ALCOHOL AND CASUALTIES: A COMPARISON OF EMERGENCY ROOM AND CORONER DATA

Data from a probability sample of casualty patients treatedat a county hospital emergency room (ER) during a 1 year period(N = 1124) are compared to data from coroner reports of allfatalities arising from unnatural causes during the same timeperiod in the same county (N = 304). The two samples are comparedon: demographic characteristics, causes of casualty (fall, laceration/puncturewound, motor vehicle, fire, ingestion, other cause), place ofinjury, and alcohol and drug use prior to the event. Alcoholand drug use data were obtained by breathalyzer and self-reportsin the ER sample and by toxicology screening of blood upon autopsyin the coroner sample. The coroner sample was significantlymore likely to be male, younger and white compared to the ERsample. A significantly larger proportion of the coroner samplewas positive for alcohol (43%) compared to those breathalyzedwithin 6 hr of injury who reported no drinking after the event(11%) and to those who reported drinking within the 6 hr priorto the event (28%) in the ER sample. Among those who were alcoholpositive no difference was found between the coroner sampleand the ER sample for the proportion of those who were alsodrug positive (24% in each). Cases in the coroner sample wereno more likely to involve violence (17%) than those in the ERsample (20%). Violence-related fatalities were more likely toinvolve alcohol (47%) than non-fatal injuries (19%), but wereno more likely to involve drug use in combination with alcohol(39% vs. 31%, respectively).     

Drinking and driving among rural youth

Data concerning rural youth drinking and driving practices werecollected from 622 junior and senior high school students innorthwest Ohio, utilizing an ex post facto cross-sectional survey-researchdesign. The results suggested that 69% of the sample had usedalcohol at least once. With regard to quantity of alcohol use,about 27% reported drinking four or more drinks at a sitting.Approximately 19% of the sample had driven under the influenceof alcohol and 35% had ridden in a car with an intoxicated school-agedriver; 35% had refused a ride from a friend who was intoxicated,while 43% had tried to stop a drunk friend from driving. Nosignificant differences were found between males and femalesregarding drinking and driving but grade level was a significantmoderating factor. As grade level increased, the frequency ofeach alcohol-related behavior increased substantially (P <0.01). This paper presents prevalence data concerning drinkingand driving among rural youth as well as recommendations forcommunity health education program development.     

THE BENEFICIAL CONSEQUENCES OF THE UNITED KINGDOM'S DECLINING PER CAPITA CONSUMPTION OF ALCOHOL IN 1979-82

Per capita consumption of alcohol rose steadily in the U.K.from 1970 to 1979, but fell by 11% between 1979 and 1982. Thisfall in consumption was followed by a 19% fall in first admissionsfor alcohol dependence, a 16% fall in drunkenness convictions,a 7% fall in drinking and driving convictions and a 4% fallin cirrhosis mortality. Between 1970 and 1982 there were highlysignificant (P < 0.01) correlations between per capita consumptionand convictions for drunkenness and drinking and driving, firstadmissions to hospital for alcohol dependence, and mortalityfrom cirrhosis, pancreatitis and cancer of the oesophagus. Thesefindings add weight to the argument that per capita consumptionis the crucial variable determining the magnitude of the burdenimposed on the community by the harmful effects of excessivedrinking.     

PREVALENCE AND CORRELATES OF DSM-IV AND ICD-10 ALCOHOL DEPENDENCE: 1990 US NATIONAL ALCOHOL SURVEY

This paper describes DSM-IV and ICD-10 alcohol dependence prevalencerates and sociodemographic and drinking correlates. The sampleunder analysis (n = 2058) constitutes a multicluster probabilitysample of the US adult household population. The study responserate is 71%. The prevalence rate for current (past 12 month)DSM-IV alcohol dependence is 3.9%, and for current ICD-10 itis 5.5%. Agreement between DSM-IV and ICD-10 on whether respondentsare dependent or not is less than optimal (Kappa = 0.67). Thepredictors of ICD-10 alcohol dependence are the frequency ofdrinking five or more drinks on occasion and age (inverse relationship).For DSM-IV alcohol dependence the correlates are drinking fiveor more drinks on occasion, being unemployed and age (also aninverse relationship). Differences in results underline theimportance of understanding the variations among DSM-IV andICD-10 criteria for alcohol dependence and the implicationsof these differences for epidemiological research. The highprevalence of dependence among young men may be the result ofrecognizing consequences of episodic heavy drinking as signsof alcohol dependence.     

