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Background/purpose: Tobacco and alcohol are the well-known carcinogenic agents of oral cavity health. The purpose of this study was to investigate the scientometric characteristics of alcohol and tobacco use and oral health. Materials and methods: The papers on alcohol and tobacco use and oral cavity were published since 1885 and 1895, respectively. All the eligible papers were retrieved on March 20, 2023 from the Scopus database. Results: There are 2529 and 1545 papers on tobacco smoking and alcohol drinking and oral cavity in the Scopus database, respectively. Based on the frequency of keywords in all included papers, both smoking and drinking are involved in mouth neoplasms, oral cancer, leukoplakia, and periodontal diseases. In the papers on tobacco and alcohol use and oral cavity, the same research keywords confirm tobacco and alcohol use associate with oral cancer risk possibly through influencing genetics and gene and protein expression. For the distinctive keywords, nicotine, smoking cessation, and electronic cigarette are unique keywords of tobacco use. Acetaldehyde, alcohol dehydrogenase, and alcohol metabolism are unique ones of alcohol use. Conclusion: This study for the first time reports the scientometric characteristics of tobacco and alcohol use and oral health, which might aid healthcare authorities to promote tobacco and alcohol control measures focused on the necessities of their population.

In England, the proportion of 13–15 year-olds who have ever drunk alcohol fell from 71% in 1999 to 35% in 2019. Despite substantial research literature studying this decline, we know little about connections with concurrent shifts in wider aspects of health and wellbeing. This paper aims to identify how indicators of health and wellbeing cluster within 15-year-olds in England, identify changes in clustering over time, and explore associations with sex and family affluence. We used latent class analysis of cross-sectional data from the Health Behaviours in School-aged Children study (n = 5,942; four waves 2001/02–2013/14). Classes were defined by indicators of substance use, sexual activity, diet, exercise, school-related measures, e-media use, parental relationships, and wellbeing. We identified three classes, which we labelled Overall unhealthy, Substance abstainers with behavioural risk indicators, and Overall healthy. The probability of being in the Overall unhealthy class fell (2001/02: 0.39; 2013/14: 0.18) while the probability of being in the Overall healthy class increased (0.21 to 0.41). The probability of weekly alcohol use fell in all classes (e.g. Overall unhealthy: 0.71 to 0.28). Females (female vs male OR: 1.74 95%CI: 1.30 – 2.34) and those with low family affluence (high vs low family affluence OR: 0.18 95%CI: 0.08 – 0.44) had significantly higher odds of being in the Overall unhealthy class. Overall, adolescents became more likely to have co-occurring indicators of good health and wellbeing, including reduced alcohol consumption, sexual activity and cigarette smoking. However, girls and those from poorer families remained more likely to have poor health and wellbeing.

Introduction: Aim of this study was to systematically review available evidence to analyse how effective are some non-pharmacological interventions such as physical exercise, sodium restriction, weight reduction and alcohol reduction in the management of hypertension and to study which of them produce the greatest reduction in blood pressure. Method: A systematic literature search was carried out on Pubmed, Medline, EBSCO and EMBASE, by using several key terms and following the PRISMA statement. Original papers and randomized clinical trials, published in English between 1988 and 2010 and regarding hypertensive individuals as participants were included. The narrative synthesis system of analysis was used and the Revman 5.0 software was used to carry out heterogeneity analysis. Results: A total of 51 RCT on salt restriction (n = 11, 22%), weight loss (n = 6, 12%), alcohol reduction (n = 7, 14%), physical exercise (n = 15, 29%), or a combination of these intervention modalities (n = 12, 23%) were included in our review. 94% of them reported a significant improvement on blood pressure following these interventions, whereas 6% of them reported a statistically non-significant improvement. None of the papers reported a post-intervention deterioration. Salt restriction was found to give the greatest reduction in blood pressure. However, significant heterogeneity exists among the results of the papers reviewed in our study. Discussion and Conclusions: Our findings confirm that physical exercise, sodium restriction, weight and alcohol use reduction are four non-pharmacological interventions effective in the control of hypertension. As they involve lifestyle modification, policy interventions for primary prevention are recommended in this area.

