Adult outcomes of binge drinking in adolescence: findings from a UK national birth cohort

AIMS: The aim of the study was to determine outcomes in adult life of binge drinking in adolescence in a national birth cohort. DESIGN AND SETTING: Longitudinal birth cohort: 1970 British Birth Cohort Study surveys at 16 years (1986) and 30 years (2000). PARTICIPANTS: A total of 11 622 subjects participated at age 16 years and 11 261 subjects participated at age 30 years. MEASUREMENTS: At the age of 16 years, data on binge drinking (defined as two or more episodes of drinking four or more drinks in a row in the previous 2 weeks) and frequency of habitual drinking in the previous year were collected. Thirty-year outcomes recorded were alcohol dependence/abuse (CAGE questionnaire), regular weekly alcohol consumption (number of units), illicit drug use, psychological morbidity (Malaise Inventory) and educational, vocational and social history. FINDINGS: 17.7% of participants reported binge drinking in the previous 2 weeks at the age of 16 years. Adolescent binge drinking predicted an increased risk of adult alcohol dependence (OR 1.6, 95% CI 1.3 to 2.0), excessive regular consumption (OR 1.7, 95% CI 1.4 to 2.1), illicit drug use (OR 1.4, 95% CI 1.1 to 1.8), psychiatric morbidity (OR 1.4, 95% CI 1.1 to 1.9), homelessness (OR 1.6, 95% CI 1.1 to 2.4), convictions (1.9, 95% CI 1.4 to 2.5), school exclusion (OR 3.9, 95% CI 1.9 to 8.2), lack of qualifications (OR 1.3, 95% CI 1.1 to 1.6), accidents (OR 1.4, 95% CI 1.1 to 1.6) and lower adult social class, after adjustment for adolescent socioeconomic status and adolescent baseline status of the outcome under study. These findings were largely unchanged in models including both adolescent binge drinking and habitual frequent drinking as main effects. CONCLUSIONS: Adolescent binge drinking is a risk behaviour associated with significant later adversity and social exclusion. These associations appear to be distinct from those associated with habitual frequent alcohol use. Binge drinking may contribute to the development of health and social inequalities during the transition from adolescence to adulthood.     

Absence of religious beliefs,unhealthy eating habits,illicit drug abuse,and self-rated health is associated with alcohol and tobacco use among college students — PADu study

Aim

Describing the factors associated with the alcohol consumption, tobacco use, binge drinking, and “binge drinking and tobacco use” by college students.

Subject and methods

Cross-sectional study carried out with 356 first-semester college students of a public educational institution at Minas Gerais, Brazil. Sociodemographic characteristics, lifestyle habits (alcohol consumption, tobacco and illicit drugs use, exposure time on screens, and eating habits), and health conditions (weight, height, self-rated health, symptoms of anxiety, and depression) were collected. Statistical analysis was performed using Stata® software version 13.0.

Results

The prevalence of alcohol consumption, tobacco use, binge drinking, and “binge drinking and tobacco use” were 73.9%, 17.4%, 43.5%, and 13.4%, respectively. Had no religious beliefs was associated with alcohol consumption (OR: 1.86 95% CI 1.06–3.27), tobacco use (OR: 2.00 95% CI 1.06–3.78), and “binge drinking and tobacco use” (OR: 2.33 95% CI 1.09–4.96). Unhealthy eating habits was associated with alcohol consumption (OR: 2.06 95% CI 1.06–3.97) and tobacco use (OR: 2.74 95% CI 1.33–5.68; OR: 0.75 95% CI 0.31–1.80). Illicit drugs was associated with alcohol consumption (OR: 8.55 95% CI 1.12–65.42) and tobacco use (OR: 3.19 95% CI 1.20–8.51). Self-rated health was associated with tobacco use, combined (OR: 2.93 95% CI 1.37–6.28) or not (OR: 2.46 95% CI 1.32–4.61) with binge drinking. Additionally, tobacco use was associated with white skin color (OR: 2.62 95% CI 1.35–5.07) and being homosexual (OR: 0.37 95% CI 0.18–0.75). Moreover, “binge drinking” was associated with being overweight (OR: 1.72 95% CI 1.03–2.84). Associations remained in the age and sex adjustment.

Conclusion

It was observed that some factors associated with alcohol consumption and tobacco use are modifiable risk factors. Therefore, we suggest strategic actions focusing on raising the population’s awareness to change these factors. Longitudinal studies are necessary to understand the causal relationship between studied variables and, thus, develop strategic actions to improve the life quality of this population group.

