Drinking patterns,gender and health II: Predictors of preventive service use

Background: Chronic diseases and injuries are elevated among people with substance use problems/dependence, yet heavier drinkers use fewer routine and preventive health services than non-drinkers and moderate drinkers, while former drinkers and abstainers use more than moderate drinkers. Researchers hypothesize that drinking clusters with attitudes and practices that produce better health among moderate drinkers and that heavy drinkers avoid doctors until they become ill, subsequently quitting and using more services. Gender differences in alcohol consumption, health-related attitudes, practices, and prevention-services use may affect these relationships.

Methods: A stratified random sample of health-plan members (7884; 2995 males, 4889 females) completed a mail survey that was linked to 24 months of health-plan records. Data were used to examine relationships between alcohol use, gender, health-related attitudes/practices, health, and prevention-service use.

Results: Controlling for attitudes, practices, and health, female lifelong abstainers and former drinkers were less likely to have mammograms; individuals with alcohol-use disorders and positive AUDIT scores were less likely to obtain influenza vaccinations. AUDIT-positive women were less likely to undergo colorectal screening than AUDIT-positive men. Consistent predictors of prevention-services use were: self-report of having a primary care provider (positive); disliking visiting the doctor (negative); smoking cigarettes (negative), and higher body mass index (BMI) (negative).

Conclusions: When factors associated with drinking are controlled, patterns of alcohol consumption have limited effects on preventive service use. Individuals with stigmatized behaviors (e.g., hazardous/harmful drinking, smoking, or high BMIs) are less likely to receive care. Making care experiences positive and carefully addressing stigmatized health practices could increase preventive service use.     

Prospective Predictors of Premature Death: Evidence from the National Longitudinal Study of Adolescent Health

Abstract

This study was based on data from the National Longitudinal Study of Adolescent Health (Add Health), which revealed that 96 of its original Wave I respondents died prior to the collection of the Wave III survey. We compared psychosocial and behavioral characteristics reported at Wave I among those who died and those who lived (n = 16,719) using chi-square tests, t-tests, and logistic regression analyses to determine the most important risk factors for premature death among adolescents and young adults. Results suggested that driving while drunk was the most important risk factor for premature death (adjusted odds ratio = 2.48; 95% confidence interval: 1.12–5.50). The prevalence of driving while drunk was 17.7% among decedents compared with 6.4% among the survivors. Decedents were also significantly more likely to report multiple risk behaviors than survivors. As the current study demonstrates the importance of alcohol use as a contributing factor to the three leading causes of youth deaths, renewed efforts are needed to prevent and reduce alcohol consumption and abuse among this vulnerable population.     

Predicting risky health behaviors 35 years later: Are parents or teacher's reports of childhood behavior problems a better judge of outcomes?

ObjectivesThis study sought to understand (1) whether parents and teachers reports of childhood behavioral problems could predict smoking and alcohol consumption 35 years later, and (2) whether propensity for smoking and alcohol consumption differed on the basis of informant agreement in their classification of behavioral syndromes.MethodsParticipants included those from the Aberdeen Children of the 1950s study (ACONF) with full childhood information as well as self-reports in adulthood (n = 1342). Latent Class Analysis was conducted to identify patterns of childhood problem behaviors as rated by teachers and parents. Regression models were then conducted predicting adulthood smoking and alcohol consumption. Informant agreement categories were constructed and differences across categories in both smoking and alcohol consumption were tested.ResultsThree subtypes of childhood behavior problems were identified by both teachers and parents: “Normative,” “Externalizing,” and “Internalizing,”. Parents also identified a distinct fourth group “Mixed”. Teacher's classification of the child as externalizing significantly predicted greater likelihood of being a current smoker, and parents' classification as internalizing predicted lower likelihood of being an ex-smoker. Parents' ratings as externalizing and mixed also predicted lower levels of alcohol consumption, which was opposite to the predicted effect. Additionally, informant agreement of externalizing indicated a greater propensity of smoking in adulthood, but did not indicate differences in alcohol consumption.ConclusionsThis study suggests that it is important to consider additive information from multiple informants when examining the life-course effects of childhood behavioral problems on risky health behaviors in adulthood.     

