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Introduction: The aim of the study is to estimate the association between bar density and nighttime emergency calls to the police., Methods: We used a pooled cross-sectional time-series data set covering the Swedish 290 municipalities spanning the time period 2012-2021. As outcome we used nighttime emergency calls to the police and daytime emergency calls to the police as control variable. Bar density was measured as number of serving establishments licensed to serve alcohol after 1 am. The municipalities were classified into three socio-economic (SES) categories: low, middle and high-SES areas. We used survey data to estimate the prevalence of heavy episodic drinking (HED) for each of the three SES areas. We applied fixed-effects modelling to estimate the association between bar density and nighttime police calls, implying that only within-unit variation was exploited., Results: Findings suggested that a 10% increase in bar density would result in a 0.46% (p = 0.001) increase in nighttime police calls. There was a marked gradient in the bar effect across SES areas; in high-SES areas the effect was not significant, while the effect was twice as strong in the low-SES areas as in mid-SES areas. We also found that the lower the status of the SES area, the higher the prevalence of HED., Discussion and Conclusions: We found a significantly positive association between bar density and nighttime police calls. However, the association was markedly stronger in low-SES areas (which were also characterised by an elevated HED prevalence) than in high-SES areas (distinguished by a lower HED prevalence)., (© 2024 The Author(s). Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

The timing, rate, and quantity of gestational alcohol consumption, collectively referred to here as Maternal Drinking Patterns (MDPs), are of known importance to fetal developmental outcomes. However, few studies have directly evaluated the impact of MDPs on offspring behavior. To do so, we used specialized equipment to record the precise amount and timing of alcohol consumption in pregnant dams, and then characterized MDPs using Principle Component Analysis (PCA). We next tested offspring on behaviors we have previously identified as impacted by prenatal alcohol exposure, and evaluated them where possible in the context of MDPs. Male alcohol exposed mice exhibited longer latencies to fall on the rotarod compared to their controls, which we attribute to a delayed decrease in body weight-gain. This effect was mediated by MDPs within the first 15 min of alcohol access (i.e. alcohol frontloading), where the highest performing male offspring came from dams exhibiting the highest rate of alcohol frontloading. Female alcohol exposed mice displayed reduced locomotor activity in the open field compared to controls, which was mediated by MDPs encompassing the entire drinking session. Surprisingly, total gestational alcohol exposure alone was not associated with any behavioral outcomes. Finally, we observed allodynia in alcohol exposed mice that developed more quickly in males compared to females, and which was not observed in controls. To our knowledge, this report represents the highest resolution assessment of alcohol drinking throughout gestation in mice, and one of few to have identified relationships between specific alcohol MDPs and neurobehavioral outcomes in offspring., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background and Aims: Previously identified national drinking patterns in Europe lack comparability and might be no longer be valid due to changes in economic conditions and policy frameworks. We aimed to identify the most recent alcohol drinking patterns in Europe based on comparable alcohol exposure indicators using a data-driven approach, as well as identifying temporal changes and establishing empirical links between these patterns and indicators of alcohol-related harm., Design: Data from the World Health Organization's monitoring system on alcohol exposure indicators were used. Repeated cross-sectional hierarchical cluster analyses were applied. Differences in alcohol-attributable harm between clusters of countries were analyzed via linear regression., Setting: European Union countries, plus Iceland, Norway and Ukraine, for 2000, 2010, 2015 and 2019., Participants/cases: Observations consisted of annual country data, at four different time points for alcohol exposure. Harm indicators were only included for 2019., Measurements: Alcohol exposure indicators included alcohol per capita consumption (APC), beverage-specific consumption and prevalence of drinking status indicators (lifetime abstainers, current drinkers, former drinkers and heavy episodic drinking). Alcohol-attributable harm was measured using age-standardized alcohol-attributable Disability-Adjusted Life Years (DALYs) lost and deaths per 100 000 people., Findings: The same six clusters were identified in 2019, 2015 and 2010, mainly characterized by type of alcoholic beverage and prevalence drinking status indicators, with geographical interpretation. Two-thirds of the countries remained in the same cluster over time, with one additional cluster identified in 2000, characterized by low APC. The most recent drinking patterns were shown to be significantly associated with alcohol-attributable deaths and DALY rates. Compared with wine-drinking countries, the mortality rate per 100 000 people was significantly higher in Eastern Europe with high spirits and 'other' beverage consumption [ β ^  = 90, 95% confidence interval (CI) = 55-126], and in Eastern Europe with high lifetime abstainers and high spirits consumption ( β ^  = 42, 95% CI = 4-78)., Conclusions: European drinking patterns appear to be clustered by level of beverage-specific consumption, with heavy episodic drinkers, current drinkers and lifetime abstainers being distinguishing factors between clusters. Despite the overall stability of the clusters over time, some countries shifted between drinking patterns from 2000 to 2019. Overall, patterns of drinking in the European Union seem to be stable and partly determined by geographical proximity., (© 2024 World Health Organization; licensed by Society for the Study of Addiction. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study ofAddiction.)

This study explores patterns of alcohol drinking within a representative New Zealand sample (2887 participants (1464 female, 1423 male)). Alcohol use and drinking patterns across the population are described. Multivariable logistic regressions document associations between alcohol use and drinking patterns and the likelihood of experiencing different health outcomes. Alcohol use, early drinking initiation, frequent drinking, and heavy episodic drinking (HED) are prevalent in New Zealand and vary in relation to gender, age, and socioeconomic characteristics. Those who reported alcohol-related problems were more likely to report poor mental health (AOR: 2.21; 95% CI: 1.42-3.46) and disability (AOR: 1.79, 95% CI: 1.06-3.00), and less likely to experience positive mental health (AOR: 0.28, 95% CI: 0.18-0.42). Those who reported HED were also less likely to experience good general health (AOR: 0.61, 95% CI: 0.47-0.81) and positive mental health (AOR: 0.67, 95% CI: 0.53-0.84). Younger age cohorts were more likely to engage in early drinking, and those who initiated regular drinking before age 18 were more likely to report HED and alcohol-related problems. Findings indicate that problem drinking and HED are not only associated with poor physical health, but also reduce the likelihood of individuals experiencing positive mental health. This provides information to enable public health practitioners to target alcohol prevention strategies at the entire population of drinkers.

Two-bottle choice home cage drinking is one of the most widely used paradigms to study ethanol consumption in rodents. In its simplest form, animals are provided with access to two drinking bottles, one of which contains regular tap water and the other ethanol, for 24 hr/day with daily intake measured via change in bottle weight over the 24 hr period. Consequently, this approach requires no specialized laboratory equipment. While such ease of implementation is likely the greatest contributor to its widespread adoption by preclinical alcohol researchers, the resolution of drinking data acquired using this approach is limited by the number of times the researcher measures bottle weight (e.g., once daily). However, the desire to examine drinking patterns in the context of overall intake, pharmacological interventions, and neuronal manipulations has prompted the development of home cage lickometer systems that can acquire data at the level of individual licks. Although a number of these systems have been developed recently, the open-source system, LIQ HD, has garnered significant attention in the field for its affordability and user friendliness. Although exciting, this system was designed for use in mice. Here, we review appropriate procedures for standard and lickometer-equipped two-bottle choice home cage drinking. We also introduce methods for adapting the LIQ HD system to rats including hardware modifications to accommodate larger cage size and a redesigned 3D printed bottle holder compatible with standard off-the-shelf drinking bottles. Using this approach, researchers can examine daily drinking patterns in addition to levels of intake in many rats in parallel thereby increasing the resolution of acquired data with minimal investment in additional resources. These methods provide researchers with the flexibility to use either standard bottles or a lickometer-equipped apparatus to interrogate the neurobiological mechanisms underlying alcohol drinking depending on their precise experimental needs., Competing Interests: DISCLOSURES All authors declare no conflicts of interest.

