The joint association of average volume of alcohol and binge drinking with hazardous driving behaviour and traffic crashes

BACKGROUND: Previous studies on alcohol-related road safety have not assessed the joint impact of average volume of alcohol and binge drinking. AIM: To examine the joint and separate association of average volume of alcohol and binge drinking with hazardous driving behaviour and traffic crashes. METHODS: Data were drawn from telephone interviews conducted in the period 2000-2005, with 12 037 individuals representative of the population aged 18-64 years in the Madrid region, Spain. The threshold between average moderate and heavy volumes was 40 g of alcohol/day in men and 24 g/day in women. Binge drinking was defined as intake of >or= 80 g of alcohol in men and >or= 60 g in women, during any drinking occasion in the preceding 30 days. Individuals were classified into the following categories: (i) non-drinkers; (ii) moderate drinkers with no binge drinking (MDNB); (iii) moderate drinkers with binge drinking (MDB); (iv) heavy drinkers with no binge drinking (HDNB); and (v) heavy drinkers with binge drinking (HDB). Analyses were performed using logistic regression, with adjustment for sex, age and educational level. FINDINGS: Frequency of inadequate seat-belt use increased progressively across categories of alcohol consumption, with odds ratio (OR) 1 in non-drinkers, 1.19 [95% confidence interval (CI) 1.06-1.33] in MDNB, 1.69 (1.41-2.03) in MDB, 1.68 (1.24-2.29) in HDNB and 2.41 (1.83-3.18) in HDB (P for trend <0.001). Compared with MDNB, alcohol-impaired driving was also more frequent in MDB (OR 7.43; 95% CI: 5.52-10.00), HDNB (OR 7.31; 95% CI: 4.37-12.25) and in HDB (OR 15.50; 95% CI: 10.62-22.61). Lastly, compared with non-drinkers, frequency of traffic crashes increased progressively across categories of alcohol consumption (P for trend=0.028), although it only reached statistical significance in HDB (OR 2.01; 95% CI: 1.00-4.09). CONCLUSIONS: Self-reported average volume of alcohol and binge drinking are both associated with self-reported hazardous driving behaviour and traffic crashes. The strength of the association is greater when average heavy consumption and binge drinking occur jointly.     

Smoking status as a clinical indicator for alcohol misuse in US adults

BACKGROUND: Screening for alcohol use in primary care settings is recommended by clinical care guidelines but is not adhered to as strongly as screening for smoking. It has been proposed that smoking status could be used to enhance the identification of alcohol misuse in primary care and other medical settings, but national data are lacking. Our objective was to investigate smoking status as a clinical indicator for alcohol misuse in a national sample of US adults, following clinical care guidelines for the assessment of these behaviors. METHODS: Analyses are based on a sample of 42 374 US adults from the National Epidemiological Survey on Alcohol and Related Conditions (Wave I, 2001-2002). Odds ratios (ORs), 95% confidence intervals (CIs), and test characteristics (sensitivity, specificity, positive and negative predictive values, and positive likelihood ratio of smoking behavior [daily, occasional, or former]) were determined for the detection of hazardous drinking behavior and alcohol-related diagnoses, assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV. RESULTS: Daily, occasional, and ex-smokers were more likely than never smokers to be hazardous drinkers (OR, 3.23 [95% CI, 3.02-3.46]; OR, 5.33 [95% CI, 4.70-6.04]; OR, 1.19 [95% CI, 1.10-1.28], respectively). Daily and occasional smokers were more likely to meet criteria for alcohol diagnoses (OR, 3.52 [95% CI, 3.19-3.90] and OR, 5.39 [95% CI, 4.60-6.31], respectively). For the detection of hazardous drinking by current smoking (occasional smokers + daily smokers), sensitivity was 42.5%; specificity, 81.9%; positive predictive value, 45.3% (vs population rate of 26.1%); and positive likelihood ratio, 2.34. For the detection of alcohol diagnoses by current smoking, sensitivity was 51.4%; specificity, 78.0%; positive predictive value, 17.8% (vs population rate of 8.5%); and positive likelihood ratio, 2.33. CONCLUSIONS: Occasional and daily smokers were at heightened risk for hazardous drinking and alcohol use diagnoses. Smoking status can be used as a clinical indicator for alcohol misuse and as a reminder for alcohol screening in general.     