Was it the drink? The conditioned association of alcohol and desire to quit smoking on the dual use of little cigars/cigarillos and cigarettes among men and women

IntroductionDual use of little cigars/cigarillos (LCCs) with cigarettes is becoming more popular; especially among men, but infrequently studied. Dual tobacco users show a higher prevalence of health-risk behaviors such as drug and alcohol use, are likely exposed to higher levels of nicotine and tobacco-related toxicants, and have greater difficulty quitting and maintaining abstinence. This study examined the effects of alcohol use, and desire to quit smoking on dual use of LCCs and cigarettes among men and women.MethodsData utilized responses from a screening survey of 571 adult smokers. Basic demographic information, current cigarette use, desire to quit smoking, frequency of current LCC use, and alcohol and drug use were collected.ResultsDual users were more likely to be male and younger, report drug use in the past 90-days, and have a lower desire to quit smoking. Regression analyses showed a 3-way interaction of gender, alcohol use frequency, and desire to quit smoking, such that men who drank alcohol more frequently who had a higher desire to quit smoking used LCCs more frequently than men with a lower desire to quit.DiscussionAlcohol use may be a risk factor for men's dual use of LCCs and cigarettes among those who want to quit smoking. Implications for prevention and treatment are discussed.     

Decreased injecting is associated with increased alcohol consumption among injecting drug users in northern Vietnam

BackgroundReducing injecting frequency may reduce the risk of HIV infection and improve health outcomes among injection drug users (IDUs). However, the reduction of one risk behavior may be associated with an increase in other risk behaviors, including the use of other risk-associated substances. Our objective was to determine if an association exists between a reduction in injecting and level of alcohol use among IDU.MethodsWe conducted a longitudinal analysis of data collected for a randomized controlled trial examining the efficacy of a peer education intervention in reducing HIV risk among IDU and their network members in Thai Nguyen, Vietnam. Our analysis included active male injectors (n = 629) who were study participants and attended both baseline and 3-month visits. Frequency of alcohol consumption was assessed as the number of alcoholic drinks in the past 30 days. Change in risk and outcome behaviors was calculated as the difference in frequencies of behaviors between baseline and 3-month follow-up visits. The outcome of interest was concurrent decreased drug injection and increased alcohol consumption.ResultsThe mean difference between baseline and 3-month follow-up of alcohol consumption and injection frequency in the past 30 days was 19.03 drinks (93.68 SD) and 20.22 injections (35.66 SD), respectively. Participants who reported reduced injection frequency were almost three times as likely to report increased alcohol consumption (OR 2.8; 95% CI, 2.0, 4.0). The proportion that both decreased injecting and increased alcohol by any amount in the past 30 days was 35.6%. In multivariate analysis higher education was significantly associated with an increase in alcohol and decrease in injecting of any amount.ConclusionMale IDU may be at risk for increasing alcohol consumption when they reduce injection frequency. Interventions with male IDU that encourage reduction of injection may need to review specific strategies to limit alcohol consumption.     

Drink monitoring for self and others: precollege drinkers and the Bad-Habit-Formation Hypothesis

Background: Past research has demonstrated that precollege alcohol consumption is related to college alcohol consumption. But whether precollege drinking is also related to drinking-related behaviors, such as drink monitoring, is unknown. Some have argued that precollege drinking, as a form of experience, should be related to the performance of positive drinking-related behaviors (learning-from-experience hypothesis) whereas others have argued that, given the environment of precollege drinkers, it should be related to negative drinking-related behaviors (bad-habit-formation hypothesis).

Methods: A cross-sectional survey of college students (n?=?284) at a large Midwestern university in the U.S. Participants completed measures of precollege drinking, college drinking, fraternity membership, and responsible drinking behaviors.

Results: Precollege drinkers were more likely to engage in college drinking; the former explained 12% of the variance in the College Drinking Scale, above and beyond other predictors. Precollege drinkers were less likely to monitor their own alcohol consumption or the consumption of their friends.

Conclusions: Precollege drinkers were less likely to monitor their own drinking and the drinking of friends, consistent with the bad-habit-formation hypothesis; that is, the notion that early drinking experiences cultivate the formation of irresponsible drinking behaviors.     