Aims: The aim of the present study was to assess the relationship between adolescent IQ and midlife alcohol use and to explore possible mediators of this relationship., Methods: Study data were from 6300 men and women who participated in the Wisconsin Longitudinal Study of high-school students graduating in 1957. IQ scores were collected during the participants' junior year of high school. In 2004, participants reported the number of alcoholic beverages consumed (past 30 days) and the number of binge-drinking episodes. A multinomial logistic regression was conducted to determine the relationship between adolescent IQ and future drinking pattern (abstainer, moderate drinker, or heavy drinker), and Poisson regression was used to examine the number of binge-drinking episodes. Two mediators-income and education-were also explored., Results: Every one-point increase in IQ score was associated with a 1.6% increase in the likelihood of reporting moderate or heavy drinking as compared to abstinence. Those with higher IQ scores also had significantly fewer binge-drinking episodes. Household income, but not education, partially mediated the relationship between IQ and drinking pattern., Conclusions: The present study suggests that higher adolescent IQ may predict a higher likelihood of moderate or heavy drinking in midlife, but fewer binge-drinking episodes. The study also suggests that this relationship is mediated by other psychosocial factors, specifically income, prompting future exploration of mediators in subsequent studies., (© The Author(s) 2024. Medical Council on Alcohol and Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Attentional bias (AB) is an implicit selective attention toward processing disorder-significant information while neglecting other environmental cues. Considerable empirical evidence highlights the clinical implication of AB in the onset and maintenance of substance use disorder. An innovative method to explore direct measures of AB relies on the eye-movement activity using technologies like eye-tracking (ET). Despite the growing interest regarding the clinical relevance of AB in the spectrum of alcohol consumption, more research is needed to fully determine the AB patterns and its transfer from experimental to clinical applications. The current study consisted of three consecutive experiments. The first experiment aimed to design an ad-hoc visual attention task (VAT) consisting of alcohol-related and neutral images using a nonclinical sample (n = 15). The objective of the second and third experiments was to analyze whether the effect of type of image (alcohol-related vs. neutral images) on AB toward alcohol content using the VAT developed in the first experiment was different for type of drinker (light vs. heavy drinker in the second experiment [n = 30], and occasional social drinkers versus alcohol use disorder (AUD) patients in the third experiment [n = 48])., Methods: Areas of interest (AOIs) within each type of image (neutral and alcohol-related) were designed and raw ET-based data were subsequently extracted through specific software analyses. For experiment 1, attention maps were created and processed for each image. For experiments 2 and 3, data on ET variables were gathered and subsequently analyzed through a two-way ANOVA with the aim of examining the effects of the type of image and drinker on eye-movement activity., Results: There was a statistically significant interaction effect between type of image and type of drinker (light vs. heavy drinker in experiment 2, F(1, 56) = 13.578, p < 0.001, partial η2 = 0.195, and occasional social drinker versus AUD patients in the experiment 3, F(1, 92) = 35.806, p < 0.001, partial η2 = 0.280) for "first fixation" with large effect sizes, but not for "number of fixations" and "dwell time." The simple main effect of type of image on mean "first fixation" score for AUD patients was not statistically significant., Conclusion: The data derived from the experiments indicated the importance of AB in sub-clinical populations: heavy drinkers displayed an implicit preference for alcohol-related images compared to light drinkers. Nevertheless, AB fluctuations in patients with AUD compared to the control group were found. AUD patients displayed an early interest in alcohol images, followed by an avoidance attentional processing of alcohol-related images. The results are discussed in light of recent literature in the field., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Africa is the continent most affected by esophageal cancer in the world. Alcoholic beverages are controversially blamed, as esophageal cancer is a rare disease in several other countries ranked in the top 10 for consumption of alcoholic beverages. This study aims to conduct a comprehensive systematic review of published literature, statistically summarizing the strength of the association between drinking patterns and types, and the risk of esophageal cancer in Africa. A computerized search of reputable databases such as Medline/PubMed, EMBASE, Web of Science, and African Journals Online was performed to identify relevant studies published up to September 2023. The quality of the studies was evaluated using the Newcastle-Ottawa scale for case-control studies and the Agency for Healthcare Research and Quality tool for cross-sectional studies. A funnel plot and Egger test were utilized to assess potential publication bias. Meta-analyses were conducted using random-effects models with RevMan 5.3 and Stata software to estimate summary effects. The systematic review identified a total of 758,203 studies, primarily from Eastern and Southern Africa. The pooled samples across all studies comprised 29,026 individuals, including 11,237 individuals with cancer and 17,789 individuals without cancer. Meta-analysis revealed a significant association between alcohol consumption and the risk of esophageal cancer (odds ratio [OR] = 1.81; 95% confidence interval [CI], 1.50-2.19). Further analysis based on the frequency of alcoholic beverage consumption indicated a stronger association with daily (OR = 2.38; 95% CI, 1.81-3.13) and weekly (OR = 1.94; 95% CI, 1.32-2.84) drinkers in contrast to occasional drinkers (OR = 1.02; 95% CI, 0.81-1.29). Additionally, consumption of traditional alcoholic beverages was significantly associated with the risk of esophageal cancer in African populations (OR = 2.00; 95% CI, 1.42-2.82). However, no relationship has been established between the exclusive consumption of non-traditional drinks and the risk of esophageal cancer. In conclusion, the results of this study confirm the hypothesis that daily and weekly drinking patterns, significantly increase the risk of esophageal cancer in Africa, while occasional consumption does not show a significant association. Additionally, the consumption of traditional alcoholic beverages is notably linked to the risk of esophageal cancer in African populations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ndebia and Kamsu.)

Background: Alcohol use disorder (AUD) has been described as a chronic disease given the high rates that affected individuals have in returning to drinking after a change attempt. Many studies have characterized predictors of aggregated alcohol use (e.g., percent heavy drinking days) following treatment for AUD. However, to inform future research on predicting drinking as an AUD outcome measure, a better understanding is needed of the patterns of drinking that surround a treatment episode and which clinical measures predict patterns of drinking., Methods: We analyzed data from the Project MATCH and COMBINE studies (MATCH: n = 1726; 24.3% female, 20.0% non-White; COMBINE: n = 1383; 30.9% female, 23.2% non-White). Daily drinking was measured in the 90 days prior to treatment, 90 days (MATCH) and 120 days (COMBINE) during treatment, and 365 days following treatment. Gradient boosting machine learning methods were used to explore baseline predictors of drinking patterns., Results: Drinking patterns during a prior time period were the most consistent predictors of future drinking patterns. Social network drinking, AUD severity, mental health symptoms, and constructs based on the addiction cycle (incentive salience, negative emotionality, and executive function) were associated with patterns of drinking prior to treatment. Addiction cycle constructs, AUD severity, purpose in life, social network, legal history, craving, and motivation were associated with drinking during the treatment period and following treatment., Conclusions: There is heterogeneity in drinking patterns around an AUD treatment episode. This study provides novel information about variables that may be important to measure to improve the prediction of drinking patterns during and following treatment. Future research should consider which patterns of drinking they aim to predict and which period of drinking is most important to predict. The current findings could guide the selection of predictor variables and generate hypotheses for those predictors., (© 2023 Research Society on Alcohol.)

Background: Most clinical studies of alcohol use disorder (AUD) treatment have short follow-up periods, underestimating the full benefits of alcohol treatment. Furthermore, clinical studies only consider one treatment cycle and do not account for the need for multiple episodes to treat a chronic recurrent condition., Methods: A validated microsimulation model of the long-term drinking patterns of people with AUD in the United States simulated 10,000 individuals resembling those from a large clinical trial. The model was used to assess the impact of (1) 1-year, 5-year, and lifetime horizon on alcohol treatment cost-effectiveness estimates and (2) no, one, two, four, and unlimited additional treatment episodes on alcohol treatment cost-effectiveness estimates. Model outcomes included healthcare costs, crime costs, labor market productivity, life expectancy, quality-adjusted life years (QALYs), alcohol-related hospitalizations, and deaths. Cost-effectiveness analyses were conducted for two perspectives: a healthcare perspective that included costs from hospitalization and AUD treatment, and a broader societal perspective that also included crime costs and productivity., Results: The incremental cost per additional QALY gained for alcohol treatment compared with no treatment decreased from $55,590 after 1 year to $78 when healthcare costs and QALYs were tracked over the lifetime, that is, treatment became more cost effective. Treatment was cost saving for any time frame when the impacts on crime and labor productivity were also accounted for in a societal perspective. Access to multiple treatment episodes dominated (i.e., it was more effective and less costly) than no-treatment and one-episode scenarios. From a healthcare perspective, incremental costs per additional QALY for increasing from a maximum of two to four treatment episodes was $499 and from four to unlimited episodes was $5049. The unlimited treatment scenario dominated all others from a societal perspective. Results were robust in sensitivity analyses., Conclusions: A long-term perspective and multiple episodes of alcohol treatment improve cost-effectiveness estimates. When societal impacts are included, alcohol treatment is cost saving. Results support the value of alcohol treatment., (© 2023 Research Society on Alcohol.)

