Pattern of Alcohol Use and its Effects in Relation to the Age of Initiation of Alcohol Use among the Residents of Jhaukhel Area of Bhaktapur District

Over the past few decades, alcohol consumption has increased in quantity and frequency. Several studies have suggested that people who start drinking at younger age have an increased risk of alcohol use disorder. This study was carried out to assess the pattern of alcohol consumption in relation to the age of initiation of alcohol use among the residents of Jhaukhel area of Bhaktapur district. A cross sectional descriptive survey was conducted in Jhaukhel area of Bhaktapur district among the permanent residents aged 15 years and above through a purposive sampling technique using a pre tested self-constructed proforma. Assessment of alcohol use, harmful/ hazardous drinking and alcohol dependence was done using an AUDIT questionnaire as a tool. Chi-square test and Fisher’s exact test were applied and ‘p’ value was calculated to see the association between age of onset of alcohol use and the alcohol use pattern and effects. The level of significance was set at 5%, and ‘p’ value of < 0.05 was considered statistically significant. A total of 190 respondents were interviewed. Mean age of the respondents was 41.25 ± 16.4 years while mean age of initiation of alcohol consumption was 20 ± 4.3 years and 31 (30.4 %) of drinkers initiated alcohol consumption before legal drinking age (18 years). This was more among males (36.5%) than females (14.3%), (p-value: 0.03, OR: 3.4, 95%CI: 1-11) Initiating alcohol consumption early in life before 18 years was strongly associated with binge drinking pattern (P value: <0.001, OR: 9.5, 95%CI: 2.7-33.3). Those who initiate drinking before 18 years were more likely to suffer from alcohol related medical problems compared to those who initiated drinking after 18 years (OR: 6.63, 95% CI: 2.3-19.3, P value: 0.001). Parental consumption of alcohol was found to be associated with the early initiation of alcohol use (OR: 2.7, 95%CI: 1.01-6.96, P value: 0.03). Early initiation of alcohol consumption before legal drinking age was not only a predictor for binge drinking and alcohol dependence, but also a risk factor for alcohol related medical problem, accidents and self-inflicted injuries. Hence this is a serious issue which needs to be addressed at the individual, family as well as community level.

Removing Temptation: New Zealand's Alcohol Restrictions, 1881-2005

<p>This thesis provides an historical overview of the legal restrictions placed on access to alcohol in New Zealand and details some consequences of these restrictions. It questions whether the historical evidence from New Zealand supports the availability theory of alcohol. The availability theory contends that for most societies the per capita consumption of alcohol can be reduced by restricting its availability, thereby reducing alcohol-related harm. The theory was propounded in detail by the international alcohol research community from the 1970s but was also implicit in 'restrictionist' approaches increasingly adopted in a variety of countries, including New Zealand, in the nineteenth and early twentieth centuries. The thesis focuses primarily on the period from 1881 onwards, when a new Licensing Act formalised the restrictionist principles that were to dominate liquor policy for much of the next century. Until the passing of 1989 Sale of Liquor Act New Zealand's liquor laws were characterised by strict controls on licence numbers, uniform hours of sale, regular polls on liquor issues and legal obligations to provide accommodation for travellers. The availability theory was tested by assessing the effect of the rapid changes in alcohol availability that resulted from tax and policy changes that increased or decreased restrictions on access. Large liquor tax increases in 1921 and 1958 were followed by significant and sustained reductions in per capita alcohol consumption. The lowering of the minimum legal age of purchase in 1969 and 1999 was followed by increased alcohol consumption. Both these findings are consistent with the availability theory. However, neither the banning of liquor sales after six pm from December 1917 ('six o'clock closing') nor the resumption of ten o'clock closing from October 1967 had any apparent effect on liquor consumption. Rapid changes in the number of liquor outlets from 1894 to 1910 and from 1990 to 1995 were inversely correlated with changes in per capita alcohol consumption, a finding that is strongly at odds the availability theory. The findings have relevance for contemporary debates on access to alcohol in Australia (outlet numbers) Great Britain (drinking hours and liquor taxes) and New Zealand (the drinking age). This thesis also attempts to explain why strict controls remained in place for so long given that restrictions on outlet numbers and. hours of sale had no apparent impact on liquor consumption. Six o'clock closing lasted for 50 years. A freeze on public house numbers instituted in 1894 remained largely in place for almost 70 years. It is argued that liquor restrictions were maintained primarily because of political inertia engendered by three main factors. Firstly, political parties avoided addressing liquor issues as they tended to threaten party unity. Secondly, repeated referendums provided politicians with a regular reminder of the strength of the temperance lobby, making them wary of reform. Thirdly, there was little lobbying for reform because the restrictions advantaged vested interests within the liquor industry, the controls were commonly believed to reduce alcohol consumption, and the isolation of New Zealand contributed to a lack of exposure to alternatives.</p>

