Socialization to binge drinking: A population-based,longitudinal study with emphasis on parental influences

Background

Binge drinking is associated with considerable harm. However, too little is known about socialization to this pattern of alcohol consumption.

Aim

To identify longitudinal predictors of young adult binge drinking, with an emphasis on possible parental influences.

Methods

A population-based prospective study, in which respondents (N = 2558) were surveyed from mid-adolescence until their late 20 s. The data set was linked to national registers. Data were collected on parental alcohol consumption, parental binge drinking and parental alcohol problems, as well as on other aspects of the family milieu. The respondents’ frequency of alcohol consumption was assessed, as well as a number of binge drinking measures: (i) frequency of intoxication episodes, (ii) frequency of consuming 5+ units, and (iii) “usual” consumption patterns of 5–6+ units, 7–9+ units, and 10+ units.

Results

A surprisingly high proportion of the sample met the criteria for binge drinking. After control for parental, peer and individual characteristics, parental binge drinking predicted respondents’ binge drinking, using all definitions, at age 28 years (p < .001). Parental frequency of alcohol consumption predicted frequency of alcohol consumption in their offspring at age 28 (p < .001).

Conclusion

The findings suggest a socialization pattern of alcohol role modeling from parents to offspring. The findings are also consistent with genetic research showing alcohol use to have moderate heritability. We may witness new binge drinking cultures in Norway, but binge drinking patterns also seem to echo parental influences.     

Self-perceived problem with alcohol use among opioid substitution treatment clients

Background and aim

Excessive alcohol use increases mortality and morbidity among opioid substitution therapy (OST) clients. Regular attendance for OST dosing presents key opportunities for screening and treatment. However, individuals' perception of their alcohol consumption as problematic or otherwise may impact their willingness to change. This study examines patterns of alcohol consumption among OST clients, perceptions of their own use and correlates of excess consumption.

Methods

Confidential, structured interviews were conducted with 264 clients of two Sydney OST clinics. Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test (AUDIT); and illicit drug dependence with the Severity of Dependence Scale.

Results

Forty-one percent of the participants scored ≥ 8 on the AUDIT (‘AUDIT-positive’), indicating excessive alcohol use. The higher a participant's AUDIT score, the more likely they were to demonstrate insight into the potential problems associated with their drinking (linear trend, p < 0.01). However, only half of AUDIT-positive participants believed they drank too much and/or had a problem with alcohol. One-third had discussed their drinking with OST staff, and a similar proportion reported a history of alcohol treatment. AUDIT-positive participants were more likely than others to be classified as dependent on an illicit drug in the last six months (AOR = 1.76, 95% CI:1.00–3.09), report a history of alcohol treatment (AOR = 5.70, 95% CI:2.83–11.48) and believe it is safe to drink 4 + standard drinks in one session (AOR = 5.30, 95% CI:2.79–10.06).

Conclusions

OST clients with AUDIT scores ≥ 8 appear to underestimate the risks associated with their alcohol consumption. Regular assessments of alcohol use and targeted brief alcohol interventions may improve health outcomes among OST clients.     

Implicit alcohol cognitions in risky drinking nicotine users with and without co-morbid major depressive disorder

Objective

Alcohol consumption, nicotine use, and major depressive disorder (MDD) are highly co-morbid. The negative reinforcement model of addiction would suggest that smokers may consume alcohol to relieve negative affective symptoms, such as those associated with MDD and withdrawal from nicotine. Over time, these behaviors may become so strongly paired together that they automatically activate a desire to use alcohol, even in the absence of conscious or deliberate intention. This study examined implicit alcohol cognitions in 146 risky drinking nicotine users (n = 83) and non-users (n = 63), to help uncover cognitive mechanisms that link drinking, nicotine use, and depression together. We proposed that nicotine users with a history of MDD would have stronger implicit motivations to drink than non-nicotine users without MDD.

Method

Participants were assessed on lifetime MDD (n = 84) or no MDD (n = 62), and then completed an Implicit Association Task designed to test the strength of associations between alcohol pictures and “approach” words.