Aims: The Alcohol Use Disorders Identification Test (AUDIT) is one of the most widely used screening instruments worldwide. Although it was translated into many languages, not many country-specific adaptations exist, and a formal validation procedure of the Russian version has been carried out only recently. The present contribution documents the different steps taken to formally translate and adapt a Russian-specific version of the AUDIT (RUS-AUDIT). Methods: The AUDIT was translated into Russian following an established protocol, revised and adapted to the country context using an expert panel, and field-tested in an iterative approach, in line with WHO rules on instrument translation and adaptation A total of three pilot phases were carried out on 134 patients from primary healthcare (PHC) and 33 patients from specialised alcohol treatment facilities (narcology), guided by a specially established advisory board. Changes in each version were informed by the findings of the previous pilot phase and a thorough panel discussion. Results: Based on the findings of three different pilot phases, the RUS-AUDIT was developed as a paper-and-pencil interview for PHC professionals. Since various issues with representation and counting of standard drinks for the second test item arose, a special show card was developed to support the assessment. Preliminary AUDIT-C scores indicated that more than one-third of the screened women (34.2%) and about half of the screened men (50.9%) from PHC facilities have exceeded risk thresholds. Conclusions: The RUS-AUDIT was constructed as a feasible assessment tool for interviewers and patients. The large number of PHC patients who exceed the risk threshold has corroborated the need for formal validation and Russia-specific cut-off scores, considering the specific drinking patterns., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Background: The incidence of stroke in China is increasing, along with a clear trend in the prevalence of risk factors. Alcohol consumption is also a risk factor for stroke. Many cohort studies have explored the relationship between alcohol consumption and stroke risk. However, findings have been inconsistent., Methods: We used cluster sampling to select 13 districts and counties (at the same level) in Chongqing, China. Then, we used stratified random sampling to distribute the number of people in each district and county. 23,308 adults aged 30-79 were recruited between October 2018 and February 2019. Follow-up was conducted through a monitoring system and questionnaires until September 2022. Information on alcohol consumption and other covariates was collected using a standardized questionnaire. Participants were asked to report their weekly frequency of drinking over the past year and weekly intake of various alcoholic beverages in general. The frequency of drinking was divided into three categories: 1-2 d/week, 3-5 d/week, and 6-7 d/week. The average daily alcohol consumption is calculated based on the amount of alcohol contained in different alcoholic beverages. It is classified as nondrinker (0 g/day), light (0 to 12 g/day), moderate (13 to 36 g/day), and high (> 36 g/day). Cox proportional hazard regression models were used to estimate the association between alcohol consumption and stroke risk. Results are shown as multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs)., Results: With an average follow-up of 3.80 years, there were 310 new stroke events. The incidence of total stroke was 368.69 per 100,000 person-years. Overall, after adjusting for covariates, moderate alcohol consumption (average daily alcohol consumption 13-36 g/d) was associated with a lower risk of total stroke (HR: 0.48; 95% CI: 0.25-0.92) compared with nondrinkers. The adjusted HR and 95% CI for total stroke and ischemic stroke for those who drank alcohol 6-7 days per week were 0.60(0.37, 0.96) and 0.53(0.30, 0.94), respectively. The risk of total stroke (HR: 0.39; 95% CI: 0.17-0.89) was reduced in a pattern of drinking 6-7 days per week but with a mean alcohol consumption of less than 36 g/d. There was no significant association between alcohol consumption and hemorrhagic stroke., Conclusion: This study suggests moderate alcohol consumption is associated with a lower risk of total stroke. And healthy drinking patterns should be of more significant concern., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Adjusting for demographics and standard drinking measures, High Intensity Drinking (HID), indexed by the maximum quantity consumed in a single day in the past 12 months, may be valuable in predicting alcohol dependence other harms across high and low income societies. The data consisted of 17 surveys of adult (15,460 current drinkers; 71% of total surveyed) in Europe (3), the Americas (8), Africa (2), and Asia/Australia (4). Gender-disaggregated country analyses used Poison regression to investigate whether HID (8-11, 12-23, 24+ drinks) was incrementally influential, beyond log drinking volume and HED (Heavy Episodic Drinking, or 5+ days), in predicting drinking problems, adjusting for age and marital status. In adjusted models predicting AUDIT-5 for men, adding HID improved the overall model fit for 11 of 15 countries. For women, 12 of 14 countries with available data showed an improved fit with HID included. The results for the five Life-Area Harms were similar for men. Considering the results by gender, each country showing improvements in model fit by adding HID had larger values of the average difference between high intensity and usual consumption, implying variations in amounts consumed on any given day. The amount consumed/day often greatly exceeded HED levels. In many societies of varying income levels, as hypothesized, HID provided important added information on drinking patterns for predicting harms, beyond the standard volume and binging indicators.

Aim: In this study, using national survey data from 2014 and 2019, we tested the hypothesis that students at schools who introduced a common alcohol policy in 2017 drank less than students at schools without a common policy., Methods: We used survey data from 41 high schools that participated in the Danish National Youth Study in 2014 and 2019. We perceived the introduction of a common high-school alcohol policy in 2017 among local groups of high schools as a natural experiment and assessed it using difference-in-difference analyses. We assessed drinking patterns from 2014 and 2019 among students at schools with and without a common alcohol policy combined and stratified by sex in negative binominal regression and logistic regression models. Drinking patterns were measured as average weekly alcohol use, average alcohol intake at last school party, proportion of non-drinkers and frequent binge drinkers., Results: Drinking patterns were similar among students in schools with and without a common alcohol policy. For example, among students at schools with a common alcohol policy, the average alcohol intake at the last school party among drinkers was 8.7 units in 2014 and 8.5 units in 2019, whereas average alcohol intake among students at schools without a common alcohol policy was 8.8 units in 2014 and 8.9 units in 2019 ( p =0.413)., Conclusions: No statistically significant effects were observed following the introduction of a common alcohol policy on students' drinking patterns, and alcohol consumption among high-school students was stable and remained high in 2014 and in 2019.

Drinking alcohol has a vast and diverse impact on many aspects of people's lives around the world. It is a major public health concern and is subject to numerous legal regulations and limitations. So far, little attention has been paid to if and how the volume of alcohol containers may affect drinking patterns. The widespread availability in recent years in Poland of small vodka bottles in various flavors and sizes was the rationale behind investigating whether the phenomenon may affect drinking patterns in any way. This was a 12-month cross-sectional survey study that started in January 2020. It included a total of 217 inpatients and outpatients that met the ICD-10 alcohol dependence criteria. The respondents were asked about their drinking habits and the use of small vodka bottles. It was found that respondents who regularly use small vodka bottles were much more likely to start their drinking early in the morning. The widespread availability and selection of small vodka bottles may encourage and facilitate drinking that starts early in the morning. It also makes it easier to maintain and control intoxication throughout the whole day, which could be considered another drinking pattern different from the other well-established ones, such as binge or continuous drinking. However, the design of this study makes it impossible to draw firm conclusions and further research is necessary.

A drinking pattern characterised by occasional excessive drinking is a key challenge for public health in Greenland. The objective was to examine sex-specific time trends in drinking patterns among Greenland Inuit. Cross-sectional and cohort data from geographically representative health surveys in 1993, 2005-2010 and 2014 were included (n = 4,938). Drinking patterns were defined as abstainer, non-problematic and occasional binge drinking. Patterns were analysed by sex-specific crude proportions and logistical analyses according to age, birth cohort and calendar time, accounting for region and settlement type. More than half of the men and one-third of the women had an occasional binge drinking pattern, while 22.6% of females and 15.1% of men were abstainers. Abstention increased with increasing age, while occasional binge drinking decreased among men. Younger male birth cohorts were less likely to have an occasional binge drinking pattern, while the youngest females had the highest odds ratio. A drinking pattern characterised by occasional excessive use remains a key challenge for public health in Greenland with age as a strong predictor. A high prevalence of abstainers co-exists with a high prevalence of occasional binge drinking. The increased odds ratio for occasional binge drinking among younger females should be addressed further.

Background and Aims: In Finland, per-capita alcohol consumption increased in the early 2000s and decreased after 2007. Our aim was to determine how these changes originated from changes in drinking practices., Design: Repeated cross-sectional general-population surveys., Setting: Finland in 2000, 2008 and 2016., Participants: Finnish residents aged 15-69 years (n = 6703, response rate 59-78%)., Measurements: Event-level data on drinking occasions (n = 21 097). Types of drinking occasions (drinking practices) were identified with latent class analysis using occasion characteristics. The aggregated volume of consumption and intoxication occasions were decomposed into contributions from drinking practice classes and years., Findings: Nine drinking occasion types were identified: three at home without company other than family (51% of occasions in 2016), three socializing occasions in different places and with different company (33%) and three party occasion types (16%). Both the frequency of drinking occasion types and the occasion type-specific amounts of alcohol consumed contributed to aggregate-level changes in alcohol use. Drinking at home without external company (with family only; for men, also alone) contributed most to the increase in alcohol use before 2008. Big parties in homes and bars became less common in the 2000s, contributing most to the decline in drinking after 2008., Conclusions: The rise in per-capita alcohol consumption in Finland in the early 2000s appears to have been linked mainly to an increase in lighter drinking occasions at home without external company. The fall in per-capita drinking after 2007 was linked mainly to a decrease in big parties in homes and in licensed premises. Changes in drinking frequency and the amounts of alcohol consumed per occasion changed in the same direction as alcohol affordability., (© 2022 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Front-loading is a drinking pattern in which alcohol intake is skewed toward the onset of reward access. This phenomenon has been reported across several different alcohol self-administration protocols in a wide variety of species, including humans. The hypothesis of the current review is that front-loading emerges in response to the rewarding effects of alcohol and can be used to measure the motivation to consume alcohol. Alternative or additional hypotheses that we consider and contrast with the main hypothesis are that: (1) front-loading is directed at overcoming behavioral and/or metabolic tolerance and (2) front-loading is driven by negative reinforcement. Evidence for each of these explanations is reviewed. We also consider how front-loading has been evaluated statistically in previous research and make recommendations for defining this intake pattern in future studies. Because front-loading may predict long-term maladaptive alcohol drinking patterns leading to the development of alcohol use disorder (AUD), several future directions are proposed to elucidate the relationship between front-loading and AUD., (© 2022 The Authors. Alcoholism: Clinical & Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcoholism.)