Correlates of Current Smoking Among Adults Served by the Public Mental Health System

Objective: As part of a study of health status among 457 adults with diagnostically heterogeneous serious mental illnesses served by the public mental health system in four U.S. states, we assessed predictors of current cigarette smoking. Methods: We examined bivariate relationships between smoking status and risks for drug and alcohol use disorders, residential setting, parental status, and employment. Finally, we used multivariable logistic regression to predict current smoking, controlling for significant confounds. Results: Of the total sample, 44% of participants reported that they currently smoked and most (62%) were moderately to severely nicotine-dependent. Those at high risk for drug use disorders were more than three times as likely and those at high risk for alcohol use disorders were more than twice as likely to smoke, compared to their counterparts with little or no drug or alcohol use disorder risk. Controlling for all other model variables including drug and alcohol disorder risk, current smokers were less likely to be parents and more likely to reside in supervised settings than nonsmokers. Younger people and those without a college degree were more likely to smoke, controlling for all other model variables. Conclusions: Given the high degree of comorbidity of smoking, alcohol disorders, and drug use disorders, the authors highlight the need for integrated interventions that address these issues simultaneously.     

Energy Drink and Alcohol mixed Energy Drink use among high school adolescents: Association with risk taking behavior,social characteristics

PurposeThe aims of the study were to: a) examine the prevalence of energy drink (ED) and alcohol mixed with energy drink (AmED) consumption; b) investigate the relationships between ED and AmED with alcohol, binge drinking and drugs accounting for at risk behaviors among a representative sample of Italian adolescents.MethodsA representative sample of 30,588 Italian high school students, aged 15–19 years, was studied. Binary and multivariate logistic regression analyses were performed to determine the independent association of the potential predictors' characteristics with the ED and AmED drinking during the last year.ResultsRespectively 41.4% and 23.2% of respondents reported drinking EDs and AmEDs in the last year. Multivariate analysis revealed that consumption of EDs and AmEDs during the last year were significantly associated with daily smoking, binge drinking, use of cannabis and other psychotropic drugs. Among life habits and risky behaviors the following were positively associated: going out with friends for fun, participating in sports, experiencing physical fights/accidents or injury, engaging in sexual intercourse without protection and being involved in accidents while driving.ConclusionsThis study demonstrates the popularity of ED and AmED consumption among the Italian school population aged 15–19 years old: 4 out of 10 students consumed EDs in the last year and 2 out of 10 AmED. Multivariate analysis highlighted the association with illicit drug consumption and harming behaviors, confirming that consumption of EDs and AmEDs is a compelling issue especially during adolescence, as it can effect health as well as risk taking behaviors.     

Drinking patterns,gender and health I: Attitudes and health practices

Background: Despite considerable research, relationships among gender, alcohol consumption, and health remain controversial, due to potential confounding by health-related attitudes and practices associated with drinking, measurement challenges, and marked gender differences in drinking. We examined gender/alcohol consumption differences in health-related attitudes and practices, and evaluated how these factors affected relationships among gender, alcohol consumption, and health status.

Methods: A stratified random sample of adult health-plan members completed a mail survey, yielding 7884 respondents (2995 male/4889 female). Using multivariate analyses of covariance and adjusting for health-related attitudes, values, and practices, we examined gender differences in relationships between alcohol consumption and health.

Results: More frequent heavy drinking was associated with worse health-related attitudes and values, worse feelings about visiting the doctor, and worse health-related practices. Relationships between health-related practices and alcohol use differed by gender, and daily or almost daily heavy drinking was associated with significantly lower physical and mental health for women compared to men. Drinking status (lifelong abstainers, former drinkers, and level of regular alcohol consumption) was related to health status and vitality, even after adjusting for health-related attitudes, values, and practices. Relationships did not differ by gender. Former drinkers reported lower physical and mental health status than either lifelong abstainers or current drinkers.

Conclusions: Drinking status is independently related to physical health, mental health, and vitality, even after controlling for the health-related attitudes, values, and practices expected to confound these relationships. Among current drinkers, women who engage in very frequent heavy drinking have worse physical and mental health than their male counterparts.     