Results

Regression analyses showed that implicit alcohol–approach attitudes were stronger among risky drinking nicotine users than non-users. Alcohol–approach motivations were also stronger among risky drinking nicotine users compared to non-users with a history of MDD; nicotine use was unrelated to implicit alcohol cognitions for risky drinkers without MDD.

Conclusions

Implicit cognitive processes may be targeted in behavioral and pharmacological treatments in risky drinking nicotine users, particularly those with depression comorbidity.     

Test–retest reliability of an online measure of past week alcohol consumption (the TOT-AL), and comparison with face-to-face interview

Objective

This paper reports on the development of a new online measure of beverage-specific past week alcohol consumption (the TOT-AL), its test–retest reliability, and comparability with the face-to-face approach of ascertaining alcohol intake.

Methods

University students participating in the reliability study completed the TOT-AL twice on the same day with at least 3 h apart. Students in the comparability study attended a face-to-face interview and completed the TOT-AL on the same day, in a randomised order, at least 3 h apart.

Results

There was a strong correlation between the repeated measurements of the TOT-AL (r = 0.99; 95% CI: 0.98, 0.99) and between the units calculated by the TOT-AL and the face-to face interview (r = 0.97; 95% CI: 0.95, 0.99). A high level of agreement between measurements was also observed in a Bland–Altman analysis.

Conclusions

The TOT-AL is a reliable, time efficient means of ascertaining alcohol intake, equivalent to that obtained face-to-face. These findings support the use of this approach to online alcohol assessment in populations with access to the Internet.     

Social desirability biases in self-reported alcohol consumption and harms

Aims

Self-reports remain the most common means of assessing alcohol consumption despite concern for their validity. The objective of this research is to assess the extent to which social desirability biases relate to self-reported consumption, hazardous use, and harms.

Methods

In each of two studies presented, undergraduate students (N = 391 and N = 177) who reported that they had consumed alcohol in the past year completed online confidential surveys.

Results

Both studies show consistent associations between impression management bias and self-reported consumption such that high impression managers report 20 to 33% less consumption and are about 50% less likely to report risky drinking. No significant correlations involving consumption were found for self-deception bias. Study 2 also indicated that high impression managers report 30–50% fewer acute harms following a drinking episode, and that these effects are maintained after controlling statistically for trait impulsivity/constraint.

Conclusions

Impression management bias represents a significant threat to the validity of self-reported alcohol use and harms. Such bias may lead to misspecification of models and under-estimates of harmful or hazardous use.     

Alcohol intake and its correlates in a transitional predominantly Muslim population in southeastern Europe

Objective

Our aim was to assess alcohol consumption and its correlates in Albania, a predominantly Muslim though largely secular Southeast European republic in transition from rigidly structured socialism to a market-oriented system.

Methods

A population-based sample of Tirana residents aged 35–74 years was interviewed and examined in 2003–2006 (450 men and 235 women with data on alcohol intake, 65.5% response). Multivariable-adjusted logistic regression was used to assess the association of drinking frequency, quantity and type of drink with socioeconomic, psychosocial and coronary risk characteristics.

Results

30.6% (95%CI = 26.3%–34.9%) of men, age-standardized to the 2005 census, and 5.6% (95%CI = 2.6%–8.6%) of women reported almost daily intake of alcohol, whereas 17.0% (95%CI = 13.4%–20.5%) of men and 46.6% (95%CI = 40.2%–53.1%) of women abstained. In men, frequent drinking was positively associated with age and not receiving financial support from close family emigrants, and was strongly inversely related to religious observance in both Muslims and Christians. In women it was associated with smoking and upward social mobility. Alcohol intake was not associated with religious affiliation in either sex. In men, intake of spirits (predominantly raki) and beer were associated with lower socioeconomic indices, smoking and obesity (beer only), whereas wine intake was associated with financial security, being secular, and not smoking. Among men, 11.3% (95%CI = 8.3%–14.3%) reported high intakes (≥ 210 g of pure alcohol/week) and 6.0% (95%CI = 3.8%–8.3%) very high intakes (≥ 420 g/week). High intakes were associated with frequent, rather than episodic, drinking.

