scholarly journals An Evaluation of Potential Unintended Consequences of a Nicotine Product Standard: A Focus on Drinking History and Outcomes

2020 ◽  
Author(s):  
Sarah S Dermody ◽  
Katelyn M Tessier ◽  
Ellen Meier ◽  
Mustafa al’Absi ◽  
Rachel L Denlinger-Apte ◽  
...  
Keyword(s):  
Public Health ◽  
Alcohol Use ◽  
Binge Drinking ◽  
Drinking Behavior ◽  
The United States ◽  
Unintended Consequences ◽  
Nicotine Content ◽  
Drinking History ◽  
Product Standard ◽  
Smoking Outcomes

Abstract Background A nicotine product standard reducing the nicotine content in cigarettes could improve public health by reducing smoking. This study evaluated the potential unintended consequences of a reduced-nicotine product standard by examining its effects on (1) smoking behaviors based on drinking history; (2) drinking behavior; and (3) daily associations between smoking and drinking. Methods Adults who smoke daily (n=752) in the United States were randomly assigned to smoke very low nicotine content (VLNC) versus normal nicotine content (NNC; control) cigarettes for 20 weeks. Linear mixed models determined if baseline drinking moderated the effects of VLNC versus NNC cigarettes on Week 20 smoking outcomes. Time-varying effect models estimated the daily association between smoking VLNC cigarettes and drinking outcomes. Results Higher baseline alcohol use (versus no-use or lower use) was associated with a smaller effect of VLNC on Week 20 urinary total nicotine equivalents (ps<.05). No additional moderation was supported (ps>.05). In the subsample who drank (n=415), in the VLNC versus NNC condition, daily alcohol use was significantly reduced from Week 17-20 and odds of binge drinking were significantly reduced from Week 9-17. By Week 7 in the VLNC cigarette condition (n=272), smoking no longer predicted alcohol use but remained associated with binge drinking. Conclusions We did not support negative unintended consequences of a nicotine product standard. Nicotine reduction in cigarettes generally impacted smoking behavior for individuals who do not drink or drink light-to-moderate amounts in similar ways. Extended VLNC cigarette use may improve public health by reducing drinking behavior. Implications There was no evidence that a very low nicotine content product standard would result in unintended consequences based on drinking history or when considering alcohol outcomes. Specifically, we found that a very low nicotine standard in cigarettes generally reduces smoking outcomes for those who do not drink and those who drink light-to-moderate amounts. Furthermore, an added public health benefit of a very low nicotine standard for cigarettes could be a reduction in alcohol use and binge drinking over time. Finally, smoking very low nicotine content cigarettes may result in a decoupling of the daily associations between smoking and drinking.

scholarly journals Toward the prevention of alcohol use disorders: Overdrinking (unintentional binge drinking) in a community sample

2018 ◽  
Vol 5 (2) ◽  
pp. 205510291879270 ◽  
Author(s):  
F Michler Bishop ◽  
Jose Luis Rodriquez Orjuela
Keyword(s):  
United States ◽  
Pilot Study ◽  
Alcohol Use ◽  
Binge Drinking ◽  
Alcohol Use Disorder ◽  
Problem Drinking ◽  
Community Sample ◽  
Alcohol Use Disorders ◽  
The United States ◽  
The Past

Approximately 64,000,000 people in the United States report binge drinking at least once in the past month. Unlike overeating and oversleeping, “overdrinking”—defined as drinking more than a person intends to drink—does not exist in the literature. Terms such as binge and problem drinking do not consider the intent of the drinker. The results of this pilot study suggest that most people drink more than they intend to drink. Moreover, they also report often being surprised that they overdrank. Smartphones may help overdrinkers be less often surprised by overdrinking and may prevent drinkers from developing an alcohol use disorder.

scholarly journals Real-Time Mobile Monitoring of Drinking Episodes in Young Adult Heavy Drinkers: Development and Comparative Survey Study

10.2196/13765 ◽  
2019 ◽  
Vol 7 (11) ◽  
pp. e13765 ◽  
Author(s):  
Daniel J Fridberg ◽  
James Faria ◽  
Dingcai Cao ◽  
Andrea C King
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Alcohol Use ◽  
Binge Drinking ◽  
Real Time ◽  
Real World ◽  
Drinking Behavior ◽  
Heavy Drinking ◽  
Natural Environments