Alcohol-related problem behaviors among Latin American immigrants in the US

BackgroundPrior research indicates that Latino immigrants are less likely than US-born individuals to use alcohol and meet criteria for an alcohol use disorder. However, our understanding of alcohol-related problem behaviors among Latino immigrants remains limited. We report the prevalence of alcohol-related problem behaviors among Latino immigrants vis-à-vis the US-born and examine the relationship between alcohol-related problem behavior and key migration-related factors and injury/receipt of emergency medical care.MethodsThe data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012–2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes.ResultsForeign-born Latinos were less likely to report one or more alcohol-related problems compared to US-born Latinos (AOR = 0.41, 95% CI = 0.33–0.50) and the US-born general population (AOR = 0.38, 95% CI = 0.32–0.46). Latino immigrants arriving as children were, compared to those arriving later in life, significantly more likely to report alcohol-related problem behaviors, and experiences of discrimination were linked with greater risk of alcohol-related problem behavior as well. Latino immigrants reporting recurrent injury/emergency medical care utilization were more likely to report alcohol-related problem behavior.ConclusionsLatino immigrants are significantly less likely than US-born Latinos and the US-born general population to operate a vehicle under the influence of alcohol, take part in risky behaviors or fight while drinking, or to be arrested due to alcohol consumption.     

Smoking Cessation and Alcohol Consumption in Individuals in Treatment for Alcohol Use Disorders

Abstract

Most individuals with alcohol use disorders are dependent on both alcohol and nicotine, and combined use of both substances is more damaging to health than use of either alone. Although research indicates that alcoholics can quit smoking, discrepant results have been reported regarding whether smoking cessation is associated with increased risk of alcohol relapse. The purpose of this paper was to examine the relationship between smoking cessation and alcohol consumption using data from Project MATCH. Of the 1,307 participants who smoked at any point during the study, 160 (12%) quit. Quitters consumed less alcohol than those who continued smoking. In addition, quitters demonstrated a significant reduction in alcohol consumption at the time of smoking cessation, which was sustained for six months post-cessation. These findings suggest that individuals in treatment for alcohol use disorders who are motivated to stop smoking can safely be encouraged to do so without jeopardizing their sobriety.     

An Analysis of Family Dynamics on High School Adolescent Risky Behaviors in Ghana

This study examined the relationship between family dynamics and student engagement in consumption of alcohol, smoking of cigarettes, and use of illicit drugs in Ghana, West Africa. Adolescents who reported that their parents consumed alcohol were more likely to do likewise. Parental consumption of alcohol increased the adolescent probability of doing the same irrespective of the gender. Adolescence is a formative period during which health risk behaviors may be learned and solidified. Policies and subsequent interventions to address health risk behaviors should not be limited to school setting. Parental engagement and monitoring outside of school significantly mediates the extent to which students engage in health risk behaviors.     

At risk alcohol consumption with smoking by national background: Results from the Hispanic community health study/study of Latinos

IntroductionTobacco smoking and binge or excess drinking are unhealthy behaviors that frequently co-occur. Studies of Hispanics/Latinos have mostly been of Mexican Americans although there are substantial differences in smoking and drinking by heritage background. Associated with co-use by 5 subpopulations.MethodsCross-sectional data of 16,412 Hispanics/Latinos from Miami, the Bronx, Chicago and San Diego collected between 2008 and 2011 as part of the HCHS/SOL were analyzed. Smoking and alcohol consumption and demographic data were measured by self-report. Prevalence of smoking and alcohol consumption and co-use were reported. Logistic regression models examined the odds of co-use of smoking and binge or excess alcohol use by Hispanic/Latino background group.ResultsMen of Cuban (10.3%), Puerto Rican (8.9%), and Mexican (8.9%) background had the highest prevalence of co-use of smoking and binge drinking compared to men of Central American (6.1%) and Dominican (6.6%) background. Women of Dominican (16.4%) and Puerto Rican (19.7%) background had the highest prevalence of binge drinking compared to women of Central American (10%) and Cuban (8%) background and Puerto Rican (34.1%) and Cuban (21.8%) women were the most likely to report current smoking compared to women of Central American (8.3%) and Mexican (10.4%) background. Acculturation was not associated with co-use among men and women. Elevated depressive symptoms were positively associated with smoking and binge drinking among men, OR = 1.5 [1.2–2.0], and women, OR = 1.5 [1.1–2.2]. Puerto Rican women had increased odds of co-use of smoking and binge or excess drinking compared to Mexican American women, OR = 3.2 [1.5–6.6].ConclusionsPuerto Rican and Dominican Latinas and Central American and South American men have a higher prevalence of co-use.     