Purpose: Alcohol consumption can lead to risky driving and increase the frequency of traffic accidents, injuries and mortalities. The main purpose of our study was to compare simulated driving performance between two groups of drivers, one consumed alcohol and the other not consumed, using a systematic review. Methods: In this systematic review, electronic resources and databases including Medline via Ovid SP, EMBASE via Ovid SP, PsycINFO via Ovid SP, PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINHAL) via EBSCOhost were comprehensively and systematically searched. The randomized controlled clinical trials that compared simulated driving performance between two groups of drivers, one consumed alcohol and the other not consumed, were included. Lane position standard deviation (LPSD), mean of lane position deviation (MLPD), speed, mean of speed deviation (MSD), standard deviation of speed deviation (SDSD), number of accidents (NA) and line crossing (LC) were considered as the main parameters evaluating outcomes. After title and abstract screening, the articles were enrolled for data extraction and they were evaluated for risk of biases. Results: Thirteen papers were included in our qualitative synthesis. All included papers were classified as high risk of biases. Alcohol consumption mostly deteriorated the following performance outcomes in descending order: SDSD, LPSD, speed, MLPD, LC and NA. Our systematic review had troublesome heterogeneity. Conclusion: Alcohol consumption may decrease simulated driving performance in alcohol consumed people compared with non-alcohol consumed people via changes in SDSD, LPSD, speed, MLPD, LC and NA. More well-designed randomized controlled clinical trials are recommended.

The harmful use of alcohol is a major risk factor for the global burden of disease, and public policies are the most effective strategies to prevent it. Population-based surveys are milestones for planning, implementing, and monitoring those policies. However, there are numerous ways to measure alcohol consumption which may result in different indicators. Researchers and stakeholders should find common ground in the understanding of these measures to avoid misinterpretation and confusion in the field. Answering to the “Five W’s Epidemiology”, when interpreting alcohol-related information, may improve the communication, as well as reproducibility and comparability of research findings. This paper aims to exemplify this approach by describing some indicators from the World Health Organization’s Global Information System on Alcohol and Health (GISAH) and the corresponding data available from the latest Brazilian household surveys. Notably, none of the Brazilian surveys reports on all the nine selected GISAH indicators, and only two provided the necessary methodological details to be fully reproducible. A stronger agenda is of the utmost importancefor advancing in the monitoring and prevention of alcohol-related harms in Brazil.

Abstract Background Randomized trials of complex interventions are increasingly including qualitative components to further understand factors that contribute to their success. In this paper, we explore the experiences of health care practitioners in a province wide smoking cessation program (the Smoking Treatment for Ontario Patients program) who participated in the COMBAT trial. This trial examined if the addition of an electronic prompt embedded in a Clinical Decision Support System (CDSS)—designed to prompt practitioners to Screen, provide a Brief intervention and Referral to Treatment (SBIRT) to patients who drank alcohol above the amounts recommended by the Canadian Cancer Society guidelines—influenced the proportion of practitioners delivering a brief intervention to their eligible patients. We wanted to understand the factors influencing implementation and acceptability of delivering a brief alcohol intervention for treatment-seeking smokers for health care providers who had access to the CDSS (intervention arm) and those who did not (control arm). Methods Twenty-three health care practitioners were selected for a qualitative interview using stratified purposeful sampling (12 from the control arm and 11 from the intervention arm). Interviews were 45 to 90 min in length and conducted by phone using an interview guide that was informed by the National Implementation Research Network’s Hexagon tool. Interview recordings were transcribed and coded iteratively between three researchers to achieve consensus on emerging themes. The preliminary coding structure was developed using the National Implementation Research Network’s Hexagon Tool framework and data was analyzed using the framework analysis approach. Results Seventy eight percent (18/23) of the health care practitioners interviewed recognized the need to simultaneously address alcohol and tobacco use. Seventy four percent (17/23), were knowledgeable about the evidence of health risks associated with dual alcohol and tobacco use but 57% (13/23) expressed concerns with using the Canadian Cancer Society guidelines to screen for alcohol use. Practitioners acknowledged the value of adding a validated screening tool to the STOP program’s baseline questionnaire (19/23); however, following through with a brief intervention and referral to treatment proved challenging due to lack of training, limited time, and fear of stigmatizing patients. Practitioners in the intervention arm (5/11; 45%) might not follow the recommendations from CDSS if these recommendations are not perceived as beneficial to the patients. Conclusions The results of the study show that practitioners’ beliefs were reflective of the current social norms around alcohol use and this influenced their decision to offer a brief alcohol intervention. Future interventions need to emphasize both organizational and sociocultural factors as part of the design. The results of this study point to the need to change social norms regarding alcohol in order to effectively implement interventions that target both alcohol and tobacco use in primary care clinics. Trial registration ClinicalTrials.gov NCT03108144. Retrospectively registered 11 April 2017, https://www.clinicaltrials.gov/ct2/show/NCT03108144

