Alcohol use beliefs and behaviors among high school students

Purpose: To identify specific alcohol use beliefs and behaviors among local high school students; to determine whether relationships exist between alcohol use and various sociodemographic and lifestyle behaviors; and to assist in the development and implementation of alcohol abuse prevention programs.Methods: This cross-sectional study involved the completion of a questionnaire by 1236 Grade 9–13 students (86% response rate) from 62 randomly selected classrooms in three Canadian urban schools. Data analyzed here are part of a larger lifestyle survey.Results: A total of 24% of students reported never having tasted alcohol, 22% have tasted alcohol but do not currently drink, 39% are current moderate drinkers, 11% are current heavy drinkers (five or more drinks on one occasion at least once a month), and 5% did not answer. Reasons stated most often for not drinking were “bad for health” and “upbringing,” while reasons stated most often for drinking were “enjoy it” and “to get in a party mood.” Student drinking patterns were significantly related to gender, ethnicity, grade, and the reported drinking habits of parents and friends. Older male adolescents who describe their ethnicity as Canadian are at higher risk for heavy drinking than students who are younger or female, or identify their ethnicity as European or Asian. Current heavy drinkers are at higher risk than other students for engaging in other high-risk behaviors such as drinking and driving, being a passenger in a car when the driver is intoxicated, and daily smoking.Conclusions: Heavy alcohol use in adolescents remains an important community health concern. Older self-described Canadian and Canadian-born male adolescents are at higher risk for heavy drinking. Current and heavy drinking rises significantly between Grades 9 and 12. Students who drink heavily are more likely to drink and drive, to smoke daily, and to have friends and parents who drink alcohol.     

The relationship between pregnancy intention and preconception health behaviors

ObjectiveTo describe smoking, heavy drinking, and folic acid supplementation in preconception women and determine if the likelihood of healthy preconception behaviors differs by whether and when women intend future pregnancy.MethodsAnalysis was based on 35,351 nonpregnant women who participated in the 2004 Behavioral Risk Factor Surveillance System who were of reproductive age (18–44 years), sexually active, and capable of future pregnancy. The association between future pregnancy intention and preconception behaviors was determined adjusting for diabetes, weight category, age group, race/ethnicity, marital status, education, income, and children living in household.ResultsEighty percent of women were non-smokers, 94.3% were non-heavy drinkers, and 42.6% were daily folic acid users. In adjusted analysis, only the odds of folic acid supplementation remained higher in women intending pregnancy in the next 12 months (adjusted odds ratio, 1.57; 95% confidence interval, 1.21–2.04) compared with women not intending future pregnancy. Women intending pregnancy later or ambivalent about future pregnancy were no more likely to be engaging in healthy preconception behaviors than women not intending future pregnancy.ConclusionWomen intending pregnancy within 12 months were more likely to use folic acid, but pregnancy intention was not associated with preconception smoking or heavy drinking.     

Alcohol use, marihuana smoking, and sexual activity in women

This report describes a prospective study of social drinking, marihuana smoking, and sexual activity by 26 healthy adult women (mean age 26.8 years). Each subject completed daily questionnaires for 3 consecutive menstrual cycles, and recorded menstrual cycle status, quantities and frequencies of alcohol consumption, marihuana smoking, and sexual activity. Consistent patterns of alcohol consumption, marihuana smoking, and sexual activity were reported across all 3 menstrual cycles. Heavy drinkers (mean greater than or equal to 1.80 drinks per day) were more likely to smoke marihuana than moderate drinkers (mean less than or equal to 1.75 drinks per day) and they also smoked significantly more marihuana (p less than 0.05). Neither age nor frequency of sexual activity were related to patterns of alcohol or marihuana consumption.     