Inverse relationship between alcohol consumption and active Helicobacter pylori infection: the Bristol Helicobacter project

OBJECTIVE: The aim of this study was to examine whether smoking or consumption of alcohol or coffee is associated with active Helicobacter pylori (H. pylori) infection. METHODS: This was a cross-sectional population study conducted as part of a randomized controlled trial of H. pylori infection eradication in southwest England. A total of 10,537 subjects, recruited from seven general practices, underwent 13C-urea breath testing for active infection with H. pylori and provided data on smoking, usual weekly consumption of alcohol, and daily intake of coffee. RESULTS: Smoking or coffee consumption were not related to active H. pylori infection. Total alcohol consumption was associated with a small, but not statistically significant, decrease in the odds of infection. After adjustment for age, sex, ethnic status, childhood and adult social class, smoking, coffee consumption, and intake of alcoholic beverages other than wine, subjects drinking 3-6 units of wine/wk had an 11% lower risk of H. pylori infection compared with those who took no wine: OR = 0.89, 95% CI = 0.80-0.99. Higher wine consumption was associated with a further 6% reduction in the risk of infection: OR = 0.83, 95% CI = 0.64-1.07. Intake of 3-6 units of beer (but no greater intake) was associated with a similar reduction in the risk of infection when compared to no beer intake (OR = 0.83, 95% CI = 0.75-0.91). CONCLUSIONS: This study indicates that modest consumption of wine and beer (approximately 7 units/wk) protects against H. pylori infection, presumably by facilitating eradication of the organism.     

Adverse outcomes of alcohol use in adolescents

Aims . To compare the occurrence of behaviours occurring under the influence of alcohol in 16-17-year-olds and determine associated risk factors for the different behaviours.
Design/setting . Cross-sectional survey administered by laptop computers in secondary schools across the state of Victoria, Australia.
Measurement/findings . The participation rate was 79%. Seventy per cent of participants drank alcohol; 17% of drinkers reported alcohol-related violence (accidents or injuries) and 15% reported problems relating to sex under the influence of alcohol (having sex and later regretting it or having had unsafe sex) in the previous 12 months. Males were more likely to report alcohol-related violence (20% compared to 14% females). Almost one in 10 young people reported having sex while under the influence of alcohol and later regretting it and 10% reported having had unsafe sex. There were no significant gender differences in the reporting rates of alcohol-related sexual risk taking (prop. cum. OR 1.1, 95% CI 0.68-1.9). For alcohol-related injuries, strong independent associations were found with dose of alcohol consumed (prop. cum. OR 2.3, 95% CI 1.3-4.0), frequency of alcohol consumption (prop. cum. OR 2.7, 95% CI 0.94-7.5), antisocial behaviour (prop. cum. OR 2.4, 95% CI 1.4-4.1) and peer drinking (prop. cum. OR 3.3, 95% CI 1.4-8.1). For alcohol-related sexual risk-taking, psychiatric morbidity (prop. cum. OR 4.1, 95% CI 1.9-9.0) and high frequency of alcohol consumption (prop. cum. OR 2.0, 95% CI 0.87-4.6) had strong independent associations.
Conclusions . Physical injury and high-risk sexual behaviour under the influence of alcohol are common in teenagers. Alcohol-related physical injury appears closely related to patterns of alcohol consumption whereas alcohol-related sexual risk-taking is most closely associated with symptoms of depression and anxiety.     

