Alcohol Consumption During Pregnancy: Baseline Data from a Scottish Prospective Study

The results are reported from the first of four phases of a prospective study on the association between alcohol consumption during pregnancy and fetal harm. These data revealed a generally low level of alcohol consumption amongst the 1, 008 respondents. Self–reported alcohol consumption was slightly, but significantly, positively correlated with previous obstetric problems. Evidence from other studies indicates that between 1.8 per cent and 4.8 per cent of the study group may run an enhanced risk of producing damaged babies.     

The 16 per cent Solution and other Mysteries concerning the Accuracy of Alcohol Consumption Estimates based on Sales Data *

Whether based on production, tax or sales statistics, estimates of alcohol consumption are subject to bias arising from record keeping procedures and from unrecorded consumption. Based on an analysis of the accuracy of consumption estimates derived from sales statistics in Ontario, two significant biases are identified. The first problem concerns the use of 16 per cent as the conversion factor for wine. As the consumption of 12 per cent table wines has increased, this figure is no longer appropriate and results in an over estimation of total alcohol consumption by about 2 per cent. The second major problem is the unrecorded home production of wine and wine brandy, which results in an underestimation of consumption by about 6 to 7 per cent. The available evidence concerning other types of unrecorded production indicates that they are not significant. It is concluded that sales data underestimate ‘true’ alcohol consumption in Ontario by about 4 to 6 per cent at this time.     

Alcohol consumption among unemployed youths: results from a prospective study

A prospective study, including all 1083 pupils in the final year of compulsory schooling in a municipality in northern Sweden, was performed. Ninety-seven point nine per cent of the pupils were followed up after five years. They completed a comprehensive self-administered questionnaire including questions on alcohol consumption. Among men a positive correlation between long-standing unemployment (> 20 weeks) and alcohol consumption at the beginning and at the end of the study, as well as the change in consumption during the follow-up period was seen. This correlation was still present when earlier alcohol consumption and socio-economic variables were controlled for. In women there was a positive correlation between unemployment and the level of alcohol consumption, but a negative correlation between unemployment and change in consumption. When controlling for motherhood and alcohol intake at the start of the study the correlation turned positive. Unemployment among women did not seem to affect recruitment to the high consumption group. Our remits support the suggestion that unemployment may be a risk indicator for increasing alcohol consumption among young people, particularly in young men.     

The Prevalence of Disturbances of Eating Behaviour in a Portuguese Female University Population

This paper reports the results of a questionnaire constructed to identify the prevalence of bulimia nervosa (BN), binge eating and other manifestations of concern with body and shape and habits of consumption of alcohol, tobacco and illicit drugs among female university students in Lisbon. It was sent out to 1542 subjects and responses from 50.1 per cent were obtained. Among those students who responded, 55.1 per cent desired to lose weight, 25 per cent reported weight fluctuations in the previous year, 12 per cent were dieting at that moment and 48.8 per cent had been on a diet before. The prevalence of BN was 3 per cent and 13.2 per cent of subjects reported at least two binge eating episodes per week (binge-eaters). Bulimics and binge-eaters were heavier, wanted to lose more weight, had used diets before more frequently, and reported ponderal oscillations more frequently than controls. They also reported more frequent consumption of alcohol, tobacco and illicit drugs than controls, but this is not statistically significant.     

Effect of Economic Changes on Scottish Drinking Habits 1978–82

An increase in excise duty on beer and other alcoholic beverages in March 1981 caused their price to increase faster than the retail price index and average disposable incomes. Unemployment was rising simultaneously. The influence of these economic changes on drinking habits was explored by comparing the survey responses of 463‘regular drinkers’in the Lothians in 1978/79 and 1981/82. Total alcohol consumption fell by 18 per cent between these two occasions, and associated adverse effects by 16 per cent. The influences of social class, income, and employment and marital status, and of changes in these, were examined. Although rising unemployment was responsible for up to 20 per cent of the reduction in consumption, and heavy drinkers appeared to be selectively at risk of losing their jobs, the increased price of alcohol was the major influence. Heavy drinkers and dependent drinkers both reduced their consumption at least as much as light or moderate drinkers and suffered fewer adverse effects as a result. Increasing the excise duty on alcohol can therefore be an effective public health measure.     