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.     

Light to Moderate Alcohol Consumption and Disability: Variable Benefits by Health Status

In adults, light to moderate alcohol consumption is associatedwith lower risks for heart disease, diabetes, and mortality.This study examined whether light to moderate alcohol use isalso associated with lower risk of incident physical disabilityover two 5-year periods in 4,276 noninstitutionalized adultsin the United States, aged 50 years or older, by using datafrom 3 waves of the National Health and Nutrition ExaminationSurvey Epidemiologic Follow-up Study surveys from 1982 to 1992.Light/moderate drinking (<15 drinks per week and <5 perdrinking day or 4 per drinking day for women) was associatedwith reduced risk for incident disability or death over 5 years,compared with abstention (adjusted odds ratio = 0.77; P = 0.008).Among survivors, light/moderate drinking was associated withlower risk for incident disability, compared with abstention(adjusted odds ratio = 0.75; P = 0.009). In stratified analyses,disability risk decreased with light/moderate drinking in adose-dependent fashion in men and women with good or betterself-reported health but not in men or women with fair or worseself-reported health. Alcohol consumption in moderation mightreduce the risk of developing physical disability in older adultsin good health but not in those in poor health. activities of daily living; alcohol drinking; longitudinal studies     

Alcohol and hypertension: an old relationship revisited

The American comedian Henny Youngman (1906–1998) oncesaid, ‘When I read about the evils of drinking, I gaveup reading.’ Ironic, but interestingly as though witha sense of foresight, he did not speak of giving up drinking!It is despite the fact that alcohol is responsible for increasedillness, being causally related to more than 60 different medicalconditions (Rehm et al., 2003). Around 4% of the global diseaseburden is also thought to be alcohol related, which is comparablewith that attributed to the effects of tobacco (4.1%) and highblood pressure (4.4%) (Ezzati et al., 2002; WHO, 2002). For most diseases related to alcohol consumption, a dose–responserelationship exists with risk of the disease increasing withgreater amounts of alcohol intake, with cardiovascular     

INCREASED FEMALE DRINKING IN ACCORDANCE WITH POST-INDUSTRIAL URBANIZATION IN JAPAN

We studied the relationship between living in an urban areaand the alcohol-consumption habits of young mothers in lightof the recent increase of the female drinking population inJapan, particularly among those from 20 to 39 years of age.We conducted a survey in four areas in and around Tokyo, eacharea representing a different level of urbanization. The studypopulation consisted of 6418 mothers of 3-year-old children;an 84.9% response rate was obtained. Thirty-eight per cent ofthe respondents had drunk at least four units of alcohol (about44 g of pure ethanol) during the most recent month The proportionof current drinkers in a more-urbanized area was greater thanthat in a less-urbanized area, and this tendency was significant(P<0.001). Current workforce participation was significantlypositively associated with current drinking (P<0.01). Youngerage significantly increased chances of current drinking (P<0.05)Effects of living in a more-urbanized area on current drinkingof mothers of 3-year-old children after excluding the effectsof workforce participation and age was significantly positive(P<0.001). An increase in female drinking in Japan was consideredto be due to acculturation associated with urbanization in apost-industrial society.     