     

Parental occupational exposure to pesticides and the risk of childhood leukemia in Costa Rica

OBJECTIVES: Parental exposure to pesticides and the risk of leukemia in offspring were examined in a population-based case-control study in Costa Rica. METHODS: All cases of childhood leukemia (N=334), in 1995-2000, were identified at the Cancer Registry and the Children's Hospital. Population controls (N=579) were drawn from the National Birth Registry. Interviews of parents were conducted using conventional and icon-based calendar forms. An exposure model was constructed for 25 pesticides in five time periods. RESULTS: Mothers' exposures to any pesticides during the year before conception and during the first and second trimesters were associated with the risk [odds ratio (OR) 2.4, 95% confidence interval (95% CI) 1.0-5.9; OR 22, 95% CI 2.8-171.5; OR 4.5, 95% CI 1.4-14.7, respectively] and during anytime (OR 2.2, 95% CI 1.0-4.8). An association was found for fathers' exposures to any pesticides during the second trimester (OR 1.5, 95% CI 1.0-2.3). An increased risk with respect to organophosphates was found for mothers during the first trimester (OR 3.5, 95% CI 1.0-12.2) and for fathers during the year before conception and the first trimester (OR 1.5, 95% CI 1.0-2.2 and OR 1.6, 95% CI 1.0-2.6, respectively), and benzimidazoles during the first, second, and third trimesters of pregnancy (OR 2.2, 95% CI 1.0-4.4; OR 2.2, 95% CI 1.0-5.0; OR 2.2, 95% CI 1.0-5.2, respectively). There was a suggestion of an exposure-response gradient for fathers as regards picloram, benomyl, and paraquat. Age at diagnosis was positively associated with fathers' exposures and inversely associated with mothers' exposures. CONCLUSIONS: The results suggest that parental exposure to certain pesticides may increase the risk of leukemia in offspring.     

"Culture of drinking" and individual problems with alcohol use

Binge drinking is a substantial and growing health problem. Community norms about drinking and drunkenness may influence individual drinking problems. Using data from the New York Social Environment Study (n = 4,000) conducted in 2005, the authors examined the relation between aspects of the neighborhood drinking culture and individual alcohol use. They applied methods to address social stratification and social selection, both of which are challenges to interpreting neighborhood research. In adjusted models, permissive neighborhood drinking norms were associated with moderate drinking (odds ratio (OR) = 1.28, 95% confidence interval (CI): 1.05, 1.55) but not binge drinking; however, social network and individual drinking norms accounted for this association. By contrast, permissive neighborhood drunkenness norms were associated with more moderate drinking (OR = 1.20, 95% CI: 1.03, 1.39) and binge drinking (OR = 1.92, 95% CI: 1.44, 2.56); the binge drinking association remained after adjustment for social network and individual drunkenness norms (OR = 1.58, 95% CI: 1.20, 2.08). Drunkenness norms were more strongly associated with binge drinking for women than for men (p(interaction) = 0.006). Propensity distributions and adjustment for drinking history suggested that social stratification and social selection, respectively, were not plausible explanations for the observed results. Analyses that consider social and structural factors that shape harmful drinking may inform efforts targeting the problematic aspects of alcohol consumption.     

Parental and Peer Influences on the Risk of Adolescent Drug Use

Using a probability sample of 4,230 adolescents from grades 7–12, we used negative binomial regression to estimate the effects of peer and six family variables on the risk of adolescent drug use. Peer drug use had relatively strong effects of adolescent drug use. Parental drug attitudes, sibling drug use, and adult drug use had significant direct effects net of peer influences. In addition, they had significant indirect effects that were mediated by peer drug use. The influences of parental monitoring, attachment to mother, and attachment to father were statistically significant but relatively small. The findings applied to alcohol, binge drinking, cigarettes, marijuana, and other illicit drugs. Editors' Strategic Implications: The authors interpret their findings as being more consistent with social learning than social control theory. This research, although cross-sectional and limited to adolescents' self-reports, contributes to a growing literature on the direct and indirect influences of parents on their teens' substance use rates. It speaks to the need for school- and community-based prevention efforts to focus on families as well as peers.     

