Alcohol and road safety behaviour among New Zealand tertiary students

In New Zealand, as in most developed countries, rates of injury mortality and morbidity peak in late adolescence (15-19 years), when they account for around three quarters of fatalities and a third of hospitalisations. Road traffic crashes account for over half of fatal injuries in New Zealand as in most developed countries. Individuals engaged in post-secondary education, i.e., tertiary students, are a large and important subgroup of young people exposed to the risk of road traffic injury. The aims of this study were to estimate the prevalence of unsafe road behaviours and to examine the role of demographic variables, alcohol use, driver licence status, and transport needs. Participants were 1,480 students (899 women) from 12 residential halls in Dunedin, New Zealand. They anonymously completed a questionnaire on alcohol use and road safety at the start of the 2000 academic year. A sub-sample of 967 students completed a follow-up survey six months later. The mean age of the sample was 18.3 years (SD=1.6), and 88% had a driver licence. Male gender and drinking status were independently associated with speeding, drink-driving and drink-riding, but not seatbelt use. Drinking levels showed a strong dose-response relationship with the prevalence of unsafe behaviours with the exception of seatbelt use. In marked contrast to drinking levels, which increased from baseline to follow-up, drink-driving and drink-riding levels decreased, probably reflecting the reduced motor vehicle transport needs of students in residential halls, relative to their out-of-term living environments. In addition to various existing, evidence-based countermeasures, application of interventions for reducing hazardous drinking may be required to help reduce road traffic injury rates in this population.     

Hazardous drinking in elite New Zealand sportspeople

AIMS: To examine the link between hazardous drinking and level of sport participation in New Zealand. METHODS: Sports science and general university students (n = 427) completed a sporting profile questionnaire that included the Alcohol Use Disorders Identification Test (AUDIT). RESULTS: Elite sportspeople (both provincial and international/country level) reported higher rates of hazardous drinking than non-sportspeople and non-elite sportspeople. Similar differences were observed in AUDIT subscale scores, with international/country level sportspeople reporting greater symptoms of dependence than other groups.     

Exploring young men's drinking using the AUDIT questionnaire.

This paper reports the findings of an AUDIT questionnaire administered to a sample of young (16-24-year-old) white males. Of the sample, 65% were drinking at potentially harmful levels. Averaging 45 U/week, 18-21 years was the age of highest alcohol consumption. Compared with 16-17- and 22-24-year-olds, this group recorded the highest proportion of hazardous drinkers and most negative consequences of drinking.     

Three questions can detect hazardous drinkers

OBJECTIVE: The researchers evaluated the Alcohol Use Disorders Identification Test (AUDIT), the first 3 questions of the AUDIT (AUDIT-C), the third AUDIT question (AUDIT-3), and quantity-frequency questions for identifying hazardous drinkers in a large primary care sample. STUDY DESIGN: Cross-sectional survey. POPULATION: Patients waiting for care at 12 primary care sites in western Pennsylvania from October 1995 to December 1997. OUTCOMES MEASURED: Sensitivity, specificity, likelihood ratios, and predictive values for the AUDIT, AUDIT-C, and AUDIT-3. RESULTS: A total of 13,438 patients were surveyed. Compared with a quantity-frequency definition of hazardous drinking (> or =16 drinks/week for men and > or =12 drinks/week for women), the AUDIT, AUDIT-C, and AUDIT-3 had areas under the receiver-operating characteristic curves (AUROC) of 0.940, 0.949, and 0.871, respectively. The AUROCs of the AUDIT and AUDIT-C were significantly different (P=.004). The AUROCs of the AUDIT-C (P<.001) and AUDIT (P <.001) were significantly larger than the AUDIT-3. When compared with a positive AUDIT score of 8 or higher, the AUDIT-C (score > or =3) and the AUDIT-3 (score > or =1) were 94.9% and 99.6% sensitive and 68.8% and 51.1% specific in detecting individuals as hazardous drinkers. CONCLUSIONS: In a large primary care sample, a 3-question version of the AUDIT identified hazardous drinkers as well as the full AUDIT when such drinkers were defined by quantity-frequency criterion. This version of the AUDIT may be useful as an initial screen for assessing hazardous drinking behavior.     