Interaction of alcohol intake and cofactors on the risk of cirrhosis

Objective: Evaluation of the interaction between alcohol intake and cofactors [hepatitis B virus (HBV), hepatitis C virus (HCV), body mass index] and coffee consumption on the risk of cirrhosis. Design: Seven hundred and forty‐nine consecutive patients with chronic liver disease referring to units for liver or alcohol diseases in Italy during a 6‐months period. Teetotalers were excluded. The odds ratios (OR) for cirrhosis were evaluated using chronic hepatitis cases as the control group. Results: An alcohol intake of more than 3 units/day resulted associated with the likelihood of cirrhosis both in males (OR 4.3; 95% CI=2.5–7.3) and in females (OR 5.7; 95% CI=2.3–14.5). A multiplicative interaction on the risk of cirrhosis between risky alcohol intake and HBsAg or HCV‐Ab/HCV‐RNA positivity was observed. A reduction of cirrhosis risk was observed in subjects consuming more than 3 alcohol units/day with increasing coffee intake. The OR for the association with cirrhosis decreased from 2.3 (95% CI=1.2–4.4) in subjects drinking 0–2 cups of coffee/day to 1.4 (95% CI=0.6–3.6) in those drinking more than 2 cups/day. Conclusions: In subjects with an alcohol intake >3 units/day the coexistence of HBV or HCV multiplies the risk of cirrhosis. Coffee represents a modulator of alcoholic cirrhosis risk.     

The J-shape effect of alcohol intake on the risk of developing acute coronary syndromes in diabetic subjects: the CARDIO2000 II Study.

AIMS: To identify the threshold of alcohol consumption above which the balance of risk and benefit becomes adverse in diabetic subjects. METHODS: We studied demographic, lifestyle, dietary and clinical information in 216 hospitalized diabetic patients (171 men, 63 +/- 9 years old, 45 women, 67 +/- 5 years old) with a first event of an acute coronary syndrome (ACS) and 196 frequency matched (age-sex) diabetic controls, without any clinical evidence of coronary heart disease. Alcohol consumption was quantified and a measure for the comparisons was predetermined to be a wine glass (100 ml of wine, 12 g of ethanol) and its alcohol equivalents. RESULTS: Alcohol consumption was associated with an age-adjusted J-shape relationship with total cholesterol, blood pressure and smoking (all P < 0.001). A J-shape association was also found between alcohol intake and the risk of ACS (OR = 2.54-2.43 x (alcohol intake) + 0.80 x (alcohol intake)2, R2 = 0.96, P < 0.001), adjusted for several risk factors and interactions between alcohol intake and smoking status, job and familial stress, and low income. In particular, low alcohol consumption (< 12 g/day) was associated with a 47% (OR = 0.53, 95% CI 0.28-0.97) reduction of the prevalence of ACS, while a higher intake (12-24 and > 24 g/day) increased the prevalence by 2.7-fold (OR = 2.72, 95% CI 1.39-5.38) and 5.4-fold (OR = 5.44, 95% CI 1.21-24.55), respectively. CONCLUSIONS: Alcohol intake is a significant predictor of coronary events. Low-to-moderate intake seems to be associated with a reduction in the prevalence of ACS in diabetes, whereas higher consumption is associated with an increase in lipids and blood pressure levels, and also the risk of developing ACS.     