Factors associated with drug use among adolescent students in southern Brazil

OBJECTIVE: To assess factors associated with drug use among adolescent students from schools providing secondary education. METHODS: A cross-sectional study was carried out in Pelotas, Southern Brazil, in 1998. An anonymous, self-administered questionnaire was answered by a proportional sample of 10-19-year-old students, enrolled in primary (5th grade and further) and secondary classes in all public and private schools of the urban area which providing secondary education. Schools were visited up to three times in order to reach absent students. Results were expressed as prevalence ratios (PR). RESULTS: 2,410 students were interviewed, losses amounting to 8%. The prevalence of drug use (except alcohol and tobacco) in the last year was 17.1%. After confounder control, associations remained between drug use and parents' divorce (PR=1.46; 95% CI: 1.18-1.80), poor relationship with father (PR=1.67; 95% CI: 1.17-2.38), poor relationship with mother (PR=2.71; 95% CI: 1.64-4.48), open-minded father (PR=1.36; 95% CI: 1.08-1.72), drug user in household (PR=1.61; 95% CI: 1.17-2.18), abuse (PR=1.62; 95% CI: 1.27-2.07), having been mugged or robbed in the previous year (PR=1.38; 95% CI: 1.09-1.76) and absence of religious practice (PR=1.31; 95% CI: 1.07-1.59). CONCLUSIONS: The study suggests associations between several family characteristics and drug use by adolescents, providing useful information for a complete understanding of this problem in Brazil.     

Excessive alcohol use and its association with risky sexual behaviour: a cross‐sectional analysis of data from Victorian secondary school students

Objective : Estimate the prevalence of sexual behaviour and alcohol use and examine the association between excessive alcohol use and risky sexual behaviour in late secondary students in Victoria, Australia. Method: The sample of Year 11 students from government and independent schools participating in the 2008 International Youth Development Study (n=450) was representative of the Victorian school population. Logistic regression analyses examined the associations between sexual behaviour, binge and compulsive drinking, adjusting for socio‐demographic, school and family factors. Results: Under half (44%) the students had experienced sex in the past year, half (50%) had engaged in binge drinking in the past two weeks and 26% reported compulsive drinking in the past year. Of those who reported sex in the past year (n=197), 34% had sex without a condom at the last sexual encounter and 28% later regretted sex due to alcohol. The likelihood of experiencing sex was increased by binge (OR=2.44, 95%CI 1.44–4.12) and compulsive drinking (OR=2.15, 95%CI 1.29–3.60). For those sexually active, binge drinking increased the risk of having three or more sexual partners (OR=3.37, 95%CI 1.11–10.26) and compulsive drinking increased the likelihood of regretted sex due to alcohol (OR=4.43, 95%CI 2.10–9.31). Excessive drinking was not associated with condom non‐use. Conclusion and implications: Risky sex – multiple sexual partners and regretted sex due to alcohol – and excessive drinking are highly prevalent and co‐associated among Victorian late secondary students.     

Mother''s and father''s birthweight as predictors of infant birthweight

Mothers' and fathers' birthweights are each significantly related to their infants' birthweight, even after control for 31 potentially confounding variables. The relationship is stronger for mothers and daughters than for other parent-offspring pairs. Parents' birthweights together account for 2% of the variance in sons', and 5% of the variance in daughters' birthweights. There are interactions of maternal birthweight with maternal adult weight, pregnancy weight gain, and parity; the predicted effect of maternal birthweight on infant birthweight is enhanced when the mother weighs more, gains more weight during pregnancy, or is multiparous. Race and parents' drinking and smoking also modify the predicted effect of parents' birthweights. The correlation between mother and offspring birthweights has been attributed to the mother's own uterine experience and its effect on her later reproductive performance. However, the significant relationship of father and infant birthweights reported in this paper suggests that the fetal genes also play some role in determining size at birth.     

Protective correlates of stages in adolescent substance use: A swiss national study

Objective: To identify factors potentially protective against involvement with additional illicit drugs among adolescent users of marijuana.

Design and Methods: A cross-sectional, secondary analysis of a national data set of Swiss adolescents was performed. The original survey was conducted in 1992–1993 (N= 9268). Stages of substance use were conceptualized as lifetime use of marijuana of three or more times and as use of marijuana and other illicit drugs (opiates, inhalants, cocaine, hallucinogens, or stimulants) more than twice in the past month. Behavioral characteristics associated with level of drug use were examined. Based on the resilience literature, factors potentially protective against progression of drug use were examined in their bivariate relationships and analyzed in a multiple regression model.

