Alcohol use in adolescents from northern Russia: the role of the social context

Drinking alcohol is an essential and commonplace part of life in Russia. Alcohol-related problems in the general population and among adolescents in particular has become a major public health concern. The problem cannot be solely explained by the frequency and quantity of alcohol consumption. The social determinants of drinking alcohol also need to be considered. These are the focus of the present investigation. The social determinants of drinking behaviour were assessed by self-reports (Social Context of Drinking Scale, Adolescent Alcohol Involvement Scale and Rutgers Alcohol Problem Index) in 387 secondary school students in Arkhangelsk, Russia. The factor structure for the Social Context of Drinking Scale was similar to that noted in respect of the original study [Thombs and Beck (1994) Health Education and Research 9, 13-22]. Significant gender differences in problem drinking and the social contexts of drinking were found. High intensity girl drinkers were likely to drink in most social contexts, whereas high intensity drinking boys were more likely to drink in the context of Stress Control. Furthermore, boy problem drinkers were more likely to drink in the context of School Defiance and Peer Acceptance, whereas girl problem drinkers tended to drink in the contexts of School Defiance and Stress Control. In general, the Social Context of Drinking Scale demonstrated a good ability to discriminate high from low intensity drinkers, and high from low problem drinkers. These results may provide useful information for targeted prevention programmes for adolescents.     

Associations of antidepressant use with alcohol use and problem drinking: Ontario population data from 1999 to 2017

ObjectiveThis study investigated the rates of and change in past-year antidepressant use from 1999 to 2017 among a representative sample of Ontario adults and past-year alcohol users and problem drinkers. It examined whether alcohol use and problem drinking are associated with antidepressant use over time, whether gender moderated the effect of problem drinking on antidepressant use, and the potential correlates of past-year antidepressant use.MethodThis study utilized data from the Centre for Addiction and Mental Health Monitor study, a repeat cross-sectional telephone survey of the Ontario general adult population. Data are from 15 annual cycles of the survey 1999–2017 (where relevant variables were included), resulting in a sample size of N = 35,210. Variables of interest included demographic variables, past-year antidepressant use, past-year alcohol use, and past-year problem drinking (e.g., 8+ on the Alcohol Use Disorders Identification Test).ResultsPast-year antidepressant use increased from 1999 to 2017 similarly among the full sample, past-year alcohol users, and past-year problem drinkers. Approximately 9% of Ontarians reported past-year antidepressant use in 2017. Overall, past-year problem drinkers were 1.5 times more likely to use antidepressants than non-problem drinkers. Past-year alcohol use was not associated with antidepressant use. Gender moderated the association between past-year problem drinking and antidepressant use.ConclusionThis study determined that past-year antidepressant use increased from 1999 to 2017, that past-year problem drinkers are more likely to use antidepressants than non-problem drinkers, and that past-year problem drinking is associated with past-year antidepressant use among women but not among men.     

Social Context, Sensation Seeking, and Teen-age Alcohol Abuse

ABSTRACT: An anonymous questionnaire was administered to more than 1,200 seventh to 12th grade students in four rural public schools in western New York State. The questionnaire measured alcohol use, the social contexts of drinking, and the personality trait known as "sensation seeking." A majority (57%) were drinkers, and discriminant function analyses were performed on their scores on these measures to determine if they could distinguish between different levels of alcohol use intensity, alcohol-impaired driving, and riding with an impaired driver. Results indicated social context measures were effective in distinguishing among levels on each indicant of abuse. In particular, high-intensity drinkers, impaired drivers, and riders of impaired drivers were more likely to drink in a context of social facilitation, stress control, and defiance of school and adult authority. The drinking context of peer acceptance was important only in distinguishing teen-agers who ride with drunk drivers from those who do not. Overall, the sensation seeking trait was of moderate importance in distinguishing among different alcohol abuse practices. Implications of these findings for assessment as well as school-based prevention programs are discussed.     