At-risk drinking among patients making routine primary care visits

BACKGROUND: Addressing non-alcoholic, at-risk patterns of alcohol consumption that are associated with increased morbidity and mortality is an important health care priority. OBJECTIVE: The objective was to describe the prevalence and characteristics of at-risk drinkers in a population-based sample of adults with routine primary care visits. Methods: Three thousand four hundred thirty-nine patients with advance appointments in 23 primary care practices completed a health survey prior to their visit. At-risk drinking was defined as consuming an average of two or more drinks per day (chronic drinking), or two or more occasions of consuming five or more drinks in the past month (binge drinking), or, in the past month, one or more occasion of driving after consuming three or more drinks (drinking and driving). RESULTS: Prevalence was: 11% at-risk drinking; 63% light to moderate drinking; 26% abstinence. Abstainers differed from alcohol users on demographics (older, fewer Caucasian, lower income, more unemployed), other health behaviors (less exercise, lower rates of smoking, and marijuana and cocaine use), and family history of alcohol problems (lower). Abstainers also reported poorer physical and psychological health. Compared to light to moderate drinkers, at-risk drinkers were more likely to be male, unmarried, and to use other substances (tobacco, marijuana, and cocaine). Among at-risk drinkers, those with two or more risk factors were more likely male, consumed more alcohol per week, had higher AUDIT scores and were more motivated to change their drinking. Among those with only one risk factor, binge drinkers reported high rates of tobacco and marijuana use, relatively poor perceived health, and the highest proportion of negative consequences from drinking. CONCLUSIONS: At least 1 in 10 patients making routine primary care visits have drinking practices that place them at risk for negative consequences from drinking. Three drinking patterns that can be used to define at-risk drinking are relatively distinct.     

A Prospective Study of Prevalence and Predictors of Concurrent Alcohol and Tobacco Use During Pregnancy

Concurrent drinking and smoking during pregnancy is a major public health concern. Changes in these behaviours are under-researched, although essential if effective interventions are to be implemented. Hence this paper investigated characteristics of women who decreased concurrent drinking and smoking during pregnancy. 1,591 women were identified as pregnant at one of three surveys from 2000 to 2006 of the Australian Longitudinal Study on Women's Health and not pregnant at the previous survey. Relative risks (RRs) were calculated for concurrent drinkers and smokers before pregnancy of (1) decreasing drinking, (2) decreasing smoking and (3) decreasing drinking and smoking during pregnancy. Three hundred and fifty-four women (22%) were concurrent drinkers and smokers before pregnancy; of these women, 73% decreased drinking, 72% decreased smoking and 53% decreased drinking and smoking during pregnancy. Decreased concurrent drinking and smoking was significantly higher among women who had at least 12 years education (RRs: 1.5–1.6), who drank at least 1–2 days/week (RRs: 1.5–1.6) and who had 3 or more drinks per occasion (RRs: 1.6–1.8), and significantly lower among heavy smokers, mothers of other children (RRs: 0.8) and disadvantaged women: those stressed about money, with poor mental health, low social support and experience of partner violence (RRs: 0.6–0.7). Clearly programs are needed to tackle concurrent drinking and smoking during pregnancy. Given many pregnancies are unplanned, these programs should target drinking and smoking before and during pregnancy, as well as disadvantaged women, to reduce the deleterious effects of concurrent substance use on their babies and themselves.     

Drinking behavior in relation to cause of death among US adults.

OBJECTIVES. Alcohol involvement is common in many fatal injuries. This study examines drinking behavior in a nationally representative sample of US adult decedents aged 25 through 64 years and its association with cause of death. METHODS. Proxy-reported information from the 1986 National Mortality Followback Survey was used to profile the decedents'' usual frequency and quantity of drinking. The association of drinking behavior with underlying cause of death was assessed while adjusting for demographic characteristics. RESULTS. Of the decedents, 17% were daily drinkers, 22% usually consumed five drinks or more per occasion, and 27% were classified as heavier drinkers. Persons who died of injury drank more frequently and heavily than those who died of disease. The adjusted odds ratio of injury''s being the underlying cause of death was 1.4 (95% confidence interval [CI] = 1.1, 1.8) for daily drinkers, 1.5 (95% CI = 1.1, 2.0) for those drinking five or more drinks per occasion, and 1.4 (95% CI = 1.1, 1.7) for heavier drinkers. CONCLUSIONS. Daily drinking, binge drinking, and heavier drinking were each associated with an increased likelihood of injury as the underlying cause of death. Persons who were young, male, Native American, or divorced or separated were more likely to drink frequently and heavily.     