Alcohol use, physical performance, and functional limitations in older men

OBJECTIVES: To describe associations between recent alcohol intake, physical performance, and functional limitations in older men. DESIGN: Cross-sectional study. SETTING: Six U.S. clinical centers. PARTICIPANTS: Five thousand nine hundred sixty-two men aged 65 and older. MEASUREMENTS: Self-reported functional limitations; problem drinking history (>or=2 positive responses on the CAGE questionnaire); history of sustained excessive drinking (history of consumption of >or=5 drinks/day on most days); and alcohol intake categorized by drinks/week (0=abstainers, n=2,116; < 1=intermittent, n=739); 1 to <7= light, n=1,563; 7 to <14=low-moderate, n=848; 14 to <21 =high-moderate, n=459; and >or=21=heavy, n=237). Grip strength, leg power, chair stand, and walking tests were completed during a standard examination. RESULTS: After age adjustment, men with low-moderate or high-moderate intake generally performed 3% to 5% better on physical performance tests than abstainers; heavy drinkers performed similarly to abstainers. These associations lessened yet tended to remain significant after multivariate adjustment. Men with low-moderate alcohol intake had the lowest odds of reporting a limitation in instrumental activities of daily living (multivariate-adjusted odds ratio (OR)=0.52, 95% confidence interval (CI)=0.39-0.69) compared to abstainers; similar odds were seen for high-moderate and heavy use. The association between alcohol intake and self-reported physical limitation was U-shaped, with the highest odds of physical limitation in abstainers (OR=1.0, referent) and heavy users (OR=0.88, 95% CI=0.58-1.36) and the lowest odds in low-moderate users (OR=0.62, 95% CI=0.46-0.95). CONCLUSION: Moderate alcohol intake was associated with modestly better physical performance and lower odds of reporting a functional limitation in older men.     

Effects of moderate alcohol consumption on inflammatory biomarkers

OBJECTIVES: Although light to moderate alcohol consumption has been associated with lower all-cause and cardiovascular (CV) mortality, the underlying mechanisms are only partly understood. Evidence has emerged in recent years that atherosclerosis is an inflammatory disease. We hypothesize that beneficial effects of moderate alcohol consumption on CV mortality may be linked to antiinflammatory effects. METHODS AND RESULTS: The association between alcohol consumption and concentrations of high sensitivity C-reactive protein (hs-CRP) and fibrinogen were investigated. Six hundred and thirtysix eligible individuals apparently healthy were included. 393 (61.8%) were men and 243 (38.2%) were women. The mean ages for men and women were 51.5 +/- 12.4 y and 50.8 +/- 12.1 y, respectively. Daily alcohol intake showed an apparent U-shaped association with hs-CRP and fibrinogen values in men, with lowest levels at an alcohol intake of 20-70 g daily (0.139 +/- 0.116 mg/dl for hs-CRP and 274 +/- 51.7 mg/dl for fibrinogen). Proportional odds model analysis showed moderate alcohol consumption (20 to 70 g vs. no drinking per day, OR = 0.32, 95% CI: 0.14-0.74), and regular exercise (> or = 3 times/week vs. no, OR = 0.52, 95% CI: 0.35-0.77) were negatively correlated with elevated hs-CRP values. CONCLUSIONS: Our results parallel the demonstration of a U-shaped relationship between alcohol consumption and cardiovascular mortality, and suggest that anti-inflammatory effects of moderate alcohol intake may partly be linked to a low cardiovascular and overall mortality.     

Cigarette, alcohol use and physical activity among Myanmar youth workers, Samut Sakhon Province, Thailand

Over 1.2 million migrants from Myanmar are currently residing in Thailand. Little information is known about Myanmar youth risk behaviors. This cross-sectional study aimed to determine the prevalence and the factors associated with cigarette and alcohol use, and physical inactivity, among Myanmar youth working in a harbor town in Samut Sakhon Province, Thailand. One hundred and seventy-seven young workers aged 15-24 years, living in the study area, were interviewed by structured questionnaire. About 21.5% were current smokers, 25.4% were alcohol drinkers, and 36.7% were physically inactive. Univariate analysis indicated one variable was significantly associated with cigarette smoking: education level higher than primary school (OR=2.3, 95% CI 1.02-5.0), Three variables were significantly associated with alcohol drinking: married status (OR=2.2, 95%CI 1.02-4.5); non-seafood-processing workers, i e, street vendors, construction laborers, etc. (OR=3.4, 95% CI 1.7-7.1), and high job stress due to supervisor/boss (OR=2.1 95% CI 1.1-4.2). Two variables were significantly associated with physical inactivity: female youth (OR=3.9 95% CI 2.1-7.5), and education level higher than primary school (OR=0.4, 95% CI 0.2-0.8). The prevalence of smoking, alcohol drinking and physical inactivity among Myanmar migrant youths was quite high. Government and non-government organizations should co-operate to provide interventions to reduce youths' risk behaviors.     