Results: Almost one quarter of the surveyed adolescents were classified as past or current marijuana users. One in 20 of these adolescents also used other illicit drugs. Prevalence of risk-related behaviors (e.g., antisocial behavior, accidents, suicide attempts) was elevated for marijuana users compared to nonusers and even more elevated for users of marijuana with other illicit drugs. In a multivariate logistic regression model, communicating well with a parent was significantly associated with not having progressed to use of illicit drugs other than marijuana [for males, odds ratio (OR) = 0.72, confidence interval (CI) = 0.55, 0.92; for females, OR = 0.60, CI = 0.39, 0.93]. Other significant protective correlates for boys were academic achievement (OR = 0.66, CI = 0.47, 0.92), type of education: school versus apprenticeship (OR = 0.42, CI = 0.21, 0.87), confiding in a family member (OR = 0.49, CI = 0.28, 0.85), and regular participation in a sports club (OR = 0.39, CI = 0.22, 0.77).

Conclusion: Within this national sample of Swiss adolescents, a cross-sectional analysis identified the quality of relationships within the family and factors related to school associated with lack of progression of illicit substance use. However, longitudinal studies will be necessary to confirm these associations and to allow for designing interventions targeting the enhancement of protective factors among young people already at risk for serious substance use.     

Concurrent binge drinking and depression among Canadian youth: prevalence,patterns, and suicidality

This study compared differences in risk for suicidality among youth living in the community who met criteria for comorbid depression and binge drinking, depression without binge drinking, and binge drinking without depression relative to a reference group with neither condition. Logistic regression analysis was used to analyze data from the Canadian Community Health Survey, Cycle 3.1 (CCHS 3.1, 2005): a cross-sectional survey of respondents from the Canadian population. To restrict the sample to youth, respondents were excluded who were younger than 15 or older than 24 years. Over 17,000 respondents were assessed to determine whether they met criteria for depression, binge drinking, the comorbid condition, or neither condition (reference group). Binge drinking was defined as five drinks or more on an occasion. The 12-month prevalence rates for comorbid binge drinking and depression were 2.7% for male respondents and 2.1% for female respondents. When adjusted for demographic factors and when compared with the reference group, the risk of suicidality was increased for the depressed group (odds ratio [OR] 5.23, 95% confidence interval [CI]: 3.34–8.2) and the comorbid group (OR 6.28, 95% CI: 3.68–10.70), but not for the binge-drinking group. With the exception of increasing age, sociodemographic factors were not correlates of comorbidity. In conclusion, binge drinking was not associated with an increased risk of suicidality among Canadian youth living in the community, although depression and comorbidity were associated with suicidality.     

Youth smoking risk and community patterns of alcohol availability and control: a national multilevel study

STUDY OBJECTIVE: To test whether college youth smoking risks are independently associated with community patterns of alcohol availability and control. DESIGN: Hierarchical multilevel multivariable modelling of cross sectional survey data. Outcomes included self reported current (past 30 day) cigarette smoking and heavy episodic (binge) drinking. SETTING: 120 nationally representative US colleges. PARTICIPANTS: 10 924 randomly selected students. MAIN RESULTS: Individual risks for smoking and binge drinking are independently associated with community patterns of alcohol availability, policy enforcement and control over and above individual perceptions about these factors, student and college characteristics, and school binge drinking rates. Youth exposed to high levels of alcohol availability are at higher risk of smoking (OR 3.61, 95% CI 1.75, 7.44) and binge drinking (OR 4.22, 95% CI 2.25, 7.93) than youth not so exposed; youth exposed to strongly enforced alcohol policy environments are at lower risk for smoking (OR 0.30, 95% CI 0.16, 0.57) and binge drinking (OR 0.17, 95% CI 0.10, 0.31) than youth not so exposed; youth exposed to communities with strong parental controls are at lower risk for smoking (OR 0.05, 95% CI 0.01, 0.23) and binge drinking (OR 0.06, 95% CI 0.01, 0.21) than youth not so exposed. Individual risks related to environmental exposures differ for youth with varying perceptions about alcohol availability and policy control. CONCLUSIONS: Drinking environments in US college communities comprise strong independent risks for smoking. Smoking prevention models should be tested that include environmental drinking prevention strategies tailored to underlying perceptions and experiences of college youth.     