University residence halls: socialization processes and drug consumption

OBJECTIVE: To investigate and analyze the discourse of students living in university residence halls regarding socialization processes and drug consumption. METHODS: This was qualitative research among 20 undergraduate students living in university residence halls in the city of S?o Paulo, Brazil, in 2003. Residence halls were taken to be socialization spaces for young people that enable the presence of low-income students at university. The interviews covered students' knowledge of the history of the residence hall, their experience of living in student residences and their perceptions regarding drug consumption. The methodological procedure that served as the basis for collection, organization and analysis of the interview data was examination of the collective discourse of the subjects. RESULTS: It was shown that the students had little knowledge of the history of the residence hall; solutions for problems they faced in the residence hall were sought individually; and the two main concepts observed among the people living there for preventing drug consumption were war on drugs and damage limitation. It was seen that there was a negative view regarding student residence halls that related to the constant publication of disturbing events and lack of knowledge of the importance of residence halls for enabling poor students to remain at university. CONCLUSIONS: In the opinion of the people living in student residence halls, such accommodation enables access to university, despite the difficulties in living together and in administration by the university. With regard to the use of drugs in the residence hall, some of the people living there emphasized the need for less tolerance towards drug consumption, while others stressed the importance of educational work, particularly among those who are just starting to live there.     

Interpretation of items in the AUDIT questionnaire

AIMS: To test for the possibility that tertiary students misinterpret certain items on the Alcohol Use Disorders Identification Test (AUDIT). METHODS: Responses to alternative question wordings were compared with responses to standard items. RESULTS: Alterations to items 5 and 9, so that consequences of drinking epitomized in these items were more specifically defined, resulted in markedly different response distributions to the item, but the total AUDIT score was not changed. CONCLUSIONS: Caution is necessary before using individual AUDIT items as measures of consequences in population surveys, and the possibility of false positives in total scores should be borne in mind.     

Hazardous drinking in New Zealand sportspeople: level of sporting participation and drinking motives

AIMS: To examine the relationship between athlete drinking motives and hazardous drinking across differing levels of sporting participation (club vs elite-provincial vs elite-international). METHODS: Data from 1214 New Zealand sportspeople was collected. We assessed hazardous drinking with the WHO's AUDIT questionnaire and sportspeople's psychosocial reasons for drinking with the ADS. Level of sporting participation (club/social, provincial/state, or international/olympic level) was also assessed. RESULTS: Hazardous drinking behaviours differed across levels of sporting participation, with elite-provincial sportspeople showing the highest level of hazardous drinking, club/social sportspeople the next highest and elite-international sportspeople the lowest. Sportspeople who placed a greater emphasis on drinking as a reward for participating in their sports tended to display more hazardous drinking behaviours, but other ADS motives differed over level of sporting participation. Elite-provincial sportspeople and elite-international sportspeople placed more emphasis on drinking as a way to cope with the stresses of participating in their sports. A relationship between team/group motives and AUDIT scores was fully mediated by positive reinforcement motives, and partially mediated by stress-related coping motives. CONCLUSIONS: These findings have implications for alcohol education programs targeted at sportspeople and sport administration, and may help improve the efficacy and focus of intervention programs.     

Concurrent validity of the alcohol use disorders identification test (AUDIT)

AIMS: To determine cut-offs for the Alcohol Use Disorders Identification Test (AUDIT) 10-item questionnaire, differentiating hazardous drinking (HZD) and alcohol use disorders (AUD) from low risk drinking (LRD), and AUD from HZD and LRD among married men in a Sri Lankan sample. METHODS: Using 62 low risk drinkers and 88 each from hazardous drinkers and AUD, the AUDIT instrument was compared with adapted and translated versions of a beverage-specific, quantity-frequency questionnaire, and the alcohol use module of the Composite International Diagnostic Interview (CIDI), and two receiver operating characteristic (ROC) curves were plotted. RESULTS: The area under the ROC curves to differentiate HZD + AUD from LRD and AUD from HZD + LRD were 0.96 (95% CI: 0.94-0.99) and 0.97 (95% CI: 0.95-0.99) respectively. The cut-off values of 7 and 16 were observed to have the best trade-offs between sensitivity, specificity, the ratio of positive likelihood to negative likelihood ratios, and positive predictive values. CONCLUSION: The AUDIT could be used to screen for LRD, HZD, and AUD among Sinhalese married men in Sri Lanka.     

