Ethnic Differences in Substance Use and Alcohol-Use-Related Mortality among First Generation Migrants to England and Wales

Epidemiological studies among migrant ethnic groups are potentially important as a way to provide insight into the relative importance of genetic, cultural, and socioeconomic factors in the etiology of substance use disorders. This paper summarizes prior United Kingdom studies of the prevalence of substance-use-associated problems in different ethnic groups before analyzing trends in recent mortality data by country of birth. On this evidence, rates of alcohol-related mortality may be marginally higher for those born in the Caribbean than for the native British, but are substantially raised for those born in Ireland and the Indian subcontinent. There is some indication that rates for the Caribbean and possibly the Irish groups have risen more rapidly than for the national population over a 12-year period. These differences in mortality rates seem to have arisen for complex reasons. [Translations are provided in the International Abstracts Section of this issue.]     

Association Between Aspects of Drinking Pattern and Experience of Alcohol-Related Problems

This article reports results from a study of two groups of workers undertaken in the late 1970s and early 1980s. Separate random samples of company directors and brewery production workers were contacted and invited to participate in an interview survey related to alcohol consumption and consequences. Multiple logistic regression analysis was employed to assess the association between total consumption of alcohol, some aspects of pattern of consumption and experience of alcohol-related problems. Pattern of consumption was not found to be significantly associated with problems related to general health and alcohol dependence after taking account of total consumption, but aspects of pattern were important in explaining problems related to work, family life and public order.     

Perceived Parental/Peer Attitudes and Alcohol-Related Behaviors: An Analysis of the Impact of the Drinking Age Law

This study examined the perceived change in parental and peer attitudes toward underage drinking associated with the raising of the legal drinking age and its effect on youthful alcohol use and drinking driving. The analysis was based on the New York State Youth Alcohol Survey, a series of four surveys conducted in 1982, before the enactment of the 19 drinking age law; 1983, after the enactment of the 19 drinking age law, 1985, before the 21 drinking law; and 1986, after the 21 drinking age law. Findings indicate that the effect of perceived parental attitudes is specific to underage alcohol use, but the effect of perceived peer attitudes is general to both underage and legal drinkers. Results from this study suggest that parental supervision is a key factor in enforcing the drinking age law and reducing youthful alcohol use. Parents' participation should be included in all enforcement and prevention/intervention efforts.     

Adolescent Drinking and Alcohol-Related Problems in a Nationwide General Population

A sample of 1,325 adolescents drawn from a nationwide multistage probability master sample of 4,290 persons were interviewed at their homes in 1984. The purpose of this study was to investigate the patterns and quantity of alcohol consumption and related problems. Moreover, mental health status of respondents and “risk” factors were explored. Alcohol use increased from the very young to the older ones and decreased between lifetime and past week frequencies. Of adolescents, 18% reported two or more alcohol-related problems including suffering from depressive symptoms. Discriminant analysis revealed 14 predictors with high discriminating power between problematic and nonproblematic drinking.     

Heterogeneity in Drinking Practices in England and Wales and Its Association With Violent Behavior: A Latent Class Analysis

Background: Crude single-item consumption metrics, such as “binge drinking” measures, mask the complexity and heterogeneity in young people's drinking; thus limiting our understanding of young people's drinking patterns as well as how alcohol drinking is associated with violent outcomes. Objectives: The current study employed a range of consumption and contextual indicators to explore heterogeneity in young people's (16–29 years) drinking practices, giving due consideration to their social nature. It also assessed to what extent heterogeneity in drinking practices was associated with violent outcomes. Methods: Employing data from the 2006 Offending Crime and Justice Survey, three measures of alcohol consumption and nine drinking context indicators were utilized within latent class analysis to create typologies of drinking practices among current drinkers in England and Wales (n = 2711) and examine their association with violent outcomes. The validity of the typologies was also assessed on age, sex, and socio-economic status. Results: Three discernible drinking profiles were identified: “regular social drinkers” (48%), “regular pub binge drinkers” (32%), and “moderate drinkers” (20%). The “regular pub binge drinkers” were found to be more than twice as likely to commit an assault offence (odds ratio = 2.8 95% CI [1.3, 6.2]) when compared to “moderate drinkers” and “regular social drinkers” (odds ratio = 2.2 95% CI [1.4, 3.4]). Conclusions: Interventions aimed at reducing alcohol-related violence ought to give due consideration to the social context of drinking as well as levels of consumption.     

Alcohol Consumption and Alcohol-Related Problems: Prevalence amongst a General Practice Population

Abstract: The prevalence of “at risk” levels of alcohol consumption and of alcohol-related problems in a sample of general practice patients was examined. Consumption was measured using both Quantity Frequency (N = 2066) and retrospective diary (N = 808) measures. The two measures yielded similar results. The proportion of females drinking “at risk” levels (40 gms a day) ranged from 0.6% to 1.2% and between 4.1% and 5.8% of males were classified “at risk” (60gms/day). Using the SMAST to measure alcohol-related problems, 8.6% of females and 12.1% of males were classified as “probable alcoholic”, while “possible alcoholism” was present in a further 15.1% of females and 20.1% of males. Only a weak relationship was found between being at physical risk on the basis of excessive consumption and being identified as having alcohol-related problems by the SMAST. Logistic regression was used in an attempt to delineate predictors of alcohol-related problems. Smoking status, alcohol consumption, age and report of skin problems entered the final model, but the prediction from this model was poor (X² = 322.67, df = 204, p = 0.122). The results are discussed in terms of strategies for general practitioner detection and intervention with patients with alcohol-related problems.     

