men than in women: alcohol (54.9% vs. 17.8%), marijuana (22.4% vs. 2.2%), and tobacco (19.2% vs. 3.9%). High income was associated with alcohol use in women, whereas low and middle incomes were associated with marijuana use among men. Being employed was associated with tobacco use among women and with alcohol use among men. Rural residence was associated with alcohol use in women and with marijuana use in men. High neighborhood disorder was associated with tobacco use in women and alcohol and marijuana use in men. Concomitant substance use increased the likelihood of alcohol, tobacco, and marijuana use in men and women. We conclude that gender-sensitive strategies to substance use prevention and treatment are needed in Jamaica.

Association Between Alcohol Intake and Prostate Specific Antigen Screening: Results From a National Behavioral Survey

ObjectiveTo assess the association between self-reported alcohol use and prostate cancer (PCa) screening using the U.S.-based Behavioral Risk Factor Surveillance System (BRFSS) survey. Materials and MethodsA cross-sectional analysis of men aged between 55 and 69 who responded to the PSA screening and alcohol consumption portions of the 2018 BRFSS survey was performed. Alcohol consumption was assessed according with the Centers for Disease Control and Prevention definition of binge and heavy drinking. Rates of PSA screening between binge and non-binge drinkers and among heavy and non-heavy drinkers were compared. A complex weighted multivariable logistic regression model, adjusted for socio-economic covariates and weighted using BRFSS sample weights, was used to test the association between the self-reported alcohol use and the odds of PSA screening. ResultsAmong 57,774 men eligible for PCa screening, there were 8,276 binge drinkers with an unadjusted PSA screening prevalence of 37% versus 40% in the non-binge drinking group (P = .018). Among 3,836 heavy drinkers, the unadjusted PSA screening prevalence was 34% versus 40% in non-heavy drinkers (P < .001). In the multivariable analysis, only heavy drinking status was significantly associated with a lower odds of PSA screening (OR: 0.84, 95% CI: 0.72-0.98, P = .02). ConclusionGiven that alcohol overuse may increase the risk of developing cancer, our finding of lower utilization of PCa screening among heavy drinkers is noteworthy. Efforts to support guideline-concordant cancer screening among heavy drinkers may represent an important strategy to reduce the burden of cancer in these men.

Exposure to Electronic Media, Smoking and Alcohol Drinking Among Guyanese Adults.

Use of electronic media has been shown to be associated with tobacco and alcohol consumption behavior among adult population. Currently, not much is known about the risk factors of tobacco and alcohol consumption in Guyana. The present study aimed to explore the association between exposure to electronic media and tobacco and alcohol consumption by adjusting for the sociodemographic correlates.MethodsData were obtained from the sixth round of Guyana Multiple Indicator Cluster Survey (MICS 2019–20). Sample population were 2,208 men and 5,872 women aged between 15 and 49 years. Outcome variables were self-reported lifetime use of tobacco and alcohol, and the main explanatory variables were the use of electronic media such as internet, television and radio. Data were analyzed using descriptive and multivariable regression analysis in Stata version 17.ResultsOverall, 55.5% (95% CI = 53.4, 57.6) men and 44.5% (95% CI = 42.4, 46.6) women reported ever smoking tobacco, while the percentage of ever drinking alcohol was 34.2% (95% CI = 32.9, 35.4) and 65.8% (95% CI = 64.6, 67.1) among men and women, respectively. Internet users had significantly higher odds of ever consuming tobacco and alcohol, however, the association was not uniform across the sociodemographic variables. For smoking, the positive association with internet use was observed for women only (OR = 1.32, 95% CI = 1.09, 1.59), whereas, for alcohol consumption the association with internet use was significantly positive among both men (OR = 1.82, 95% CI = 1.58, 2.09) and women (OR = 1.84, 95% CI = 1.22, 2.70). Men and women who ever tried alcohol drinking had (OR = 4.64, 95% CI = 3.16, 6.82) and (OR = 10.62, 95% CI = 7.83, 14.40) times higher odds of trying tobacco smoking.ConclusionCurrent findings indicate over a quarter of the participants reported ever smoking tobacco and more than three-fifths ever drinking alcohol. Electronic media use, especially that of internet, is a strong predictor of tobacco and alcohol consumption among Guyanese adults. Results also revealed a strong interrelation between alcohol and tobacco smoking, and suggesting that strengthening the tobacco prevention programs may reduce the prevalence of alcohol drinking as well.