THE IMPACT OF DIABETES MELLITUS ON THE PROGNOSIS OF ALCOHOLICS

In this study, the mortality of clinically treated Japanesealcoholics with diabetes mellitus was analysed. Fifty-one diabeticalcoholics without liver cirrhosis (DM), 23 diabetic and cirrhoticalcoholics (DM LC), 44 cirrhotic alcoholics without diabetes(LC), and 354 alcoholics without either complication (AL) admittedto the National Institute on Alcoholism in 1985 were studied.Thirty-seven diabetics required insulin treatment, and 12 oralhypoglycemic agents. The 4.4-year survival and drinking statusafter discharge were studied in 1990. Stepwise logistic regressionanalysis showed that the estimated odds for death increased8.10, 4.38, 3.70, and 3.27 times for the subjects with the alcoholmisuse after discharge, DM, DM LC, and LC, respectively. The4.4-year survival rate of alcoholics who continued misusingalcohol was much lower in DM (26%, P < 0.0005) and LC (35%,P < 0.0001) than in AL (73%). The survival rate of thosewho stopped misusing alcohol was significantly higher in DM(90%, P < 0.0001), LC (88%, P < 0.0001) and AL (94%, P< 0.0005) than those who continued misusing alcohol. Therewas no significant difference in the survival rate between thealcoholics with DM LC who continued misusing alcohol (50%) andthose who stopped misusing alcohol (73%). In the dead patients,56% of DM died unexpectedly or suddenly, whereas 71% of LC diedof liver failure after hospitalization. These results suggestthat diabetic alcoholics should be intensively educated forabstinence.     

Alcohol Use Among Arab Americans: What is the Prevalence?

Information is limited on alcohol use among Arab Americans. The purpose of this study was to describe and analyze the alcohol use pattern among Arab Americans by reviewing existing surveys using an acculturation model. Secondary data analysis. Nationally, English-speaking immigrant Arab Americans reported lower rates of lifetime alcohol use (50.8%), past month use (26.4%) and binge drinking (10%) than the White majority group. In a state survey, self-identified English-speaking Arab Americans were less likely to report past month use (45.6%) than the White majority group but reported similar rate of binge drinking (17.0%). Locally, lifetime drinking was reported by 46.2% of the immigrants but only 13.4% of refugees fleeing war. Few databases are available to estimate alcohol use pattern among Arab Americans; the limited data suggest a drinking pattern consistent with acculturation. However, the potential influence of other factors is unknown and needs to be investigated.     

Dietary and alcohol intake patterns of a sample of homeless men in Sydney, Australia

Dietary intakes of food and beverages, including alcohol, were collected by questionnaire and prompted 24-h recall on a sample of 107 homeless men living in Inner Sydney. Over 70% reported drinking at least twice a week and drinking heavily (> 80g alcohol) on those occasions. Forty-one per cent reported regularly drinking beverages supplying over 240 g at a time and over half (60%) claimed not to eat while drinking, which would increase their chances of developing disorders such as the Wernicke-Korsakoff syndrome. Biochemical markers of high alcohol consumption, such as alkaline phosphatase and γ-glutamyl transferase, were elevated in 35–41% of the men and were significantly correlated with reported high alcohol consumption. Using 24-h recall methodology, thiamin, magnesium, zinc, pyridoxine, folate and energy appeared to be the nutrients most at risk for this group.     

ALCOHOL AND THE YOUNG CHILD

With the increasing availability of alcohol in modern times,the child neglect and abuse portrayed in Hogarth's engravingGin Lane may once again be witnessed. Reports occur occasionallyof alcohol being given deliberately to infants to quieten them,but alcohol poisoning in the slightly older child is not uncommon. The introduction of child-proof containers has altered poisoningfigures recently. However, alcohol poisoning tends to occurat ages 3 and 4, that is, about 2 years after the peak of allpoisonings in children. This difference may be an indicationthat alcohol is taken in imitation of parents' drinking, a suggestionwhich has some support from reported cases of mouthwash poisoning.Holidays and high days where children and alcohol mix, are potentiallydangerous periods. Since alcohol poisoning can be fatal, yetif recognised is relatively easily managed, every child withthe slightest degree of drowsiness should be suspect until provenor not by blood alcohol. The prevention of alcohol poisoningin the young child consists in protecting the alcohol by lockand key, not setting an example by drinking or gargling in frontof childrenMany substances such as mouthwash and perfume shouldalso be under supervision. Once actual poisoning has occurred blood sugar is probably moreimportant than the level of blood ethanol and blood sugar levelsshould be monitored frequently and the child treated with glucose,preferably intravenously.     