Alcohol and Self-Rated Health in a Mediterranean Country: The Role of Average Volume, Drinking Pattern, and Alcohol Dependence

Background: The association between average alcohol consumption and self‐rated ill‐health is “J‐shaped” in Scandinavian and Anglo‐Saxon countries, but it has shown an inverse linear relationship in the few studies conducted in Mediterranean countries, based on average volume solely. Objective: To examine the relationship between alcohol and self‐rated health in the general population of a Mediterranean country, by simultaneously taking into account average volume, drinking pattern, and alcohol abuse. Methods: From 2000 to 2005, we conducted telephone interviews on 12,037 persons, representative of the population aged 18 to 64 years in Madrid, Spain. The drinking pattern encompassed binge drinking, beverage preference, and drinking at mealtimes. Alcohol abuse was estimated by the CAGE test. The association between each alcohol‐related variable and self‐rated suboptimal (fair, poor, or very poor) health was estimated from logistic regression, with adjustment for the remaining alcohol‐related variables and other potential confounders. Results: In comparison with never‐drinkers, suboptimal health was less frequent among occasional drinkers [odds ratio (OR) 0.72; 95% confidence interval (CI): 0.61 to 0.86], average moderate drinkers (OR 0.57; 95% CI: 0.48 to 0.69), and excessive drinkers (OR 0.51; 95% CI: 0.36 to 0.72), but more frequent among former drinkers with ≥1 year of abstinence (OR 1.30; 95% CI: 1.03 to 1.64). Frequency of suboptimal health was likewise higher in subjects with ≥3 episodes of binge drinking (OR 1.55; 95% CI: 1.12 to 2.14) or alcohol abuse (OR 1.47; 95% CI: 1.22 to 1.76). No differences were observed in suboptimal health according to beverage preference or drinking at mealtimes. Results in each gender were similar to those for total study participants. Conclusions: Occasional, moderate, and excessive consumption of alcohol are associated with better self‐rated health, even after adjustment for drinking pattern and alcohol abuse. In contrast, former‐drinking, frequent binge drinking, and alcohol abuse are all associated with suboptimal self‐rated health.     

Alcohol intake and the risk of osteonecrosis of the femoral head in Japanese populations: a dose-response meta-analysis of case-control studies

Studies examining the association between alcohol intake and the risk of osteonecrosis of the femoral head (ONFH) have inconsistent results. The purpose of this study was to examine and summarize the evidence regarding the association between alcohol intake and ONFH based on results from case-control studies. This analysis included five case-control studies reporting data from 1251 individuals. Alcohol intake habits (never, former, or current), average drinking consumption (g/week), and cumulative drinking consumption (drink-years) were extracted. The risk of ONFH was evaluated, and a two-stage dose-response meta-analysis was performed using restricted cubic splines with four knots at fixed percentiles of 5, 35, 65, and 95% of the distribution. Former alcohol intake increased the risk of ONFH with a marginal significance (odds ratio [OR], 2.62; p = 0.055). Current alcohol intake was associated with an increased risk of ONFH (OR, 3.63; p < 0.001 in occasional drinkers, OR, 5.90; p < 0.001 in daily drinkers). The dose-response meta-analysis revealed that the risk of ONFH increased by 35.3% for every 100 g/week (95% confidence interval [CI], 1.24–1.47; p < 0.001) and by 44.1% for every 500 g drink-years (95% CI, 1.295–1.601; p < 0.001). Current intake and the dose of alcohol were positively associated with an increased risk of ONFH in a non-linear pattern.     