Exposure to alcohol use in motion pictures and teen drinking in Germany

BACKGROUND: To assess whether movie alcohol exposure is associated with alcohol use during early adolescence. METHODS: We conducted a survey of adolescents (N = 5,581) from 27 schools in Germany. Each was asked if he/she had seen a list of 50 movie titles, randomly selected from a sample of 398 US box office hits released there. Screen alcohol use was timed for each movie, summed for movies each adolescent had seen, and adjusted to reflect exposure to all 398 movies. We assessed the association between this exposure and any alcohol use without parental knowledge (WPK) and binge drinking (>or= 5 drinks). RESULTS: Alcohol use was depicted in 88% of the 398 movies. Median exposure to movie alcohol use was 3.44 h (interquartile range = 1.51-6.23 h). Overall 36.6% of subjects used alcohol WPK and 18.1% reported binge drinking. Movie alcohol exposure was directly associated with alcohol use WPK and binge drinking, after controlling for multiple covariates including sociodemographics, personality characteristics and social influences. Compared with quartile one, the adjusted odds of alcohol use WPK were 1.47 [95% confidence interval (CI) 1.19-1.82], 2.12 (1.75-2.57) and 2.95 (2.35-3.70) for quartiles 2, 3 and 4, respectively; similarly, adjusted odds of binge drinking were 1.42 (0.93-2.28), 1.84 (1.27-2.67) and 2.59 (1.70-3.95). CONCLUSION: This study demonstrates an association between exposure to alcohol use in US movies and alcohol use without parental knowledge in Germany, and is the first study to link movie exposure with binge drinking. Given international distribution of US movies, depicted behaviours may influence adolescents outside the country of origin.     

Estimating and comparing incidence and prevalence of chronic diseases by combining GP registry data: the role of uncertainty

Background

As the promotion of alcohol and tobacco to young people through direct advertising has become increasingly restricted, there has been greater interest in whether images of certain behaviours in films are associated with uptake of those behaviours in young people. Associations have been reported between exposure to smoking images in films and smoking initiation, and between exposure to film alcohol images and initiation of alcohol consumption, in younger adolescents in the USA and Germany. To date no studies have reported on film images of recreational drug use and young people's own drug use.

Methods

Cross sectional multivariable logistic regression analysis of data collected at age 19 (2002-4) from a cohort of young people (502 boys, 500 girls) previously surveyed at ages 11 (in 1994-5), 13 and 15 in schools in the West of Scotland. Outcome measures at age 19 were: exceeding the 'sensible drinking' guidelines ('heavy drinkers') and binge drinking (based on alcohol consumption reported in last week), and ever use of cannabis and of 'hard' drugs. The principle predictor variables were an estimate of exposure to images of alcohol, and of drug use, in films, controlling for factors related to the uptake of substance use in young people.

Results

A third of these young adults (33%) were classed as 'heavy drinkers' and half (47%) as 'binge drinkers' on the basis of their previous week's consumption. Over half (56%) reported ever use of cannabis and 13% ever use of one or more of the 'hard' drugs listed. There were linear trends in the percentage of heavy drinkers (p = .018) and binge drinkers (p = 0.012) by film alcohol exposure quartiles, and for ever use of cannabis by film drug exposure (p = .000), and for ever use of 'hard' drugs (p = .033). The odds ratios for heavy drinking (1.56, 95% CI 1.06-2.29 comparing highest with lowest quartile of film alcohol exposure) and binge drinking (1.59, 95% CI 1.10-2.30) were attenuated by adjustment for gender, social class, family background (parental structure, parental care and parental control), attitudes to risk-taking and rule-breaking, and qualifications (OR heavy drinking 1.42, 95% CI 0.95-2.13 and binge drinking 1.49, 95% CI 1.01-2.19), and further so when adjusting for friends' drinking status (when the odds ratios were no longer significant). A similar pattern was seen for ever use of cannabis and 'hard' drugs (unadjusted OR 1.80, 95% CI 1.24-2.62 and 1.57, 95% CI 0.91-2.69 respectively, 'fully' adjusted OR 1.41 (0.90-2.22 and 1.28 (0.66-2.47) respectively).

Conclusions

Despite some limitations, which are discussed, these cross-sectional results add to a body of work which suggests that it is important to design good longitudinal studies which can determine whether exposure to images of potentially health-damaging behaviours lead to uptake of these behaviours during adolescence and early adulthood, and to examine factors that might mediate this relationship.     