大学生酒精相关伤害危险行为影响因素的Logistic回归分析

目的了解国内大学生与酒精相关伤害危险行为的发生情况及影响因素,探索大学生酒精相关伤害危险行为的监测和干预方法。方法自行设计封闭式调查问卷,其引用了WHO推荐的《酒精使用障碍筛查量表（AUDIT）》和东北师范大学编制的《中国版大学生感觉寻求问卷》。通过便利抽样,抽取广州市8所高校1 200名大学生。用Epi Data 3.0录入,SPSS 16.0进行χ^2检验和Logistic回归分析。结果大学生饮酒者中酒后伤害危险行为发生率为43.8%。分别以各种酒后伤害危险行为为因变量,将30个大学生酒后伤害危险行为的影响因素作为自变量建立多个Logistic回归模型,经多因素非条件Logistic回归分析得出：周末、期末饮酒,高感觉寻求,是大学生各种酒后伤害危险行为共同的危险因素。结论作为一种人格特质,感觉寻求特质越高,发生酒后伤害的危险越大。大学生各种酒后伤害危险行为的危险因素各有不同,应进行针对性的预防。     

Moving Beyond Drinking to Have a Good Time: a Person-Centered Approach to Identifying Reason Typologies in Legal-Aged College Student Drinkers

Alcohol use, reasons for use, and consequences of use continue to be a major concern in college student populations. This is especially true for students of legal drinking age who may experience different reasons for and greater negative consequences of alcohol use than students under 21 years old. Although multiple studies have used person-centered approaches to understand motivations for and ultimately prevent alcohol use, few have identified multiple typologies of reasons for alcohol use. The current study used latent class analysis to identify homogeneous subtypes of reasons for alcohol use and how classification was associated with alcohol-related consequences in college students aged 21 years old and older (N?=?2300) from the 2013 Indiana College Substance Use Survey. Four profiles of reasons for alcohol use emerged across males and females: social drinkers, feel good drinkers, relaxed escaping drinkers, and emotion coping drinkers. Although the likelihood of consequences differed across gender, the emotion coping drinkers were more likely to experience all negative consequences, suggesting that it was a high-risk class. In general, this pattern of risk continued with the feel good drinkers and female relaxed escaping drinkers. These results can help optimize college substance use prevention and intervention efforts to (1) identify and understand characteristics of high- and low-risk student drinkers and (2) tailor the content of interventions to those specific profiles resulting in more effective approaches to reducing alcohol use.     

Hazardous alcohol use among hospital doctors in Germany

AIMS: To describe alcohol use, and the prevalence and predictors of hazardous drinking, among hospital doctors. METHODS: Data were collected by anonymous mail survey in 2006, from a representative national sample of 1917 (58% response rate) hospital doctors in Germany. Alcohol use was measured using the AUDIT-C, scores of 5 or more for males and females indicating "hazardous drinking." RESULTS: There were 9.5% abstainers, 70.7% moderate drinkers, and 19.8% hazardous drinkers. The majority of doctors (90.5%) used alcohol--mainly at a sensible level, e.g., 2-4 times a month (32%) or 2-3 times a week (29%), and 1-2 glasses on one occasion (83%). Binge drinking was common (53%), but for most occurred less than once in a month (39%). When hazardous drinking was controlled for certain confounders, being male (OR 4.7; 95% CI 3.4-6.5) and having a surgical specialty (OR 1.4; 1.1-1.8) were significantly correlated to hazardous drinking. Age had no influence on this model. By contrast, the age group 40 years and younger (OR 2.1; 1.4-3.0) was a significant predictor of abstinence. CONCLUSIONS: There is a higher rate of abstainers and a lower rate of binge drinkers among hospital doctors in Germany than in the general population. However, some hospital doctors drink hazardously, the risk being greater among males and among surgeons, which should be paid due attention in the interest of their health and their function as doctors.     

Heavy drinking and alcohol-related injuries in college students

Objective

The main objective of this study is to evaluate the effect of heavy drinking on alcohol-related injuries.

Material and methods

We carried out an open cohort study among university students in Spain (n = 1,382). Heavy drinking and alcohol-related injuries were measured by administrating AUDIT questionnaires to every participant at the ages of 18, 20, 22 and 24. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for consumption of alcohol and cannabis.

Results

The response rate at the beginning of the study was 99.6% (1,369 students). The incidence rate of alcohol-related injuries was 3.2 per 100 students year. After adjusting for alcohol consumption and cannabis use, the multivariate model revealed that a high frequency of heavy drinking was a risk factor for alcohol-related injuries (Odds Ratio = 3.89 [95%CI: 2.16 – 6.99]). The proportion of alcohol-related injuries in exposed subjects attributable to heavy drinking was 59.78% [95%CI: 32.75 – 75.94] while the population attributable fraction was 45.48% [95%CI: 24.91 – 57.77].

Conclusion

We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern.     

