The association between age at first use of alcohol and alcohol consumption levels among adult general drinking population

Aim

The goal of the study was to investigate the association between age at first alcohol use and current levels of alcohol consumption among the adult Australian general drinking population.

Subject and methods

A retrospective cohort study was performed using self-report data collected by the 2004 and 2007 Australian National Drug Strategy Household surveys. Participants were selected using a multi-stage, stratified-area, random sample design. Male and female participants aged 20–49?years at the time of the survey, who were current drinkers and consumed their first full serve of alcohol before the age of 25?years, were included in this study. Poisson regression models (with robust estimations of variance) were used to explore associations between age when a full serve of alcohol was first consumed and relative likelihood of consuming alcohol above low risk levels at the time of survey, while adjusting for a number of potential confounders.

Results

Younger age at first use of alcohol was associated with increased likelihood of consuming alcohol at levels associated with increased risk of long- and short-term harms in adulthood, even among a subsample of participants with good mental health status as measured by the Kessler Psychological Distress Scale.

Conclusion

Younger age at first use of alcohol was associated with increased likelihood of high level alcohol use in adulthood. Effective strategies to delay onset of alcohol use are needed in order to reduce the future prevalence of high risk drinking adults.     

The association of alcohol consumption and hypertension

A review of the literature on the association of alcohol consumption and hypertension shows increasing attention to this topic. The diversity in the nature of the populations studied leads to problems in comparisons across studies, and the differences in the measurement of alcohol consumption and the variety of research designs have led to problems in ascertaining the true relationship between levels of alcohol consumption and blood pressure. An historical review shows an increasing tendency for the assertion of a positive relationship, although the question of threshold effects and the physiological mechanism underlying the association remain unclear. Recent studies have shown the existence of a relationship in well-controlled studies of cohorts of workers, and numerous confounding factors have been adjusted for in the analyses. However, many questions remain in asserting a causal relationship between alcohol consumption and elevated blood pressure in general populations, given the relative dearth of findings for the female population as well as for various other subgroups.     

The association of alcohol consumption with outcome of pregnancy

Patterns of alcohol consumption were assessed in 12,440 pregnant women interviewed at the time of delivery. Only 92 women (0.7 per cent) reported drinking 14 or more drinks per week, with most consuming fewer than 21 drinks per week. In the crude data, alcohol intake of 14 or more drinks per week was associated with a variety of adverse pregnancy outcomes, including low birthweight, gestational age under 37 weeks, stillbirth, and placenta abruptio. After use of logistic regression to control for confounding by demographic characteristics, smoking, parity and obstetric history, only the association of placenta abruptio with alcohol consumption of 14 or more drinks per week remained statistically significant. With the exception of placenta abruptio, alcohol intake of fewer than 14 drinks per week was not associated with and increased risk of any adverse outcome. No association was seen with congenital malformations at any level of alcohol intake.     

Consumed with worry: 'unsafe' alcohol consumption and self-reported problem drinking in England

Using data from the 1994 Health Survey for England, logistic multivariate multilevel modelling techniques are used to investigate the simultaneous effect of individual demographic characteristics and socio-structural factors on self-reported problem drinking as revealed by CAGE scores and 'unsafe' levels of alcohol consumption. Whilst the influence of key socio-structural variables is broadly similar for both unsafe alcohol consumption and high CAGE scores, there are notable exceptions when results are examined by tenure group: those in the rented sector are more likely to be problem drinkers as revealed by CAGE, but less likely to consume 'unsafe' amounts of alcohol. Both dimensions of drinking behaviour are influenced by the consumption patterns of others in the household, with both likelihoods increasing as the average consumption of others in the household rises. After taking into account individual compositional variables, the research indicates that there is very little evidence for geographical variation remaining in these two dimensions of drinking behaviour. It is found that the proportion of the population whose drinking behaviour may be classed as (potentially) problematic via the CAGE responses is substantially less than the proportion consuming above recommended 'safe' levels. The research concludes, however, that the two measures are broadly similar in their relationship to social and structural variables. Tenure provides an exception to this conclusion and indicates a continuing need to take account of housing circumstances in developing an understanding of drinking behaviour.     