Alcohol use beliefs and behaviors among high school students

Purpose: To identify specific alcohol use beliefs and behaviors among local high school students; to determine whether relationships exist between alcohol use and various sociodemographic and lifestyle behaviors; and to assist in the development and implementation of alcohol abuse prevention programs.Methods: This cross-sectional study involved the completion of a questionnaire by 1236 Grade 9–13 students (86% response rate) from 62 randomly selected classrooms in three Canadian urban schools. Data analyzed here are part of a larger lifestyle survey.Results: A total of 24% of students reported never having tasted alcohol, 22% have tasted alcohol but do not currently drink, 39% are current moderate drinkers, 11% are current heavy drinkers (five or more drinks on one occasion at least once a month), and 5% did not answer. Reasons stated most often for not drinking were “bad for health” and “upbringing,” while reasons stated most often for drinking were “enjoy it” and “to get in a party mood.” Student drinking patterns were significantly related to gender, ethnicity, grade, and the reported drinking habits of parents and friends. Older male adolescents who describe their ethnicity as Canadian are at higher risk for heavy drinking than students who are younger or female, or identify their ethnicity as European or Asian. Current heavy drinkers are at higher risk than other students for engaging in other high-risk behaviors such as drinking and driving, being a passenger in a car when the driver is intoxicated, and daily smoking.Conclusions: Heavy alcohol use in adolescents remains an important community health concern. Older self-described Canadian and Canadian-born male adolescents are at higher risk for heavy drinking. Current and heavy drinking rises significantly between Grades 9 and 12. Students who drink heavily are more likely to drink and drive, to smoke daily, and to have friends and parents who drink alcohol.     

Clustering of atherogenic behaviors in coffee drinkers.

We studied the clustering of coffee consumption and selected atherogenic behaviors in older adults living in a southern California community. Men were somewhat more likely to drink caffeinated coffee while women were more likely to drink decaffeinated coffee. In men, but not women, caffeinated coffee drinking decreased with age and decaffeinated coffee drinking increased. Caffeinated coffee drinkers drank more alcohol, consumed more dietary saturated fats and cholesterol, were more likely to be current smokers and less likely to be current exercisers than were non-coffee drinkers. Smoking and exercise also showed a dose-response relationship to the amount of caffeinated coffee consumed. Risk factor levels among drinkers of decaffeinated coffee were more like those of caffeinated coffee than non-drinkers. These data illustrate the clustering of atherogenic behaviors with coffee drinking and highlight their potential importance in interpreting the growing body of literature about coffee and health.     

Encouraging responsible drinking among underage drinkers

Public Service Announcements tailored to specific college drinking rituals (Treise, Wolburg and Otnes 1999) were tested on 133 underage undergraduate drinkers. More significant reductions in drinking intentions were found when using appeals focusing on drinking rituals pertaining to Maturity/Order (older students drink moderately: "Don't drink like a freshman.") than to Transformation (desired personality and mood changes), Community (social bonding and camaraderie), or a no-message Control. Gender did not moderate this effect. Underage drinkers may drink, in part, to feel more "grown up." Emphasizing that more senior students actually drink responsibly may diminish this belief and result in reduced alcohol consumption among underage students.     

DRINKING AND SMOKING PATTERNS AMONGST WOMEN ATTENDING AN ANTENATAL CLINIC-I. BEFORE PREGNANCY

This paper provides basic epidemiological data on smoking anddrinking patterns before pregnancy amongst 1117 pregnant womenattending a London antenatal clinic. Similar data are alreadyavailable from North America and surveys have been done in Scotlandbut there is a dearth of information from England and Wales. In the early stages of pregnancy, prior to recognition, heavyalcohol consumption (in excess of 56 units of alcohol per week)is associated with the Foetal Alcohol Syndrome. More moderatelevels of intake (as little as 10 units of alcohol per week)have been associated with Foetal Alcohol Effects such as growthretardation. In our sample 19% of the mothers were drinkingmore than 10 units of alcohol per week. Six per cent were consumingmore than the 14 units of alcohol currently recommended by threeof the medical Royal Colleges as ‘safe’ for non-pregnantwomen. Average weekly alcohol consumption was related to both the usualfrequency and amount drunk, but also to binge drinking, beveragechoice and combination, and reasons for drinking. In general,drinking was frequent and light. Those women who drank moreper week tended to drink more frequently than those in the lowerweekly consumption bands. Fourteen per cent of the sample admittedto binge drinking (more than 14 units of alcohol in a singlesitting). Wine was the most popular beverage type. The rangeof beverages consumed was wider in the higher alcohol consumptionbands. Those in the lower bands were more likely to drink onlyone beverage type. Social reasons for drinking were of far greaterimportance than reasons which emphasised the effects of drinking.However, heavy drinkers were unlikely to drink solely for socialreasons. Seventy-seven per cent of the mothers were non-smokers, butthe incidence of smoking increased in the higher alcohol consumptionbands. The demographic characteristics of the smokers were inmarked contrast to those of the heavier drinkers. Smokers tendedto be younger, of lower social status and multiparous, whereasthe heavier drinkers were more likely to be older, of highersocial status and primiparous. This finding is of fundamentalimportance to those interested in planning screening or interventionprogrammes.     