Increased mortality related to heavy alcohol intake pattern

STUDY OBJECTIVE: Although moderate alcohol intake is related to decreased all cause and ischaemic heart disease mortality, intake of large amounts at a time may be harmful. DESIGN: A cohort study, average follow up time was 7.3 years. SETTING: Finland. PARTICIPANTS: General population sample of 5092 men, aged from 25 to 64 years, who had consumed alcohol during the 12 months before the baseline examination. MAIN RESULTS: The main outcome measure was death. After excluding cases with previous myocardial infarction at the baseline examination and after adjustment for age, education, smoking, and average alcohol intake in Cox proportional hazards model, subjects with heavy drinking pattern (six or more drinks at a time) still had higher mortality from all causes than drinkers without heavy drinking occasions (RR 1.57; 95% CI 1.17 to 2.10). Respective analyses showed increased risk also for ischaemic heart disease (1.77; 95% CI 1.01 to 3.08), external causes (2.90; 95% CI 1.47 to 5.72) and alcohol related causes of death (2.73; 95% CI 1.13 to 6.64). The last two risk ratios were not adjusted for smoking. Relative risk point estimates were approximately similar for drinkers with heavy drinking occasions irrespective of beverage type, although those for beer and wine did not reach significance, probably because of the small number of cases. The highest average alcohol intake was found among drinkers who consumed all three types of beverage. CONCLUSIONS: Consuming six or more drinks at a time is related to increased mortality among working age male drinkers. The authors found no clear evidence for beverage specific differences.     

Alcohol use in pregnancy, craniofacial features, and fetal growth.

STUDY OBJECTIVE--The aim was to study the relationship between the level of alcohol consumption in pregnancy and craniofacial characteristics of the neonate. DESIGN--This was a prospective survey of a sample of pregnant women, stratified on prepregnancy level of alcohol consumption. SETTING--The study was carried out at the public antenatal clinic of Roubaix maternity hospital. PARTICIPANTS--During an eight month period, 684 women (89% of those eligible) were interviewed in a standardised way at their first antenatal clinic visit. Of these, all who were suspected of being alcoholic or heavy drinkers (at least 21 drinks per week) were selected for follow up, as was a subsample of light (0-6 drinks per week) and moderate (7-20 drinks per week) drinkers. Of 347 women selected in this way, 202 had their infants assessed by a standardised morphological examination. MEASUREMENTS AND AND MAIN RESULTS--Suggestive craniofacial characteristics of the infants, present either in isolation or in association with growth retardation ("fetal alcohol effects"), were compared in relation to maternal alcohol consumption (alcoholic 12%; heavy drinking 24%; moderate drinking 28%; light drinking 36%). No differences were found between light and moderate drinkers. Infants born to alcoholics had a greater number of craniofacial characteristics and the proportion with features compatible with fetal alcohol effects was higher. There was a similar trend for infants of heavy drinkers. Infants of heavy drinkers who had decreased their alcohol consumption during pregnancy had fewer craniofacial features. Infants of heavy smokers were also found to have increased numbers of craniofacial characteristics. CONCLUSIONS--Craniofacial morphology could be a sensitive indicator of alcohol exposure in utero. Altered morphology is usually considered specific for alcohol exposure, but the relation observed with smoking needs further exploration.     