Lifetime income patterns and alcohol consumption: investigating the association between long- and short-term income trajectories and drinking

Lifetime patterns of income may be an important driver of alcohol use. In this study, we evaluated the relationship between long-term and short-term measures of income and the relative odds of abstaining, drinking lightly-moderately and drinking heavily. We used data from the US Panel Study on Income Dynamics (PSID), a national population-based cohort that has been followed annually or biannually since 1968. We examined 3111 adult respondents aged 30-44 in 1997. Latent class growth mixture models with a censored normal distribution were used to estimate income trajectories followed by the respondent families from 1968 to 1997, while repeated measures multinomial generalized logit models estimated the odds of abstinence (no drinks per day) or heavy drinking (at least 3 drinks a day), relative to light/moderate drinking (<1-2 drinks a day), in 1999-2003. Lower income was associated with higher odds of abstinence and of heavy drinking, relative to light/moderate drinking. For example, belonging to a household with stable low income ($11-20,000) over 30 years was associated with 1.57 odds of abstinence, and 2.14 odds of heavy drinking in adulthood. The association between lifetime income patterns and alcohol use decreased in magnitude and became non-significant once we controlled for past-year income, education and occupation. Lifetime income patterns may have an indirect association with alcohol use, mediated through current socioeconomic conditions.     

The regional geography of alcohol consumption in England: Comparing drinking frequency and binge drinking

Alcohol consumption frequency and volume are known to be related to health problems among drinkers. Most of the existing literature that analyses regional variation in drinking behaviour uses measures of consumption that relate only to volume, such as ’binge drinking’. This study compares the regional association of alcohol consumption using measures of drinking frequency (daily drinking) and volume (binge drinking) using a nationally representative sample of residents using the Health Survey for England, 2011–2013. Results suggest the presence of two differentiated drinking patterns with relevant policy implications. We find that people in northern regions are more likely to binge drink, whereas people in southern regions are more likely to drink on most days. Regression analysis shows that regional variation in binge drinking remains strong when taking into account individual and neighbourhood level controls. The findings provide support for regional targeting of interventions that aim to reduce the frequency as well as volume of drinking.     

The association of alcohol consumption with metabolic syndrome and its individual components: the Taichung community health study

Alcohol has both adverse and protective effects on the individual components of metabolic syndrome (MS). We hypothesize that alcohol consumption increases the risk of developing MS and that the consumption of different types of alcoholic beverages has different effects on the development of MS and its individual components. We enrolled 2358 men for this cross-sectional study. The data were collected from self-reported nutrition and lifestyle questionnaires. Individuals who drank at least once per week for 6 consecutive months were classified as current drinkers. Current drinkers were at a higher risk of developing MS, abdominal obesity, and high triglyceride levels, but they were at a lower risk of developing low levels of high-density lipoprotein cholesterol (HDL-C). The increased risk of developing MS, high triglyceride, and high fasting glucose levels was dose dependent, whereas low HDL-C levels demonstrated a reverse relationship. The dose needed to reduce the risk of having low HDL-C levels was ≧50 g/d. This dose, however, resulted in an increased risk of developing high fasting glucose and high triglyceride levels. Consuming mixed types of alcohol increased the risk of developing MS and abdominal obesity. Meanwhile, those who drank liquor or wine had a greater risk of developing high triglyceride or high fasting glucose levels, respectively. In conclusion, alcohol consumption dose-dependently increased the risk of developing MS and some of its individual components while dose-dependently decreasing the risk of developing low HDL-C levels. The type of alcoholic beverage had different effects on the development of the individual components of MS.     