Background Binge drinking, defined as consuming five or more standard alcoholic drinks for men (four for women) within a 2-hour period, is common among young adults and is associated with significant alcohol-related morbidity and mortality. To date, most research on this problem in young adults has relied upon retrospective questionnaires or costly laboratory-based procedures. Smartphone-based ecological momentary assessment (EMA) may address these limitations by allowing researchers to measure alcohol use and related consequences in real time and in drinkers’ natural environments. To date, however, relatively less research has systematically examined the utility of this approach in a sample of young adults targeting real-world heavy drinking episodes specifically. Objective This study aimed to evaluate the feasibility, acceptability, and safety of a smartphone-based EMA method targeting binge drinking and related outcomes in heavy drinking young adults during real-world drinking occasions. Methods Young adult binge drinkers in the smartphone group (N=83; mean 25.4 (SD 2.6) years; 58% (48/83) male; bingeing on 23.2% (6.5/28) days in the past month) completed baseline measures of alcohol use and drinking-related consequences, followed by up to two smartphone-based EMA sessions of typical drinking behavior and related outcomes in their natural environments. They also completed next-day and two-week follow-up surveys further assessing alcohol use and related consequences during the EMA sessions and two weeks after study participation, respectively. A separate demographic- and drinking-matched safety comparison group (N=25) completed the baseline and two-week follow-up surveys but did not complete EMA of real-world drinking behavior. Results Most participants (71%, 59/83) in the smartphone group engaged in binge drinking during at least one 3-hour EMA session, consuming 7.3 (SD 3.0) standard alcoholic drinks. They completed 87.2% (507/581) system-initiated EMA prompts during the real-world drinking episode, supporting the feasibility of this approach. The procedure was acceptable, as evidenced by high participant ratings for overall satisfaction with the EMA software and study procedures and low ratings for intrusiveness of the mobile surveys. Regarding safety, participants endorsed few drinking-related consequences during or after the real-world drinking episode, with no adverse or serious adverse events reported. There were no differences between the groups in terms of changes in drinking behavior or consequences from baseline to two-week follow-up. Conclusions This study provided preliminary support for the feasibility, acceptability, and safety of a smartphone-based EMA of real-time alcohol use and related outcomes in young adult heavy drinkers. The results suggest that young adults can use smartphones to safely monitor drinking even during very heavy drinking episodes. Smartphone-based EMA has strong potential to inform future research on the epidemiology of and intervention for alcohol use disorder by providing researchers with an efficient and inexpensive way to capture large amounts of data on real-world drinking behavior and consequences.

Real-Time Mobile Monitoring of Drinking Episodes in Young Adult Heavy Drinkers: Development and Comparative Survey Study (Preprint)

2019 ◽  
Author(s):  
Daniel J Fridberg ◽  
James Faria ◽  
Dingcai Cao ◽  
Andrea C King
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Alcohol Use ◽  
Binge Drinking ◽  
Real Time ◽  
Real World ◽  
Drinking Behavior ◽  
Heavy Drinking ◽  
Natural Environments

BACKGROUND Binge drinking, defined as consuming five or more standard alcoholic drinks for men (four for women) within a 2-hour period, is common among young adults and is associated with significant alcohol-related morbidity and mortality. To date, most research on this problem in young adults has relied upon retrospective questionnaires or costly laboratory-based procedures. Smartphone-based ecological momentary assessment (EMA) may address these limitations by allowing researchers to measure alcohol use and related consequences in real time and in drinkers’ natural environments. To date, however, relatively less research has systematically examined the utility of this approach in a sample of young adults targeting real-world heavy drinking episodes specifically. OBJECTIVE This study aimed to evaluate the feasibility, acceptability, and safety of a smartphone-based EMA method targeting binge drinking and related outcomes in heavy drinking young adults during real-world drinking occasions. METHODS Young adult binge drinkers in the smartphone group (N=83; mean 25.4 (SD 2.6) years; 58% (48/83) male; bingeing on 23.2% (6.5/28) days in the past month) completed baseline measures of alcohol use and drinking-related consequences, followed by up to two smartphone-based EMA sessions of typical drinking behavior and related outcomes in their natural environments. They also completed next-day and two-week follow-up surveys further assessing alcohol use and related consequences during the EMA sessions and two weeks after study participation, respectively. A separate demographic- and drinking-matched safety comparison group (N=25) completed the baseline and two-week follow-up surveys but did not complete EMA of real-world drinking behavior. RESULTS Most participants (71%, 59/83) in the smartphone group engaged in binge drinking during at least one 3-hour EMA session, consuming 7.3 (SD 3.0) standard alcoholic drinks. They completed 87.2% (507/581) system-initiated EMA prompts during the real-world drinking episode, supporting the feasibility of this approach. The procedure was acceptable, as evidenced by high participant ratings for overall satisfaction with the EMA software and study procedures and low ratings for intrusiveness of the mobile surveys. Regarding safety, participants endorsed few drinking-related consequences during or after the real-world drinking episode, with no adverse or serious adverse events reported. There were no differences between the groups in terms of changes in drinking behavior or consequences from baseline to two-week follow-up. CONCLUSIONS This study provided preliminary support for the feasibility, acceptability, and safety of a smartphone-based EMA of real-time alcohol use and related outcomes in young adult heavy drinkers. The results suggest that young adults can use smartphones to safely monitor drinking even during very heavy drinking episodes. Smartphone-based EMA has strong potential to inform future research on the epidemiology of and intervention for alcohol use disorder by providing researchers with an efficient and inexpensive way to capture large amounts of data on real-world drinking behavior and consequences.