Examining Australia's heaviest drinkers

Objective : This study examined the distribution of alcohol consumption in Australia, identifying the heaviest drinking 10% of the population and examining their sociodemographic characteristics and their alcohol consumption and purchasing practices. Methods : Data came from the 2016 National Drug Strategy Household Survey and the 2013 International Alcohol Control Study. The heaviest drinking 10% of the population identified based on estimates of annual alcohol consumption. Logistic regression was then used to assess the factors that distinguished these heaviest drinkers from the rest of the drinking population. Results : The heaviest drinking 10% of the population consumed 54.4% of all alcohol consumed. These heavy drinkers were more likely to be men and to live in regional and remote areas. They were more likely to drink cask wine and full‐strength beer and to purchase cheaper alcohol than other drinkers. Conclusions : Australian alcohol consumption is heavily skewed. Alcohol consumption practices appear to differentiate the heaviest drinkers from others more clearly than sociodemographic factors. Implications for public health : Public health interventions that reduce drinking among the heaviest 10% of drinkers in Australia have the potential to markedly reduce per‐capita consumption and reduce alcohol‐related harm. Interventions focused on cheap alcohol may be effective with these drinkers.     

How similar are the smoking and drinking habits of men and women in non-manual jobs?

BACKGROUND: Men used to be more likely to smoke and drink heavily than women. However, as social roles changed, so have gender differences in health-related behaviours. This paper explores whether gender differences in these behaviours persist or disappear among men and women occupying similar social roles: working in the same non-manual jobs in Britain. METHODS: Self-completion questionnaires were distributed to full-time employees in a bank (n = 2,139) and a university (n = 1,611). Response rates were 76% and 67% respectively. Respondents were asked whether they smoked currently. Men who reported drinking more than 21 units of alcohol, and women who reported drinking more than 14 units, in the last week were classed as 'heavy' drinkers. RESULTS: In both organizations there were no significant gender differences in smoking, but men were significantly more likely than women to report drinking 'heavily'. Employees in clerical jobs in the university were more than twice as likely as their more senior colleagues to smoke, but were significantly less likely to report drinking 'heavily' in both organizations. High masculinity scores among both men and women were associated with smoking and 'heavy' drinking. CONCLUSION: Men and women occupying similar social roles are equally likely to smoke but men are significantly more likely to drink 'heavily'. The relationship between paid work variables and these health behaviours are similar for both men and women. The association between high masculinity scores and health-damaging behaviours in both men and women points to the importance of considering gender role orientation, rather than just comparing men and women.     

The association between stress and drinking: modifying effects of gender and vulnerability

AIMS: To assess the relationship between number and type of past-year stressful experiences and alcohol consumption, with a focus on how gender, poverty, and psychological vulnerability moderate this association. METHODS: Data from 26 946 US past-year drinkers 18 years of age and over, interviewed in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), were used to construct multivariate linear regression models predicting six measures of drinking pattern and volume. RESULTS: There was a consistent positive relationship between number of past-year stressors experienced and all measures of heavy drinking. Frequency of heavy (5+ drinks for men; 4+ drinks for women) drinking increased by 24% with each additional stressor reported by men and by 13% with each additional stressor reported by women. In contrast, the frequency of moderate drinking (<5 drinks for men; <4 drinks for women) decreased as stress levels increased. Job-related and legal sources of stress were more strongly associated with alcohol consumption than were social and health-related stress. Men showed a stronger association than women between the number of stressors and the most consumption measures; they also responded more strongly to the presence of any legal and job-related stress. Having an income below the poverty level intensified the effects of job-related stress, but having a mood or anxiety disorder did not affect any of the associations between stress and consumption. CONCLUSIONS: Stress does not so much lead individuals to drink more often as to substitute larger quantities of alcohol on the days when they do drink. Treatment and brief interventions aimed at problem drinkers might benefit from addressing the issue of tension alleviation and the development of alternative coping mechanisms.     