Abstract Objective: This paper provides a case study of the responses to alcohol of an Aboriginal Community Controlled Health Service (The Service), and investigates the implementation of comprehensive primary health care and how it challenges the logic of colonial approaches. Methods: Data were drawn from a larger comprehensive primary health care study. Data on actions on alcohol were collected from: a) six‐monthly service reports of activities; b) 29 interviews with staff and board members; c) six interviews with advocacy partners; and d) community assessment workshops with 13 service users. Results: The Service engaged in rehabilitative, curative, preventive and promotive work targeting alcohol, including advocacy and collaborative action on social determinants of health. It challenged other government approaches by increasing Aboriginal people’s control, providing culturally safe services, addressing racism, and advocating to government and industry. Conclusions: This case study provides an example of implementation of the full continuum of comprehensive primary health care activities. It shows how community control can challenge colonialism and ongoing power imbalances to promote evidence‐based policy and practice that support self‐determination as a positive determinant for health. Implications for public health: Aboriginal Community Controlled Health Services are a good model for comprehensive primary health care approaches to alcohol control.

Abstract Objective Mobile Health approaches show promise as a delivery mode for alcohol screening and brief intervention. The ‘YourCall’ trial evaluated the effect of a low-intensity mobile phone text message brief intervention compared with usual care on hazardous drinking and alcohol-related harms among injured adults. This paper extends our previously published primary outcome analysis which revealed a significant reduction in hazardous drinking associated with the intervention at 3 months, with the effect maintained across 12 months follow-up. The objective of the current study was to evaluate the effect of the intervention on alcohol-related harms and troubles and help-seeking behaviours (secondary outcomes) at 12-months follow-up. Results A parallel two-group, single-blind, randomised controlled trial was conducted in 598 injured inpatients aged 16–69 years identified as having medium-risk hazardous drinking. Logistic regression models applied to 12-month follow-up data showed no significant differences between intervention and control groups in self-reported alcohol-related harms and troubles and help-seeking behaviours. Although this text message intervention led to a significant reduction in hazardous alcohol consumption (previously published primary outcome), changes in self-reported alcohol-related harms and troubles and help seeking behaviours at 12-months follow up (secondary outcomes) were small and non-significant. Trial registration ACTRN12612001220853. Retrospectively registered 19 November 2012.

Background: The prevalence of alcohol consumption in Iran cannot be estimated because large variations have been observed in the reported prevalences of alcohol consumption. The main aim of this study was to assess the methodological challenges in estimation of the life time prevalence of alcohol consumed in Iran. By the same token we provided a standard approach for future researches in this regard. Methods: Published articles were reviewed systematically. Using the risk of bias tool, 49 out of 600 articles met the eligibility criteria. Based on the population of alcohol consumers, the included studies were categorized into 5 groups: general populations, patients, school students, university students, and specific population (first relatives of opium addicts and women who were faced with epistemic violence). Results: There was a paucity of reliable information in about 40% of provinces. Almost all studies applied the direct size estimation methods, but 11 studies used face to face interview and 38 studies used self-administered questionnaires. The non-response bias seemed prominent in entire studies except those on school students. It is important to mention that 97% of papers in general population did not represent any information about the non-response rate. The reported prevalence ranged from 1.37% in university students to 88.8% in patient population. Even among university students, the prevalence varied considerably (1.37% to 34.7%). Conclusion: The observed huge variations in the reported prevalence of alcohol consumption, due to the methodological consideration, appear largely in Iran. Therefore, it is necessary to develop a standard protocol for data collection and sampling to harmonize the findings in future studies. In addition, it is recommended to assess the frequency of alcohol use by indirect methods such as the Network Scale Up method.