Alcoholism in Black Male Heroin Addicts

This study systematically evaluates the presence of alcoholism and alcohol problems in a large sample of black male heroin addicts. Of 192 addicts 24 per cent were diagnosed as alcoholics and 13 per cent as probable alcoholics when objective criteria for alcoholism were used. An additional 19 per cent reported isolated problems with alcohol. Thus 56 per cent of this sample of addicts had experienced some problem because of alcohol. The occurrence of such problems as medical complications from alcohol and use of non-beverage alcohol indicates the seriousness of their alcohol use. Among subgroups of the study sample, the highest rate of alcoholism was in addicts currently addicted - 49 per cent; while the lowest rate of alcoholism was in addicts who were in successful treatment – 22 per cent. Thus, a sizeable portion of the heroin addict population is having problems from the use of two drugs - heroin and alcohol.     

Brief interventions in routine health care: a population-based study of conversations about alcohol in Sweden

Aims To investigate how brief alcohol interventions are delivered in routine practice in the Swedish health‐care system. Design, setting and participants A cross‐sectional sample of 6000 individuals representative of the adult population aged 18–64 years registered in the Swedish total population register was drawn randomly. Data were collected in 2010 by means of a mail questionnaire. The response rate was 54%. Measurements The questionnaire consisted of 27 questions, of which 15 variables were extracted for use in this study. Whether alcohol had been discussed and the duration, contents, experiences and effects of any conversations about alcohol, as reported by patients themselves, were assessed. Findings Sixty‐six per cent of the respondents had visited health‐care services in the past 12 months and 20% of these had had one or more conversations about alcohol during these visits (13% of the population aged 18–64 years). The duration of the conversations was generally brief, with 94% taking less than 5 minutes, and were not experienced as problematic. The duration, contents, experiences and effects of these conversations generally varied between abstainers, moderate, hazardous and excessive drinkers. Twelve per cent of those having a conversation about alcohol reported that it led to reduced alcohol consumption. Reduced alcohol consumption was more likely when conversations lasted for 1–10 minutes rather than less than 1 minute and included advice on how to reduce consumption. Conclusions Population survey data in Sweden suggest that when health‐care professionals give brief advice to reduce alcohol consumption, greater effects are observed when the advice is longer and includes advice on how to achieve it.     

Alcohol Consumption Among Victims of Violence and Among Comparable U.K. Populations

Controlled investigations of alcohol consumption in victims of assault are lacking. A prospective survey was performed to compare victims' drinking habits with age and sex matched U.K. populations. All 539 adult victims of assault who attended an inner-city Accident and Emergency (A and E) Department in 1986 were interviewed. Seventy-four per cent of male victims and 42% of female victims reported alcohol consumption in the 6 hours prior to assault: 30% of males and 4% of females had consumed <10 units. Forty per cent males and 25% of females exceeded established safe-levels of consumption while 16% of males and 26% of females demonstrated abnormally high gamma-GT levels. Mean expenditure on alcohol by assault victims was 14% of net income, compared to 7.5% by the U.K. adult population overall. Results suggested that young male victims of assault may not be distinguishable from other young males on the basis of habitual or binge alcohol consumption. Assault victims over 25 years of age drank excessively compared to control populations and should be a priority group for alcohol education programmes.     

Liver morphology in morbid obesity: a literature study

Literature on liver morphology in untreated obesity reveals varying prevalences of various pathological findings. The purpose of this literature study was to summarize and evaluate the published observations and to discuss discrepant findings. A complete search was aimed at utilizing bibliographic methods including a computerized survey. Forty-one original articles were included, comprising information on liver morphology in 1515 morbidly obese patients. Liver biopsy was considered normal in 12 per cent of the cases. The most frequent abnormality reported was fatty change, present in 80 per cent of the biopsies. Portal inflammation was also common (33 per cent). Fibrosis, mainly portal or periportal, was observed in 29 per cent. Cirrhosis, however, involved only 3 per cent. Study of relationships between the degree of liver change and certain possible pathogenetic factors (eg degree and duration of obesity, age, sex, alcohol consumption, diabetes mellitus) does not point towards a single causal factor. Co-influence of additional pathogenetic factors are likely in the development of liver changes in morbid obesity.     