PREDICTORS FOR HIDDEN PROBLEM DRINKERS IN GENERAL PRACTICE

In The Netherlands general practice attenders are not usuallyquestioned about their drinking habits. The objective of thisstudy was to determine to what extent easily available data(e.g. age, gender) can be used to identify categories of patientswho are at risk of problem drinking as a preliminary to moreintensive screening. Sixteen practices with a total populationof 32,000 patients were involved in the study. All problem drinkersknown by their GPs and a random sample of one in ten patientsnot thought to be problem drinkers were admitted to the studyat their first surgery visit during a 1-year period. A screeningquestionnaire was used to find hidden problem drinkers amongstthe individuals thought to be non-problem drinkers. The overallresponse rate was 91% (n=1405). Problem drinking was detectedin 6% (n=82) of the group regarded by the GPs as non-problemdrinkers (n=1283). Male gender, smoking, life events and chronicsocial problems were the strongest non-alcohol-related predictorsof hidden problem drinking. We conclude that a pre-selectionof patients with a greater risk of problem drinking can be madewithout information related directly to alcohol. Case-findingin this category is much more effective and probably much moreacceptable both to the GP and the patients, than the screeningof all patients.     

DRINKING AND SMOKING PATTERNS AMONGST WOMEN ATTENDING AN ANTENATAL CLINIC--II. DURING PREGNANCY

This paper describes smoking and drinking patterns during pregnancyamongst a cohort of 2266 women who enrolled at a London antenatalclinic 1982–1983. Only 12% of mothers were non-drinkersbefore pregnancy, but 44% abstained in the first trimester,38% in the second and 50% in the third. Before pregnancy 20%of mothers were drinking more than the recommended 10 unitsof alcohol per week. This dropped to 6% during pregnancy. Meanconsumption at each of the three stages of pregnancy was highestamongst those mothers who were the heaviest drinkers beforepregnancy. The heaviest pre-pregnancy drinkers were also theleast likely to abstain at any point in pregnancy. Of thosemothers who were drinking less than 10 units of alcohol perweek before pregnancy, 3% increased during pregnancy. Wine wasthe most popular beverage choice but heavier drinkers were morelikely to drink beers and spirits in addition. Before pregnancy 29% of mothers smoked. This dropped to 23%in pregnancy. Consumption levels fell amongst those who continuedsmoking. The heaviest pre-pregnancy smokers were the most likelyto reduce but the least likely to stop. Smoking was positivelyassociated with the level of both pre-pregnancy and pregnancydrinking. The most commonly cited reasons for changes in drinking andsmoking habits in pregnancy were concern for the child, concernfor self or concern for both. Feeling sick or ill was a morecommonly stated reason for reduction of drinking than smoking.Social pressures were important in reducing smoking, but themass media were quoted as a more important influence in reducingdrinking. Mothers who drank more than 10 units of alcohol per week duringpregnancy were more likely to be older, of higher social statusand primiparous. In contrast those who smoked in pregnancy weremore likely to be younger, of lower social status and multiparous.This has important implications for planning antenatal healtheducation.     