OBJETIVO: Problemas relacionados ao consumo de álcool são freqüentes, especialmente entre a população jovem. A publicidade de bebidas alcoólicas é um dos fatores passíveis de modificação com impacto no aumento do consumo de álcool. MÉTODO: Foi realizada uma revisão bibliográfica de trabalhos que investigaram de diversos pontos de vista o impacto da publicidade do álcool sobre o consumo. A busca foi feita nas bases de dados Medline, SciELO, PsychoInfo e Google Scholar no período entre 1990 e 2008 e utilizou-se a técnica de " bola de neve" para a indicação de autores mais profícuos na área. Obtiveram-se mais de uma centena de artigos. RESULTADOS: O conjunto de trabalhos aponta que fatores como exposição à publicidade e atratividade da publicidade de bebidas alcoólicas estão relacionados com uma maior expectativa de consumo futuro e com um consumo maior e mais precoce, principalmente entre adolescentes e adultos jovens. Apesar das dificuldades metodológicas, estudos econométricos mais recentes consideram que a redução e/ou banimento de publicidade teria efeito de redução do consumo de álcool. Questões referentes às bases neurofisiológicas do processo de tomada de decisões e da liberdade de escolha no contexto da exposição à publicidade também são discutidas. CONCLUSÕES: O conhecimento atual sobre o tema indica que a redução da exposição à publicidade tem impacto sobre o consumo de álcool, principalmente entre os mais jovens.OBJECTIVE: Problems related to alcohol consumption are frequent, especially among the youth population. We analyzed advertisement as one of several modifiable factors with impact over alcohol consumption. METHOD: The authors carried out a literature review within Medline, SciELO, PsychoInfo and Google Scholar databases between 1990 and 2008, retrieving studies with different approaches of the alcohol advertisement impact on consumption. Besides, a " snowball" technique was applied to identify the most proficuous authors on the matter. Over a hundred papers were initially selected. RESULTS: The overall set of papers indicate that factors such as exposition to the advertising and attractiveness of the alcoholic beverage advertising are related with greater expectation of future consumption and with a higher and precocious consumption of alcohol, specially among adolescents and young adults. Despite methodological difficulties, recent econometrical studies indicate that reduction and/or banishment of advertising would decrease alcohol consumption. We also consider issues about the neurophysiology of decision making process and the freedom of choice in the context of exposition to advertisements. CONCLUSIONS: The current knowledge on the matter strongly suggests that a reduction of the exposition to alcohol advertisements impacts on its consumption, mainly among young populations.

Abstract Background Binge-drinking in adolescents is a highly prevalent healthcare problem that associates physical and mental health complications with community implications. This paper describes the design, implementation and evaluation of the first web-based computer tailored intervention aimed at the prevention of binge drinking in Spanish adolescents. Methods The Alerta Alcohol program is based on the I-Change Model. First, feedback from focus and Delphi groups are used for cultural adaptation and to obtain further information on the items to be included on the program. A pilot study is then conducted to assess feasibility and to identify strengths and weaknesses. Second, a Cluster Randomized Controlled Trial is conducted to test the effectiveness of Alerta Alcohol in students aged 16 to 18 years. The study is performed in 16 high schools from Andalusia (southern Spain), which are randomized either to the experimental or the control condition (EC and CC). The EC receives the Alerta Alcohol intervention, which consists of four sessions at school (baseline questionnaire, two sessions in three scenarios: at home, celebrations, and public places, and a final evaluation). The adolescents are provided with answers related to their views of each scenario; this information is used to provide highly specific feedback regarding their knowledge, risk perception, self-esteem, attitude, social influence, and self-efficacy. In addition, two booster sessions are given at home to reinforce the previous messages. The CC just completes the baseline and the final evaluation questionnaires and then they are allowed to receive the intervention as well (as a waiting list). Evaluation takes place after four months. The primary endpoint is binge drinking within 30 days prior to the evaluation and alcohol use in the previous week. It is expected that Alerta Alcohol reduce the prevalence of binge drinking by 10%. Follow up analyses are carried out to determine the differences in effectiveness according to the compliance of the program (quality of the implementation). Discussion The results are expected to be applicable and may incorporate improvements in the practice of the Healthcare and Education Systems. If the program proves to be effective, regional and eventual national implementation should be considered. Trial registration Trial registration number (ClinicalTrials.gov): NCT03288896. This study was retrospectively registered on 19/09/2017.