The purposes of this study were to explore the drinking patterns, and urinary and plasma hydration biomarkers of young adults with different levels of habitual total drinking fluid intake. A cross-sectional study was conducted among 111 young male athletes in Beijing, China. Total drinking fluids and water from food were assessed by a 7-day, 24-h fluid intake questionnaire and the duplicate portion method, respectively. The osmolality and electrolyte concentrations of the 24-h urine and fasting blood samples were tested. Differences in groups LD1 (low drinker), LD2, HD1, and HD2 (high drinker), divided according to the quartiles of total drinking fluids, were compared using one-way ANOVA, Kruskal−Wallis H-tests, and chi-squared tests. A total of 109 subjects completed the study. The HD2 group had greater amounts of TWI (total water intake) and higher and lower contributions of total drinking fluids and water from food to TWI, respectively, than the LD1, LD2, and HD1 groups (p < 0.05), but the amounts of water from food did not differ significantly among the four groups (all p > 0.05). Participants in the HD2 group had higher amounts of water than participants in the LD1, LD2, and HD1 groups (p < 0.05); SSBs were the second top contributor of total drinking fluids, ranging from 24.0% to 31.8%. The percentage of subjects in optimal hydration status increased from 11.8% in the LD1 group to 58.8% in the HD2 group (p < 0.05). The HD2 and HD1 groups had 212−227 higher volumes of urine than the LD1 and LD2 groups (p < 0.05). No significant differences were found in the plasma biomarkers (p > 0.05), with the exception of higher concentrations of K in the HD1 group than in the LD1 group (p < 0.05). Subjects with higher amounts of total drinking fluids had better hydration status than those with lower total drinking fluids, but not better drinking patterns. Habitual total drinking fluids did not affect the plasma biomarkers.

The purpose of this integrative review is to synthesize prior research on the relationship between adolescents' perceived subjective and descriptive drinking norms and their drinking intention and behaviors. Four databases (CINAHL, PubMed, Cochrane, and Sociological Abstracts) were searched to identify relevant articles. Thirty-one peer-reviewed articles published from 2010 to 2020 were reviewed. The results highlight that adolescents' perceived drinking norms derived from their parents and peers, such as approving or disapproving attitudes, significantly influence adolescents' drinking intention and behaviors. Moreover, pro-drinking messages, advertisements, and postings from electronic media (i.e., TV, movies, and the Internet) and online social networks (e.g., Facebook, Instagram, and Twitter) shape adolescents' drinking intention and encourage adolescents to initiate alcohol consumption early and/or escalate their drinking. Thus, future interventions should focus on subjective drinking norms that stem from interpersonal relationships in combination with perceived descriptive drinking norms derived from various media exposure.

Two not mutually exclusive theories explain the effects of the COVID-19 pandemic on alcohol use. The Availability hypothesis contends that reduced opportunities to drink due to the closure of outlets and consumption sites should lead to decreases in alcohol use, whereas the Stress and Coping hypothesis argues that those exposed to stressful situations may increase drinking. The primary aim of this study was to examine changes-separately by gender-in the prevalence of drinking patterns among Italian young adults (18-34 years) before and during a COVID-19 lockdown. Study design was a repeated cross-sectional study, whereby data collected in 2015 and 2020 from nationally representative samples were analyzed. Latent class analysis identified five, fully invariant for women and partially invariant for men, drinking pattern classes among both cohorts: current non-drinkers (CND), weekend risky (WRD) and weekend non-risky drinkers (WnRD), daily non-risky (DnRD) and daily risky drinkers (DRD). In support of the Availability hypothesis, increases in abstaining and moderate drinking women and men were observed from 2015 to 2020. Concomitantly, among men only there were also increases in the prevalence of patterns characterized by risky drinking, coping drinking motives and related harm (Stress and Coping hypothesis). The pandemic and the three-tier lockdown imposed by the Italian government likely reduced overall alcohol use in the general population who drink moderately. However, there was a substantial increase in the prevalence of a small but significant group of men who drank daily and heavily to cope. Outreach and prevention efforts should target primarily this group, but also consider the opportunities that the exceptional circumstances of a quarantine offer to any individuals to reshape their lifestyle and health-related behaviors., (© 2022. The Author(s).)

The body's water and sodium balances are tightly regulated and monitored by the brain. Few studies have explored the relationship between water and salt intake, and whether sodium intake with different levels of fluid intake leads to changes in hydration status remains unknown. The aim of the present study was to determine the patterns of water intake and hydration status among young adults with different levels of daily salt intakes. Participants' total drinking fluids and water from food were determined by a 7-day 24-h fluid intake questionnaire for 7 days (from Day 1 to Day 7) and duplicate portion method (Day 5, Day 6 and Day 7). Urine of 24 h for 3 days (Day 5, Day 6 and Day 7) was collected and tested for the osmolality, the urine-specific gravity (USG), the concentrations of electrolytes, pH, creatinine, uric acid and the urea. The fasting blood samples for 1 day (Day 6) were collected and measured for the osmolality and the concentrations of electrolytes. The salt intakes of the participants were evaluated from the concentrations of Na of 24 h urine of 3 days (Day 5, Day 6 and Day 7). Participants were divided into four groups according to the quartile of salt intake, including the low salt intake (LS 1 ), LS 2 , high salt intake (HS 1 ) and HS 2 groups. In total, 156 participants (including 80 male and 76 female young adults) completed the study. The salt intakes were 7.6, 10.9, 14.7 and 22.4 g among participants in the four groups (LS 1 , LS 2 , HS 1 and HS 2 groups, respectively), which differed significantly in all groups ( F = 252.020; all p < 0.05). Compared to the LS 1 and LS 2 groups, the HS 2 group had 310-381, 250-358 and 382-655 mL more amounts of water from the total water intake (TWI), total drinking fluids and water from food (all p < 0.05), respectively. Participants in the HS 2 group had 384-403, 129-228 and 81-114 mL more in the water, water from dishes and staple foods, respectively, than those in the groups of LS 1 and LS 2 ( p < 0.05). The HS 2 group excreted 386-793 mL more urine than those in the groups of LS 1 and LS 2 ( p < 0.05). However, regarding urine osmolality, the percentage of participants with optimal hydration status decreased from 41.0% in LS 1 and LS 2 to 25.6% in the HS 2 group ( p < 0.05). Participants with higher salt intake had higher TWI, total drinking fluids and water from food. Nevertheless, they had inferior hydration status. A reduction in salt intake should be encouraged among young adults to maintain optimal hydration status.

Introduction: The COVID-19 outbreak and the related lockdown measures have raised concerns regarding mental health, including alcohol misuse. Preliminary studies investigated alcohol consumption at the early stages of lockdown, but no longitudinal data regarding its evolution during and after the first lockdown are currently available., Methods: We investigated changes in alcohol consumption among a convenience sample of 1,693 French-speaking Belgian adults using a 3-stage longitudinal online survey. All participants reported their consumption at different stages of lockdown: before lockdown onset (retrospectively, T0), at 2 different times during lockdown (T1 and T2), and after lockdown offset (T3). We also measured socio-demographic variables and the harmfulness of drinking patterns before lockdown., Results: A mixed model with negative binomial distribution indicated that participants decreased their alcohol consumption after lockdown onset and returned to their initial alcohol consumption after lockdown offset. Younger individuals (18-30 years old) were more likely to decrease their consumption during the lockdown period (T1 and T2) than the periods preceding or following lockdown (T0 and T3), especially if they presented hazardous or problematic drinking patterns before lockdown. We only observed a rebound effect after lockdown offset among young moderate drinkers. All participants kept stable their alcohol consumption during lockdown (T1 and T2)., Conclusions: Lockdown onset and offset constitute key periods for alcohol consumption changes during the COVID-19 crisis, particularly in youth and in individuals with hazardous or problematic drinking patterns., (© 2021 S. Karger AG, Basel.)