Functioning, problem behavior and health services use among nursing home residents with alcohol-use disorders: nationwide data from the VA minimum data set

OBJECTIVE: We examined (1) whether nursing home residents with alcohol-use disorders (AUDs) function more poorly, have more behavioral problems and use more health services than do demographically matched controls without such disorders, and (2) whether AUDs interact with alcohol consumption to predict poorer behavioral and health services outcomes among nursing home residents. METHOD: We used Department of Veterans Affairs (VA) Patient Treatment File data to identify a nationwide sample of older VA nursing home residents with recent AUD diagnoses (n = 3,336) and a demographically matched sample without such diagnoses (n = 3,336). The groups were compared on the Resident Assessment Instrument Minimum Data Set indices of health-related functioning, substance use, problem behavior and health services use. We conducted two-way analyses of variance to determine interactions between presence of an AUD and alcohol consumption on problem behavior and health services use. RESULTS: Residents with AUD diagnoses functioned somewhat better than demographically matched controls. However, they were more likely to have falls and fractures, difficulties in social functioning and to use more health services. AUD diagnoses interacted with alcohol consumption to predict an elevated risk of falls and fractures and more mental health services use. CONCLUSIONS: Older residents with an AUD form a distinct nursing home population that functions somewhat better than residents without such disorders but they may pose more challenges to staff and use more health care services. Residents' drinking histories should be considered in formulating nursing home policies about alcohol consumption.     

杭州市老年人群心血管事件发生风险的危险因素及相关预防干预对策研究

目的探讨杭州市老年人群心血管事件发生风险的危险因素,制定预防干预措施对策提供依据。方法选取2015年2月至2019年2月在我院进行健康体检的老年人278例作为研究对象,统计心血管事件发生情况,并收集相关资料,分析心血管事件发生风险的危险因素。结果278例健康体检的老年人中心血管事件高危风险者100例,发生率35.97%;2组性别、婚姻状况、文化程度及人均收入对比,差异无统计学意义(P>0.05);与无心血管事件风险者比较,年龄(≥80岁)、收缩压(异常)、空腹血糖(异常)、总胆固醇(异常)、吸烟、饮酒占比较高,运动习惯占比较低,差异有统计学意义(P<0.05);经Logistic分析,年龄(≥80岁)、收缩压(异常)、空腹血糖(异常)、总胆固醇(异常)、吸烟、饮酒为老年人心血管事件风险发生的危险因素(OR>1,P<0.05);而运动习惯为老年人心血管事件风险发生的保护因素(OR<1,P<0.05)。结论收缩压、年龄、空腹血糖、总胆固醇、吸烟、饮酒及运动习惯为老年人心血管事件风险发生的影响因素,需采取对应干预措施,控制心血管事件发生率。     

Health-, medication- and dietary supplement-related behaviors and beliefs relatively unchanged during the COVID-19 pandemic lockdown

BackgroundThe lockdown imposed to counter the coronavirus disease 2019 (COVID-19) pandemic has evoked an unprecedented phenomenon that could affect health behaviors and beliefs.ObjectiveTo examine how medication-, dietary supplement- and health-related behaviors, beliefs and other psychological constructs changed in Polish online health service users during the COVID-19 pandemic lockdown.MethodsA one-time online survey accessed through a health service website was completed before and during the pandemic lockdown by separate samples of respondents. The survey examined beliefs about medicines and dietary supplements, consumption of dietary supplements, trust and contact with their advertisements, sources of dietary supplement knowledge as well as perceived health, diet, physical activity and smoking, among other things.ResultsThe study included 1560 participants. Most examined outcomes remained unchanged over COVID-19 pandemic lockdown. Beliefs that the dietary supplement quality is well controlled became significantly more pronounced during the lockdown (adjusted ratio of estimates 1.16, 95%CI 1.06–1.27, p = 0.001). Fewer people reported having contact with dietary supplement advertisements (adjusted odds ratio 0.59, 95%CI 0.43–0.83, p = 0.002).ConclusionsThe results may help understand some health-related issues associated with COVID-19 pandemic lockdown and may be used to shape aspects of health-related policy.     