Introduction: The aim of the paper is to evaluate the association between overall state school assessment and selected problem behaviours among secondary school students. Method: The nationwide sample included 4085 students interviewed in 2015, from 70 randomly selected schools that had undergone comprehensive external evaluation. Two standardised scales describing alcohol drinking and delinquent behaviour taken from Polish version of CHIP-AE questionnaire (Child Health and Illness Profile – Adolescent Edition) were used. Hierarchical data structure was taking into account by comparison between a standard linear model and a mixed model with random intercept. The school assessment was based on 12 evaluation requirements and three categories of schools were distinguished (worse, average and better; 20%, 60% and 20% of the sampled schools respectively). Impact of gender, age, school achievements and family affluence on problem behaviours were analysed at the individual level. Results: Among individual determinants, males and poor school achievements were a prediction of both problem behaviours (alcohol use and delinquent behaviour). A significant relationship between the results of school evaluation and alcohol use was demonstrated in preliminary analyses, but was weakly confirmed in multilevel models. However, the association between these results of school evaluation and the variability of delinquent behaviour index was revealed in the multivariate analysis, particularly in interaction with school achievements. Conclusion: Better school may reduce the negative impact of factors contributing to adolescence problem behaviour.

OBJETIVO: A literatura científica mais recente aponta que a publicidade de bebidas alcoólicas influencia o comportamento, particularmente o consumo precoce e em grandes quantidades por crianças e adolescentes. Da perspectiva da saúde pública, a publicidade de bebidas alcoólicas deve ser restringida. Em muitos países, assim como no Brasil, os limites são estabelecidos pela autorregulamentação (ou seja, controlados pela própria comunidade publicitária). Analisou-se na presente revisão o conjunto dos trabalhos publicados na literatura internacional sobre este tipo de controle. MÉTODO: Realizou-se uma revisão bibliográfica sistemática de trabalhos que investigaram a eficácia da autorregulamentação da publicidade de bebidas alcoólicas. A busca foi feita nas bases de dados Medline, SciELO, Camy e Google Scholar, entre 1991 e 2010, bem como pela técnica de "bola de neve" para a indicação dos principais autores no tema. Foram considerados para o presente propósito 11 artigos. DISCUSSÃO: O conjunto dos trabalhos obtidos aponta que a autorregulamentação da publicidade de bebidas alcoólicas é pouco eficaz, não cumprindo com os objetivos de evitar, por exemplo, publicidade direcionada às crianças e adolescentes. CONCLUSÃO: Outras medidas devem ser consideradas para o controle e a veiculação das propagandas de bebidas alcoólicas, tais como monitoramento independente e controle legal.OBJECTIVE: The most recent scientific literature indicates that alcohol advertising influences behavior, particularly early and higher alcohol consumption by children and adolescents. From a public health perspective, alcohol advertising should be restricted. In many countries, as well as in Brazil, limits to alcohol advertising are established by industry self-regulation (e.g. controlled by the advertising community itself). We examined in this review all papers on the subject of industry self-regulation of alcohol advertising published in the international literature. METHOD: A systematic literature review was realized on papers investigating the effectiveness of self-regulation of alcohol advertisings. The search was conducted in Medline, SciELO, Camy and Google Scholar, between the years of 1991 and 2010. In addition, the "snowball" technique for the indication of the main authors on the subject was employed. From the papers found, 11 focused on the subject discussed here. DISCUSSION: The set of papers obtained indicates that industry self-regulation of alcohol advertising does not show evidence of efficacy. In other words, such a regulation does not prevent, for instance, alcohol advertising directed at children and adolescents. CONCLUSION: Further measures should be considered for the control and the broadcast of alcohol advertising, such as independent monitoring, legal control.