Tabak- und Alkoholkonsum bei 11- bis 17-jährigen Jugendlichen

In this paper, tobacco and alcohol consumption among adolescents in Germany was analyzed. In addition to the current situation, we report temporal developments and trends. Data were obtained from the first follow-up of the KiGGS study (KiGGS Wave 1) conducted from 2009 to 2012. All girls and boys aged 11–17 years (n?=?5,258) were included. The results show that currently 12.0?% of 11- to 17-year-old adolescents in Germany smoke, 5.4?% of them on a daily basis. At-risk drinking (AUDIT-C total score) was prevalent among 15.8?% of adolescents, heavy episodic drinking (six or more alcoholic standard drinks on a single occasion at least once a month) among 11.5?%. No significant gender differences were found for most indicators. However, among adolescents aged 14–17 years, boys revealed a greater inclination toward heavy episodic drinking than girls did (23.1 vs. 16.5?%, p?<?0.01). Regarding smoking, distinct socioeconomic differences were observed. For example, adolescents from families with a low socioeconomic status (SES) smoke significantly more often on a regular or daily basis compared with their peers from high-SES families (OR?=?1.95, 95?% CI?=?1.16–3.27 and OR?=?3.71, 95?% CI?=?2.05–6.69, respectively). The relationship between SES and alcohol consumption is rather weak. Significant differences emerged only regarding lifetime prevalence of alcohol consumption, and indicate lower consumption rates among low-SES compared with high-SES adolescents (OR?=?0.47, 95?% CI?=?0.33–0.68). Consideration of the KiGGS baseline study data (2003–2006) shows that smoking prevalence has dropped almost by half from 20.4 to 12.0?%. The percentage of adolescents who have ever drunk alcohol has decreased from 62.8 to 54.4?%. These results are consistent with the findings of other studies on adolescent tobacco and alcohol consumption and should be considered in the context of preventive efforts that have been strengthened in recent years, especially regarding tobacco use.     

Drinking levels, knowledge, and associated characteristics, 1985 NHIS findings

Several questions in the 1985 Health Promotion and Disease Prevention Questionnaire, which was part of the 1985 National Health Interview Survey, addressed respondents' consumption of alcohol. Sociodemographic characteristics, knowledge of health risks related to heavy drinking, health practices, and the prevalence of certain health conditions were examined in relation to drinking levels. Although cause-effect relationships should not be inferred from the associations, the findings suggest some provocative areas for prevention and research. Heavier drinkers were more commonly found among men than women. Level of drinking was associated positively with years of education and family income, but was inversely related to age. Compared with light drinkers, heavier drinkers were much more likely to drive after they had had too much to drink. While more than 90 percent of the population knew that heavier drinking increases the risk of 'liver cirrhosis, less than half knew about the increased risk of throat cancer and cancer of the mouth. Most respondents aged 18-44 years (80 percent or more) knew that heavy drinking increases the chance of adverse pregnancy outcomes, and more women than men (62 versus 49 percent) had heard of fetal alcohol syndrome (FAS). However, 70 percent or more of those who had heard of FAS described the syndrome as a newborn addicted to alcohol rather than a child born with certain birth defects. Heavier drinkers of both sexes were less likely than others to be nonsmokers, and moderate drinkers were more likely than others to exercise or play sports regularly. Moderate drinkers also tended to have lower lifetime prevalence rates than others for hypertension and heart trouble.     

Associations between behavioural risk factors and smoking,heavy smoking and future smoking among an Australian population-based sample

IntroductionTobacco smoking co-occurs with behavioural risk factors including diet, alcohol use and obesity. However, the association between behavioural risk factors and heavy smoking (> 20 cig/day) compared to light–moderate smoking is unknown. The link between behavioural risk factors and future smoking for both ex and current smokers is also unknown. This study sought to examine these relationships. It is hypothesised that behavioural risk factors will be more strongly associated with heavy smoking.MethodData from Wave 7 (2007) of the Household and Labour Dynamics in Australia (HILDA) survey was analysed using logistic regression to determine relationships between diet (fruit and vegetable consumption, and unhealthy diet choices), alcohol consumption, obesity and physical activity with light–moderate smoking and heavy smoking. The association between these risk factors and future smoking (2008) was assessed for current and ex-smokers (2007).ResultsObese respondents were less likely to be light/moderate smokers (RRR: 0.53; 95% CI: 0.43, 0.66) but not heavy smokers. Those who consume confectionary weekly were less likely to be light/moderate smokers (RRR: 0.73; 95% CI: 0.61, 0.87), but not heavy smokers. Smokers in 2007 were more likely to continue smoking in 2008 if they consumed 1–4 drinks per occasion (OR: 2.52; 95% CI: 1.13, 5.62). Ex-smokers in 2007 were less likely to relapse in 2008 if they consumed recommended levels of both fruit and vegetables (OR: 0.31; CI: 0.10, 0.91).ConclusionThe relationships between heavy smoking and behavioural risk factors differ from moderate–light smoking. Future primary care interventions would benefit from targeting multiple risk factors, particularly for heavy smokers.     