In July 2013, a train derailment profoundly disrupted the tranquility of the population of Lac-Mégantic for months and even years. In 2016, we conducted a representative population-based survey among 387 people from Lac-Mégantic and 413 from other municipalities with the aim to document psychological and physical health of adults exposed to the disaster. This article examines differences between 3 groups of respondents: those who were highly, moderately or not exposed to the train accident. Khi Square analyses, odds ratios and logistic regressions were used to examine differences between the 3 groups of respondents (high, moderate and no exposure). Results show that the level of exposure to this technological disaster is strongly associated with psychological suffering, post-traumatic growth, physical heath, drinking patterns, and use of prescribed and non-prescribed drugs. We can explain these results by the nature and cause of the event as well as its consequences.

In China, approximately 70% of beverage alcohol is consumed in the form of spirits. An estimated 25% of all alcohol consumed is unrecorded, mostly spirits (bai jiu), produced outside regulatory systems in small neighborhood distilleries, mostly in rural areas. Unrecorded bai jiu drinkers are generally older, male, prefer higher-strength bai jiu, and drink daily and mostly at home. To explore possible regional differences, researchers used interview data from 2919 bai jiu drinkers in rural areas in Hebei, Anhui, and Hubei provinces in China. Results confirmed that patterns varied by province. The sample in Hubei preferred unrecorded bai jiu with a more stable preference to alcohol type, tended to drink less frequently, and reported experiencing less drinking pressure, suggesting lower-risk drinking patterns in this region. The Hebei and Anhui sample reported higher frequency and greater amount of alcohol consumption, were more likely to experience drinking pressure, indicating higher-risk patterns in alcohol use in these two regions. The results provide needed details about regional differences in unrecorded bai jiu drinking patterns that are not evident in aggregated data and suggest variations in drinking patterns that may reflect local geography, local values, traditions, and ethnic differences.

Background: Previous research has demonstrated the utility of subanesthetic doses of ketamine in decreasing binge (Drinking-in-the-Dark, or DID) 20% alcohol intake in female inbred (C57BL/6J) mice when administered 12 hours prior to alcohol access (Crowley et al., 2019). In the current study, we assess the efficacy of a similar ketamine pretreatment using male and female selectively bred, crossed High Alcohol Preferring (cHAP) mice, which also drink to intoxication, but are not inbred. We hypothesized that ketamine would decrease binge alcohol intake without impacting locomotor activity., Methods and Results: Subjects were 28 adult cHAP mice. Mice first received a 2-week DID drinking history using 2-h/day alcohol access. On day 12, prior to ketamine treatment, the average blood ethanol concentration (BEC) was 130 mg/dL, confirming that mice reliably reached intoxicating BECs. On day 15, mice were given 0, 3, or 10 mg/kg of ketamine 12 hours prior to the DID session. Ketamine did not decrease total (2-h) alcohol consumption or locomotion. Interestingly, the 10 mg/kg dose of ketamine did alter the drinking pattern in male mice, decreasing front-loading for a single day. We opted to then increase the doses to 32 or 100 mg/kg (i.e., an anesthetic dose) two days after the initial treatment, keeping the saline control. Mice of both sexes decreased total binge alcohol intake at the 100 mg/kg dose only, but again, the effect only lasted one day., Conclusions: The current study found that cHAP mice reached more than double the BECs observed in C57BL/6J mice during DID, but did not respond to subanesthetic ketamine. Modest efficacy was found for ketamine pretreatment at anesthetic doses. Differences in findings may be due to differential intake during DID, or genetic differences between C57Bl/6J mice and cHAP mice. Drug efficacy in multiple models is important for discovering reliable pharmacotherapies for alcoholism., Competing Interests: Declaration of competing interest None., (Copyright © 2021 Elsevier Inc. All rights reserved.)

This paper explores trends in beverage preference in adolescents, identifies related regional differences, and examines cluster differences in key drinking measures. Data were obtained from the European School Survey Project on Alcohol and Other Drugs (ESPAD), covering 24 European countries between 1999 and 2019. Trends in the distribution of alcoholic beverages on the participants' most recent drinking occasion were analysed by sex and country using fractional multinomial logit regression. Clusters of countries based on trends and predicted beverage proportions were compared regarding the prevalence of drinkers, mean alcohol volume and prevalence of heavy drinking. Four distinct clusters each among girls and boys emerged. Among girls, there was not one type of beverage that was preferred across clusters, but the proportion of cider/alcopops strongly increased over time in most clusters. Among boys, the proportion of beer decreased, but was dominant across time in all clusters. Only northern European countries formed a geographically defined region with the highest prevalence of heavy drinking and average alcohol volume in both genders. Adolescent beverage preferences are associated with mean alcohol volume and heavy drinking at a country-level. Future approaches to drinking cultures need to take subpopulations such as adolescents into account.

Background: Alcohol consumption is an important risk factor for hepatic neoplastic and non-neoplastic diseases. Questions remain, however, about the relevance to disease risk of drinking patterns and alcohol tolerability, which differ appreciably between Chinese and Western populations., Methods: The prospective China Kadoorie Biobank included 512,715 adults (41% men) aged 30-79 years recruited from ten areas during 2004-2008, recording alcohol intake, drinking patterns, and other characteristics. After median 10 years' follow-up, 2531 incident liver cancer, 2040 liver cirrhosis, 260 alcoholic liver disease (ALD), and 1262 non-alcoholic fatty liver disease (NAFLD) cases were recorded among 492,643 participants without prior cancer or chronic liver disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HR) relating alcohol intake and drinking patterns to each disease., Results: Overall, 33% of men and 2% of women drank alcohol regularly (i.e. at least weekly) at baseline. Among male current regular drinkers, alcohol consumption showed positive dose-response associations with risks of several major chronic liver diseases, with HRs per 280 g/week (i.e. around four drinks/day) higher usual alcohol intake of 1.44 (95% CI 1.23-1.69) for liver cancer (n = 547), 1.83 (1.60-2.09) for liver cirrhosis (n = 388), 2.01 (1.77-2.28) for ALD (n = 200), 1.71 (1.35-2.16) for NAFLD (n = 198), and 1.52 (1.40-1.64) for total liver disease (n = 1775). The association with ALD appeared stronger among men reporting flushing (i.e., with low alcohol tolerance). After adjustment for the total amount of weekly alcohol consumption, daily drinkers had significantly increased risk of ALD (2.15, 1.40-3.31) compared with non-daily drinkers, and drinking without meals was associated with significantly greater risks of liver cancer (1.32, 1.01-1.72), liver cirrhosis (1.37, 1.02-1.85), and ALD (1.60, 1.09-2.33) compared with drinking with meals. Female current regular drinkers had significantly higher risk of ALD, but not other liver diseases, than female abstainers., Conclusions: In Chinese men, alcohol intake was associated with significantly increased risks of several major chronic liver diseases, and certain drinking patterns (e.g. drinking daily, drinking without meals) may further exacerbate the disease risks., (© 2021. The Author(s).)

Alcohol drinking is associated with increased risks of several site-specific cancers, but its role in many other cancers remains inconclusive. Evidence is more limited from China, where cancer rates, drinking patterns and alcohol tolerability differ importantly from Western populations. The prospective China Kadoorie Biobank recruited >512 000 adults aged 30 to 79 years from 10 diverse areas during 2004 to 2008, recording alcohol consumption patterns by a standardised questionnaire. Self-reported alcohol consumption was estimated as grams of pure alcohol per week based on beverage type, amount consumed per occasion and drinking frequency. After 10 years of follow-up, 26 961 individuals developed cancer. Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) relating alcohol consumption to incidence of site-specific cancers. Overall, 33% (n = 69 734) of men drank alcohol regularly (ie, ≥weekly) at baseline. Among male current regular drinkers, alcohol intake showed positive dose-response associations with risks of cancers in the oesophagus (655 events; HR = 1.98 [95%CI 1.79-2.18], per 280 g/wk), mouth and throat (236; 1.74 [1.48-2.05]), liver (573; 1.52 [1.31-1.76]), colon-rectum (575; 1.19 [1.00-1.43]), gallbladder (107; 1.60 [1.16-2.22]) and lung (1017; 1.25 [1.10-1.42]), similarly among never- and ever-regular smokers. After adjustment for total alcohol intake, there were greater risks of oesophageal cancer in daily drinkers than nondaily drinkers and of liver cancer when drinking without meals. The risks of oesophageal cancer and lung cancer were greater in men reporting flushing after drinking than not. In this male population, alcohol drinking accounted for 7% of cancer cases. Among women, only 2% drank regularly, with no clear associations between alcohol consumption and cancer risk. Among Chinese men, alcohol drinking is associated with increased risks of cancer at multiple sites, with certain drinking patterns (eg, daily, drinking without meals) and low alcohol tolerance further exacerbating the risks., (© 2021 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of Union for International Cancer Control.)