Conclusions

Our study may be the first to provide information on alcohol intake and its characteristics in an Albanian population sample, one of the few predominantly Muslim countries in Europe. Alcohol consumption in women was extremely low. However, consistent very heavy intake of alcohol appears to be more frequent among Albanian men than in many former communist countries in Europe, and is cause for concern.     

A cluster randomized trial on the effects of a parent and student intervention on alcohol use in adolescents four years after baseline; no evidence of catching-up behavior

Objective

It is questioned whether the alcohol prevention program “Prevention of Alcohol use in Students” (PAS) is effective in reducing the prevalence of heavy weekend drinking and the amount of drinking among adolescents at the age at which they are allowed to buy alcohol in The Netherlands (16 years). In addition, it is questioned whether the intervention effects are attributed to a delay in onset earlier in adolescence or to the development of skills due to the PAS intervention (mediation analyses).

Design

A cluster randomized trial including 3490 Dutch early adolescents (M age = 12.66, SD = 0.49) and their parents randomized over four conditions; 1) parent intervention, 2) student intervention, 3) combined intervention and 4) control group.

Outcome measures

Outcome measures were prevalence of heavy drinking and amount of weekend drinking measured at age 16, 50 months after baseline.

Results

Only when parents and students were targeted simultaneously could the prevalence of heavy weekend drinking (b = − .44, p = .02) and the amount of alcohol use (b = − .24, p = .02) be reduced. No significant effects of the separate parent and student interventions were found. The effect of the combined PAS intervention on heavy weekend drinking and amount of drinking can be attributed to respectively the increase in self-control and strict parenting, and a delayed alcohol initiation earlier in adolescence.

Conclusions

The current study confirms the effectiveness of the combined PAS intervention up to the legal drinking age of 16. The results underline that postponing the onset of drinking among early adolescents is not only crucial for health development in the short term, but also impacts the development of a healthier drinking pattern later on.     

Drinking and driving in southeastern Brazil: Results from a roadside survey study

Objective

The objective of this study is to present data from a roadside survey study on drinking and driving and alcohol consumption in southeastern Brazil.

Methods

A cross-sectional roadside survey study using a questionnaire and breathalyzer data is the method used to determine the prevalence of drinking and driving and to examine whether socio-demographic characteristics and drivers' behavior, attitude and alcohol consumption predicted positive blood alcohol content (BAC). The data were gathered from 2005 to 2007 through roadside surveys conducted on high volume public roads in four cities in southeastern Brazil. A total of 4182 randomly selected drivers took part in the research. Of these drivers, 3488 (83.4%) completed the questionnaire and agreed to take a breath test.

Results

Overall, 24.6% of drivers had a detectable blood alcohol concentration (BAC) and 15.9% had a BAC above the legal limit (0.6 g/l) at the time of the study. Logistic regression controlling for locale (city), sex, age and marital status was used to predict whether each driver would present a positive breath test. Socio-demographic characteristics, driving behaviors and attitudes, and alcohol consumption patterns were included as predictors. These analyses indicated that those who believed drinking and driving was a serious offense were about two-thirds as likely to have a positive breath test, and that drivers reporting a pattern of regular alcohol use were three times as likely to have a positive breath test.

Conclusions

These findings indicate that drinking and driving is relatively common in Brazil, and that it occurs considerably more frequently than similar surveys suggest, is the case in other countries.     

Individual patterns of alcohol use

Aims

We present methodology to identify statistically distinct patterns of daily alcohol use and classify them into categories that could be further used in monitoring of transitions between patterns such as transitions from regular to problem use.

Data

The study analyzed individual patterns of adult alcohol consumption from two datasets containing short (< 6 month) and long (up to 2 years) daily records of drinking. These data were collected over the period between 1999 and 2003.