The association between alcohol consumption and health services utilization

The association between alcohol consumption patterns and the use of health services was examined in a cross-sectional survey of the general population of the Region of Madrid. Logistic regression analysis was used to determine the odds of moderate drinkers, excessive drinkers and non-drinkers to utilize health care services. Our findings indicate that moderate drinkers have a lower probability of utilizing health care services as compared to non-drinkers. Specifically, moderate drinkers showed a lower probability of utilizing both hospital (OR = 0.65 CI = 0.48-0.89) and ambulatory care (OR = 0.79 CI = 0.66-0.95) services. Furthermore, the frequency of use of ambulatory (OR = 0.79 CI = 0.64-0.95) and emergency care services (OR = 0.38 CI = 0.21-0.69) was also lower for moderate drinkers. Excessive drinkers also showed a tendency to use emergency care services less frequently (OR = 0.43 CI = 0.19-0.93). Both moderate and excessive drinking were also significantly associated with a shorter length of stay as compared to non-drinkers. The odds ratios are 0.41 (CI = 0.21-0.79) and 0.29 (CI = 0.19-0.39) respectively. Possible explanations of this "protective" effect of alcohol consumption, especially of moderate drinking, are discussed in relation to the diagnostic entities motivating the use of health care services.     

Variability of self reported measures of alcohol consumption: implications for the association between drinking in pregnancy and birth weight.

STUDY OBJECTIVE--To describe the intra-subject variability of self reported maternal alcohol consumption using different ways of collecting information and to analyse the implications of this variability for research into the effect of low to moderate maternal alcohol consumption on birth weight. DESIGN--This was a longitudinal study. Self reported maternal alcohol consumption before, during, and after pregnancy was assessed on four occasions over two years. The data were collected by two self administered questionnaires and during two personal interviews (one by phone and another face to face). SETTINGS--The Obstetrics Department, Odense University Hospital, Odense, Fünen, Denmark. PARTICIPANTS--A total of 2880 pregnant women were recruited consecutively from the hospital catchment area. Altogether 328 pregnant women and their babies were selected. All women who reported an average alcohol consumption of five drinks or more per week were recruited to the study (164 women) and a 1:1 control group was selected from the remaining women based upon two matching criteria: expected date of delivery and the women's year of birth. Some 279 women (85%) completed the study. MEASUREMENTS AND MAIN RESULTS--Self reported alcohol consumption (number of drinks per week) and birth weight (g) were the main outcomes. Women's self reported alcohol consumption varied over time and according to the data collection method. When different methods of data collection were used to assess alcohol intake in similar periods of time, significant differences in reporting were found despite the relatively high correlations between the measurements. Although a consistent reduction in birth weight with increasing consumption of alcohol was found, there were differences in the shape and strength of this association when comparing the six available alcohol measurements. CONCLUSIONS--The type of questions used, the way the data were collected, the period of time referred to, and the time the questions were asked, should be taken into consideration when describing the drinking pattern of pregnant women. Furthermore, birth weight results from studies that have used different alcohol measures should be interpreted or compared with caution because of possible large differences resulting from the differing methods of assessing fetal exposure to alcohol.     

Circadian drinking rhythms and blood alcohol levels in two rat lines developed for their alcohol consumption

The circadian drinking behavior of the AA (Alko Alcohol) and ANA (Alko Non-Alcohol) rat lines developed for high and low voluntary alcohol consumption was studied by using a microcomputer lick-counting system. The blood alcohol concentrations of AA rats were measured during the drinking peaks. The results showed that AA rats voluntarily drink intoxicating amounts of alcohol. The highest blood alcohol levels were about 25 mmol/l. Differences in circadian drinking rhythms between AA and ANA lines were also found. AA rats had a trimodal drinking pattern for alcohol intake during the dark period but ANA rats drank alcohol rather evenly throughout the period.     

A cross-sectional survey of compliance with national guidance for alcohol consumption by children: measuring risk factors,protective factors and social norms for excessive and unsupervised drinking

Background  

The Chief Medical Officer for England has developed the first guidance in England and some of the first internationally on alcohol consumption by children. Using the most recent iteration of a large biennial survey of schoolchildren we measure the extent to which young people's drinking fell within the guidelines just prior to their introduction and the characteristics of individuals whose drinking does not; how alcohol related harms relate to compliance; and risk factors associated with behaving outside of the guidance.     