The paper assesses blood alcohol concentration and risk behaviors for traffic accidents before and after the implementation of a law which prohibits the use of alcoholic beverages on city gas stations. In Porto Alegre, Southern Brazil, young people go out at night and drive to gas station convenience stores to buy alcoholic beverages which are consumed on the premises of parking lots in gas stations. Data were obtained from self-administered questionnaires and breath analyzers in two cross-sectional collections with purposive samples of youngsters in May and July 2006 (n=62, and n=50, respectively). There were no significant differences between the groups before and after the city law was passed. Blood alcohol concentration greater than 0.06% was found in 35.5% of pre-law group and 40% of post-law group (p=0.62). Results point out heavy alcohol use in both groups, which did not change after the law was passed.En el artículo se analizaron la alcoholemia y los comportamientos de riesgo de accidentes de transito en jóvenes antes y después de la implementación de la ley que prohíbe el consumo de bebidas alcohólicas en puestos de gasolina. En Puerto Alegre (Sur de Brasil), los jóvenes acostumbran salir de noche y conducir hasta las tiendas de conveniencia de puestos de gasolina para comprar y consumir bebidas alcohólicas en los estacionamientos dentro de los puestos. Los datos fueron obtenidos de encuestas auto-aplicables y alcoholímetro en dos colectas transversales realizadas con jóvenes, abordados en mayo y julio de 2006 con muestreo intencional (n=62 y n=50, respectivamente). No hubo diferencia significativa entre los grupos entrevistados. Alcoholemia > 0,06% fue encontrada en 35,5% y 40% de los individuos antes y después de la ley, respectivamente (p=0,62). Los resultados señalan el uso pesado de alcohol en ambos grupos, inalterado por la implementación de la ley.No artigo foram analisados a alcoolemia e comportamentos de risco para acidentes de trânsito em jovens antes e depois da implementação de lei proibindo o consumo de bebidas alcoólicas em postos de gasolina. Em Porto Alegre (RS), os jovens costumam sair à noite e dirigir até lojas de conveniência de postos de gasolina para comprar e consumir bebidas alcoólicas nos estacionamentos dentro dos postos. Os dados foram obtidos de questionários autoaplicáveis e bafômetro em duas coletas transversais realizadas com jovens, abordados em maio e julho de 2006 com amostragem intencional (n=62 e n=50, respectivamente). Não houve diferença significativa entre os grupos entrevistados. Alcoolemia >0,06% foi encontrada em 35,5% e 40% dos indivíduos antes e depois da lei, respectivamente (p=0,62). Os resultados apontam o uso pesado de álcool em ambos os grupos, inalterado pela implementação da lei.

O texto analisa o processo de alcoolização em populações indígenas do Alto Rio Negro, Amazonas, Brasil. Baseando-se num enfoque compreensivo sobre o que se bebe, como se bebe e quando se bebe, a etnografia privilegia o estudo do contexto sócio-cultural e histórico no qual se dá o consumo de álcool e a interpretação nativa sobre a questão; discute as transformações históricas nas formas de beber e suas correlações com as permanências e mudanças da vida social. Conclui que as formas atuais de consumo de álcool estão ligadas à adoção de comportamentos e valores engendrados na fronteira das relações interétnicas e às ressignificações da cultura tradicional que hoje enfrenta dificuldade para oferecer parâmetros para a ação e para a simbolização da vida social pelas gerações mais jovens, frente aos desafios do mundo contemporâneo.This paper analyzes the development of alcoholism among Indian peoples in the Upper Rio Negro, Amazonas State, Brazil. Based on a comprehensive approach to what, how, and when individuals drink, this ethnography emphasizes the socio-cultural and historical context in which alcohol is consumed and interpretation of the issue by Indian people themselves. The article discusses historical transformations in the forms of drinking and their correlations with the status quo and changes in social standards of living. The article concludes that current forms of alcohol consumption are linked to the behaviors and values emerging on the frontier of interethnic relations and the resignification of the traditional culture, currently experiencing difficulties in offering parameters for action and symbolization of social life by the younger generations as they deal with challenges from the modern world.

