Depressive Symptoms, Alcohol Beliefs and Heavy Episodic Drinking in Adolescents

Adolescents who engage in heavy episodic drinking (HED—i.e., 5+ drinks on a single occasion) increase risks for psychopathology, alcohol dependence, and similar negative consequences in adulthood. We explored associations among depressive symptoms, positive alcohol beliefs, and progression of heavy episodic drinking (HED) in 3021 German adolescents (M(SD) age at baseline = 12.4 (1.0)) followed for 30 months in 4 waves, using a conditional parallel process linear growth model, with full information maximum likelihood estimation. By wave 4, 40.3% of participants had engaged in HED more than once; 16.4% had done so ≥5 times. Depressive symptoms were indirectly related to baseline values of HED (through positive beliefs and wave 1 drinking frequency and quantity) and to the rate of growth in HED (through positive beliefs and wave 1 quantity). Adolescents with higher levels of depressive symptoms and positive alcohol beliefs drink more frequently and at greater quantities, which is associated with initiating HED at a higher level and escalating HED more rapidly than peers with similar depressive symptoms who lack those beliefs. This suggests that, to the extent that positive alcohol beliefs can be tempered through public health campaigns, education and/or counseling, HED among depressed adolescents might be reduced.

A systematic review of self-report measures used in epidemiological studies to assess alcohol consumption among older adults

Background There is a lack of standardization regarding how to assess and categorize alcohol intake in older adults. The aim of this study was to systematically review methods used in epidemiological studies to define drinking patterns and measure alcohol consumption among older adults. Methods A systematic search was conducted in the MEDLINE, PubMed, PsycINFO, EMBASE, and CINAHL databases for studies published from January 2009 to April 2021. Studies were included if they were observational studies with a quantitative design; the mean age of the participants was ≥ 65 years; questionnaires, screening tools, or diagnostic tools were used to define alcohol consumption; and alcohol consumption was self-reported. Results Of 492 studies considered, 105 were included. Among the 105 studies, we detected 19 different drinking patterns, and each drinking pattern had a wide range of definitions. The drinking patterns abstaining from alcohol, current drinking, and risk drinking had seven, 12 and 21 diverse definitions, respectively. The most used questionnaire and screening tools were the quantity-frequency questionnaire, with a recall period of 12 months, and the full and short versions of the Alcohol Use Disorders Identification Test, respectively. Conclusion No consensus was found regarding methods used to assess, define, and measure alcohol consumption in older adults. Identical assessments and definitions must be developed to make valid comparisons of alcohol consumption in older adults. We recommend that alcohol surveys for older adults define the following drinking patterns: lifetime abstainers, former drinkers, current drinkers, risk drinking, and heavy episodic drinking. Standardized and valid definitions of risk drinking, and heavy episodic drinking should be developed. The expanded quantity-frequency questionnaire including three questions focused on drinking frequency, drinking volume, and heavy episodic drinking, with a recall period of 12 months, could be used.

Factors associated with increase in alcohol consumption during first months of COVID‑19 pandemic among online social media users in Russia

The significant proportion of the Russian population are active online social media users. Changes in alcohol consumption in this target group during the COVID-19 pandemic remain understudied. The aim of this survey was to investigate changes in alcohol consumption and factors associated with the increase in alcohol use among online social media users in Russia during the first months of the COVID-19 pandemic. An online survey was conducted among 1,518 users of online social networking services popular in Russia from June to September 2020. The survey revealed that 35.4% of men and 25.6% of women started drinking more frequently during the first months of the pandemic; 24.9% of men and 17.7% of women increased their usual consumption (volume) of alcohol on a typical drinking occasion, whereas 28.5% of men and 27.9% of women increased the frequency of heavy episodic drinking. Adjusted binary logistic regression analysis revealed a positive association between the increase in the frequency of alcohol consumption and the following factors: age from 18 to 29 years (OR: 1.710; 95% CI: 1.002–2.917), severe restrictions in everyday private life (OR: 3.127; 95% CI: 1.011–9.675) and severe negative professional or financial consequences due to the spread of SARS-CoV-2 (OR: 2.247; 95% CI: 1.131–4.465). The odds of an increase in the frequency of heavy episodic drinking were more than twice higher (OR: 2.329; 95% CI: 1.001–5.428) among those who had experienced severe negative consequences of the pandemic to their professional and financial situation. Higher typical frequency and usual consumption (volume) of alcohol on a typical drinking occasion and higher typical frequency of heavy episodic drinking before the pandemic were positively significantly associated with the increase in these parameters of alcohol consumption during the first months of the pandemic. In times of large-scale epidemics and public health crises, it is advisable to consider the possibility of implementing screening and brief interventions, including via online social media, to prevent problems associated with alcohol use.

Association between age at first alcohol use and heavy episodic drinking: An analysis of Thailand’s smoking and alcohol drinking behavior survey 2017

According to evidence from developed countries, age at first alcohol use has been identified as a determinant of heavy episodic drinking (HED). This study aimed to investigate the association between age at first alcohol use and HED using data from the Smoking and Drinking Behavior Survey 2017, a Thai nationally representative survey. Binary logistic regression was used to examine the association. This study used data from 23,073 current drinkers in the survey. The survey participants were chosen to represent the Thai population aged 15 years and older. The prevalence of HED and frequent HED among Thai drinkers was 18.6% and 10.1%, respectively. Age at first drinking <20 years was associated with higher odds of HED (adjusted OR, 1.43; 95% CI, 1.26–1.62) and frequent HED (adjusted OR, 1.31; 95% CI, 1.12–1.53) relative to age at first drinking ≥25 years. Regular drinking, drinking at home, and exposure to alcohol advertising increased the odds of HED. Drinking at home was associated with frequent HED. There was a significant interaction between the effect of age at first alcohol use and sex on HED and frequent HED with a stronger effect of age at first alcohol use observed in females. This study provides evidence from a developing country that early onset of alcohol use is associated with HED. Effective measures such as tax and pricing policy should be enforced to delay the onset of drinking.