Evaluating the believability and effectiveness of the social norms message "most students drink 0 to 4 drinks when they party"

In an effort to reduce dangerous drinking levels among college students, university health educators have initiated social norms campaigns based on the rationale that students will be more likely to reduce their own drinking behaviors if they think that most students on campus are not heavy or binge drinkers. Within the framework of social comparisons theory, this study reports the findings of a survey of 277 college students and explores the correlates of accuracy and bias in students' estimates of whether or not most other students think that binge drinking on campus is a problem and whether or not most other students believe the campaign message. The overwhelming majority (72.6%) of students did not believe the norms message that most students on campus drink "0 to 4" drinks when they party, and 52.7% reported drinking "5 or more" drinks in a sitting. The social norms campaign was effective in motivating 61% of the respondents to think about binge drinking as a problem. For the most part, group or social network norms were more influential on students' own drinking behavior than were their estimates of the campus drinking norm. The findings also clarify that accuracy in estimating the campus social norm in and of itself does not necessarily lead to an increase or reduction in alcohol consumption. The social comparisons approach underscores the complex and social nature of human interaction and reinforces the need for the development of multiple approaches to alcohol education with messages that are designed to target the specific needs of students based on their orientations toward alcohol consumption.     

Alcohol Use Among Rural Middle School Students: Adolescents,Parents, Teachers,and Community Leaders’ Perceptions*

BACKGROUND: Although rural adolescents use of alcohol is at some of the highest rates nationally, rural adolescent alcohol use has not been studied extensively. This study examines how community attitudes and behaviors are related to adolescent drinking in rural environments. METHODS: Data were gathered in 22 rural communities in the Upper Midwest (North Dakota, South Dakota, Wisconsin, and Wyoming). Surveys were collected from 1424 rural sixth‐ to eighth‐grade adolescents and 790 adults, including parents, teachers, and community leaders. Census data were also collected. RESULTS: Drinkers differed from nondrinkers by the following factors: higher perceptions of peer, parental, and overall community drinking, as well as lower levels of parental closeness and religiosity. Factors distinguishing binge and nonbinge drinkers were increased drinking to reduce stress, drinking to fit in, perceptions of peer drinking, and perceived lack of alternatives to drinking. Parents were significantly less likely to perceive adolescent alcohol use as a problem than other community adults; school officials were most likely to perceive it as a problem. Parental perceptions were also the least correlated to actual adolescent use, while adolescent perceptions were the most highly correlated. CONCLUSIONS: Community fac tors such as overall prevalence of drinking, community support, and controls against drinking are important predictors of reported use in early adolescence. School officials were more likely to view adolescent alcohol use as a problem than were parents. School officials’ perceptions of adolescent use were also more related to actual adolescent use than were parental perceptions of adolescent use.     

Environmental correlates of underage alcohol use and related problems of college students

BACKGROUND: Underage alcohol use is a major contributor to morbidity and mortality in adolescents and young adults. This study examined drinking levels and ensuing problems among college students and factors associated with binge drinking. METHOD: The Harvard School of Public Health College Alcohol Study conducted a self-administered survey. The participants include a random sample of 7061 students aged <21 years (defined as underage drinkers), and 4989 between ages 21 and 23 in 1997 at 116 nationally representative 4-year colleges in 39 states. The outcomes of the study include self-reports of alcohol use, binge drinking (defined as five or more drinks in a row for men and four or more for women at least once in a 2-week period), alcohol-related problems, preferred type of drink, access to alcohol, and price paid per drink. RESULTS: Underage students drink less often but have more drinks per occasion, are more likely to drink in private settings (off-campus, dormitory, and fraternity parties), and pay less per drink than do of-age students. Correlates of underage binge drinking include residence in a fraternity or sorority (odds ratio [OR]=6.2), very easy access to alcohol (OR=3.3), obtaining drinks at lower prices (OR=2.1, for under $1 each or a set fee for unlimited drinks), and drinking beer (OR=9.5). CONCLUSIONS: Effective controls on price, access, and fraternity and off-campus parties, and reinforcing minimum drinking age laws are needed to reduce the high levels of binge drinking and related health and behavioral problems of underage students.     

Alcohol use among entrants to a Hong Kong University

AIM: This study of first year entrants to one of the major universities in Hong Kong describes the pattern of their alcohol consumption, their binge drinking, alcohol abuse, and dependence. METHODS: A retrospective cross-sectional study was conducted. A representative sample of year 1 students 2630/2968 (89%) newly admitted to the Chinese University of Hong Kong in 2003 were recruited to participate in a structured self-administered questionnaire. RESULTS: First year university students in Hong Kong have low rates of ever drinking alcohol (62%), and the rates of binge drinking and alcohol-related problems were 7 and 0.8%, respectively. The pattern of binge drinking is more common than weekly drinking (2.3%). Binge drinkers are more likely to have experienced alcohol-related interpersonal problems or (95% CI) = 6.5 (1.7-24.5). Males were more likely to drink, to binge drink, and to drink frequently. CONCLUSIONS: In contrast with students in the west, the majority of first year university students in Hong Kong are not binge or regular drinkers. However, there is a subgroup who smoke, drink more, and use alcohol as a means of coping with stress. This group may be particularly in need of a brief intervention, such as providing counseling and referral services.     