ALCOHOL CONSUMPTION,CIGARETTE SMOKING AND FETAL OUTCOME IN VICTORIA, 1985

The aims of this study were to document the extent of cigarette smoking and alcohol consumption by Victorian women during pregnancy and relate the use of cigarettes and alcohol to various measures of pregnancy outcome. The study found that 24 per cent of women smoked during pregnancy and smoking was more common amongst younger women; 99.5 per cent of women drank, on average, less than two standard drinks per day and older women were more likely to be drinkers than younger women; 3.6 per cent of women reported at least one episode of binge drinking during pregnancy. There was an increasing trend in the proportion of low birthweight (>2500g) infants with increasing use of tobacco and a dose-dependent reduction in mean birthweight. Drinkers were less likely to have a pre-term or low birthweight infant than abstainers and babies born to drinkers had a higher mean birthweight than babies born to abstainers. The results of our study did not suggest that drinkers were at increased risk of delivering an infant with a congenital malformation, however heavy drinking was very uncommon in the studied population.     

Predictive value of readiness, importance, and confidence in ability to change drinking and smoking

ABSTRACT: BACKGROUND: Visual analog scales (VAS) are sometimes used to assess change constructs that are often considered critical for change.Aims of Study: 1.) To determine the association of readiness to change, importance of changing and confidence in ability to change alcohol and tobacco use at baseline with the risk for drinking (more than 21 drinks per week/6 drinks or more on a single occasion more than once per month) and smoking (one or more cigarettes per day) six months later. 2.) To determine the association of readiness, importance and confidence with alcohol (number of drinks/week, number of binge drinking episodes/month) and tobacco (number of cigarettes/day) use at six months. METHODS: This is a secondary analysis of data from a multi-substance brief intervention randomized trial. A sample of 461 Swiss young men was analyzed as a prospective cohort. Participants were assessed at baseline and six months later on alcohol and tobacco use, and at baseline on readiness to change, importance of changing and confidence in ability to change constructs, using visual analog scales ranging from 1--10 for drinking and smoking behaviors. Regression models controlling for receipt of brief intervention were employed for each change construct. The lowest level (1--4) of each scale was the reference group that was compared to the medium (5--7) and high (8--10) levels. RESULTS: Among the 377 subjects reporting unhealthy alcohol use at baseline, mean (SD) readiness, importance and confidence to change drinking scores were 3.9 (3.0), 2.7 (2.2) and 7.2 (3.0), respectively. At follow-up, 108 (29%) reported no unhealthy alcohol use. Readiness was not associated with being risk-free at follow-up, but high importance (OR 2.94; 1.15, 7.50) and high confidence (OR 2.88; 1.46, 5.68) were. Among the 255 smokers at baseline, mean readiness, importance and confidence to change smoking scores were 4.6 (2.6), 5.3 (2.6) and 5.9 (2.7), respectively. At follow-up, 13% (33) reported no longer smoking. Neither readiness nor importance was associated with being a non-smoker, whereas high confidence (OR 3.29; 1.12, 9.62) was. CONCLUSIONS: High confidence in ability to change was associated with favorable outcomes for both drinking and smoking, whereas high importance was associated only with a favorable drinking outcome. This study points to the value of confidence as an important predictor of successful change for both drinking and smoking, and shows the value of importance in predicting successful changes in alcohol use.Trial registration numberISRCTN78822107.     

Peer Reviewed: Patterns of Clinically Significant Symptoms of Depression Among Heavy Users of Alcohol and Cigarettes

Introduction

Depression is among the most prevalent and treatable diseases, and it is associated with cigarette smoking and heavy alcohol use. This study estimates the prevalence of depression, its variation among demographic subgroups, and its association with heavy alcohol use and cigarette smoking in California.