Covariations of emotional states and alcohol consumption: Evidence from 2 years of daily data collection

We examined inter- and intra-individual covariations of mood and alcohol consumption in a sample of 171 light, medium, and heavy alcohol consumers aged 21 and over who reported daily about drinking and mood for a period of up to 2 years. The sample was recruited by advertisements in local newspapers and referral from former respondents in Northern Vermont, USA, between July 1997 and September 2000. Participants reported daily alcohol consumption and mood via interactive voice response (IVR) technology. Within-subject correlations were calculated for each individual separately and analyzed via cluster analysis. The cluster solution was subsequently used as a categorical Level-2 predictor in hierarchical linear modeling of daily alcohol consumption. Cluster analyses of the within-subject correlations revealed four clusters: (1) emotion-inhibited drinking (drinking combined with reduced emotional arousal, n=12); (2) “positive emotion drinking” (drinking in combination with positive mood, n=69); (3) “stress drinking” (drinking combined with negative mood, n=12); and (4) “non-emotional drinking” (no relationship between alcohol consumption and mood, n=78). Hierarchical linear modeling (HLM) analyses revealed that a significant amount of random variance of the Level-1 mood slopes (38% and 40%) was accounted for by the clusters, demonstrating the predictive power of cluster membership on individual drinking patterns. Although Cluster 3 members (stress drinking) did not report significantly higher levels of alcohol consumption, they were more likely to report current and lifetime dependence symptoms. The results point to the existence of stable, but diverse drinking patterns among non-clinical alcohol consumers with potentially different implications for development into alcohol abuse and dependence.     

Alcohol and sleep problems in primary care patients: a report from the AAFP National Research Network

PURPOSE Hazardous and harmful drinking and sleep problems are common, but their associations among patients seen in primary care have not been examined. We hypothesized that greater levels of alcohol consumption would be associated with several self-reported sleep problems.METHODS In a cross-sectional survey in primary care practices, 94 participating clinicians recruited up to 30 consecutive adult patients, and both clinicians and patients completed anonymous postvisit questionnaires. Patients were asked questions on demographics, alcohol consumption, cardinal symptoms of alcohol use disorders, sleep quality, insomnia, sleep apnea, and symptoms of restless leg syndrome. Multivariate analyses explored the associations of drinking status (none, moderate, or hazardous) and sleep problems, adjusting for demographics and clustering of patients within physician.RESULTS Of 1,984 patients who responded, 1,699 (85.6%) provided complete data for analysis. Respondents’ mean age was 50.4 years (SD 17.4 years), 67% were women, and 72.9% were white. Of these, 22.3% reported hazardous drinking, 47.8% reported fair or poor overall sleep quality, and 7.3% reported a diagnosis or treatment of sleep apnea. Multivariate analyses showed no associations between drinking status and any measure of insomnia, overall sleep quality, or restless legs syndrome symptoms. Moderate drinking was associated with lower adjusted odds of sleep apnea compared with nondrinkers (OR = 0.61; 95% CI, 0.38–1.00). Using alcohol for sleep was strongly associated with hazardous drinking (OR = 4.58; 95% CI, 2.97–7.08, compared with moderate drinking).CONCLUSIONS Moderate and hazardous drinking were associated with few sleep problems. Using alcohol for sleep, however, was strongly associated with hazardous drinking relative to moderate drinking and may serve as a prompt for physicians to ask about excessive alcohol use.     

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.     