Alcohol is the single most important public health challenge in Greenland. We provide an overview of alcohol consumption, drinking patterns, and consequences of excessive use of alcohol in Greenland since 1950 through a synthesis of published results and analyses of population-based interview surveys. The import of alcohol fluctuated over the last 70 years with a peak in the 1980s at 22 litres 100% alcohol per person per year. In 1950 and 2015, the import of alcohol was similar at 8 litres. Several explanations have been put forward to explain the changes including restrictions, increased tax, demographic changes, treatment of alcohol disorders, and public health interventions. The proportion of abstainers increased from 1993 to 2018 while the proportion of participants with regular consumption decreased. About half of the population reported binge drinking at least monthly. Compared with Denmark, there were more abstainers and binge drinkers in Greenland, and fewer had a regular consumption. Although genetics may play a role for drinking patterns, social and cultural conditions are more important. Exposure to domestic alcohol problems and sexual abuse in childhood parallel the recorded import of alcohol and is a likely cause of transgenerational consequences such as youth suicides and alcohol problems.

Background : Although more than 40% of US military veterans have lifetime histories of alcohol use disorder (AUD), little is known about the prevalence and correlates of current drinking patterns (i.e., abstinent, subthreshold, hazardous drinking) in this population. Objectives : To characterize the prevalence and key correlates of abstinence, subthreshold drinking, and hazardous drinking in a nationally representative sample of US veterans with lifetime AUD. Methods : Data from 1,282 veterans with lifetime AUD who participated in the National Health and Resilience in Veterans Study were analyzed using analyses of variance, chi-square analyses, and multinomial regression models. Results : Of the 1,282 veterans with lifetime AUD (of which 94.7% were males), 674 (48.2%) were past-year subthreshold drinkers, 317 (28.0%) were abstinent and 291 (23.8%) were hazardous drinkers. Abstinent veterans were older, less educated, less socially engaged, and had higher levels of religiosity than subthreshold and hazardous drinkers. They were also more likely to smoke, screen positive for PTSD, reported greater somatic symptoms than subthreshold drinkers, and had more physical difficulties and lifetime trauma than hazardous drinkers. Subthreshold drinkers were more likely than hazardous drinkers to be female and report physical health problems and less likely to smoke and be depressed. Conclusion : More than three-quarters of US veterans with lifetime AUD are currently abstinent or subthreshold drinkers. Factors associated with abstinence included older age, health problems, religiosity and social engagement. Results suggest a "J-shaped" relationship between current drinking patterns and health and psychosocial factors in veterans, with subthreshold drinkers generally having better health than abstinent and hazardous drinkers.

Background and Aims: To reduce health and social inequities, it is important to understand how drinking patterns vary within and between Indigenous peoples. We aimed to assess variability in estimates of Indigenous Australian drinking patterns and to identify demographic and methodological factors associated with this., Design: A three-level meta-analysis of Australian Aboriginal and Torres Strait Islander ('Indigenous') drinking patterns [International Prospective Register of Systematic Reviews (PROSPERO) no. CRD42018103209]., Setting: Australia., Participants: Indigenous Australians., Measurements: The primary outcomes extracted were drinking status, single-occasion risk and life-time risk. Moderation analysis was performed to identify potential sources of heterogeneity. Moderators included gender, age, socio-economic status, local alcohol restrictions, sample population, remoteness, Australian state or territory, publication year, Indigenous involvement in survey design or delivery and cultural adaptations., Findings: A systematic review of the literature revealed 41 eligible studies. For all primary outcomes, considerable heterogeneity was identified within ( I 2 2 = 51.39-68.80%) and between ( I 3 2 = 29.27-47.36%) samples. The pooled proportions (P) of current drinkers [P = 0.59, 95% confidence interval (CI) = 0.53-0.65], single-occasion (P = 0.34, 95% CI = 0.24-0.44) and life-time (P = 0.21, 95% CI = 0.15-0.29) risk were all moderated by gender, age, remoteness and measurement tool. Reference period moderated proportions of participants at single-occasion risk., Conclusions: Indigenous Australian drinking patterns vary within and between communities. Initiatives to reduce high-risk drinking should take account of this variability., (© 2020 Society for the Study of Addiction.)

Aim: To analyse prevalence and trends in older people's (60+) alcohol use in Finland in 1993-2018., Data and Method: Data on people aged 65+ were obtained from the Health Behaviour and Health among the Finnish Elderly study (HBHFE) for the years 1993-2011 and from its successor the National FinSote Survey for the years 2013-2018. Data for 60-64-year-olds and for the reference group (20-59-year-olds) were obtained from the Health Behaviour and Health among the Finnish Adult Population (HBHFA) study for the years 1993-2011 and from the FinSote study for the years 2013-2018. Four measures were chosen to describe prevalence and trends in drinking patterns in five-year age groups among men and women aged 60+: prevalence of current drinking, prevalence of frequent drinking, typical amounts of drinking and prevalence of heavy episodic drinking (HED)., Results: Regarding prevalence of current drinking and frequent drinking, older women have been catching up with men, but older men still consume larger amounts of alcohol per occasion. The long-lasting increase in the prevalence of current drinkers continued in most older female age groups into the 2010s, settled in most older male and some female age groups, and shifted downwards in the oldest male age groups. In most older male and female age groups, the increasing trend in frequent drinking continued to the present. Data on typical amounts consumed and HED were only available for 2013-2018. In that period those measures remained rather stable., Conclusion: More detailed research on drinking patterns among people aged 60+ years is needed for two reasons: older people's drinking is a new cultural phenomenon and alcohol-related social and health harms are increasing in older age groups., Competing Interests: Declaration of conflicting interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

Objectives: Ireland has high per capita alcohol consumption and also has high levels of problematic drinking patterns. While it is accepted that patterns of alcohol consumption in Ireland are a cause for concern, it is not clear if Irish people are actually aware of the extent of their hazardous or harmful pattern of drinking. The aim of this study was to determine awareness of drinking pattern in an Irish population using a representative random sample and to identify characteristics associated with self-awareness of hazardous or harmful drinking., Methods: We analysed data from Ireland's 2014/2015 Drug Prevalence Survey which recruited a stratified clustered sample of 7005 individuals aged 15 years and over living in private households. Logistic regression analysis was used to determine characteristics associated with self-awareness of hazardous or harmful drinking., Results: Almost one half of drinkers had a hazardous or harmful pattern of drinking; 38% engaged in monthly risky single occasion drinking (RSOD) and 10.5% met Diagnostic and Statistical Manual version IV (DSM-IV) criteria for alcohol dependence. Of the 2420 respondents who had a hazardous or harmful pattern of drinking, 67% were unaware of this and misclassified themselves as being either a light or moderate drinker who did not engage in RSOD. An adjusted logistic regression model identified that hazardous and harmful drinkers were more likely to be aware of their drinking pattern if they had completed third level education (OR=1.80, 95% CI: 1.30 to 2.49) while older drinkers (aged 65 and over) were less likely to be aware of their drinking pattern (OR=0.30, 95% CI: 0.14 to 0.65). Subjects who engaged in risk taking behaviours such as illicit drug use and gambling were also significantly more likely to be aware of their drinking pattern., Conclusions: The results of this study suggest that patterns of alcohol use in Ireland are problematic. Older respondents and those with lower educational attainment are less likely to be aware of their hazardous or harmful drinking pattern. There is also a population of younger, more-educated drinkers who engage in potentially risk-taking behaviours and these subjects are aware of their harmful drinking pattern. Initiatives to reduce overall alcohol consumption and raise awareness around drinking patterns are required., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: In combination with systematic routine screening, brief alcohol interventions have the potential to promote population health. Little is known on the optimal screening interval. Therefore, this study pursued 2 research questions: (i) How stable are screening results for at-risk drinking over 12 months? (ii) Can the transition from low-risk to at-risk drinking be predicted by gender, age, school education, employment, or past week alcohol use?, Methods: A sample of 831 adults (55% female; mean age = 30.8 years) from the general population was assessed 4 times over 12 months. The Alcohol Use Disorders Identification Test-Consumption was used to screen for at-risk drinking each time. Participants were categorized either as low-risk or at-risk drinkers at baseline, 3, 6, and 12 months later. Stable and instable risk status trajectories were analyzed descriptively and graphically. Transitioning from low-risk drinking at baseline to at-risk drinking at any follow-up was predicted using a logistic regression model., Results: Consistent screening results over time were observed in 509 participants (61%). Of all baseline low-risk drinkers, 113 (21%) received a positive screening result in 1 or more follow-up assessments. Females (vs. males; OR = 1.66; 95% confidence intervals [95% CI] = 1.04; 2.64), 18- to 29-year-olds (vs. 30- to 45-year-olds; OR = 2.30; 95% CI = 1.26; 4.20), and those reporting 2 or more drinking days (vs. less than 2; OR = 3.11; 95% CI = 1.93; 5.01) and heavy episodic drinking (vs. none; OR = 2.35; 95% CI = 1.06; 5.20) in the week prior to the baseline assessment had increased odds for a transition to at-risk drinking., Conclusions: Our findings suggest that the widely used time frame of 1 year may be ambiguous regarding the screening for at-risk alcohol use although generalizability may be limited due to higher-educated people being overrepresented in our sample., (© 2020 The Authors. Alcoholism: Clinical & Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcoholism.)