Baseando-se numa revisão, apresentada pela Organização Mundial da Saúde (OMS), de recentes estudos sobre avaliação do custo social e de saúde decorrentes do uso do álcool, este artigo tem o objetivo de expor as evidências que permitem avaliar o consumo do álcool para além da esfera médica assistencial, pessoal e familiar, como questão prioritária do ponto de vista sócio-político e de saúde pública. São discutidos os dados mundiais e enfatizados os dados específicos do cenário brasileiro. O custo social é dimensionado com metodologia aplicada a diversos fatores, sendo unificados dados sobre violência, problemas familiares, abuso de menores, desordem pública, problemas profissionais, entre outros. O custo dos problemas de saúde é evidenciado pelo método epidemiológico, por meio de uma categorização elementar de dados de morbi-mortalidade geral de cada região e sub-região continental e triangulando-se dados de volume médio de consumo e padrões de consumo. Os resultados finais são obtidos através de análise comparativa de risco, utilizando-se basicamente um indicador representativo do número de anos de vida útil perdidos por adoecimento ou mortalidade precoce atribuíveis ao consumo do álcool, na língua inglesa designado "DALYs" (Disability Adjusted Life Years). O valor global do "DALYs", no ano de 2000, para o álcool, foi de 4% da morbi-mortalidade mundial, revelando tendência de ascensão. Os gradientes encontrados entre as diversas regiões do planeta são analisados à luz de uma crítica de seus potenciais determinantes.Based on the recent report on alcohol-related health and social burdens issued by the World Health Organization (WHO), this paper explores and discusses the evidence in support of the view that concerns about alcohol consumption extend far beyond consideration of personal and family health consequences, but should be considered in the context of major socio-political and public health priorities. The global findings of the WHO report are first discussed, followed by analysis of the specific findings regarding the burden of alcohol problems in Brazil. The social burden of alcohol problems is quantified by applying a unifying methodology which incorporates outcomes for alcohol-related violence, family problems, child abuse, public disorder, lost productivity, and other consequences. By analyzing the epidemiological date on alcohol-related morbidity and mortality data from each continental region and sub-region, and cross-tabulating data on average consumed volume and patterns of consumption, the burden of disease are estimated for the various regions of the world. The final results provide a comparative analysis of risk, basically using a representative indicator of number of productive years lost because of illness or premature mortality due to alcohol consumption ("DALYs" - Disability Adjusted Life Years). The DALYs global value in 2000 was 4% of world mortality, with this rate predicted to increase as global alcohol consumption increases. Variations among various regions in the planet are critically analyzed on predictive factors.

IntroductionThe efficacy of screening and brief interventions (SBI) for excessive alcohol use in primary care is well established; however evidence on their cost-effectiveness is limited. A small number of previous reviews have concluded that SBI programmes are likely to be cost-effective, but these results are equivocal and important questions around the cost-effectiveness implications of key policy decisions such as staffing choices for delivery of SBIs and the intervention duration remain unanswered. MethodsStudies reporting both the costs and a measure of health outcomes of programmes combining screening and brief interventions in primary care were identified by searching MEDLINE, EMBASE, Econlit, the Cochrane Library Database (including NHS EED), CINAHL, PsycINFO, Assia and the Social Science Citation Index and Science Citation Index via Web of Knowledge. Included studies have been stratified both by delivery staff and intervention duration and assessed for quality using the Drummond checklist for economic evaluations.ResultsThe search yielded a total of 23 papers reporting the results of 22 distinct studies. There was significant heterogeneity in methods and outcome measures between studies; however almost all studies reported SBI programmes to be cost-effective. There was no clear evidence that either the duration of the intervention or the delivery staff used had a substantial impact on this result.ConclusionThis review provides strong evidence that SBI programmes in primary care are a cost-effective option for tackling alcohol misuse.