Pulmonary function in alcoholics

Twenty-three chronic alcoholics were investigated by means of pulmonary function studies. All 23 patients had respiratory symptoms. Clinically, 21 (91 per cent) of 23 patients were diagnosed as having chronic bronchitis, and 14 patients (60 per cent) had dyspnea. The maximal mid-expiratory flow and single breath diffusing capacity for carbon monoxide (SBDCO) were abnormal in 16 (70 per cent) and 14 (61 per cent) patients, respectively. Twenty-two of 23 patients had one or more abnormal function. The total lung capacity, residual volume, vital capacity, 1 second forced expiratory volume and SBDCO progressively declined with increasing alcohol consumption. An attempt was made to separate the pulmonary effects of alcohol from (1) the effects of previous pulmonary infections, (2) the effects of cigarette smoking, and (3) the effects of cirrhosis of the liver. The data suggest that either alcohol itself through some unknown mechanism may be a causative agent in producing lung disease or that alcohol makes a higher percentage of the population susceptible to the harmful effects of cigarette smoking.     

Unemployment and use of drug and alcohol among young people: a longitudinal study in the general population

A prospective study of a representative sample of nearly 2000 young people aged 17–20 years was started in 1985. It was followed up twice, in 1987 and in 1989. The Central Bureau of Statistics in Norway was responsible for the data collection. Sixty-five per cent of the stratified sample (1985) participated in all the three surveys. The aim of this paper has been to explore the relationship between unemployment and the use of drugs and alcohol. The results show that unemployment does not appear to influence the consumption of alcohol. In a high consumption group, unemployment seems to lead to a decrease in alcohol consumption, though there was a clear tendency to increase use of cannabis. The results seem to indicate that there was no increase in use of alcohol or drugs in response to stress as a result of unemployment, though unemployment may lead to a stronger identification with or joining marginalized or deviant subcultures which in turn leads to an increased use of cannabis.     

The national addictions survey of Mexico

A probabilistic household survey was made with the following objectives: to estimate the prevalence of consumption of tobacco, alcohol and legal and illegal drugs; to identify attitudes and values, risk factors and problems associated with the consumption of addictive substances in a population from 12 to 65 years old, which resides in the urban areas of Mexico. This survey forms part of the National Health Surveys System, and its sample design is based on the Master Sample Framework of the National Health Surveys System, which gathered information representative of the national population and for seven regions. In the elaboration of the questionnaire indicators proposed by the World Health Organization (WHO), validated for Mexico, were used as well as previous knowledge about the topic. Thirteen thousand and five interviews were made, of which 96.7 per cent were complete and 2.6 per cent were rejected. In the group from 12 to 17 years old, 32 per cent of the men and 23 per cent of the women already consumed alcoholic drinks. The age group with the largest proportion of men who were frequent drinkers is from 30 to 39 years of age, with 36.3 per cent. For women 34.0 per cent of the frequent drinkers were found in the 40 to 49 year age group. It was found that six per cent of the population from 18 to 65 years of age is alcohol dependent, 12.5 per cent of men and less than one per cent of women. The population which smokes reaches 26 per cent of the total, with 38.3 per cent of men and 14.4 per cent of women. Forty two and four per cent of smokers are from 18 to 29 years of age. Among the daily smokers, 17 per cent were considered dependent on cigarettes. Only 4.8 per cent of the population admits having consumed some type of drug on at least one occasion, with the men from 12 to 34 years old being the age group which is most affected by the use of drugs (8.5%). Active users in the last year made up 2.1 per cent and in the last month the proportion of active users was less than one per cent. The most frequently used drug was marihuana (1%), the second used were tranquilizers (0.4%), and the third most frequently used were inhalants (glue, thinner) (0.26%). The most commonly consumed drug by male users was marihuana and by female users the most commonly used drug was stimulants.(ABSTRACT TRUNCATED AT 250 WORDS)     