A significantly joint effect between arsenic and occupational exposures and risk genotypes/diplotypes of CYP2E1, GSTO1 and GSTO2 on risk of urothelial carcinoma

Cigarette smoking, arsenic and occupational exposures are well-known risk factors for the development of urothelial carcinoma (UC). Therefore, the aim of this study is to investigate whether the effect of cigarette smoking, alcohol consumption, arsenic and occupational exposures on risk of UC could be modified by genetic polymorphisms of cytochrome P450 2E1 and glutathione S-transferase omega. A hospital-based case-control study consisted of 520 histologically confirmed UC cases, and 520 age- and gender-matched cancer-free controls were carried out from September 1998 to December 2007. Genotyping of CYP2E1, GSTO1 and GSTO2 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Subjects with both of cigarette smoking and alcohol consumption have a significantly increased UC risk (odds ratio [OR] = 2.9; 95% confidence interval [CI] = 1.9-4.4). Significantly increased UC risks of 1.5 and 1.9 were found for study subjects with high arsenic exposure and those who have been exposed to two or more occupational exposures, respectively. A significantly increased UC risk of 3.9 was observed in study subjects with H2-H2 diplotype of GSTO1 and GSTO2. The significantly highest UC risk of 9.0 was found for those with all environmental risk factors of cigarette smoking, alcohol consumption, arsenic and occupational exposures and two or more risk genotypes/diplotypes of CYP2E1, GSTO1 and GSTO2. Our findings suggest that a significantly joint effect of cigarette smoking, alcohol consumption, arsenic and occupational exposures and risk genotypes/diplotypes of CYP2E1, GSTO1 and GSTO2 on risk of UC was found.     

Microsomal epoxide hydrolase genotype and risk of myocardial infarction

DNA damage caused by mutagens found in tobacco smoke may contribute to the development of coronary heart disease (CHD). Microsomal epoxide hydrolase (EPHX1) is involved in the metabolism of tobacco smoke mutagens and an amino acid substitution (H139R) in exon 4 of the EPHX1 gene is associated with increased enzyme activity. The objective of this study was to investigate the effect of EPHX1 genotype on risk of myocardial infarction (MI) and to determine whether smoking interacts with genotype to modify risk. Cases (n = 2,022) with a first acute non-fatal MI and population-based controls (n = 2,022) living in Costa Rica, matched for age, sex and area of residence were genotyped by RFLP-PCR. Smoking status was determined by questionnaire. The frequency of the R139 allele was 17% for both cases and controls. EPHX1 genotype was not associated with risk of MI, regardless of smoking status. Compared to individuals with the HH genotype, the multivariate adjusted odds ratio (95% confidence interval) for risk of MI was 0.95 (0.81–1.11) for individuals with the HR genotype and 1.18 (0.79–1.76) for those with the RR genotype. These results suggest that EPHX1 does not play a significant role in the development of CHD.     

Smoking and alcohol use among women in Russia: Dual risk for prenatal exposure

Alcohol consumption during pregnancy can produce adverse outcomes; maternal smoking compounds this risk. We examined prevalence of smoking and associations between smoking and alcohol use in Russian women of childbearing age (N?=?648). Smoking was reported by 35% of nonpregnant and 14% of pregnant women. Smoking prevalence was higher (45%) among at-risk drinkers and those at risk for an alcohol-exposed pregnancy (AEP). In a multivariate model, smoking status and city of residence significantly predicted AEP risk. Pregnant women in urban locations were more likely to smoke. Smoking and alcohol misuse often co-occur among Russian women, presenting risk for dual prenatal exposure.