Removing Temptation: New Zealand's Alcohol Restrictions, 1881-2005

<p>This thesis provides an historical overview of the legal restrictions placed on access to alcohol in New Zealand and details some consequences of these restrictions. It questions whether the historical evidence from New Zealand supports the availability theory of alcohol. The availability theory contends that for most societies the per capita consumption of alcohol can be reduced by restricting its availability, thereby reducing alcohol-related harm. The theory was propounded in detail by the international alcohol research community from the 1970s but was also implicit in 'restrictionist' approaches increasingly adopted in a variety of countries, including New Zealand, in the nineteenth and early twentieth centuries. The thesis focuses primarily on the period from 1881 onwards, when a new Licensing Act formalised the restrictionist principles that were to dominate liquor policy for much of the next century. Until the passing of 1989 Sale of Liquor Act New Zealand's liquor laws were characterised by strict controls on licence numbers, uniform hours of sale, regular polls on liquor issues and legal obligations to provide accommodation for travellers. The availability theory was tested by assessing the effect of the rapid changes in alcohol availability that resulted from tax and policy changes that increased or decreased restrictions on access. Large liquor tax increases in 1921 and 1958 were followed by significant and sustained reductions in per capita alcohol consumption. The lowering of the minimum legal age of purchase in 1969 and 1999 was followed by increased alcohol consumption. Both these findings are consistent with the availability theory. However, neither the banning of liquor sales after six pm from December 1917 ('six o'clock closing') nor the resumption of ten o'clock closing from October 1967 had any apparent effect on liquor consumption. Rapid changes in the number of liquor outlets from 1894 to 1910 and from 1990 to 1995 were inversely correlated with changes in per capita alcohol consumption, a finding that is strongly at odds the availability theory. The findings have relevance for contemporary debates on access to alcohol in Australia (outlet numbers) Great Britain (drinking hours and liquor taxes) and New Zealand (the drinking age). This thesis also attempts to explain why strict controls remained in place for so long given that restrictions on outlet numbers and. hours of sale had no apparent impact on liquor consumption. Six o'clock closing lasted for 50 years. A freeze on public house numbers instituted in 1894 remained largely in place for almost 70 years. It is argued that liquor restrictions were maintained primarily because of political inertia engendered by three main factors. Firstly, political parties avoided addressing liquor issues as they tended to threaten party unity. Secondly, repeated referendums provided politicians with a regular reminder of the strength of the temperance lobby, making them wary of reform. Thirdly, there was little lobbying for reform because the restrictions advantaged vested interests within the liquor industry, the controls were commonly believed to reduce alcohol consumption, and the isolation of New Zealand contributed to a lack of exposure to alternatives.</p>

Am I My Brother's Barkeeper? Sibling Spillovers in Alcohol Consumption at the Minimum Legal Drinking Age

We use data on sibling pairs near the minimum legal drinking age to provide causal estimates of peer effects in alcohol consumption. Following prior work on other outcomes, we exploit the discontinuous increase in alcohol consumption of the older sibling at the legal drinking age in a regression discontinuity design. Our preferred point estimates imply that the number of binge drinking days reported by the younger sibling decreases by 27% of the mean at the cutoff. While our estimates are somewhat imprecise, we are consistently able to rule out positive estimates from the existing literature. Our research design provides estimates which are interpretable as the causal effect of the peer's alcohol consumption. This is in contrast to most prior work which instead identifies the causal effect of exposure to the peer. We explain how this distinction matters for policy.