Total Alcohol Consumption as an Index of Anxiety among Urbanised Africans

A relationship exists between anxiety and alcoholism; and as alcohol is an anxiolytic substance, any increase in prevailing alcoholism in a racial or national group is an index of anxiety in such a group. The increase in prevailing alcoholism based on total consumption has been noted on two occasions in respect of an influx controlled African population group, living in an African township in the South Western area of Johannesburg. On the first occasion, in 1969, ⁵ in this racial group there was an increase of total Bantu beer (3 per cent concentration] consumption from 15 million gallons per annum to nearly 30 million gallons per annum. Over a period of seven years the total consumption had doubled. On a second occasion recently we noticed a most significant drop in total Bantu beer consumption with a significant rise in total European type liquor consumption (40 per cent concentration), ¹² in this same population controlled African group. In 1969⁵ with the rise in the total Bantu beer consumption, we indicated that anxiety was present and its level was high, a situation confirmed by social workers and ministers of religion in close contact with, these people; presently on the second occasion, we have sufficient evidence (Table 2) to indicate that there has been compute change in the drinking pattern in this same African race group. The fact that this group has changed over from relatively mild traditional alcoholic beverage,1 to the use of high alcohol content loquor, with a rising total consumption, is indicative of the fact that anxiety is present and is maximal.     

Alcohol Consumption Between the Ages of 16 and 23 in Britain: a longitudinal study

Data on alcohol consumption were available in a national sample of young people at age 16 and again at 23. Twelve per cent of men consumed more than 50 units of alcohol per week at age 23, and 2% of women consumed more than 35 units, levels of intake which have previously been defined as heavy consumption. A comparison of drinking behaviour at the two ages showed that those who drank most and more frequently at 16 were the most likely to drink heavily at 23.     

Alcohol induced damage to the pancreas in patients with increased blood alcohol levels detected in road traffic

50 patients, driving motor-cars, having increased blood alcohol levels, were registrated and prosecuted. They voluntary underwent catamnestic researches for early diagnosis of alcohol induced lesions of the pancreas. In relation to the habitual drinking systems the study concluded 28 (56 per cent) healthy persons, 13 (26 per cent) alcohol endangered cases, 9 (18 per cent) alcoholics. Various biochemical parameters were changed, liver histomorphology resulted in about 50 per cent of cases a fatty degeneration of the liver and hepatitis. Special diagnostic methods (CCK-test, ERCP, ultrasound echography, computer-tomography) submitted in 24 per cent of cases suspect of alcohol induced pancreatitis. Results, which promote alcoholic pancreatic damage, are being discussed.     

Effects of Deprivation and Pre-loading on the Experimental Consumption of Tea by Alcoholics and Social Drinkers

An analogy was drawn between the so-called compulsive behaviours af over-eating and over-drinking. A study of drinking by alcoholics and social drinkers (of a non-alcoholic drink) was based on the example of experiments which have analysed the differential effects of various environmental cues on over-eating. During repeated ‘tea taste’ sessions which alternated deprivation and preloading experimental conditions, a differential pattern of consumption was recorded from 14 hospitalised alcoholics and 14 normal drinkers from the local community. The normal drinkers drank significantly more of their overall tolal consumption when deprived (63 per cent) but the alcoholics drank similar quantities whether deprived (51·7 per cent), or preloaded (48·3 per cent).     

Prevention strategies and alcohol policy

This paper addresses the potentials of high risk strategy and population strategy far preventing mortality from liver cirrhosis, accidents and suicide. The methodological approach is based on an integration of an empirical distribution of consumption and the risk functions of the damages at issue. According to the findings, the rate of alcohol-induced mortality from the three causes combined would be halved either by a 25 per cent decrease in overall consumption or a 36 per cent decrease in the alcohol consumption of the heavy drinkers (the top 5 per cent). The high risk strategy is most efficient in preventing cirrhosis; however the effect of the population strategy is also quite substantial here. The comparative advantage of the population strategy is most marked in connection with accidents and suicide, but the high risk approach yields an appreciable impact in this context as well. That is, neither of the two strategies appears as dearly superior to the other in terms of efficiency. The high risk strategy thus seems to be a sensible complement to the population strategy, and should have the potential of yielding effects on the population level if implemented on a large scale.     