Prevalence of problem drinking in a Venezuelan Native American population

This is the first study of alcohol-related problems among a Latin American indigenous population using the Alcohol Use Disorders Identification Test (AUDIT). A randomly selected community sample consisting of 3% of the adult population of the tribe completed oral interviews (n = 105 adults, completion rate 86%). The majority of both men (98%) and women (53%) had drunk alcohol at some time in their lives, with 94 and 26% respectively having consumed alcohol within the past 12 months. Using a cut-off score of 8 for the AUDIT, 86.5% of all men and 7.5% of all women were found to be problem drinkers. Focus group discussions revealed that traditional patterns of binge drinking of corn liquor had gradually been replaced by consumption of commercial beer and rum at more frequent intervals and with more negative social consequences. This male population demonstrates one of the highest prevalence rates for problem drinking reported in the world literature. Both the magnitude of problems detected and participants' concerns about them suggest that broad-scale interventions are warranted at the community level.     

Prevalence of alcohol use and associated factors in urban hospital outpatients in South Africa

The aim of this study was to assess the prevalence of alcohol use and associated factors among outpatients in an urban hospital in South Africa. The sample included 1,532 (56.4% men and women 43.6%) consecutively selected patients from different hospital outpatient departments. Results indicate that 41.2% of men and 18.3% of women were found to be hazardous drinkers, and 3.6% of men and 1.4% of women meet criteria for probable alcohol dependence or harmful drinking as defined by the Alcohol Use Disorder Identification Test (AUDIT). Two in five patients (40.5%) were hazardous or harmful drinkers and/or had anxiety or depression. Logistic multiple regression found that for men tobacco use and not having been diagnosed with diabetes and for women tobacco use and having been diagnosed with migraine headache was associated with hazardous and harmful drinking. Although the study is cross-sectional, it does identify groups that may be at high risk of alcohol misuse and for whom intervention is urgent. Because prevalence of hazardous and harmful alcohol use is high in this population, routine screening should be introduced in hospital out-patient settings.     

Validation of the alcohol use disorders identification test (audit) as a screening tool for alcohol-related problems among Nigerian university students

AIMS: To investigate the screening properties of the alcohol use disorders identification test (AUDIT) in the detection of alcohol-related problems among Nigerian university students. METHODS: Eight hundred and ten students completed the AUDIT. A percentage of them were assessed for alcohol-related diagnosis with structured clinical interview. RESULTS: The AUDIT at cut-off of 5 and above could clearly identify participants with alcohol-related problems with sensitivity of 0.935 and specificity of 0.915. CONCLUSIONS: The AUDIT is a valid instrument for screening for alcohol-related problems in Nigerian university students.     

Personalized Feedback as a Universal Prevention Approach for College Drinking: A Randomized Trial of an e-Mail Linked Universal Web-Based Alcohol Intervention

Alcohol use among first-year university students continues to be a central health concern. Efforts to address drinking in this population have increasingly relied on web-based interventions, which have the capacity to reach large numbers of students through a convenient and highly utilized medium. Despite evidence for the utility of this approach for reducing hazardous drinking, recent studies that have examined the effectiveness of this approach as a universal prevention strategy in campus-wide studies have produced mixed results. We sought to test the effectiveness of a web-based alcohol intervention as a universal prevention strategy for first-year students. An e-mail invitation linked to a brief, web-based survey on health behaviors was sent to all first-year students during the fall semester. Those who completed the baseline assessment were randomized to receive either a feedback-based alcohol intervention (intervention condition) or feedback about other health-related behaviors such as sleep and nutrition (control condition). A second web-based survey was used to collect follow-up drinking data 5 months later. The number of heavy drinking episodes in the previous month and alcohol-related consequences in the previous 3 months served as the primary dependent variables. Negative binomial regression analyses did not indicate a significant effect of the intervention at follow-up on either heavy drinking episodes or alcohol-related consequences. Analyses of additional drinking outcomes among the subsample of students who reported that they did not drink at baseline showed that those who received the alcohol intervention were subsequently less likely to drink alcohol. These results suggest that web-based alcohol interventions may be a potentially useful method of maintaining abstinence among underage, non-drinking students. Overall, however, results indicate that an e-mail-linked, campus-wide, web-intervention approach to address alcohol use among first-year students may have limited effectiveness as an approach to minimize hazardous drinking over the course of the year.     

Double jeopardy--drug and sex risks among Russian women who inject drugs: initial feasibility and efficacy results of a small randomized controlled trial

Background

Alcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse.