Results

By using a non-parametric (Kolmogorov–Smirnov) test we have identified distinct drinking patterns and classified them into 8 types according to their means, percentages of non-drinking days and variances of consumed amount during drinking days. For each studied individual we calculated a transition chart that characterizes transitions between the types.

Conclusions

Individual daily consumption patterns can be identified, and classified into distinct patterns. Changes between the patterns could be related to life events or environmental trends, and thus provide insights into pathways towards either heavier use or recovery.     

Event-level analyses of energy drink consumption and alcohol intoxication in bar patrons

Aim

To assess event-level associations between energy drink consumption, alcohol intoxication, and intention to drive a motor vehicle in patrons exiting bars at night.

Method

Alcohol field study. Data collected in a U.S. college bar district from 802 randomly selected and self-selected patrons. Anonymous interview and survey data were obtained as well as breath alcohol concentration (BrAC) readings.

Results

Results from logistic regression models revealed that patrons who had consumed alcohol mixed with energy drinks were at a 3-fold increased risk of leaving a bar highly intoxicated (BrAC ≥ 0.08 g/210 L), as well as a 4-fold increased risk of intending to drive upon leaving the bar district, compared to other drinking patrons who did not consume alcoholic beverages mixed with energy drinks.

Discussion

These event-level associations provide additional evidence that energy drink consumption by young adults at bars is a marker for elevated involvement in nighttime risk-taking behavior. Further field research is needed to develop sound regulatory policy on alcohol/energy drink sales practices of on-premise establishments.     

Drinking identity as a mediator of the relationship between drinking motives and weekly alcohol consumption among heavy drinking undergraduate students

Objectives

The present study assessed relationships among social, coping, enhancement, and conformity drinking motives and weekly alcohol consumption by considering drinking identity as a mediator of this relationship.

Methods

Participants were 260 heavy drinking undergraduate students (81% female; M_age = 23.45; SD = 5.39) who completed a web-based survey.

Results

Consistent with expectations, findings revealed significant direct effects of motives on drinking identity for all four models. Further, significant direct effects emerged for drinking identity on weekly drinking. Results partially supported predictions that motives would have direct effects on drinks per week; total effects of motives on drinking emerged for all models but direct effects of motives on weekly drinking emerged for only enhancement motives. There were significant indirect effects of motives on weekly drinking through drinking identity for all four models.

Conclusions

The findings supported the hypotheses that drinking identity would mediate the relationship between drinking motives and alcohol consumption. These examinations have practical utility and may inform development and implementation of interventions and programs targeting alcohol misuse among heavy drinking undergraduate students.     

Combined exposure to tobacco smoke and ethanol during adolescence leads to short- and long-term modulation of anxiety-like behavior

Background

Tobacco smoking is associated with alcohol drinking and consumption of both drugs typically begins during adolescence. Since anxiety is considered a relevant factor for both smoking and drinking due to its motivating force for a continued consumption, anxiety alterations shared by these two drugs could explain their co-use and co-abuse.

Methods

Here, we investigated the short- and long-term effects of adolescent tobacco smoke and/or ethanol exposure on anxiety levels. From postnatal day 30–45, Swiss mice were exposed to tobacco smoke (SMK – whole body exposure, 8 h/day) and/or ethanol (ETOH – 25% solution, 2 g/kg i.p. injected every other day) as follows: (1) SMK + ETOH exposure; (2) SMK exposure; (3) ETOH exposure; (4) Control. Anxiety levels were assessed with the elevated plus maze and open field tests.

Results

By the end of exposure, SMK female mice presented an anxiolytic response in the elevated plus maze and this response was intensified by co-exposure to ethanol. A short-term deprivation from SMK elicited an anxiogenic state in females in this maze. Although neither smoke nor ethanol effects persisted one month post-exposure, SMK + ETOH male and female mice exhibited an anxiogenic response in the open field.