Women's alcohol consumption and risk for alcohol-exposed pregnancies in Russia

Aims Alcohol‐exposed pregnancies (AEP) are the direct cause of fetal alcohol spectrum disorders (FASD). This study examines drinking patterns among pregnant and non‐pregnant women of childbearing age in Russia, a country with one of the highest levels of alcohol consumption in the world. Design Cross‐sectional survey. Setting Seven public women's clinics in two locations: St Petersburg (SPB) and the Nizhny Novgorod region (NNR). Participants A total of 648 pregnant and non‐pregnant childbearing‐age women. Measurements A face‐to‐face structured interview assessed alcohol consumption, pregnancy status/possibility of becoming pregnant and consumption before and after pregnancy recognition. Findings Eighty‐nine per cent of non‐pregnant women reported consuming alcohol and 65% reported binge drinking in the past 3 months; 47% in NNR and 28% in SPB reported binges at least monthly. Women who might become pregnant consumed alcohol similarly to women who were not likely to become pregnant, and 32% of women in SPB and 54% in NNR were categorized as at risk for AEP. There was a significant decline in drinking after pregnancy identification. Twenty per cent of pregnant women reported consuming alcohol and 6% in SBP (none in NNR) reported binge drinking; however, a high prevalence of binge drinking was found among women who might become pregnant or who were trying to conceive. Conclusions Russian women substantially reduce drinking after pregnancy recognition compared to pre‐pregnancy levels. No reductions were found prior to pregnancy recognition, either when a woman might become pregnant or when she was trying to conceive. The pre‐conception period presents a risk window and, therefore, a prevention opportunity.     

Alcohol use and mortality from coronary heart disease: the role of high-density lipoprotein cholesterol. The Multiple Risk Factor Intervention Trial Research Group.

OBJECTIVE: To study the association between alcohol consumption and death from coronary heart disease and to determine the extent to which the association can be explained by the high-density lipoprotein (HDL) cholesterol level. DESIGN: A cohort study involving men enrolled in the Multiple Risk Factor Intervention Trial (MRFIT). SETTING: Community-based study. PARTICIPANTS: Men (n = 11,688) at high risk for developing coronary heart disease but without clinical evidence of it. More than 90% of the men were white, and the average age was 46 years. Five percent of the men abstained from alcohol during the trial, 81% consumed fewer than 21 alcoholic drinks per week, and 14% consumed more than 21 alcoholic drinks per week. MEASUREMENTS: Average alcohol intake over 7 years was calculated for MRFIT participants who were alive at the end of the trial and who had at least three follow-up records of alcohol consumption. Post-trial mortality during a 3.8-year period was assessed. RESULTS: The adjusted relative risk for death from coronary heart disease for each increase of 7 drinks per week was 0.89 (95% CI, 0.80 to 1.00), with an apparent dose-response relationship. The average HDL level was associated with the average alcohol intake in a least-squares regression model (beta = -0.0074; P less than 0.01). When the average HDL level was included in the proportional hazards model for mortality from coronary heart disease, the absolute value of the coefficient for average drinks per week declined 45%, yielding an adjusted relative risk for each additional 7 drinks per week of 0.94 (CI, 0.84 to 1.05). CONCLUSION: In middle-aged men who are light to moderate drinkers, the inverse association between alcohol consumption and death from coronary heart disease can be explained, in large part, by the HDL cholesterol level, which increases with alcohol consumption. However, alcohol consumption cannot be recommended because of the known adverse effects of excess alcohol use.     

The liver in consecutive patients with morbid obesity: a clinical, morphological, and biochemical study

Liver morphology and biochemistry were investigated in 61 morbidly obese subjects selected by defined criteria. Median overweight was 82 per cent (range 61 to 170 per cent), and median duration of overweight was 20 years (range two to 45 years). No patient had more than a moderate alcohol consumption and only one was diabetic. Four biopsies (7 per cent) showed normal liver tissue, while fatty change was the main diagnosis in most cases (85 per cent). Increasing degrees of fatty change was significantly (P less than 0.02) associated with presence of lipogranulomas (found in 54 per cent of the biopsies), focal necroses (found in 28 per cent), slight parenchymal inflammation (found in 33 per cent), and Kupffer cell proliferation (found in 49 per cent). Slight portal inflammation was seen in 23 per cent but portal fibrosis in only 2 per cent of the biopsies. No case of cirrhosis was registered. Patients with moderate or severe fatty change, lipogranulomas , focal necroses or with parenchymal inflammation were significantly more obese than patients without these changes (P less than 0.05). Even in absence of fatty change, obese subjects showed a markedly decreased serum albumin concentration and an elevated serum alkaline phosphatase activity (P less than 0.0001) compared with non-obese controls. Serum lactate dehydrogenase and aspartate aminotransferase were significantly raised only in patients with fatty change. With respect to serum bilirubin and plasma cholesterol concentrations no significant differences were detected between patient subgroups and controls.(ABSTRACT TRUNCATED AT 250 WORDS)