Tobacco use as a predictor of illicit drug use and drug-related problems in Colombian youth.

PURPOSE: To examine the extent to which personality and peer factors mediate the relationship between early cigarette use and later illicit drug use, as well as associated drug use problems, in a population of Colombian adolescents. METHODS: A longitudinal study (2-year interval), using face-to-face structured interviews was begun in 1996 using a community-based sample, randomly selected from census data in three cities in Colombia, South America. The participants were 2837 adolescents with a mean age of 15.0 (SD +/- 1.6) years at time 1 (T1). Males comprised 52% of the sample and 65% resided with two parents. Approximately 78% (N = 2226) completed the second structured interview 2 years later (T2). The main outcome measures were marijuana use, other illicit drug use, and associated drug use problems at T2. Three series of logistic regressions were conducted. RESULTS: The odds of marijuana use (adjusted odds ratio [AOR] = 1.64-2.01; confidence interval [CI]: 1.11-2.94), other illicit drug use (AOR = 1.77-2.49; CI: 1.03-4.19), and associated drug use problems (AOR = 2.25-3.47; CI: 1.45-5.26) at T2, was increased two- to three-fold among adolescents reporting cigarette use at T1, with control on the demographic, personality, and peer factors, as well as T1 drug use variables. CONCLUSIONS: Earlier adolescent cigarette smoking was directly associated with later marijuana use, other illicit drug use, and problems with drug use.     

A prospective study of overeating, binge eating, and depressive symptoms among adolescent and young adult women

PurposeTo investigate the temporal relationship between depressive symptoms and overeating and binge eating among adolescent and young adult females in the United States.MethodsWe investigated incident overeating, binge eating, and depressive symptoms among 4,798 females in the Growing Up Today Study, a prospective cohort study of adolescents and young adults throughout the United States. Participants who reported at least monthly episodes of eating a very large amount of food in a short amount of time in the past year, but not experiencing a loss of control, were classified as overeaters. Those who reported a loss of control while overeating were classified as binge eaters. Depressive symptoms were assessed with the McKnight Risk Factor Survey. Participants were followed between 1999 and 2003. Generalized estimating equations were used for lagged analysis with time-varying covariates. Analyses were adjusted for age, age at menarche, body mass index, and follow-up time.ResultsFemales reporting depressive symptoms at baseline were two times more likely than their peers to start overeating (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.4, 2.5) and binge eating (OR = 2.3; 95% CI = 1.7, 3.0) during the follow-up. Similarly, females engaging in overeating (OR = 1.9; 95% CI = 1.1, 3.4) or binge eating (OR = 1.9; 95% CI = 1.2, 2.9) at baseline were two times more likely than their peers to develop depressive symptoms during the follow-up.ConclusionsThese results indicate that it is important to consider depressive symptoms in overeating and binge eating prevention and treatment initiatives targeting adolescent and young adult females.     

The relationship between alcohol supply source and young people's risky drinking and alcohol‐related problem behaviours in Victoria,Australia

Objective: To determine whether source of alcohol supply is related to adolescent underage drinkers’ reports of risky drinking and alcohol‐related problem behaviours. Methods: In 2003/04, a cross‐sectional survey of 2,644 16–17 year‐olds were recruited from Victorian households and surveyed by phone as part of the Victorian Youth Alcohol and Drug Survey. The results were analysed to determine whether alcohol supply source was associated with weekly or more frequent risky single occasion drinking (RSOD) and reports of alcohol‐related problem behaviours. Results: Around 20% (524/2,644) of the sample reported weekly RSOD and 34% (904/2,644) of the sample reported engaging in at least one alcohol‐related problem behaviour. These outcomes were associated with reported usual source of alcohol supply, with reports of alcohol sources in addition to parents alone more than twice as likely to be accompanied by reports of RSOD (OR=2.53, 95%CI=1.85–3.46) and/or problem behaviours (OR=2.16, 95%CI=1.64–2.84), compared to when adolescents reported parents as their sole source of alcohol. Reports of alcohol supply only from sources other than parents were similarly more than twice as likely to be accompanied by reports of RSOD (OR=2.27, 95% CI=1.74–2.95) and/or problem behaviours (OR=2.27, 95%CI=1.82–2.82) compared to compared to parental supply alone. Conclusions and implications: The rate at which older adolescents report RSOD and alcohol‐related problem behaviour is increased when they obtain alcohol from sources other than their parents. Parents need to be equipped with strategies for managing the supply of alcohol to adolescents.     