How alcohol and/or tobacco use and raised glycemia are associated with oral hygiene practices among Burkinabè adults: Evidence from the first national non-communicable disease risk factors survey

Socio-demographic correlates with oral hygiene practices are commonly investigated. The present study aimed to determine whether alcohol and/or tobacco use and hyperglycemia were associated with oral hygiene practices among Burkinabè adults. This descriptive, cross-sectional study included 4550 adults selected through multistage cluster sampling performed during the first WHO STEPS survey conducted in 2013 in Burkina Faso. The practices we considered were the frequencies of tooth cleaning, the fluoridated toothpaste use and the dentist visit within the past-six months. We collected data on self-reported alcohol and tobacco use and measured fasting blood glucose (FBG). About 82.8% of respondent reported they cleaned their teeth at least once a day, 31.5% cleaned them at least twice a day, 25.4% used fluoridated toothpaste, 2.2% had visited a dentist in the past six months, 38.8% used either alcohol or tobacco and 8.4% had raised FBG. After adjusting for socio-demographic factors, alcohol and/or tobacco use was an unfavorable factor for tooth cleaning at least once a day [aOR = 0.7 (0.6–0.8) p < 0.001], or at least twice a day [aOR = 0.6 (0.5–0.7) p < 0.001]. Moreover, raised FBG was negatively associated with cleaning tooth at least twice a day [aOR = 0.7 (0.5–0.9) p < 0.01] or the use of fluoridated toothpaste [aOR = 0.7 (0.6–0.9) p < 0.05]. Oral health education in addition to cardiovascular risk factor reduction should be efficiently integrated in the behavioral lifestyle interventions’ strategies for the non-communicable diseases’ prevention.

0562 Associations of Insomnia Symptoms and Unhealthy Alcohol Use with Post-Operative Healthcare Utilization in Veterans Undergoing Decompressive Laminectomy for Lumbar Spinal Stenosis

Abstract Introduction Lumbar spinal stenosis (LSS) affects 11-39% of adults and contributes to significant pain and disability. Decompressive laminectomy (DL) is a common surgical intervention for LSS but many with medical and psychosocial comorbidities may not improve. Insomnia and unhealthy alcohol use, for example, are common among people living with chronic pain and may affect key laminectomy outcomes, such as healthcare utilization rates. We examined associations of self-reported rates of post-DL healthcare utilization in Veterans with insomnia symptoms and alcohol use. Methods We analyzed data from a multi-site prospective cohort study of Veterans with LSS undergoing DL. Participants (N=200) self-reported prior 12-month alcohol use behavior (Short Michigan Alcohol Screening Test; SMAST) and prior two-week insomnia symptoms (Insomnia Severity Index; ISI) prior to surgery; 12-months of post DL healthcare office visits, ER visits, hospitalizations, and mental health visits were reported over the telephone monthly. Negative binomial regression models via incident rate ratios (IRR) compared healthcare utilization rates between individuals reporting alcohol-related problems only (SMAST &amp;gt;2), insomnia symptoms only (ISI ≥ 8), and both to those reporting neither. Results Approximately 52% of participants reported insomnia symptoms, 75% unhealthy alcohol use, and 39% both. Rates of office, ER, and hospital visits were descriptively highest in those reporting insomnia only; mental health visits were highest in those with both insomnia and unhealthy alcohol use. Those with insomnia only had more ER (IRR=2.39, p=.04) and mental health visits (IRR=4.32, p=.03) than those with neither insomnia nor unhealthy alcohol use; individuals with both insomnia and unhealthy alcohol use also had more mental health visits (IRR=4.22, p=.01). Adjusting for covariates rendered IRRs attenuated and statistically nonsignificant, but magnitudes remained high. Conclusion Most Veterans with LSS reported insomnia symptoms and/or unhealthy alcohol use. Those with insomnia symptoms reported the highest rates of healthcare utilization, including higher rates of ER and mental health visits. Insomnia symptoms may contribute to post-operative healthcare utilization, lending support for assessment and intervention of sleep-related problems pre-laminectomy. Support (If Any) This material is based on work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, grant # RX000798. Dr. Tighe is supported by Career Development/Capacity Building Award Number IK2 RX003393 from the United States (U.S.) Department of Veterans Affairs Rehabilitation R&amp;D (Rehab RD) Service. Dr. Bachrach is supported by a U.S. Department of Veterans Affairs Health Services Research and Development Service (HSR&amp;D) Career Development Award (CDA 20-057).