Abstract 13745: Hazardous Alcohol Use is a Common but Infrequently Addressed Problem Among Hospitalized Cardiovascular Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kyle Gobeil ◽  
Theodore Medling ◽  
Paolo Tarvaez ◽  
khalid sawalha ◽  
Mohammed Abozenah ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Binge Drinking ◽  
Problem Drinking ◽  
Drinking Behavior ◽  
Hazardous Drinking ◽  
Hazardous Alcohol Use ◽  
Hazardous Alcohol ◽  
Audit Score ◽  
National Estimates ◽  
Excessive Alcohol

Introduction: Excessive alcohol intake and binge drinking behavior has known detrimental cardiovascular impacts. National estimates suggest that about 7% of U.S. adults has hazardous drinking behavior, but it is unclear if this is different among the inpatient cardiac population and, furthermore, how often this issue is addressed during hospitalization. Hypothesis: Prevalence of alcohol use is underappreciated in the cardiac population due to purported health benefits, and therefore, likely to be overlooked. Methods: Disorders Identification Test (AUDIT), among patients hospitalized for cardiac surgery, heart failure (HF) or myocardial infarction (MI) between June and September 2019. Problem drinking was defined as an AUDIT score of ≥8 with binge drinking defined as 5+ drinks for men or 4+ for women on a single occasion within the past 30 days. Hazardous drinking was defined as a combination of either problem or binge drinking behavior. Results: Of 300 patients approached, a total of 290 (96.7%) completed the survey (33% non-drinkers, age 69 ± 11 years, 70% male, 4% Spanish-speaking, 31% surgical). The rate (95% CI) of problem, binge, and hazardous drinking was 12% (9-16), 16% (12-20), and 18% (14-23), respectively. Irrespective of alcohol use, 58% of patients reported being asked about alcohol use during their admission, mostly by nurses (56%). Patients with hazardous drinking were counseled more frequently about their alcohol use compared to non-hazardous drinkers, (11% vs 3%, p = 0.03), but the large majority (89%) of hazardous drinkers received no advice about their alcohol use while hospitalized and only 34 (12%) patients reported having ever been given a recommendation about alcohol consumption by a cardiologist or cardiac surgeon. Conclusions: In patients hospitalized for acute cardiac illnesses, the prevalence of problem drinking was more than double national estimates. About half of patients with problem drinking behavior were asked about their alcohol, and only a minority of patients received counseling. Our findings suggest that hazardous alcohol use is more common that previously appreciated, and that there are substantial health-system gaps in screening and counseling for this important cardiovascular risk factor.

scholarly journals Examining factors associated with heavy episodic drinking among college undergraduates

2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Kristen Scholly ◽  
Alan R. Katz ◽  
Lisa Kehl
Keyword(s):  
Alcohol Use ◽  
Social Life ◽  
Drinking Behavior ◽  
Multivariate Logistic Regression Analysis ◽  
The United States ◽  
Heavy Episodic Drinking ◽  
Health Concern ◽  
Accurate Information ◽  
Undergraduate College Student ◽  
Factors Associated

Heavy episodic drinking among college students is a serious health concern. The purpose of this study was to identify factors associated with heavy episodic drinking behaviors amongst a predominately Asian undergraduate college student population in the United States. A survey measuring alcohol use behaviors was completed by a random sample of 18-24 year old undergraduates during April, 2011. A multivariate logistic regression analysis was conducted to determine factors associated with students’ heavy episodic drinking behavior. Independent factors associated with heavy episodic drinking included living on campus, ethnicity, perceived drinking behavior among peers, and a belief that alcohol is a central part of one’s social life. Heavy episodic drinking was also associated with poor academic performance. Campus-wide educational strategies to reduce heavy episodic drinking among college undergraduates should incorporate accurate information regarding alcohol use norms to correct students’ perceived over estimation of their peers alcohol consumption rates and the under estimation of students protective alcohol use behaviors. These efforts should focus in on-campus residence halls where a higher occurrence of heavy episodic drinking is often found.