Risk modifying effect of social capital on measures of heavy alcohol consumption, alcohol abuse, harms, and secondhand effects: national survey findings

STUDY OBJECTIVE: To examine associations between social capital and individual risk for alcohol abuse and harms and identify protective effect mechanisms. DESIGN: Multilevel multivariate analysis with individual level data from a national panel survey of drinking and a contextual measure of social capital reflecting college mean aggregate reports of student volunteerism. Outcomes include heavy episodic (binge) drinking, frequent drinking, frequent drunkenness, diagnosable alcohol abuse, intentional drunkenness, acquisition of binge drinking, harms, secondhand effects from others' drinking. SETTING: United States, 119 four year colleges. PARTICIPANTS: Representative samples of youth ages 18-24 surveyed in 1997 and 1999 using an anonymous mailed questionnaire (total n = 27 687). MAIN RESULTS: Students from colleges with higher levels of social capital reported reduced risks for binge drinking (adjusted OR 0.38, 95% CI 0.20 to 0.69, p = 0.002), frequent drunkenness (adjusted OR 0.58, 95% CI 0.34 to 0.98, p = 0.04), acquisition of binge drinking in college (adjusted OR 0.48, 95% CI 0.24 to 0.95, p = 0.03), and alcohol abuse (adjusted OR 0.55, 95% CI 0.34 to 0.91, p = 0.02) in multilevel multivariate analyses that controlled for individual volunteering, the measure on which social capital was based. Higher levels of social capital protected against multiple drinking related harms (adjusted OR 0.51, 95% CI 0.29 to 0.90, p = 0.02) and secondhand drinking effects (adjusted OR, 0.30, 95% CI 0.16 to 0.58, p = 0.0003). Significant cross level interactions exist between fraternity/sorority membership and social capital for measures of risky drinking. Harm reduction primarily reflects consumption modification. CONCLUSIONS: Social capital exerts strong protective effects on alcohol abuse and harm in college including among high risk students.     

Social capital and substance use among Swedish adolescents--an explorative study

Cross-sectional survey data on Swedish adolescents aged 12-18 was used to estimate the link between individual social capital and smoking, illicit drug use and binge drinking. Major conclusions drawn were (1) that social capital, indicated by measures of social participation and trust, was negatively correlated with the probability of smoking and illicit drug use, but (2) that social capital showed no statistically significant correlation with the probability of binge drinking.     

Poor health is associated with episodic heavy alcohol use: evidence from a National Survey

OBJECTIVES: The objective of this study was to examine the relationship between self-rated health and episodic heavy drinking in a representative sample of American adults. We also sought to determine ethnic and gender differences in the association between self-rated health and episodic heavy drinking. METHODS: Data (n=4649) from the Third US National Health and Nutrition Examination Survey were utilized for this investigation. Episodic heavy drinking was defined as the consumption of five or more and four or more alcoholic beverages on one occasion for men and women, respectively. Poor health was defined as answering fair or poor to the question: "Would you say your health in general is excellent, very good, good, fair or poor?" Odds ratio from the logistic linear regression analysis was used to estimate the risk for poor health that was associated with episodic heavy drinking. Statistical adjustments were made for age, hypertension, diabetes, current smoking, body mass index and race/ethnicity. RESULTS: Overall, episodic heavy drinking was associated with increased odds of poor self-rated health in men and women. In men, episodic heavy drinking was independently associated with 1.28 (95% CI: 1.07-1.82) increased odds of poor health. The corresponding value in women was 1.86 (95% CI: 1.05-2.28). In men, being Black was associated with approximately two-fold (OR=1.96; 95% CI: 1.33, 2.89), and being Hispanic was associated with approximately four-fold (OR=3.59; 95% CI: 2.50, 5.14) increased odds of poor self-rated health relative to being White. The corresponding odds ratios in women were 2.97 (95% CI: 1.90, 4.64) and 5.18 (95% CI: 3.23, 8.30). Associations were greater among blacks (adjusted OR=2.41; 95% CI: 1.81-3.22) and Hispanics (adjusted OR=4.15; 95% CI: 3.12-5.52) than among whites. CONCLUSIONS: Poor health is associated with episodic heavy alcohol consumption. Public health strategies to curb alcohol abuse may improve self-reported health status in these at-risk populations.