Two or more significant life-events in 6-months are associated with lower rates of HIV treatment and virologic suppression among youth with HIV in Uganda and Kenya

ABSTRACT Youth living with HIV in sub-Saharan Africa have poor HIV care outcomes. We determined the association of recent significant life-events with HIV antiretroviral treatment (ART) initiation and HIV viral suppression in youth aged 15–24 years living with HIV in rural Kenya and Uganda. This was a cross-sectional analysis of 995 youth enrolled in the SEARCH Youth study. At baseline, providers assessed recent (within 6 months) life-events, defined as changes in schooling/employment, residence, partnerships, sickness, incarceration status, family strife or death, and birth/pregnancy, self-reported alcohol use, being a parent, and HIV-status disclosure. We examined the frequencies of events and their association with ART status and HIV viral suppression (<400 copies/ul). Recent significant life-events were prevalent (57.7%). Having >2 significant life-events (aOR = 0.61, 95% CI:0.45-0.85) and consuming alcohol (aOR = 0.61, 95% CI:0.43-0.87) were associated with a lower odds of HIV viral suppression, while disclosure of HIV-status to partner (aOR = 2.39, 95% CI:1.6-3.5) or to family (aOR = 1.86, 95% CI:1.3-2.7), being a parent (aOR = 1.8, 95% CI:1.2-2.5), and being single (aOR = 1.6, 95% CI:1.3-2.1) had a higher odds. This suggest that two or more recent life-events and alcohol use are key barriers to ART initiation and achievement of viral suppression among youth living with HIV in rural East Africa. Trial registration: ClinicalTrials.gov identifier: NCT03848728..

Minimizing sample bias due to stigmatized behaviours: the representativeness of participants in a cohort study of alcohol in pregnancy

BackgroundStigmatized behaviours are often underreported, especially in pregnancy, making them challenging to address. The Alcohol and Child Development Study (ACDS) seeks to inform prevention of foetal alcohol harm, linking self-report as well as a maternal blood alcohol biomarker with child developmental outcomes. Samples were requested using passive, generic consent. The success of this approach at minimizing bias is presented comparing characteristics of women who provided samples to those who did not.MethodsAll pregnant women in the study city were sent a Patient Information Sheet (PIS) with their first NHS obstetric appointment letter. The PIS informed them that the NHS would like to take an extra blood sample for research purposes, unless they opted out. Neither the women nor the midwives were informed that the samples might be tested for an alcohol biomarker. This paper examines the extent to which women who provided the extra sample were representative of women where no sample was provided, in terms of routinely collected information: age; body mass index; area-based deprivation; previous pregnancies, abortions and caesarians; smoking status and carbon monoxide level; self-reported alcohol use, gestation and birth weight of their baby. Chi-square and Mann-Whitney U tests were used to compare groups.Results3436 (85%) of the 4049 pregnant women who attended their appointment provided the extra sample. Women who did not were significantly younger (p < 0.001), more materially deprived (p < 0.001), and less likely to be considered for intervention based on self-reported alcohol use (p < 0.001). There were no significant differences between the two groups on other routine data.ConclusionsThe use of passive consent without disclosure of the specific research focus resulted in a high level of sample provision. There was no evidence that study blinding was breached, and women who provided a sample were more likely to report alcohol consumption. Passive consent to draw additional blood for research purposes at routine antenatal venipuncture reduced sampling bias compared to asking women to give blood for an alcohol study. This methodology may be useful for other stigmatised behaviours.

Mental Imagery to Reduce Alcohol-related harm in patients with alcohol dependence and alcohol-related liver damaGE: the MIRAGE pilot trial protocol

IntroductionIn the UK, alcohol use is the main driver of chronic liver disease and each year results in over 1 million unplanned hospital admissions and over 25 000 deaths from...

Self-reported alcohol consumption of pregnant women and their partners correlates both before and during pregnancy: Acohort study with 21,472 singleton pregnancies.