Conclusion

Adolescent female mice are more susceptible to the anxiolytic effects of SMK. The stronger effect in SMK + ETOH group suggests that, in females, the combined exposure leads to lower anxiety levels. Anxiety levels do not seem to be relevant during a short-term SMK + ETOH deprivation, however, increased anxiety during long-term smoking and drinking deprivation demonstrate late-emergent effects both in males and females.     

Childhood abuse and neglect and transitions in stages of alcohol involvement among women: A latent transition analysis approach

Background

Childhood abuse and neglect have been linked with alcohol disorders in adulthood yet less is known about the potential of early trauma to influence transitions in stages of alcohol involvement among women. Study aims were to (1) identify stages of women's alcohol involvement, (2) examine the probability of transitions between stages, and (3) investigate the influence of four domains of childhood abuse and neglect (sexual abuse, physical abuse, neglect, and witness to domestic violence), assessed individually and as poly-victimization, on transitions.

Methods

The sample consisted of 11,750 adult female current drinkers identified in Wave 1 (2001–2002) and re-interviewed in Wave 2 (2004–2005) of the National Epidemiological Survey on Alcohol and Related Conditions.

Results

Three stages of alcohol involvement emerged from latent class analysis of 11 DSM-IV abuse/dependence criteria: severe (1.5% at Wave 1, 1.9% at Wave 2), hazardous (13.6% at Wave 1, 16.0% at Wave 2), and non-problem drinking (82.1% at Wave 1, 84.5% at Wave 2). Adjusted latent transition analyses determined transition probabilities between stages across waves. Women reporting any childhood abuse and neglect were more likely to advance from the non-problem drinking class at Wave 1 to severe (AOR = 3.90, 95% CI = 1.78–8.53) and hazardous (AOR = 1.56, 95% CI = 1.22–2.01) drinking classes at Wave 2 relative to women without this history. Associations were also observed between individual domains and transition from no problems to severe alcohol stage.

Conclusions

Results suggest a long-term impact of childhood abuse and neglect as drivers of progression in women's alcohol involvement.     

Alcohol mixed with energy drinks: Are there associated negative consequences beyond hazardous drinking in college students?

Objective

The consumption of alcohol mixed with energy drinks (AmED) is prevalent among college students as is hazardous drinking, a drinking pattern that places one at risk for alcohol-related harm. The present study, therefore, examined associations between AmED use, hazardous drinking, and alcohol-related consequences in college students.

Methods

Based on a probability sample conducted in 2010, participants were 606 undergraduate students aged 18–25. AmED consumption included lifetime and past year use. Hazardous drinking and alcohol-related consequences were measured during the past year. Point prevalence was used to estimate rates of AmED use, and chi-square, ANOVA, and logistic regression were used to examine associations between AmED use, hazardous drinking, and alcohol-related consequences.

Results

Lifetime and past year AmED use prevalence rates were 75.2% and 64.7%, respectively. Hazardous drinkers who engaged in AmED use were significantly more likely than past year hazardous drinkers who did not engage in AmED use to have had unprotected sex (OR = 2.35, CI 1.27–4.32).

Conclusions

AmED use appears to be highly prevalent among college students, and AmED use may confer additional risk for unprotected sex beyond hazardous drinking. Unprotected sex has implications for public health, and students who drink hazardously and consume AmED may be at greater risk.     

Risky drinking in the older population: A comparison of Florida to the rest of the US

Introduction

While alcohol use has traditionally been thought to decrease with age, several recent studies have shown an increase in heavy drinking among retirees. Florida's unique population distribution that includes a higher proportion of elderly residents warrants an in-depth look at the drinking patterns in the elderly and how they may differ from those in other areas of the country. However, state-level comparisons of excessive alcohol consumption are limited.

Methods

We compared risky drinking (defined as ten or more drinks/week in men and seven or more drinks/week in women; or five or more drinks at one sitting, one or more times/year for both men and women) in Florida to the rest of the US. We used pooled data from the 1997–2010 National Health Interview Survey (NHIS).