Adapting Intervention Approaches to New Contexts: Three Case Studies of International Adaptation of the Teen Online Problem Solving (TOPS) Program

Purpose/Objective: To describe the process of adapting the evidence-based Teen Online Problem Solving (TOPS) program, a telehealth problem-solving treatment addressing executive function and behavior regulation challenges in adolescents with traumatic brain injury, in Italy, New Zealand, and the United Kingdom. Research Method/Design: We describe the process of adapting and translating the TOPS program in three case studies with unique methods and samples. In Italy, 14 parents of adolescents with TBI participated in focus groups and two adolescents with TBI and their parents and two physicians provided input on the resulting translation. In New Zealand, an independent Māori cultural advisor reviewed the content, and six adolescent-parent dyads and two health professionals completed the 10 modules independently over a five-week period to inform adaptation. In the United Kingdom, a team of neuropsychologists and a parent of an adolescent with ABI reviewed and adapted the content through successive iterations. Results: In Italy, suggested changes included greater emphasis on nonverbal communication and clearer examples of inappropriate problem-solving responses. In New Zealand, parents and adolescents rated the program as acceptable and helpful. Suggestions included incorporating familiar Māori settings, integrating religion, and developing videos with New Zealand adolescents. In the United Kingdom, iterative refinements focused on adapting TOPS for other acquired brain injuries and reflecting cross-national differences (e.g., drinking age). Conclusions/Implications: These three case studies suggest that programs such as TOPS developed in one cultural context can be broadly acceptable in other contexts, with adaptations focusing on tailoring to reflect the unique cultural and linguistic setting.

The Self-Validating Role of Political Ideology on Political Attitudes

Recently there has been a resurgence of interest in the influence of ideology on the formation and maintenance of political attitudes. Much of this work has examined ideology as an individual difference that influences evaluations of political issues; these studies instead examined how one's ideology explicitly serves to polarize political opinions. Using the self-validation perspective as a theoretical backdrop, two studies examine the role of political ideology in validating thoughts about a political issue. In Study 1, considering one's political ideology after writing about one's attitude toward abortion increased thought confidence and attitude extremity related to abortion. Study 2 utilized a more subtle manipulation of ideology salience and found that political ideology validated thoughts about abortion, but not the issue of changing the legal drinking age (an issue less related to political ideology). These studies suggest that political ideology plays a role in attitude extremity and certainty toward ideology-relevant issues.

Investigating Underage Alcohol-Intoxicated Driver Crash Patterns in Louisiana

Despite the zero tolerance and minimum legal drinking age laws since 1999, crashes caused by underage drinking drivers have occurred every year in the United States, which is a huge cause for concern for roadway safety. This study utilized multiple correspondence analysis (MCA) on 9 years (2010 to 2018) of at-fault, underage (aged 15 to 20 years), alcohol-intoxicated driver crashes in Louisiana to investigate hidden crash attribute patterns. This exploratory multivariate analysis technique identifies systematic associations among categories of qualitative variables rather than recognizing the effect of a single factor on the response variable. The results exhibited the capability of MCA in discovering the meaningful clouds of crash contributory factors from a complex multidimensional dataset. Fatal crashes happened to underage alcohol-intoxicated drivers who were not using seatbelts on high-speed curve segments under dark without streetlights, whereas single-vehicle crashes resulted in moderate injuries among drinking novice teenagers operating light trucks. The findings also revealed the driving behavior patterns of rookie drivers after alcohol intake that resulted in collisions. For example, male teenagers were engaged in impaired driving during weekends under adverse weather conditions, and underage drinking drivers tended to use cellphones during late-night driving. Targeting critical attributes identified from associations could be helpful in reducing the number of related crashes and fatalities. Furthermore, knowledge gained about the attribute groups identified in this study could be included in educational training programs targeting risky driving maneuvers. Integration of multiple interventions could be more strategic in minimizing underage drinking collisions.

Are people aware of the link between alcohol and different types of Cancer?

Background Alcohol consumption is causally linked to several different types of cancer, including breast, liver, and colorectal cancer. While prior studies have found low awareness of the overall alcohol-cancer link, few have examined how awareness differs for each type of cancer. Greater awareness of risks associated with alcohol use may be a key factor in reducing alcohol-related cancer incidence. Methods We surveyed 1759 people of legal drinking age at the 2019 Minnesota State Fair. We used multivariable generalized linear models and linear regression models with robust standard errors to investigate factors associated with alcohol-cancer risk awareness. Models were fit examining predictors of overall awareness of alcohol as a risk factor for cancer, and prevalence of awareness of alcohol as a risk factor for specific types of cancer. Results Prevalence of awareness varied by cancer type, with awareness of alcohol causing liver cancer having the highest prevalence (92%) and awareness of alcohol causing breast cancer having the lowest prevalence (38%). Factors associated with awareness of alcohol-cancer risk differed by type of cancer. Conclusions In general, awareness of the risk of alcohol for certain types of cancer was low to moderate, reflecting a need to inform people not only that alcohol increases risk of cancer, but which types of cancer are most highly associated alcohol.