Women's gender role orientation predicts their drinking patterns: a follow-up study of Czech women

AIMS: Evaluation of the hypothesis that women's non-traditional gender role orientation contributes to drinking patterns typical for men. DESIGN: A two-wave prospective study with data collected in 1992 and 1997. SETTING: The data reflect Czech women's changing gender role orientation and their drinking patterns during a historical period of post-totalitarian societal transformation. PARTICIPANTS: A representative cohort of 497 Prague women aged 30-59 years in 1997. MEASUREMENTS: Face-to-face interview data on drinking patterns and individually collected original questionnaire on gender role orientation. FINDINGS: An analysis of the principal components of the gender role orientation questionnaire has led to four components, designated as egalitarianism, liberalism, feminism and hedonism. Constructed role orientation scales had Cronbachs's alpha reliabilities ranging from 0.57 to 0.74. With possible confounders controlled (thanks mainly to the prospective design), non-traditional gender role orientation components assessed in 1992 predicted the usual quantities of alcohol women have consumed per occasion in 1997, as well as three hazardous drinking patterns (occasional use of > or = 96 g alcohol, usual use of > or = 48 g and daily intake of > or = 40 g). Specifically, women's usual quantity per occasion and occasional use of > or = 96 g were predicted by egalitarianism and hedonism, and hedonism predicted usual use of > or = 48 g as well as average daily intake of > or = 40 g ethanol. CONCLUSIONS: Women's gender role orientation can be associated with their drinking patterns with non-traditional gender role identification being associated with greater likelihood of hazardous drinking.     

Association between alcohol intake and metabolic syndrome in patients with hypertension

The aim of this study was to determine how alcohol consumption influences metabolic syndrome in patients with hypertension. The subjects were 3938 male workers being treated with anti-hypertensive drugs and they were divided into four groups by average ethanol intake [non-, light (<22 g/day), moderate (≥22 and <44 g/day), and heavy (≥44 g/day) drinkers]. The relationships of alcohol intake with atherosclerotic risk factors and metabolic syndrome were investigated. Waist circumference and hemoglobin A1c were significantly smaller and lower, respectively, in light, moderate, and heavy drinkers than in nondrinkers. Systolic blood pressure and log-converted triglyceride were significantly higher in heavy drinkers than in nondrinkers. HDL cholesterol was significantly higher in all of the drinker groups than in nondrinkers and tended to be higher as alcohol intake increased. Prevalence of metabolic syndrome was significantly lower in light, moderate, and heavy drinkers than in nondrinkers. Age- and smoking history-adjusted odds ratios (ORs) vs. nondrinkers for metabolic syndrome were significantly low in light drinkers (OR = 0.71, 95% confidence interval [CI]: 0.56-0.89), moderate drinkers (OR = 0.64, 95% CI: 0.54-0.75) and heavy drinkers (OR = 0.68, 95% CI: 0.57-0.82). The results suggest that alcohol drinking is associated with a lower risk of metabolic syndrome in patients with hypertension.     

Moderate alcohol consumption and hearing loss: a protective effect

OBJECTIVE: To determine if moderate alcohol consumption is associated inversely with hearing loss in a large population based study of older adults. DESIGN: Cross-sectional population based cohort study. Data are from the 1993-1995 examinations for the population based Epidemiology of Hearing Loss Study (EHLS) (n = 3571) and the Beaver Dam Eye Study (BDES) (n = 3722). SETTING: Midwestern community of Beaver Dam, Wisconsin. PARTICIPANTS: Residents of Beaver Dam aged 43 to 84 in 1987-1988 were eligible for the BDES (examinations in 1988-1990 and 1993-1995). During 1993-1995, this same cohort was eligible to participate in the baseline examination for the EHLS. MEASUREMENTS: Hearing thresholds were measured by pure tone air and bone conduction audiometry (250-8000 Hz.). History of alcohol consumption in the past year, heavy drinking (ever), medical history, occupation, noise exposure, and other lifestyle factors were ascertained by a questionnaire that was administered as an interview. RESULTS: In multiple logistic regression analyses controlling for potential confounders, moderate alcohol consumption (>140 grams/week) was inversely associated with hearing loss (PTA(.5,1,2,4 > 25 dB HL); odds ratio [OR] = .71, 95% confidence interval [CI] = .52, .97; where PTA is pure tone average). A similar association was found for moderate hearing loss (PTA(.5,1,2,4 > 40 dB HL); OR = 0.49, 95% CI = 0.32, 0.74). Alcohol consumption was associated inversely with the odds of having a low frequency hearing loss (OR = 0.61) or a high frequency hearing loss (OR = 0.60). These findings did not vary significantly by age or gender. There was an increase in the odds of having a high frequency hearing loss (OR = 1.35, 95% CI = 1.04, 1.75), in those with a history of heavy drinking (> or =4 drinks/day). Including cardiovascular disease or its related factors did not significantly attenuate the protective effect. CONCLUSIONS: There is evidence of a modest protective association of alcohol consumption and hearing loss in these cross-sectional data. This finding is in agreement with a small body of evidence suggesting that hearing loss is not an inevitable component of the aging process.     