Results

The prevalence of risky drinking for those aged ≥ 65 in Florida and the rest of the US was 24.1%, and 21.8%, respectively, compared to 31.9% and 37.4% for all ages in Florida and the rest of the US, respectively. In multivariable analyses of those aged ≥ 65 years, risky drinking was significantly associated with male gender, younger age, non-Hispanic White race/ethnicity, more than a high school education, unemployment (including retirement), lower BMI, and current or former smoking. Floridians aged ≥ 65 were significantly more likely to report risky drinking than their counterparts in the rest of the US (Odds ratio = 1.13; 95% CI: 1.04–1.21), in contrast to analyses of all ages where Floridians were less likely to report risky drinking compared to the rest of the US (0.77; 0.67–0.86).

Discussion

Excessive alcohol consumption is an important modifiable risk factor for cancer, cardiovascular disease, and liver disease; a reduction among the elderly has great potential to reduce disease burden. Although Floridians overall were less likely to be risky drinkers than the rest of the US, almost a third of the Florida population reported this behavior. It is, therefore, an important public health concern, particularly in Florida's older population who are more likely to engage in this behavior than their counterparts in the rest of the US.     

Impulsivity and drinking motives predict problem behaviours relating to alcohol use in University students

Aims

This study used a four-factor model of impulsivity to investigate inter-relationships between alcohol consumption, impulsivity, motives for drinking and the tendency to engage in alcohol-related problem behaviours.

Methods

400 University students aged 18–25 completed an online survey consisting of the following measures: Urgency, Premeditation, Perseverance and Sensation Seeking Scale (UPPS) to measure impulsivity; Student Alcohol Questionnaire to assess drinking quantity, frequency and rates of problem behaviours; Drinking Motives Questionnaire to assess motives for drinking.

Results

The majority of the sample (94.5%) drank alcohol at least monthly. Path analysis revealed direct effects of urgency, sensation seeking and premeditation, as well as the quantity of alcohol consumed, on the tendency to engage in risky behaviours with negative consequences. The effect of urgency was mediated by drinking for coping motives and by a combined effect of drinking for social motives and consumption of wine or spirits. Conversely the effect of sensation seeking was mediated by the quantity of alcohol consumed, irrespective of drink type, and the effect of premeditation was mediated by the consumption of wine and spirits, in combination with enhancement motives.

Conclusions

Sensation seeking, urgency and lack of premeditation are related to different motives for drinking and also demonstrate dissociable relationships with the consumption of specific types of alcohol (beer, wine and spirits) and the tendency to engage in risky behaviours associated with alcohol consumption. Screening for high levels of urgency and for severe drinking consequences may be useful predictors of alcohol-related problems in UK University students aged 18 to 25 years.     

Project Reduce: Reducing alcohol and marijuana misuse: Effects of a brief intervention in the emergency department

Study objective

Brief interventions (BI) for alcohol misuse and recently for marijuana use for emergency department patients have demonstrated effectiveness. We report a 12-month outcome data of a randomized controlled trial of emergency department (ED) patients using a novel model of BI that addresses both alcohol and marijuana use.

Methods

ED research assistants recruited adult patients who admitted alcohol use in the last month, and marijuana use in the last year. In the ED, patients received an assessment of alcohol and marijuana use and were randomized to treatment (n = 249) or standard care (n = 266). Treatment consisted of two sessions of BI. At 3 and 12 months, both groups had an assessment of alcohol and marijuana use and negative consequences of use.

Results

515 patients were randomized. We completed a 12-month follow-up assessments on 83% of those randomized. Measures of binge drinking and conjoint marijuana and alcohol use significantly decreased for the treatment group compared to the standard care group. At 12-month binge alcohol use days per month in the treatment group were (M = 0.72:95% CI = 0.36–1.12) compared to standard care group (M = 1.77:95% CI = 1.19–1.57) Conjoint use days in the treatment group (M = 1.25.1:95% CI = 0.81–1.54) compared to standard care group (M = 2.16:95% CI = 1.56–2.86). No differences in negative consequences or injuries were seen between the treatment and standard care groups.