Impulsivity moderates the association between physical activity and alcohol consumption

Mounting evidence indicates that physical activity and alcohol consumption are positively associated, but potential moderators of this relationship remain unclear. Both physical activity and alcohol drinking are potentially reinforcing and may be more strongly associated among individuals who tend to be higher in reward seeking and related processes governed by the prefrontal cortex. Thus, behaviors linked to the prefrontal cortex, such as impulsivity, may influence the association between physical activity and alcohol intake. The present study therefore evaluated dimensions of impulsivity as moderators of the association between physical activity and alcohol consumption. We surveyed 198 undergraduate students and obtained self-reports of their drinking habits, physical activity, and dimensions of impulsivity. We found that moderate but not vigorous physical activity was positively associated with drinking. Linear regression analyses were used to evaluate dimensions of impulsivity as moderators of the association between physical activity (vigorous or moderate) and drinks per week. Results revealed a consistent pattern of interactions between the positive urgency and sensation seeking dimensions of impulsivity and moderate physical activity on number of drinks per week. For both interactions, there was a significant positive association between moderate physical activity and drinking at higher but not lower levels of impulsivity. We conclude that impulsivity moderates the positive association between physical activity and alcohol consumption. These results have significant implications for the development of prevention and treatment programs for alcohol use disorders.     

Sex differences in alcohol drinking patterns during forced and voluntary consumption in rats.

Wistar rats were studied during forced and voluntary alcohol consumption, and continuous or periodic access to ethanol (6%) v/v with different availability of fluids. Absolute volume of alcohol consumption was not different between sexes in any condition; however, females consumed significantly more alcohol than males on a g/kg basis in all conditions. These differences were significantly more extensive during continuous free-choice to alcohol and water than during forced alcohol consumption. Females showed greater alcohol preference than males only during continuous free-choice to alcohol and water. During periodic free-choice to alcohol and water condition, alcohol consumption was distributed during more hours throughout the day in females than males. During periodic free-choice to alcohol and to an isocaloric sweetened solution (ISS), intakes of ISS were very high compared to regular intakes of daily water; nevertheless, alcohol consumption was maintained to similar levels observed in continuous free-choice to alcohol and water and represented almost 50% of regular daily consumes of water in males and females. Free-choice for alcohol and ISS modified the usual pattern of alcohol consumption during the daily light-dark cycle in males and females and reduced the time devoted to drinking alcohol compared to other conditions, in which similar intakes were observed. Results show that the extent of the higher alcohol consumption in females than males and the changes in patterns of alcohol intake were dependent on the nature of the ingestion schedule.     

Eating disorders and alcohol use: group differences in consumption rates and drinking motives

Alcohol use and drinking motives were investigated among college women divided into four probable eating disorder groups: Bulimia Nervosa, purging subtype (BN n=16) Binge Eating Disorder (BED n=30) Eating Disorder, Not Otherwise Specified (EDNOS n=85) and Non-Eating Disordered Controls (NEDC n=252). Participants completed questionnaires that assessed eating behaviors and attitudes, motives for drinking alcohol, quantity and frequency of alcohol use, and binge drinking. The BED group reported greater weekend alcohol consumption and binge drinking than the EDNOS and NEDC groups. The BN and BED groups were significantly more likely to endorse Coping as a drinking motive than the EDNOS and NEDC groups. The NEDC group was more likely to endorse Mood Enhancement than the EDNOS group. These results offer one explanation for the relationship between eating and alcohol use disorders. Women with eating disorders may use alcohol to cope with negative affect, analogous to findings that women with eating disorders report binge eating to regulate negative affect [Mizes, J. S. (1985). Bulimia: A review of its symptomatology and treatment. Advances in Behavior Research and Therapy, 7, 91-142].     