Brief interventions for hazardous drinkers delivered in primary care are equally effective in men and women

Background Despite the accumulated evidence on the efficacy of brief interventions in hazardous drinkers some ambiguity remains regarding their differential effectiveness by gender. Methods Meta‐analysis of independent studies conducted in primary health care settings with a follow‐up of 6–12 months which report results separately by gender. Two outcome measures were selected: the quantity of typical weekly alcohol consumption and the frequency of drinkers who reported consumption below hazardous levels after the intervention. Results Seven studies were included in the meta‐analysis. The standardized effect sizes for the reduction of alcohol consumption were similar in men (d =? 0.25; 95% CI = ? 0.34 to ?0.17) and women (d = ? 0.26; 95% CI = ? 0.38 to ? 0.13). The odds ratios (OR) for the frequency of individuals who drank below harmful levels were also similar (four studies; OR for men = 2.32; 95% CI = 1.78–2.93; OR for women = 2.31; 95% CI = 1.60–3.17). The difference between genders was negligible. Conclusion Our results support the equality of outcomes among men and women achieved by brief interventions for hazardous alcohol consumption in primary care settings.     

Cigarette smoking and alcohol consumption associated with gastro-oesophageal reflux disease in Japanese men

BACKGROUND: Associations between lifestyle factors and gastro-oesophageal reflux disease (GORD) have been conflicting. We aimed to examine these associations in Japanese men. METHODS: We performed a cross-sectional study of Japanese male workers who visit a clinic for a routine health check-up and asked them to fill out a self-report questionnaire. Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI) for GORD, defined as heartburn and/or acid regurgitation at least twice weekly. RESULTS: Of the 4095 eligible subjects, 276 (6.7%) were diagnosed as having GORD. Current smoking was significantly associated with CORD compared with non-smoking (OR = 1.35, 95% CI, 1.01-1.82). Moderate drinking (16-37 mL/day) and heavy drinking (> or = 38 mL/day) were also associated with GORD, while age and body mass index were not. After adjustment for age, daily alcohol consumption and body mass index, an increase in number of pack-years of cigarette smoking was significantly associated with an increased OR of GORD (P for trend = 0.034), and the OR for persons whose number of pack-years of cigarette smoking was more than 20.1 was 1.45 (CI 1.04-2.04) compared with non-smokers. CONCLUSION: Cigarette smoking and alcohol consumption are associated with an increased odds ratio for GORD in Japanese men.     

Alcohol use and non‐adherence to antiretroviral therapy in HIV‐infected patients in West Africa

Aim To investigate the association between alcohol use and adherence to highly active antiretroviral treatment (HAART) among human immunodeficiency virus (HIV)‐infected patients in subSaharan Africa. Design and setting Cross‐sectional survey conducted in eight adult HIV treatment centres from Benin, Côte d'Ivoire and Mali. Participants and measurements During a 4‐week period, health workers administered the Alcohol Use Disorders Identification Test to HAART‐treated patients and assessed treatment adherence using the AIDS Clinical Trials Group follow‐up questionnaire. Findings A total of 2920 patients were enrolled with a median age of 38 years [interquartile range (IQR) 32–45 years] and a median duration on HAART of 3 years (IQR 1–4 years). Overall, 91.8% of patients were identified as adherent to HAART. Non‐adherence was associated with current drinking [odds ratio (OR) 1.4; 95% confidence interval (CI) 1.1–2.0], hazardous drinking (OR 4.7; 95% CI 2.6–8.6) and was associated inversely with a history of counselling on adherence (OR 0.7; 95% CI 0.5–0.9). Conclusions Alcohol consumption and hazardous drinking is associated with non‐adherence to HAART among HIV‐infected patients from West Africa. Adult HIV care programmes should integrate programmes to reduce hazardous and harmful drinking.     