Conclusions

BI for alcohol and marijuana decreased binge drinking and conjoint use in our treatment group. BI appears to offer a mechanism to reduce risky alcohol and marijuana use among ED patients but expected reductions in consequences of use such as injury were not found 12 months after the ED visit.     

Patterns of substance use among Argentinean adolescents and analysis of the effect of age at first alcohol use on substance use behaviors

Objective

The present study used an empirically based method to characterize substance use in a sample of Argentinean adolescents and analyzed the association between age at drinking onset and substance use behaviors. Differences in alcohol expectancies and personality traits as a function of different patterns of substance use were also explored.

Method

Data were obtained from 583 adolescents aged 13–18 years (M = 15.01 years; SD = 1.5 years; 59.5% female) from the city of Cordoba, Argentina. Alcohol, tobacco, and drug use and age at first alcohol use were measured. Personality traits, including extroversion, conscientiousness, impulsivity, and aggression, and positive and negative alcohol expectancies were assessed. Latent Class Analysis was applied to examine the structure of five co-occurring substance use behaviors: frequency of alcohol use, quantity of alcohol use, prevalence of drunkenness episodes, tobacco use, and drug use.

Results

Latent Class Analysis revealed five distinct patterns of substance use. The classes differed in substance use behaviors, personality traits, and alcohol expectancies. Adolescents with early drinking onset were more likely to show heavier alcohol use, more drunkenness episodes, and more drug use than adolescents with late drinking onset.

Conclusions

Latent Class Analysis allowed the detection of groups of adolescents with distinct patterns of substance use. These groups exhibited significantly different personality and alcohol expectancy profiles, likely representing subgroups who are at greater risk for developing alcohol-related problems.     

Factors associated with weight changes in successful quitters participating in a smoking cessation program

Objective

To identify possible predictors of post-cessation weight gain in smoking abstainers.

Patients and methods

A sample of 607 successful abstainers seen at the Centre for Tobacco-Dependent in Prague, Czech Republic, between 2005 and 2010, was included in this analysis. This sample was followed up for 1 year and included 47.9% women (N = 291) with the mean age of 48 years (18–85).

Findings

Post-cessation weight gain occurred in 88.6% of the 607 abstainers. The mean weight gain after one year post-quit was 5.1 kg (95% confidence interval 4.7–5.5 kg). Baseline characteristics associated with increased weight gain included a higher baseline smoking rate (p < 0.001), more severe cigarette dependence (p = 0.003), less physical activity (p = 0.008), and a report of increased appetite on the baseline assessment of withdrawal symptoms (p < 0.001).

Conclusions

Smokers who are more dependent and have minimal physical activity are at increased risk for post-cessation weight gain. For these smokers, incorporating interventions targeting the weight issue into tobacco dependence treatment is recommended. Further research should be done to identify reasons for this important quitting complication.     

Associations between alcohol outlet densities and adolescent alcohol consumption: A study in Australian students

Objective

To assess whether the density of alcohol sales outlets in specific geographic communities is associated with adolescent alcohol consumption.

Method

A cross-sectional representative sample of secondary school students from Victoria, Australia (N = 10,143), aged between 12 and 17 years, self-reported on alcohol use in the last 30 days in 2009. The density of alcohol outlets per local community area was merged with this information.

Results

After controlling for risk factors, multilevel modelling (MLM) revealed a statistical interaction between age and density on alcohol consumption. While older adolescents had higher alcohol consumption, increases in the density of alcohol outlets were only significantly associated with increased risk of alcohol consumption for adolescents between the ages of 12 and 14.

Conclusion

Increased alcohol availability was associated with an increased risk of alcohol consumption specifically for early adolescents (12 and 14 years). Potential mechanisms as to how density is associated with direct and indirect alcohol availability, such as through parents or older siblings, need to be explored in future research.