Brand Preferences of Underage Drinkers Who Report Alcohol-Related Fights and Injuries

Background: A significant body of research has demonstrated an association between adolescent alcohol consumption and subsequent fights and injuries. To date, however, no research has identified which brands are associated with alcohol-related fights and injuries among underage drinkers. Objectives: We aimed to: (1) report the prevalence of alcohol-related fights and injuries among a national sample of underage drinkers in the U.S. and (2) describe the relationship between specific alcohol brand consumption and these alcohol-related negative consequences. Methods: We recruited 1,031 self-reported drinkers (ages 13–20 years) via an internet panel maintained by Knowledge Networks to complete an online survey. Respondents reported their past-month overall and brand-specific alcohol consumption, risky drinking behavior, and past-year alcohol-related fights and injuries. Results: Over one-quarter of the respondents (26.7%, N = 232) reported at least one alcohol-related fight or injury in the past year. Heavy episodic drinkers were over six times more likely to report one of these negative alcohol-related consequences (AOR: 6.4, 95% CI: 4.1–9.9). Respondents of black race and those from higher-income households were also significantly more likely to report that experience (AOR: 2.2, 95% CI: 1.3–3.7; AOR: 1.8, 95% CI: 1.1–3.0 and 1.1–3.2, respectively). We identified eight alcohol brands that were significantly associated with alcohol-related fights and injuries. Conclusions/Importance: Alcohol-related fights and injuries were frequently reported by adolescent respondents. Eight alcohol brands were significantly more popular among drinkers who experienced these adverse consequences. These results point to the need for further research on brand-specific correlates of underage drinking and negative health outcomes.     

Challenging,co-operating and splitting: a qualitative analysis of how the trade press responded to cumulative impact policies in England and Wales

Introduction: Cumulative impact policies (CIPs) increase English and Welsh local authority powers to regulate licences to sell alcohol. Commercial actors’ responses to CIPs potentially affect implementation and impacts. An analysis of the trade press provides perspectives on how commercial actors respond to this intervention.

Methods: Qualitative, thematic analysis of trade press articles (published 2003–2016, n?=?6 trade journals) focusing on depictions and responses to CIPs, including strategies for commercial actors engaging with the intervention.

Results: Included articles (n?=?257) provided both positive, but more typically, negative depictions of CIPs. CIPs were criticised for being unfair and an economic threat. Legal challenges to CIPs were at times advocated. Partnership and dialogue with local authority stakeholders were presented as a means by which licence applicants could promote their commercial interests in areas where CIPs were implemented, or as an alternative to regulatory interventions such as CIPs. Some alcohol retailers hoped CIPs could protect their businesses from market competition.

Conclusions: Commercial actors do not respond uniformly to alcohol regulation. This study of CIPs found that at times different commercial interests could be served by directly challenging the intervention or strategically co-operating with implementers. Implementation and evaluation of such interventions should consider commercial actors’ responses.     

Perceived Cognitive Competence,Depressive Symptoms and the Incidence of Alcohol-Related Problems in Urban School Children

ABSTRACT

Objective: This study is to test the hypothesis that poor perceived cognitive competence might signal an increased risk of subsequent alcohol-related problems in children. Method: A prospective epidemiologic study of elementary school students aged 9–13 years in Baltimore, Maryland, was undertaken. Perceived cognitive competence, peer use of alcohol, and other suspected risk characteristics for alcohol-related problems were assessed in 1990, among 1232 children with no prior history of problems associated with drinking alcohol. Occurrences of alcohol-related problems were assessed in subsequent annual interviews through 1994. Results: Four years later, 17.6% of these children are found to have developed one or more alcohol-related problems for the first time during the follow-up. Having depressive symptoms is associated with higher risk of developing alcohol-related problems while perceived cognitive competence is not (estimated Relative Risk (RR) = 1.6, 95% Confidence Interval (CI) 1.1–2.1 for depressive symptoms). The evidence from exploratory analyses suggests a possible interaction between depressive symptoms and perceived cognitive competence. Alcohol-related problems develop earlier for youths reporting both lower perceived cognitive competence and depressive symptoms relative to those with no depressive symptoms and high perceived cognitive competence. Furthermore, among children with at least one depressive symptom, having low or moderate perceived cognitive competence is associated with doubling the risk of developing alcohol-related problems relative to those with high cognitive competence (RR = 2.3, 95%CI 1.1–4.7 for low competence; RR = 2.1, 95%CI 1.2–3.9 for moderate competence). Conclusions: The evidence does not support a strong association between perceived cognitive competence and later alcohol-related problems. However, the exploratory search for interactions disclosed a possibility that depressive symptoms and poor perceived cognitive competence might combine to foster subsequent development of alcohol-related problems.