Alcohol use among HIV-infected persons in care: results of a multi-site survey

OBJECTIVE: We sought to determine the prevalence of any alcohol use and hazardous alcohol consumption among HIV-infected individuals engaged in care and to identify factors associated with hazardous alcohol use. METHODS: During 2003, 951 patients were interviewed at 14 HIV primary care sites in the USA. Hazardous drinking was defined as >14 drinks/week or >or=5 drinks/occasion for men and >7 drinks/week or >or=4 drinks/occasion for women. Moderate alcohol use was consumption at less than hazardous levels. We used logistic regression to identify factors associated with any alcohol use and hazardous alcohol use. RESULTS: Forty per cent of the sample reported any alcohol use in the 4 weeks prior to the interview; 11% reported hazardous use. In multivariate regression, male sex [adjusted odds ratio (AOR) 1.52 (95% confidence interval, CI, 1.07-2.16)], a college education (compared toor=500 cells/microL [AOR 2.65 (1.23-5.69)] and illicit drug use [AOR 2.67 (1.48-4.82)] were associated with increased odds of hazardous alcohol use (compared to moderate and none). CONCLUSIONS: Alcohol use is prevalent among HIV-infected individuals and is associated with a variety of socioeconomic and demographic characteristics. Screening for alcohol use should be routine practice in HIV primary care settings.     

Risk factors for sporadic colorectal cancer in southern Chinese

AIM： To investigate the role of smoking, alcohol drinking, family history of cancer, and body mass index （BMI） in sporadic colorectal cancer in southern Chinese. METHODS： A hospital-based case-control study was conducted from July 2002 to December 2008. There were 706 cases and 723 controls with their sex and age （within 5 years） matched. An unconditional logistic regression model was used to analyze the association between smoking, alcohol drinking, family history of cancer, BMI and sporadic colorectal cancer. RESULTS： No positive association was observed between smoking status and sporadic colorectal cancer risk. Compared with the non alcohol drinkers, the current and former alcohol drinkers had an increased risk of developing sporadic colorectal cancer （CRC） （adjusted OR = 8.61 and 95% CI = 6.15-12.05, adjusted OR = 2.30, 95% CI = 1.27-4.17）. Moreover, the increased risk of developing sporadic CRC wassignificant in those with a positive family history of cancer （adjusted OR = 1.62, 95% CI = 1.12-3.34） and in those with their BMI ≥ 24.0 kg/m^2 （adjusted OR = 1.39, 95% CI = 1.10-1.75）. Stratification analysis showed that the risk of developing both colon and rectal cancers was increased in current alcohol drinkers （adjusted OR = 7.60 and 95% CI = 5.13-11.25; adjusted OR = 7.52 and 95% CI = 5.13-11.01） and in those with their BMI ≥ 24.0 kg/m^2 （adjusted OR = 1.38 and 95% CI = 1.04-1.83; adjusted OR = 1.35 and 95% CI = 1.02-1.79）. The risk of developing colon cancer, but not rectal cancer, was found in former alcohol drinkers and in those with a positive family history of cancer （adjusted OR = 2.51 and 95% CI = 1.24-5.07; adjusted OR = 1.82 and 95% CI = 1.17-2.82）. CONCLUSION： Alcohol drinking, high BMI （≥ 24.0 kg/m^2） and positive family history of cancer are the independent risk factors for colorectal cancer in southern Chinese.