Alcohol use and HIV risk behaviors among rural adolescents in Khanh Hoa Province Viet Nam

Research suggests that youth are consuming more alcohol and at younger ages than in the past. Data also indicate that alcohol consumption is associated with participation in other risk behaviors including aggression and sexual behaviors. As part of a randomized control effectiveness trial for an HIV prevention program, 480 Vietnamese youth (15-20 years old) living in eight rural communes in Khanh Hoa Province were administered a paper and pencil baseline evaluation. The evaluation included items for actual and intended alcohol use, perceptions of peers' alcohol consumption, and attitudinal questions regarding alcohol. The tool included questions on engagement and intention to engage in sexual behaviors. In addition, 96 randomly selected youth participated in qualitative interviews on similar topics. Among the 480 surveyed youth, 29.2% had consumed alcohol. Among those youth, 17.6% reported intoxication in the past 6 months. While young men were significantly more likely to drink than young women (P < 0.00), those young women who did drink were as likely to report intoxication. Alcohol use was significantly associated with engagement in sexual behaviors (P < 0.00) and intention to engage in sexual behaviors (P < 0.02). The qualitative data provided information on the social contexts of drinking behaviors and more in-depth findings regarding associated risk behaviors. With limited information about alcohol consumption among Vietnamese youth, these findings suggest that there is a need for more extensive research on alcohol use and associated risk behaviors among this population, and for targeted alcohol prevention and harm-reduction programs.     

北京市2014年高中生饮酒行为及其影响因素分析

了解北京市高中生饮酒相关行为现状及其影响因素,为预防青少年过早饮酒和过量饮酒提供依据.方法 2014年3-5月,采用分层整群随机抽样方法,抽取北京市18个区县的15 726名高中生进行健康危险行为自填问卷调查.结果 北京市高中生曾饮酒率为67.9%,13岁前饮酒率为35.2%,现在饮酒率为41.0%,过量饮酒率为16.6%.“与家人朋友喝”是北京市高中生饮酒的最主要原因.职业技术学校、男生、高二、母亲高中文化水平、重组家庭、人均月收入高和学习成绩差的高中生各项饮酒率均较高.有健康危险行为的高中生更容易出现饮酒相关行为,如有吸烟行为的学生更容易发生现在饮酒行为(OR=4.41,95%CI=3.90~4.98),有打架行为的学生更容易出现过量饮酒行为(OR=2.00,95%CI=1.77~2.26),有性行为的学生更容易出现13岁前饮酒行为(OR=1.58,95%CI=1.36~1.84),有尝试自杀行为的学生更容易出现过量饮酒行为(OR=1.67,95%CI=1.27~2.19).结论 在预防青少年饮酒相关行为时,应考虑年龄、家庭、性别等因素,并重视其他健康危险行为因素的影响,家庭和学校需尽早积极开展预防青少年饮酒行为的综合性健康教育.     

Alcohol quantity and quality price elasticities: quantile regression estimates

Many people drink more than the recommended level of alcohol, with some drinking substantially more. There is evidence that suggests that this leads to large health and social costs, and price is often proposed as a tool for reducing consumption. This paper uses quantile regression methods to estimate the differential price (and income) elasticities across the drinking distribution. This is also done for on-premise (pubs, bars and clubs) and off-premise (supermarkets and shops) alcohol separately. In addition, we examine the extent to which drinkers respond to price changes by varying the ‘quality’ of the alcohol that they consume. We find that heavy drinkers are much less responsive to price in terms of quantity, but that they are more likely to substitute with cheaper products when the price of alcohol increases. The implication is that price-based policies may have little effect in reducing consumption amongst the heaviest drinkers, provided they can switch to lower quality alternatives.