The association of tobacco and alcohol consumption with the use of health care services in Spain

BACKGROUND: Information on the impact of tobacco and alcohol consumption on the use of health services is scant and partially inconsistent. This paper examines the relationship between tobacco and alcohol consumption and the use of health care services in Spain. METHODS: Data were drawn from the 1993 Spanish National Health Survey, covering a random 21,120-person representative sample of Spain's noninstitutionalized population ages 16 years and older. Information was obtained through home-based interviews. RESULTS: Compared with never smokers, male smokers of more than 20 cigarettes/day tend to be hospitalized more frequently (odds ratio (OR) 1.31; 95% confidence limits (CL) 0.89-1.93) and make greater use of hospital emergencies (OR 1.51; 95%CL 1.13-2.01; P < 0.01). Among female smokers of more than 20 cigarettes/day, hospitalizations (OR 1.62; 95%CL 0.80-3.26) and medical visits (OR 1. 35; 95%CL 0.79-2.30) are also higher than among never smokers, although the associations do not reach statistical significance. Compared with never smokers, ex-smokers of both sexes make greater use of health care services (P < 0.01 for most services). There is a negative dose-response relationship (P < 0.001) between alcohol consumption and utilization of hospital and ambulatory services, for both sexes. Results are reasonably consistent across all age groups and are observed after adjustment for the principal confounding factors. We have found no evidence of a tobacco-alcohol interaction with the use of health care services. CONCLUSIONS: Smokers and ex-smokers make greater use of health care services. Control of smoking might reduce the use of such services and the ensuing human and economic costs. However, as alcohol consumption increases, the use of health care services decreases. This finding should not be used to promote even the moderate consumption of alcoholic drinks.     

The effects of sensation seeking, misperceptions of peer consumption, and believability of social norms messages on alcohol consumption

The social norms marketing approach is one method used to reduce extreme alcohol consumption. The current study implemented a web-based survey (N = 891) to assess whether sensation-seeking, perceived moderate drinking norms, and social norm message believability impacted alcohol consumption on a college campus. Sensation seeking was not directly related to normative perceptions of others' moderate alcohol consumption. Sensation seeking, perceived norms, and message believability all had direct effects on alcohol consumption, and the interaction of sensation seeking and message believability impacted alcohol consumption, while the interaction of sensation seeking and perceived norms on alcohol consumption was marginally significant. Implications of these findings for the social norms marketing approach are discussed.     

中小学生坚果摄入行为及其与肥胖的关联

目的 探讨我国中、小学生坚果摄入现状及其与肥胖发生的关联。方法 2012年11月,采用方便样本整群抽样的方法选取北京、湖南、宁夏3个省市的城市和农村中、小学校19所,使用自填式结构问卷收集学生过去一周食用坚果的情况(一周几把)。通过学校体检记录和现场测量两种方式获得身高、体重数据,采用生物电阻抗体成分测量仪MC-980(TANITA,中国广州东莞百利达健康器材有限公司生产)测量部分超重肥胖儿童的体脂肪率。采用多因素Logistic回归方法,在控制地区、城乡、性别、年级、父母受教育程度和家庭经济情况等因素的影响后,分析坚果摄入行为与肥胖发生的关系。结果 4 164名9~18岁儿童少年提供合格问卷。平均年龄(13.2±2.4)岁,平均体质指数(body mass index,BMI)(21.0±4.5)kg/m²。超重肥胖者占36.3%,超重肥胖儿童平均体脂率(fat%):(35.2±7.8)%。过去一周吃过坚果的比例为70.3%。儿童过去一周没吃坚果者超重肥胖发生率明显高于吃坚果者(P<0.05),而每天吃坚果的多少与肥胖发生率未见明显剂量-反应关系(P>0.05)。Logistic多元回归分析结果发现:每天摄入坚果1把及以上,发生超重肥胖的危险性是过去一周没吃坚果学生的0.75倍(95%CI:0.61～0.92)。结论 不吃坚果是儿童少年发生超重肥胖的独立危险因素。