Methods

The 2006 California Behavioral Risk Factor Surveillance System (BRFSS) includes the 8-item Patient Health Questionnaire, a standardized instrument used to measure depressive symptoms. We used findings from the 2006 BRFSS to calculate the prevalence of depression in California; we used logistic models to explore the relationships between depression, alcohol use, and smoking.

Results

We found that 9.2% of adults in California had clinically significant depressive symptoms. Logistic models indicated that daily smokers were more than 3 times more likely to have clinically significant depressive symptoms than were nonsmokers, and heavy drinkers were approximately 3 times more likely to have clinically significant depressive symptoms than were nondrinkers.

Conclusion

Because heavy alcohol use and daily smoking are each associated with depression, people who do both may be at an increased risk for depression. This is a public health issue because people who drink alcohol often also smoke and vice versa. Intervention efforts might target persons who are users of both these drugs, and practitioners should be aware that smokers who are heavy alcohol users are at an increased risk for depression.     

Alcohol, smoking, coffee, and cirrhosis.

Since most heavy drinkers do not develop alcoholic cirrhosis, other causes or predisposing factors are probable. The authors studied traits of 128,934 adults who underwent health examinations at the Oakland and San Francisco, California, facilities of the Kaiser Permanente Medical Care Program from January 1978 to December 1985 in relation to subsequent hospitalization or death from cirrhosis of the liver. In analyses adjusted for nine covariates, past and current alcohol drinking were strongly related to cirrhosis risk, but usual choice of alcoholic beverage had no independent relation. Cigarette smoking was independently related to risk of alcoholic cirrhosis, with cigarette smokers of a pack or more per day at trebled risk compared with lifelong nonsmokers. Coffee drinking, but not tea drinking, was inversely related to alcoholic cirrhosis risk, with persons who drank four or more cups per day at one-fifth the risk of noncoffee drinkers. This inverse relation between coffee consumption and risk of alcoholic cirrhosis was consistent in many subsets, including persons free of gastrointestinal disease and those with 5 or more years before hospitalization or death. Cigarette smoking and coffee consumption were not consistently related to risk of hospitalization or death for nonalcoholic cirrhosis. These data could mean that cigarette smoking promotes alcoholic cirrhosis and that coffee drinking might be protective.     

Smoking, alcohol consumption, and susceptibility to the common cold.

OBJECTIVES. This study was conducted to test the supposition that both smoking and consuming alcohol suppress host resistance to viral infections. METHODS. The relations between smoking, alcohol consumption, and the incidence of documented clinical colds were prospectively studied among 391 subjects intentionally exposed to one of five respiratory viruses and 26 subjects given saline. Clinical colds were defined as clinical symptoms verified by the isolation of virus or by an increase in virus-specific antibody titer. Analyses included control variables for demographics; body weight; virus; and environmental, immunological and psychological factors. RESULTS. Smokers were at greater risk for developing colds than nonsmokers because smokers were more likely both to develop infections and to develop illness following infection. Greater numbers of alcoholic drinks (up to three or four per day) were associated with decreased risk for developing colds because drinking was associated with decreased illness following infection. However, the benefits of drinking occurred only among nonsmokers. CONCLUSIONS. Susceptibility to colds was increased by smoking. Although alcohol consumption did not influence risk of clinical illness for smokers, moderate alcohol consumption was associated with decreased risk for nonsmokers.     

A quasi-randomized group trial of a brief alcohol intervention on risky single occasion drinking among secondary school students

Objectives

To show the effectiveness of a brief group alcohol intervention. Aims of the intervention were to reduce the frequency of heavy drinking occasions, maximum number of drinks on an occasion and overall weekly consumption.

Methods

A cluster quasi-randomized control trial (intervention n?=?338; control n?=?330) among 16- to 18-year-old secondary school students in the Swiss Canton of Zürich. Groups homogeneous for heavy drinking occasions (5+/4+ drinks for men/women) consisted of those having medium risk (3–4) or high risk (5+) occasions in the past 30?days. Groups of 8–10 individuals received two 45-min sessions based on motivational interviewing techniques.