Background: The purposes were to investigate the drinking patterns and hydration biomarkers among young adults with different levels of habitual total drinking fluids intake., Methods: A cross-sectional study was conducted among 159 young adults aged 18-23 years in Baoding, China. Total drinking fluids and water from food were assessed by 7-day 24-h fluid intake questionnaire and duplicate portion method, respectively. The osmolality and electrolyte concentrations of the 24 h urine and fasting blood samples were tested. Differences in LD 1 (low drinker), LD 2 , LD 3 and HD (high drinker) groups, stratified according to the quartiles of total drinking fluids, were compared using one-way ANOVA, Kruskal-Wallis H test and chi-square test., Results: A total of 156 participants (80 males and 76 females) completed the study. HD group had greater amounts of TWI (Total Water Intake), water from food, higher and lower contributions of total drinking fluids and water from food to TWI, respectively, than LD 1 , LD 2 and LD 3 groups (p < 0.05). Participants in HD group had higher amounts of water and water from dishes than participants in LD 1 , LD 2 and LD 3 groups (p < 0.05). No significant differences were found in the contributions of different fluids to total drinking fluids within the four groups (p > 0.05). The osmolality of urine was 59-143 mOsm/kg higher in LD 1 than that in LD 2 , LD 3 and HD group (p < 0.05). The percentage of participants in optimal hydration status increased from 12.8% in LD 1 group to 56.4% in HD group (p < 0.05). HD and LD 3 groups had 386~793 higher volumes of urine than that of LD 1 and LD 2 groups (p < 0.05). Differences were found in the concentrations of electrolytes among the four groups (p < 0.05). No significant differences were found in the plasma biomarkers (p > 0.05), with the exception of higher concentration of Mg in LD 3 and HD groups than that in LD 1 and LD 2 groups (p < 0.05)., Conclusions: Participants with higher total drinking fluids had better drinking pattern and hydration status. Interventions should be undertaken to advise adults to have adequate total drinking fluids, in order to keep in optimal hydration status., Trial Registration: The registration number was ChiCTR-ROC-17010320, which was registered on the Chinese clinical trial registry.

Objective: There is a substantial body of evidence that the recidivism of impaired-driving offenders is reduced while an ignition interlock device (IID) is on their vehicles. This study examines changes in driving behaviors and drinking behaviors used by DWI offenders to manage driving with the IID., Methods: A total of 166 IID participants who completed two surveys covering the period from arrest to IID installation (T1) and during IID use (T2) were examined. Four domains were covered: demographics, driving environments and transportation needs, reported driving activity, and reported drinking activities. Participants were on average 38 years old, 43% were female, 35% completed college, 34% had an income of more than $50,000, and 83% were employed. For those who provided it, the mean blood alcohol content (BAC) at arrest was .184 g/dL, with only 8 (5%) individuals below .08 g/dL, and 93 (56%) at over .18 g/dL. About 45% were repeat DWI offenders., Results: Between T1 and T2 there was a slight increase in acknowledging public transportation was available (p=.001), an increase in other individuals driving the interlock-equipped vehicle (p=.002), an increase in the number of vehicles in the household not registered to the DWI offender (p< .001), and an increase in the number of participants who reported that driving was important to their lifestyle (p=.008). Initial (T1) expectations about whether the interlock would be a problem were significantly different from actual experiences reported in T2 (p<.001). With respect to alcohol consumption, 14% reported abstinence at T2 compared to 2% at T1 (p=.001) and the number of drinks per drinking occasion decreased from a mean of 4.90 at T1 to 3.14 at T2 (p=.001), but the number of drinking occasions increased by a third (p=.003). The number of drinking locations (p=.001), the frequency of stopping after work for a drink (p=.001), and drinking at a bar all decreased (p<.001)., Conclusions: Interlock users make some adjustments in how they drink, the amount they drink, and where they drink. This finding suggests that there may be methods that can be used to extend the benefits of the IID beyond the sanction period.

Background: According to the prevention paradox, the majority of alcohol-related harms in the population occur among low-to-moderate risk drinkers, simply because they are more numerous in the population, although high-risk drinkers have a higher individual risk of experiencing alcohol-related harms. In this study we explored the prevention paradox in the Irish population by comparing alcohol-dependent drinkers (high-risk) to low-risk drinkers and non-dependent drinkers who engage in heavy episodic drinking (HED)., Methods: Data were generated from the 2013 National Alcohol Diary Survey (NADS), a nationally representative cross-sectional survey of Irish adults aged 18-75. Data were available for 4338 drinkers. Respondents dependent on alcohol (as measured by DSM-IV criteria), respondents who engaged in monthly HED or occasional HED (1-11 times a year) and low-risk drinkers were compared for distribution of eight alcohol-related harms., Results: Respondents who were dependent on alcohol had a greater individual risk of experiencing each harm (p < .0001). The majority of the harms in the population were accounted for by drinkers who were not dependent on alcohol. Together, monthly and occasional HED drinkers accounted for 62% of all drinkers, consumed 70% of alcohol and accounted for 59% of alcohol-related harms., Conclusions: Our results indicate that the majority of alcohol consumption and related harms in the Irish population are accounted for by low- and moderate-risk drinkers, and specifically by those who engage in heavy episodic drinking. A population-based approach to reducing alcohol-related harm is most appropriate in the Irish context. Immediate implementation of the measures in the Public Health (Alcohol) Act (2018) is necessary to reduce alcohol-related harm in Ireland.

Background. There is a lack of data on alcohol consumption over time. This study characterizes the long-term drinking patterns of people with lifetime alcohol use disorders who have engaged in treatment or informal care. Methods. We developed multinomial logit models using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to estimate short-term transition probabilities (TPs) among the 4 World Health Organization drinking risk levels (low, medium, high, and very high risk) and abstinence by age, sex, and race/ethnicity. We applied an optimization algorithm to convert 3-year TPs from NESARC to 1-year TPs, then used simulated annealing to calibrate TPs to a propensity-scored matched set of participants derived from a separate 16-year study of alcohol consumption. We validated the resulting long-term TPs using NESARC-III, a cross-sectional study conducted on a different cohort. Results. Across 24 demographic groups, the 1-year probability of remaining in the same state averaged 0.93, 0.81, 0.49, 0.51, and 0.63 for abstinent, low, medium, high, and very high-risk states, respectively. After calibration to the 16-year study data ( N = 420), resulting TPs produced state distributions that hit the calibration target. We find that the abstinent or low-risk states are very stable, and the annual probability of leaving the very high-risk state increases by about 20 percentage points beyond 8 years. Limitations. TPs for some demographic groups had small cell sizes. The data used to calibrate long-term TPs are based on a geographically narrow study. Conclusions. This study is the first to characterize long-term drinking patterns by combining short-term representative data with long-term data on drinking behaviors. Current research is using these patterns to estimate the long-term cost effectiveness of alcohol treatment.

Aims: To understand the extent of the alcohol industry's financial dependence on drinking above government low-risk guidelines in England., Design: Scenario modelling using descriptive analyses of pooled data from the 2013 and 2014 waves of two nationally representative surveys: the Health Survey for England (HSE) and the Living Costs and Food Survey (LCF). We estimated the proportion of alcohol sales revenue accounted for by drinkers above guideline levels, and how this varies between different beverage and retailer types. We then estimated the impact on sales revenue if the entire population reduced their drinking to within guideline levels, as well as the average price increases necessary to compensate for such a loss of revenue., Setting: England., Participants: A total of 16 872 individual (HSE) and 9975 household (LCF) survey respondents., Measurements: Transaction-level estimates of volume of alcohol purchased and price paid by beverage type and trade sector., Findings: Those drinking above guideline levels are estimated to account for 68% of total alcohol sales revenue in 2013/14: 81% of off-trade revenue and 60% of on-trade revenue. This represents 77% of beer, 70% of cider, 66% of wine and 50% of spirits sales value. The heaviest drinking 4% of the population account for 30% of all consumption and 23% of all industry revenue. If all consumers reduced their drinking to within guideline levels, alcohol sales revenue could decline by 38% (£13 billion). To mitigate this loss, average prices paid would have to rise substantially-for example, by £2.64 for a pint of on-trade beer or £12.25 for a 70 cl bottle of off-trade spirits., Conclusions: In England, the alcohol industry appears to be highly financially dependent upon heavy drinking, and might face significant financial losses were consumers to drink within guideline levels., (© 2018 Society for the Study of Addiction.)