Bayesian modelling of population trends in alcohol consumption provides empirically based country estimates for South Africa

Background Alcohol use has widespread effects on health and contributes to over 200 detrimental conditions. Although the pattern of heavy episodic drinking independently increases the risk for injuries and transmission of some infectious diseases, long-term average consumption is the fundamental predictor of risk for most conditions. Population surveys, which are the main source of data on alcohol exposure, suffer from bias and uncertainty. This article proposes a novel triangulation method to reduce bias by rescaling consumption estimates by sex and age to match country-level consumption from administrative data. Methods We used data from 17 population surveys to estimate age- and sex-specific trends in alcohol consumption in the adult population of South Africa between 1998 and 2016. Independently for each survey, we calculated sex- and age-specific estimates of the prevalence of drinkers and the distribution of individuals across consumption categories. We used these aggregated results, together with data on alcohol production, sales and import/export, as inputs of a Bayesian model and generated yearly estimates of the prevalence of drinkers in the population and the parameters that characterise the distribution of the average consumption among drinkers. Results Among males, the prevalence of drinkers decreased between 1998 and 2009, from 56.2% (95% CI 53.7%; 58.7%) to 50.6% (49.3%; 52.0%), and increased afterwards to 53.9% (51.5%; 56.2%) in 2016. The average consumption from 52.1 g/day (49.1; 55.6) in 1998 to 42.8 g/day (40.0; 45.7) in 2016. Among females the prevalence of current drinkers rose from 19.0% (17.2%; 20.8%) in 1998 to 20.0% (18.3%; 21.7%) in 2016 while average consumption decreased from 32.7 g/day (30.2; 35.0) to 26.4 g/day (23.8; 28.9). Conclusions The methodology provides a viable alternative to current approaches to reconcile survey estimates of individual alcohol consumption patterns with aggregate administrative data. It provides sex- and age-specific estimates of prevalence of drinkers and distribution of average daily consumption among drinkers in populations. Reliance on locally sourced data instead of global and regional trend estimates better reflects local nuances and is adaptable to the inclusion of additional data. This provides a powerful tool to monitor consumption, develop burden of disease estimates and inform and evaluate public health interventions.

Framing Responsible Drinking Messages in Nigeria: An Empirical Examination

Nigeria ranks first for per capita consumption and heavy episodic drinking prevalence in Africa. Yet, there are no alcohol policies, standard drinks measurements, or low-risk drinking guidelines in the country. We explored the awareness and understanding/interpretations of the alcohol industry-sponsored ‘‘drink responsibly’’ message (DRM) among Nigerian youths. Data were elicited through semi-structured interviews and focus groups, and we also observed product labels and industry websites. Undergraduate participants were aware of the DRM, but some out-of-school participants with low-level education did not know it existed. This is likely because the DRM is promoted in the English language without any indigenous language alternatives. It is embedded in conventional advertisements that glamorize drinking without stand-alone public health messages encouraging low-risk drinking behaviours. Participants shared divergent but subjective interpretations of the DRM, but none associated it with abstinence. Some associated the DRM with the ability to hold one’s drink, stating that it means: ‘drinks very well, but don’t get drunk’, and ‘drink to your satisfaction, but don’t misbehave’. Other interpretations included: ‘know your limit’ and ‘drink in moderation'. Alcohol companies in Nigeria redirect consumers to Drinkaware’s and DrinkIQ’s websites in the UK but use inconspicuous fonts to inscribe the DRM on product labels. By design, alcohol companies frame the DRM to promote drinking and individual responsibility. Thus, it engendered subjective interpretations, including high-risk drinking behaviours. Policymakers should jettison self-regulation, implement alcohol policies and introduce low-risk drinking guidelines to encourage low-risk drinking. Also, Drinkaware’s and DrinkIQ’s websites should be avoided. To be effective, all RDMs should include the indigenous language versions.

Quantifying patterns of alcohol consumption and its effects on health and wellbeing among BaYaka hunter-gatherers: A mixed-methods cross-sectional study

Ethnographers frequently allude to alcoholism and related harms in Indigenous hunter-gatherer communities, but very few studies have quantified patterns of alcohol consumption or its health and social impacts. We present a case study of the Mbendjele BaYaka, a Congolese population undergoing socioeconomic transition. 83 adults answered questions about their frequency and quantity of alcohol consumption, underwent biometric measurements and reported whether they were currently experiencing a cough or diarrhoea; 56 participated in structured interviews about their experiences with alcohol. Based on WHO standards, we found 44.3% of the full sample, and 51.5% of drinkers (excluding abstainers), had a hazardous volume of alcohol consumption; and 35.1% of the full sample, and 40.9% of drinkers, engaged in heavy episodic drinking; consumption habits varied with sex and age. Total weekly consumption was a positive predictor of blood pressure and the likelihood of experiencing diarrhoea; associations with other biometric variables were not statistically significant. Interview responses indicated numerous other economic, mental and physical health harms of alcohol use, the prevalence of which demonstrate some variability between forest camps and permanent village settlements. These include high rates of drinking during pregnancy and breastfeeding (~40%); frequent alcohol-induced violence; and considerable exchange of foraged foods and engagement in exploitative labour activities to acquire alcohol or repay associated debts. Our findings demonstrate the prevalence of hazardous alcohol consumption among transitioning hunter-gatherers is higher than other segments of the Congolese population and indicate negative impacts on health and wellbeing, highlighting an urgent need for targeted public health interventions.