Results

Borderline significant beneficial effects (p?<?0.10) on heavy drinking occasions and alcohol volume were found 6?months later for the medium-risk group only, but not for the high-risk group. None of the effects remained significant after Bonferroni corrections.

Conclusions

Group intervention was ineffective for all at-risk users. The heaviest drinkers may need more intensive treatment. Alternative explanations were iatrogenic effects among the heaviest drinkers, assessment reactivity, or reduction of social desirability bias at follow-up through peer feedback.     

Alcohol consumption and all-cause and cancer mortality among middle-aged Japanese men: seven-year follow-up of the JPHC study Cohort I. Japan Public Health Center

To examine the association between alcohol consumption and mortality in Japan, where mortality and lifestyle differ substantially from Western countries, a population-based prospective study was conducted in four public health center areas as part of the Japan Public Health Center-based prospective study on cancer and cardiovascular disease (JPHC). After excluding subjects with self-reported serious diseases at baseline, 19,231 men aged 40-59 years who reported their alcohol intake were followed from 1990 through 1996, and 548 deaths were documented. The association between all-cause mortality and alcohol consumption was J-shaped. The lowest risk was observed for men who consumed 1-149 g/week (relative risk (RR) = 0.64, 95% confidence interval (CI) 0.46, 0.88), while the highest risk was seen for men who consumed > or =450 g/week (RR = 1.32, 95% CI 1.00, 1.74), after adjustment for possible confounders. The association did not change after excluding deaths that occurred in the first 2 years of follow-up. However, the association was modified by smoking, and beneficial effects of moderate drinking were largely limited to nonsmokers. The risk of cancer death showed a similar trend, but increased more in heavy drinkers. The background characteristics of moderate drinkers were healthier than either nondrinkers or heavy drinkers. The authors conclude that moderate alcohol consumption was associated with the lowest risks of all-cause and cancer mortality, especially among nonsmokers.     

Heavy drinking on Canadian campuses

OBJECTIVE: To describe the prevalence and frequency of heavy drinking episodes among Canadian undergraduates. METHODS: Data are drawn from the Canadian Campus Survey, a national mail survey, conducted in the fall of 1998, with a random sample of 7,800 students from 16 universities. RESULTS: Overall, 62.7% and 34.8% of students reported consuming 5 or more drinks and 8 or more drinks, respectively, on a single occasion at least once during the fall semester. On average, drinkers reported having 5 or more drinks almost 5 times during the fall semester, and having 8 or more drinks almost twice during the same period. The groups reporting the highest rates of heavy drinking were males, those living in university residences, those with low academic orientation and those with high recreational orientation. INTERPRETATION: Generally, this study has shown that heavy drinking is highly engrained in Canadian undergraduates' drinking patterns, and is related to a number of factors. These factors can be used to develop targeted prevention efforts.     

Empirically based guidelines for moderate drinking: 1-year results from three studies with problem drinkers.

OBJECTIVES. The study was conducted to refine guidelines on moderate drinking for problem drinkers, persons whose alcohol use is hazardous or harmful. Information on levels of alcohol intake unlikely to cause problems is useful for health professionals, educators, and policymakers. METHODS. Based on their reports of alcohol-related problems, participants in three studies assessing interventions to reduce heavy drinking (114 men, 91 women) were categorized as "problem-free" or "problem" drinkers at follow-up. Drinking measures were examined to identify patterns separating these outcome categories. RESULTS. Analyses using 95% confidence intervals for means on drinking measures showed that guidelines should be sex-specific. Based on analyses of positive and negative predictive value, sensitivity, and specificity, it is recommended that men consume no more than 4 standard drinks in any day and 16 drinks in any week, and that women consume no more than 3 drinks in any day and 12 drinks in any week. CONCLUSIONS. These guidelines are consistent with those from several official bodies and should be useful for advising problem drinkers when moderation is a valid treatment goal. Their applicability to the general population is unevaluated.