CHARACTERISTICS OF ALDEHYDE DEHYDROGENASES OF CERTAIN AEROBIC BACTERIA REPRESENTING HUMAN COLONIC FLORA

We have proposed the existence of a bacteriocolonic pathwayfor ethanol oxidation resulting in high intracolonic levelsof toxic and carcinogenic acetaldehyde. This study was aimedat determining the ability of the aldehyde dehydrogenases (ALDH)of aerobic bacteria representing human colonic flora to metabolizeintracolonically derived acetaldehyde. The apparent Michaelisconstant (K_m) values for acetaldehyde were determined in crudeextracts of five aerobic bacterial strains, alcohol dehydrogenase(ADH) and ALDH activities of these bacteria at conditions prevailingin the human large intestine after moderate drinking were thencompared. The effect of cyanamide, a potent inhibitor of mammalianALDH, on bacterial ALDH activity was also studied. The apparentK_m for acetaldehyde varied from 6.8 (NADP⁺ -linked ALDH of Escherichiacoli IH 13369) to 205 µM (NAD⁺ -linked ALDH of Pseudomonasaeruginosa IH 35342), and maximal velocity varied from 6 nmol/min/mg(NAD⁺ -linked ALDH of Klebsiella pneumoniae IH 35385) to 39nmol/min/mg (NAD⁺ -linked ALDH of Pseudomonas aeruginosa IH35342). At pH 7.4, and at ethanol and acetaldehyde concentrationsthat may be prevalent in the human colon after moderate drinking,ADH activity in four out of five bacterial strains were 10–50times higher than their ALDH activity. Cyanamide inhibited onlyNAD⁺ -linked ALDH activity of Pseudomonas aeruginosa IH 35342at concentrations starting from 0.1 mM. We conclude that ALDHsof the colonic aerobic bacteria are able to metabolize endogenicacetaldehyde. However, the ability of ALDHs to metabolize intracolonicacetaldehyde levels associated with alcohol drinking is ratherlow. Large differences between ADH and ALDH activities of thebacteria found in this study may contribute to the accumulationof acetaldehyde in the large intestine after moderate drinking.ALDH activities of colonic bacteria were poorly inhibited bycyanamide. This study supports the crucial role of intestinalbacteria in the accumulation of intracolonic acetaldehyde afterdrinking alcohol. Individual variations in human colonic floramay contribute to the risk of alcohol-related gastrointestinalmorbidity.     

Contribution of drinking patterns to differences in rates of alcohol related problems between three urban populations

OBJECTIVES: To examine, on empirical data, whether drinking patterns, in addition to overall alcohol consumption, contribute to differences in rates of alcohol related problems between populations. DESIGN: Cross sectional survey. SETTINGS: One Russian, one Polish, and one Czech city. PARTICIPANTS: 1118 men and 1125 women randomly selected from population registers. MAIN OUTCOME MEASURES: Problem drinking; negative social consequences of drinking; alcohol consumption and drinking pattern. RESULTS: Rates of problem drinking and of negative consequences of drinking were much higher in Russian men (35% and 18%, respectively) than in Czechs (19% and 10%) or Poles (14% and 8%). This contrasts with substantially lower mean annual intake of alcohol reported by Russian men (4.6 litres) than by Czech men (8.5 litres), and with low mean drinking frequency in Russia (67 drinking sessions per year, compared with 179 sessions among Czech men). However, Russians consumed the highest dose of alcohol per drinking session (means 71 g in Russians, 46 g in Czechs, and 45 g in Poles), and had the highest prevalence of binge drinking. In women, the levels of alcohol related problems and of drinking were low in all countries. In ecological and individual level analyses, indicators of binge drinking explained a substantial part of differences in rates of problem drinking and negative consequences of drinking between the three countries. CONCLUSIONS: These empirical data confirm high levels of alcohol related problems in Russia despite low volume of drinking. The binge drinking pattern partly explains this paradoxical finding. Overall alcohol consumption does not suffice as an estimate of alcohol related problems at the population level.     