Methods

This cross-sectional study was conducted in patients attending the medicine out-patient department of a university hospital. DSM-IV diagnostic categories (alcohol abuse and alcohol dependence) were used as the gold standard to calculate the diagnostic parameters of the AUDIT. Hazardous drinking was defined as self reported consumption of ≥21 standard drink units per week for males and ≥14 standard drink units per week for females.

Results

A total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%), alcohol abusers (n= 78; 8.3%) and alcohol dependent (n=304; 32.2%). The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender) and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females). For alcohol dependence/abuse the cut off values was ≥9 for both males and females.

Conclusion

The AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university hospital. This study also reveals a very high prevalence of alcohol use disorders in Nepal.     

What harms do young Australians experience in alcohol‐use situations?

OBJECTIVE: An insight into the alcohol-related experiences of young students in Perth, Western Australia, with particular emphasis to alcohol-related harm. METHOD: The sample of 2,329 students (female: n = 1,089, male: n = 1,240) is a school-based group selected using cluster sampling, with stratification by socio-economic area and represents 11 to 12 year olds' experiences with alcohol and alcohol-related harm. The SHAHRP survey instrument was developed and pre-tested to measure students' knowledge, attitudes, patterns and context of use, harms associated with the students' own alcohol consumption and harms associated with other people's use of alcohol and incorporates the students' perceptions of alcohol-related harm. RESULTS: Nearly two-thirds of all young people consumed alcohol under adult supervision; nearly 40% of all young males and 34% of all young females drink alcohol in unsupervised situations; and a fifth of young males consumed alcohol alone. Young males start drinking younger and consumed alcohol more regularly than young females, and consumed more alcohol per occasion. In the past 12 months, young males experienced more than five and young females more than three alcohol-related harms associated with their own alcohol consumption. They experienced a similar number of harms associated with other people's use of alcohol. Unsupervised drinkers were nearly seven times more likely to experience alcohol-related harm than supervised drinkers and nearly 13 times more likely to experience alcohol-related harm than non-drinkers. CONCLUSION AND IMPLICATIONS: The results can help inform the development of alcohol education programs for young people.     

At-risk drinking among patients making routine primary care visits

BACKGROUND: Addressing non-alcoholic, at-risk patterns of alcohol consumption that are associated with increased morbidity and mortality is an important health care priority. OBJECTIVE: The objective was to describe the prevalence and characteristics of at-risk drinkers in a population-based sample of adults with routine primary care visits. Methods: Three thousand four hundred thirty-nine patients with advance appointments in 23 primary care practices completed a health survey prior to their visit. At-risk drinking was defined as consuming an average of two or more drinks per day (chronic drinking), or two or more occasions of consuming five or more drinks in the past month (binge drinking), or, in the past month, one or more occasion of driving after consuming three or more drinks (drinking and driving). RESULTS: Prevalence was: 11% at-risk drinking; 63% light to moderate drinking; 26% abstinence. Abstainers differed from alcohol users on demographics (older, fewer Caucasian, lower income, more unemployed), other health behaviors (less exercise, lower rates of smoking, and marijuana and cocaine use), and family history of alcohol problems (lower). Abstainers also reported poorer physical and psychological health. Compared to light to moderate drinkers, at-risk drinkers were more likely to be male, unmarried, and to use other substances (tobacco, marijuana, and cocaine). Among at-risk drinkers, those with two or more risk factors were more likely male, consumed more alcohol per week, had higher AUDIT scores and were more motivated to change their drinking. Among those with only one risk factor, binge drinkers reported high rates of tobacco and marijuana use, relatively poor perceived health, and the highest proportion of negative consequences from drinking. CONCLUSIONS: At least 1 in 10 patients making routine primary care visits have drinking practices that place them at risk for negative consequences from drinking. Three drinking patterns that can be used to define at-risk drinking are relatively distinct.     

Knowledge about and attitudes towards drinking among university students in Spain

A total of 545 Spanish university students from the University of Valladolid, were surveyed in 1985 about their alcohol use, knowledge of the effects of alcohol, and attitudes towards social drinking and towards alcoholism and alcoholics. The knowledge regarding alcohol (mean scores 7.7 +/- 0.1, ranging 1-15) was associated with academic aspects: it was higher among medicine and nursing students and increased according to the length of stay at university. The attitudes both towards social drinking (mean scores 0.6 +/- 0.1, ranging -9 to 9) and towards alcoholism and the alcoholics (mean scores 3.0 +/- 0.1, ranging -6 to 9), were related to alcohol consumption: those students self-reported as "heavy" and "moderate" drinkers, and those with alcohol intake over 40 g/day, had a more favourable attitude. The results suggest a need for education on alcohol.