scholarly journals Effects of the COVID-19 Mitigation Measures on Alcohol Consumption and Binge Drinking in College Students: A Longitudinal Survey

2021 ◽  
Vol 18 (18) ◽  
pp. 9822
Author(s):  
Margarida Vasconcelos ◽  
Alberto Crego ◽  
Rui Rodrigues ◽  
Natália Almeida-Antunes ◽  
Eduardo López-Caneda
Keyword(s):  
College Students ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Binge Drinking ◽  
Drinking Behavior ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Alcohol Craving ◽  
Binge Drinkers ◽  
The Impact

To “flatten the curve” of COVID-19 contagion, several countries ordered lockdowns amid the pandemic along with indications on social distancing. These social isolation measures could potentially bring alterations to healthy behavior, including to alcohol consumption. However, there is hardly any scientific evidence of the impact of such measures on alcohol consumption and binge drinking (BD) among young adults, and how they relate to alcohol craving, stress, anxiety, and depression levels. We addressed these questions by conducting a longitudinal study with 146 Portuguese college students—regular binge drinkers (regular BDs), infrequent binge drinkers (infrequent BDs) and non-binge drinkers (non-BDs)—in three moments: before the pandemic (Pre-Lockdown), during lockdown (Lockdown) and 6 months after (Post-Lockdown). Results revealed that regular BDs decreased alcohol use during Lockdown, a change in behavior that was even greater during Post-Lockdown, when regular BDs displayed similar levels of consumption to infrequent/non-BDs. Additionally, alcohol craving and living with friends were predictive of alcohol use during Lockdown, whereas stress, anxiety, and depression symptoms did not contribute to explain changes in drinking behavior. Collectively, the results suggest that BD in young Portuguese college students can be stopped when the contexts in which alcohol intake usually takes place are suppressed, which may have important implications for future prevention and intervention strategies.

scholarly journals Alcohol Use Among Patients With Cancer and Survivors in the United States, 2000–2017

2020 ◽  
Vol 18 (1) ◽  
pp. 69-79 ◽  
Author(s):  
Nina N. Sanford ◽  
David J. Sher ◽  
Xiaohan Xu ◽  
Chul Ahn ◽  
Anthony V. D’Amico ◽  
...  
Keyword(s):  
Risk Factor ◽  
Alcohol Use ◽  
Cancer Survivors ◽  
Binge Drinking ◽  
Cancer Diagnosis ◽  
The United States ◽  
Self Report ◽  
Smoking History ◽  
Cancer Type ◽  
Moderate Drinking

Background: Alcohol use is an established risk factor for several malignancies and is associated with adverse oncologic outcomes among individuals diagnosed with cancer. The prevalence and patterns of alcohol use among cancer survivors are poorly described. Methods: We used the National Health Interview Survey from 2000 to 2017 to examine alcohol drinking prevalence and patterns among adults reporting a cancer diagnosis. Multivariable logistic regression was used to define the association between demographic and socioeconomic variables and odds of self-reporting as a current drinker, exceeding moderate drinking limits, and engaging in binge drinking. The association between specific cancer type and odds of drinking were assessed. Results: Among 34,080 survey participants with a known cancer diagnosis, 56.5% self-reported as current drinkers, including 34.9% who exceeded moderate drinking limits and 21.0% who engaged in binge drinking. Younger age, smoking history, and more recent survey period were associated with higher odds of current, exceeding moderate, and binge drinking (P<.001 for all, except P=.008 for excess drinking). Similar associations persisted when the cohort was limited to 20,828 cancer survivors diagnosed ≥5 years before survey administration. Diagnoses of melanoma and cervical, head and neck, and testicular cancers were associated with higher odds of binge drinking (P<.05 for all) compared with other cancer diagnoses. Conclusions: Most cancer survivors self-report as current alcohol drinkers, including a subset who seem to engage in excessive drinking behaviors. Given that alcohol intake has implications for cancer prevention and is a potentially modifiable risk factor for cancer-specific outcomes, the high prevalence of alcohol use among cancer survivors highlights the need for public health strategies aimed at the reduction of alcohol consumption.

scholarly journals Interest in Illicit Purchase of Cigarettes Under a Very Low Nicotine Content Product Standard