Teenage alcohol and intoxication debut: the impact of family socialization factors, living area and participation in organized sports

The aim of the present study was to examine the age distribution of alcohol and intoxication debut and factors associated with this among a representative sample of Norwegian teenagers. A sample of 3368 teenagers aged 12-18 years was recruited from 34 Norwegian secondary schools to complete an 87-item questionnaire under examination conditions; 5.2% (168/3239) reported drinking alcohol for the first time when 10 years or younger, 25.2% (816/3239) when they were 13 years or younger and 60.1% (1948/3239) when 16 years or younger, with 39.9% having never drunk alcohol; 1.3% (44/3239) were first intoxicated by 10 years or younger, 12.8% (418/3239) when 13 years or younger and 37.5% (1649/3239) when 16 years or younger. Pupils with early alcohol or intoxication debut (<14 years) tended to come from single-parent families, from cities, experienced less family support and a more highly organized family life, reported more frequent peer and parental drinking, and did not participate in sports. They also showed a substantially elevated total yearly current alcohol consumption, compared to the group with alcohol debut at 14 years or later (8.1 and 2.5 l pure alcohol, respectively). Poor family support but high family organization, living in single-parent families and in cities, and more frequent parental and peer drinking are associated with early alcohol debut, whereas participation in organized sport activities may delay drinking and intoxication debut in teenagers. Sports organizations should be included in drinking prevention programmes.     

PERCEPTIONS OF DRINKERS AND ABSTAINERS IN A SAMPLE OF SCOTTISH ADULTS

Following Davies and Stacey's investigation (1972, Teenagersand Alcohol, HMSO, London) into perceptions of drinking andabstaining among Scottish teenagers, this study extended theirgeneral method to an investigation of the perceptions of 239Scottish adults. Results showed that the stereotypes of theheavy drinker as ‘tough and rebellious’ and theabstainer as ‘weak and cissy’ persist into adulthood.Heavy drinkers were seen as low on ‘sociability’and ‘sexual attractiveness’ and abstainers wereseen as less ‘sociable’ than moderate drinkers.There was also some evidence of a ‘double standard’in perceptions of male and female drinking roles. Other findingsconcerning the effects on perceptions of subjects sex and drinkingbehaviour are compared to those reported in the earlier studyand implications for the treatment of alcohol problems are discussed.It is concluded that the dimensions described by Davies andStacey represent a relatively stable structure within futureresearch where fresh initiatives in alcohol education may belocated.     

A study of South Korean casino employees and gambling problems

Background Casino employees are exposed to disproportionatelyhigh levels of gambling, drinking and smoking compared to otheroccupations. Because of their occupation, they have the opportunityto detect and prevent pathological gambling (PG). Aims To identify differences in the mental health status andsocial attitudes towards PG among casino workers in South Koreadepending upon whether they report any gambling problems. Methods Data were collected from 388 full-time casino employees.This data provided information about the prevalence of gamblingproblems, alcohol and tobacco use and depression. Employeeswere grouped according to their scores on the Korean versionof South Oaks Gambling Screen (SOGS), and those employees whogambled without experiencing any gambling problems (Group NP:SOGS = 0) and those who reported any gambling problems (GroupP: SOGS > 0) were compared. An exploratory factor analysesidentified the domains of casino employee social attitudes towardsgambling. Results Employees who reported gambling problems (Group P) reporteda higher prevalence of smoking, alcohol problems and depression(P < 0.01) compared to employees who did not report gamblingproblems (Group NP). The primary employee social attitude towardsgambling was identified by the factor of ‘Disease concept/socialawareness’. Group NP reported more positive attitudesin this domain than Group P (P < 0.01). Conclusions Employees who reported any gambling problems reporteda less positive attitude towards developing the public healthsystem to be responsive to gambling problems. These findingsindicate a need to develop health education programmes thatfocus more specifically on casino employees with gambling problems.