OBJETIVO: Evaluar el riesgo para el uso excesivo de etanol en personas con historia familiar positiva de consumo de alcohol (HF+). MATERIAL Y MÉTODOS: Los datos corresponden a una muestra de población general (n= 8 890) y fueron recopilados a partir de una encuesta nacional de adicciones en población urbana de México, realizada en 1988. Se determinaron medidas epidemiológicas de frecuencia y asociación considerando los antecedentes de HF+ como factor de exposición. RESULTADOS: La prevalencia actual del consumo consuetudinario de alcohol fue de 13.7% para los hombres y 0.6% para las mujeres, las cifras para el síndrome de dependencia fueron 9.9% para hombres y 0.6% para las mujeres. Los hombres con HF+ tienen dos veces más probabilidad de desarrollar el síndrome de dependencia que aquellos con HF-. La razón de momios en el grupo de mujeres fue de 1.27. CONCLUSIONES: Se observaron patrones diferenciales por sexo en la transmisión de problemas de consumo. El consumo de los padres representa un factor de riesgo importante para el desarrollo del síndrome de dependencia de los hijos. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlOBJETIVE: To assess the risk for alcohol abuse among individuals with a positive family history of alcohol abuse (FH+). MATERIAL AND METHODS: The study population was a sample (n=8 890) drawn from a 1988 national survey on addictions in Mexico City's urban population. Data analysis consisted of frequency and association measures, using family history of alcohol abuse as the exposure factor. RESULTS: Prevalence of heavy drinking was 13.7% for males and 0.6% for females. Alcohol dependence syndrome was found in 9.9% of males and 0.6% of females. Men with HF+ were twice more likely to develop dependence syndrome than HF- males. The odds ratio for women was 1.27. CONCLUSIONS: Differential patterns by gender were found for familial transmission of alcohol abuse; parental alcohol intake is a main risk factor for developing alcohol dependence syndrome. The English version of this paper is available at: http://www.insp.mx/salud/index.html

This paper presents an assessment of alcohol consumption, including the popular Mexican liquor tequila, in relation to the incidence of gastric cancer. We conducted a population-based case-control study in Mexico City, with 220 gastric cancer cases and 752 population-based controls. A food frequency questionnaire was used to measure consumption of alcohol and other dietary items. Grams of ethanol were estimated by the Food Intake Analysis System 3.0 software. After adjustment for known risk factors, wine consumption was positively associated with the risk of developing gastric cancer (OR = 2.93; CI 95% 1.27-6.75) in the highest category of wine consumption, corresponding to at least 10 glasses of wine per month, with a significant trend (p = 0.005). This association remained among intestinal (OR = 2.16; CI 95% 0.68-6.92, p-value for trend = 0.031) and diffuse (OR = 4.48; CI 95% 1.44-13.94, p-value for trend = 0.018) gastric cancer cases. A borderline significant trend between GC risk and total ethanol intake was observed (p = 0.068). Consumption of beer and distilled alcoholic beverages including brandy, rum, and tequila was not associated with GC risk. The results indicate the need to focus on the study of the potential effects of different types of wine, with emphasis on components other than ethanol regarding the incidence of gastric cancer, even among populations with moderate to low levels of alcohol consumption.

This paper presents an assessment of alcohol consumption, including the popular Mexican liquor tequila, in relation to the incidence of gastric cancer. We conducted a population-based case-control study in Mexico City, with 220 gastric cancer cases and 752 population-based controls. A food frequency questionnaire was used to measure consumption of alcohol and other dietary items. Grams of ethanol were estimated by the Food Intake Analysis System 3.0 software. After adjustment for known risk factors, wine consumption was positively associated with the risk of developing gastric cancer (OR = 2.93; CI 95% 1.27-6.75) in the highest category of wine consumption, corresponding to at least 10 glasses of wine per month, with a significant trend (p = 0.005). This association remained among intestinal (OR = 2.16; CI 95% 0.68-6.92, p-value for trend = 0.031) and diffuse (OR = 4.48; CI 95% 1.44-13.94, p-value for trend = 0.018) gastric cancer cases. A borderline significant trend between GC risk and total ethanol intake was observed (p = 0.068). Consumption of beer and distilled alcoholic beverages including brandy, rum, and tequila was not associated with GC risk. The results indicate the need to focus on the study of the potential effects of different types of wine, with emphasis on components other than ethanol regarding the incidence of gastric cancer, even among populations with moderate to low levels of alcohol consumption.Para determinar o papel do consumo de bebidas alcoólicas, incluindo tequila, sobre incidência de câncer gástrico (CG), foi realizado um estudo caso-controle de base populacional na Cidade do México, com 220 casos de CG e 752 controles. Um questionário de freqüência alimentar foi empregado para medir o consumo de bebidas alcoólicas e outros itens da dieta. O consumo de etanol (gr) foi estimado usando-se o software Food Intake Analysis System 3.0. Após ajustamento por fatores de risco conhecidos, consumo de vinho esteve associado positivamente com o risco de desenvolver CG no estrato de maior consumo, ao menos dez copos de vinho mensais (OR = 2,93; I.C. 95% 1,27-6,75), p