2019 ◽  
Vol 21 (Supplement_1) ◽  
pp. S128-S132
Author(s):  
Marissa G Hall ◽  
M Justin Byron ◽  
Noel T Brewer ◽  
Seth M Noar ◽  
Kurt M Ribisl
Keyword(s):  
Public Health ◽  
Health Impact ◽  
Control Group ◽  
Information Control ◽  
Street Vendor ◽  
Indian Reservation ◽  
Convenience Sample ◽  
Nicotine Content ◽  
Product Standard ◽  
The Impact

Abstract Significance The US Food and Drug Administration (FDA) is considering a very low nicotine content (VLNC) product standard to substantially reduce nicotine in cigarettes. We examined whether learning about a potential VLNC standard increased smokers’ interest in illicit purchases of cigarettes with regular nicotine content if such a standard were adopted. Methods Participants were a national convenience sample of 1712 US adult smokers. In an online experiment, we randomly assigned smokers to view information about a new VLNC standard (experimental condition) or no information (control condition). The experimental condition explained that a VLNC standard would remove 95% of the nicotine in cigarettes and would require stores to only sell VLNC cigarettes. Then, the survey assessed smokers’ interest in purchasing regular cigarettes from three illicit sources. Results Smokers who learned about the VLNC standard were more likely to be very or extremely interested in purchasing regular cigarettes illicitly from a Web site compared to smokers in the control group (24% vs. 16%, p &lt; .001). They were also more interested in illicitly buying cigarettes from a street vendor (19% vs. 13%, p &lt; .001) and a store on an Indian reservation (28% vs. 22%, p &lt; .05), compared to the control. The impact of learning about the VLNC standard on interest in illicit purchases did not differ by smoking frequency or current e-cigarette use. Conclusions A VLNC standard could increase smokers’ interest in illicit purchases of regular nicotine cigarettes. To prevent VLNC-induced illicit trade from undermining public health, FDA should consider proven measures such as track and trace for these products. Implications Little is known about how a VLNC cigarette standard would affect consumer interest in regular content cigarettes purchased from illicit sources (eg, the Internet). We found that smokers informed about a potential VLNC product standard had greater interest in illicit cigarette purchases, compared to controls. This suggests the importance of proactive measures accompanying a VLNC standard, such as track-and-trace cigarette packaging regulations and communication campaigns, in order to maximize the standard’s public health impact.

scholarly journals Components of alcohol use and all-cause mortality

2017 ◽  
Author(s):  
Sarah M. Hartz ◽  
Mary Oehlert ◽  
Amy C. Horton ◽  
Richard Grucza ◽  
Sherri L. Fisher ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Binge Drinking ◽  
Drinking Behavior ◽  
Health Administration ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Typical Day ◽  
Drinking Frequency ◽  
The Impact

AbstractImportanceCurrent recommendations for low-risk drinking are based on drinking quantity: up to one drink daily for women and two drinks daily for men. Drinking frequency has not been independently examined for its contribution to mortality.ObjectiveTo evaluate the impact of drinking frequency on all-cause mortality after adjusting for drinks per day and binge drinking behavior.DesignTwo independent observational studies with self-reported alcohol use and subsequent all-cause mortality: the National Health Interview Survey (NHIS), and data from Veteran’s Health Administration clinics (VA).SettingEpidemiological sample (NHIS) and VA outpatient database (VA Corporate Data Warehouse).Participants208,661 individuals from the NHIS interviewed between 1997 and 2009 at the age of 30 to 70 with mortality follow-up in the last quarter of 2011; 75,515 VA outpatients born between 1948 and 1968 who completed an alcohol survey in 2008 with mortality follow-up in June 2016.ExposuresQuantity of alcohol use when not binging (1-2 drinks on typical day, 3-4 drinks on typical day), frequency of non-binge drinking (never, weekly or less, 2-3 times weekly, 4 or more times weekly), and frequency of binge drinking (never, less than weekly, 1-3 times weekly, 4 or more times weekly). Covariates included age, sex, race, and comorbidity.Main Outcomes and MeasuresAll-cause mortality.ResultsAfter adjusting for binge drinking behavior, survival analysis showed an increased risk for all-cause mortality among people who typically drink 1-2 drinks four or more times weekly, relative to people who typically drink 1-2 drinks at a time weekly or less (NHIS dataset HR=1.15, 95% CI 1.06-1.26; VA dataset HR=1.31, 95% CI 1.15-1.49).Conclusions and RelevanceDrinking four or more times weekly increased risk of all-cause mortality, even among those who drank only 1 or 2 drinks daily. This was seen in both a large epidemiological database and a large hospital-based database, suggesting that the results can be generalized.

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