Background: Young adults report the heaviest drinking of any age group, and many are at risk for experiencing an alcohol use disorder. Most research investigating young adult drinking has focused on single indicators of use. Using multiple dimensions of consumption, such as federal guidelines for daily/weekly drinking and engagement in drinking at twice the binge threshold ("high-intensity drinking") to characterize drinking behavior could illuminate drinking patterns linked with harms., Objectives: We used a person-centered approach to examine latent classes of drinkers from a national sample of young adults. Further, we compared classes on college status., Methods: We used 2012-2013 data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)-III. We included past-year drinkers aged 18-22 years (n = 2213). Latent classes were estimated based on drinking frequency, daily/weekly drinking, frequency of heavy episodic drinking (4+/5+ drinks for women/men), frequency of high-intensity drinking (8+/10+ drinks), and intoxication frequency., Results: Five latent classes were identified: Occasional, Light Drinkers (30%), Regular Drinkers (6%), Infrequent Drinkers with Occasional Binging (10%), Frequent Drinkers with Occasional Binging (22%), and High-Intensity Drinkers (32%). Although membership in the two riskiest classes were more common among college-attenders, odds of being a High-Intensity Drinker relative to the second riskiest class was not significantly different for college- and non-college-attending young adults. Conclusions/Importance: As high-intensity drinking does not appear to be a drinking pattern unique to college-attenders and non-college-attenders are less likely to mature out of heavy drinking patterns, intervention efforts are needed for this at-risk age group.

Background: While individual-level drinking pattern is an important risk factor for alcohol-related injury, societal-level pattern and alcohol policy are also important, and no research exists on the relationship of these variables with specific causes of injury., Methods: A probability sample of 14,142 emergency department (ED) patients from 32 ED studies in 28 countries included in the International Collaborative Alcohol and Injury Study (ICAIS) is analyzed using multilevel modeling of individual-level volume and pattern of drinking, country-level detrimental drinking pattern (DDP), and alcohol policy using the International Alcohol Policy and Injury Index (IAPII) on self-reported drinking prior to the injury event, categorized as traffic, violence, fall or other cause. The IAPII includes four domains: availability, vehicular, advertising, and drinking context., Results: Frequent heavy drinking was a strong predictor (p < .0.001) of injuries related to violence (OR = 2.57), falls (OR = 2.86), and other causes (OR = 1.71), while episodic heavy drinking was a significant predictor of injuries related to violence and falls. DDP was a significant predictor (p < 0.05) of traffic (OR = 1.54) and violence-related injuries (OR = 1.38) but lost significance when the IAPII was included. The IAPII was a significant predictor only for traffic injury (OR = 0.97, p < 0.001), and each domain with the exception of context were also significant., Conclusions: Findings here clearly point to the importance of targeted policies for specific causes of injury as well as the importance of individual and societal drinking patterns, the latter of which may be difficult to influence by preventive measures aimed to reduce alcohol-related injury., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Alcohol consumption contributes to health inequalities, but few studies have examined how socially differentiated alcohol use develops across the life course. In this study, we examine how one aspect of childhood socioeconomic position (parental education) relates to two often-conflated young adult drinking patterns: drinking frequency and quantity per occasion. Using a life course perspective, we also explore whether parental drinking patterns or young adults' own educational attainment might account for such associations., Methods: This study used longitudinal data from the nationally representative Swedish Level of Living Surveys (LNU). Young adults' (aged 20-28, n = 803) drinking patterns and educational attainment were determined through the LNU 2010 and official registers. A decade earlier, parents self-reported their education and drinking patterns in the LNU 2000 and Partner-LNU 2000., Results: Logistic regression models showed that high parental education predicted young adult frequent drinking, while low parental education predicted young adult high quantity drinking. Drinking patterns were associated inter-generationally, but parental alcohol use did not account for differences in young adult drinking patterns by parental education. Young adults' own education similarly predicted their drinking patterns but did not account for differences in drinking frequency by parental education. Differences in drinking quantity by parental education were no longer significant when young adults' own education was included in the final model., Conclusions: Findings suggest that parental education constitutes an early-life structural position that confers differential risk for young adult drinking patterns. Young adults whose parents had low education were less likely to drink frequently but were more likely to drink heavily per occasion, a drinking pattern that may place more disadvantaged young adults at a greater health risk.

Introduction and Aims: Gender and age patterns of drinking are important in guiding country responses to harmful use of alcohol. This study undertook cross-country analysis of drinking across gender, age groups in some high-and middle-income countries., Design and Methods: Surveys of drinkers were conducted in Australia, England, Scotland, New Zealand, St Kitts and Nevis (high-income), Thailand, South Africa, Mongolia and Vietnam (middle-income) as part of the International Alcohol Control Study. Drinking pattern measures were high-frequency, heavier-typical quantity and higher-risk drinking. Differences in the drinking patterns across age and gender groups were calculated. Logistic regression models were applied including a measure of country-level income., Results: Percentages of high-frequency, heavier-typical quantity and higher-risk drinking were greater among men than in women in all countries. Older age was associated with drinking more frequently but smaller typical quantities especially in high-income countries. Middle-income countries overall showed less frequent but heavier typical quantities; however, the lower frequencies meant the percentages of higher risk drinkers were lower overall compared with high-income countries (with the exception of South Africa)., Discussion and Conclusions: High-frequency drinking was greater in high-income countries, particularly in older age groups. Middle-income countries overall showed less frequent drinking but heavier typical quantities. As alcohol use becomes more normalised as a result of the expansion of commercial alcohol it is likely frequency of drinking will increase with a likelihood of greater numbers drinking at higher risk levels., (© 2018 The Authors Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Background: Older adults constitute a rapidly expanding proportion of the U.S., Population: Contemporary studies note the increasing prevalence of alcohol consumption in this group. Thus, understanding alcohol effects, consumption patterns, and associated risks in aging populations constitute critical areas of study with increasing public health relevance., Methods: Participants (n = 643; 292 women; ages 21-70) were community residing adult volunteers. Primary measures of interest included four patterns of alcohol consumption (average [oz./day]; typical quantity [oz./occasion]; frequency [% drinking days]; and maximal quantity [oz.]). Regression analyses explored associations between these measures, age, and relevant covariates. Subsequent between-group analyses investigated differences between two groups of older adults and a comparator group of younger adults, their adherance to "low-risk" guidelines, and whether alcohol-associated risks differed by age and adherence pattern., Results: Average consumption did not vary by age or differ between age groups. In contrast, markedly higher frequencies and lower quantities of consumption were observed with increasing age. These differences persisted across adherence categories and were evident even in the oldest age group. Exceeding "low-risk" guidelines was associated with greater risk for alcohol-related problems among the older groups., Conclusions: These results emphasize the utility of considering underlying constituent patterns of consumption in older drinkers. Findings highlight difficulties in identifying problem drinking among older adults and contribute to the few characterizations of "risky" drinking patterns in this group. Taken together, our data contribute to literatures of import for the design and enhancement of screening, prevention, and education initiatives directed toward aging adults., (Copyright © 2018. Published by Elsevier B.V.)

Alcohol problems have variable outcomes for marital relationships depending on whether drinking patterns are concordant or discordant among the members of the dyad; however, it is unclear what impact these variations in drinking patterns have on children. The current study was designed to explore several gaps and limitations in the parent heavy drinking literature. In particular, the prospective associations over 3years between parent heavy drinking, parenting, and child externalizing behavior were investigated in an integrated model to examine the influence of concordant and discordant drinking within couples on subsequent outcomes for their children. The study consisted of 180 couples recruited by mailings with children primarily between the ages of 4 and 11years old (52% male children). Parent-report of marital conflict, parenting, alcohol use, and child externalizing behavior were measured in a longitudinal study. Actor-Partner Interdependence Model analyses were conducted. Higher levels of maladaptive parenting were associated with higher externalizing for children of concordant drinking couples as opposed to discordant drinking couples. Implications for research and practice are discussed, including investigating mediators and moderators of the current findings such as quality of the parent-child relationship., (Copyright © 2017 Elsevier Ltd. All rights reserved.)