BackgroundThe partners’ role in determining the alcohol consumption behavior of pregnant women is not well studied. We measured alcohol use before and during pregnancy in pregnant women and their partners to evaluate the correlation in their levels of consumption.MethodsWe evaluated the self‐reported alcohol use of 14,822 women and their partners during 21,472 singleton pregnancies delivered in Kuopio University Hospital, Finland during the period 2009‒2018. The information was gathered during pregnancy and at the time of childbirth and recorded in two databases that were merged to yield a single cohort. Missing data were accounted for by multiple imputation using the predictive mean matching method.ResultsIn 86% of the pregnancies, women reported alcohol use before pregnancy, whereas in 4.5% of the pregnancies women reported alcohol use during pregnancy. In contrast, no decrease was detected in their partners’ alcohol use before or during pregnancy. In 26% of the pregnancies, the woman reported stopping alcohol use only after recognizing that she was pregnant. Before pregnancy, there were strong correlations between the pregnant women and their partners in the total Alcohol Use Disorders Identification Test score (r s = 0.69, p < 0.0001) and the self‐reported average weekly amount of alcohol consumed (r s = 0.56, p < 0.0001). During pregnancy, there were weak correlations between the pregnant women and their partners in the frequency of drinking (r s = 0.20, p < 0.0001) and the average weekly amount of alcohol consumed (r s = 0.18, p < 0.0001).ConclusionsThe self‐reported alcohol consumption of pregnant women and their partners was positively correlated both before and during pregnancy, though the correlation declined substantially during pregnancy. Evaluating the alcohol consumption of both parents before pregnancy could assist in identifying women at risk of prenatal alcohol exposure. Supporting a reduction in partners' alcohol use could help to reduce pregnant women's alcohol consumption and prevent its associated harms.

Problematic alcohol use history among persons experiencing homelessness in Northwest Arkansas

ABSTRACT Little research has attempted to simultaneously understand the myriad of social factors that might amplify or mitigate alcohol misuse patterns among persons experiencing homelessness. Using a sample of homeless adults in Northwest Arkansas (n = 168), the current study explores the role of social vulnerabilities, individual risks, and social and psychological resources on a history of self-reported problematic alcohol use. A series of ordinary least squares regressions were used to model relationships between social vulnerabilities, individual risks, social and psychological resources, and a history of problematic alcohol use. Findings support the notion that social vulnerabilities and individual risks were associated with problematic alcohol use histories. In particular, homeless individuals that were older, male, experiencing recent incarceration, and reported suicidal ideation were more likely to report a higher incidence of a history of problematic alcohol use. We find no evidence that social and psychological resources mitigated problematic alcohol use histories. The study partially corroborates prior evidence of demographic and psychosocial factors associated with understanding the history of problematic alcohol use among persons experiencing homelessness. However, these findings differ measurably with regards to social connectedness, mastery, and an expression of spirituality not being associated with problematic alcohol use histories.

Kink in an English Field: The Drinking, Drug use and Sexual Practices of English Festival-Goers Who Engage in Kink

Little is known about the other leisure activities of people who engage in kink, including sexual practices and the use of alcohol and other drugs. This article examines the drinking, illicit drug use and sexual practices of people who engage in kink from a novel sample of attendees at an English festival. Of 966 respondents, 64 reported having engaged in kink within the past 12 months. We provide evidence of these respondents’ self-reported demographic characteristics, alcohol and other drug use in their lifetime and within the past 12 months, as well as other sexual practices they engaged in. This study illustrates the value of accessing participants through in situ festival fieldwork to understand kink practices, and helps us move beyond notions of clustered risky activities toward a leisure studies approach to understanding the practices of people who engage in kink.

Association between caregiver and household alcohol use and child behavior problems in KwaZulu Natal, South Africa.

We explored the association between household alcohol use and behavior problems among South-African children, using data from the Asenze study, a population-based cohort of South African children and their caregivers. Household alcohol use and child behavior were assessed when children were 6-8 years old. To examine the association, we performed linear regressions. The sample included 1383 children with complete data under the care of 1251 adults. Children living in a household where self-reported caregiver alcohol use was scored as hazardous (4.6%) had higher levels of problem behavior (β = 1.94, 95% CI 0.06-3.82). There were no statistically significant associations between reported hazardous alcohol use by another member of the household (14.5%) and child problem behavior. Hazardous household alcohol use was associated with child problem behavior and this effect appeared to be mainly driven by primary caregiver use.