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Aims Many observational studies suggest that increased drinking frequency is associated with reduced mortality among those with low-dose alcohol consumption. The purpose of this paper was to examine whether frequent drinkers consume lower-risk amounts during drinking days or have favorable risk factor profiles compared with those who drink less frequently, and discuss implications for the larger debate about the limitations of non-randomized studies about 'moderate' drinking and the development of low-risk drinking guidelines. Methods Data from the 2008 Behavioral Risk Factor Surveillance System survey were used to characterize alcohol consumption characteristics and their relationship with risk factors among adult drinking men who consumed an average of fewer than two drinks per day and adult drinking adult women who consumed an average of less than one drink per day. Results Those who drank relatively infrequently (14 or fewer days per month) consumed more during drinking days, were more likely to exceed the US Dietary Guidelines drinking limits (41.0% versus 9.7%) and had a larger proportion of drinking days that included binge drinking (13.4% versus 4.3%). Infrequent drinkers also had a higher prevalence of 13 of 15 risk factors assessed. Findings from analyses of those aged ≥40 years were similar. Conclusions Among those with low average alcohol consumption, infrequent drinkers drink more during drinking days and have unfavorable risk factors profiles compared with more frequent drinkers, suggesting that confounding may contribute to favorable associations with 'moderate' average alcohol consumption and increased drinking frequency observed in non-randomized studies. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims This paper examined whether or not: (a) care-giver 'alcohol abuse' is associated with recurrent child maltreatment; (b) other 'risk factors' affect this relationship; and (c) which of alcohol abuse or other drug abuse plays a stronger role. It also examined (d) how children and families where alcohol-related child abuse was identified were managed by child protection services (CPS) in Victoria, Australia. Design, setting and participants Using anonymized data from Victorian CPS, repeat cases were examined involving 29 455 children identified between 2001 and 2005. Measurements Carer alcohol abuse, other drug abuse, mental ill-health, carer experience of abuse as a child, child age and gender, family type, socio-economic variables and level of child protection service intervention as recorded in the CPS electronic database were examined as risk factors for recurrence, using bivariate and multivariate techniques. Findings Almost one-quarter of children in CPS experienced a recurrent incident of child maltreatment in a 5-year period. Where carer alcohol abuse was identified children were significantly more likely to experience multiple incidents compared with children where this was not identified ( P < 0.001), as were children where other family risk factors (including markers of socio-economic disadvantage) were identified. The majority of children whose carers were identified with alcohol abuse experienced either repeat incidents or interventions (84%), although almost three-quarters of these children were managed without resort to the most serious outcome, involving court orders. Conclusions Alcohol and drug abuse in carers are important risk-factors for recurrent child maltreatment after accounting for other known risk factors; the increased risk appears to be similar between alcohol and drug abuse. [ABSTRACT FROM AUTHOR]

Background and Aims: Several recent studies have investigated the relationship between telomere length and substance use disorders with inconsistent results. We aimed to assess this association and to identify moderators of the relationship. Methods: Systematic review and meta‐analysis. Selection criteria were observational studies reporting telomere length in people with a substance use disorder compared with a control group. Studies focused solely on nicotine addiction, employing other study designs, and non‐human studies were excluded. Study selection and data extraction were independently conducted by two researchers following a standardized protocol and included studies until December 2019. Standardized mean differences were used as the effect size index [d; 95% confidence interval (CI)] and random‐effects models were used for the meta‐analysis. Cochran's Q‐statistic, I2 index, visual inspection of the forest plot and a 95% prediction interval were applied to verify study heterogeneity. Subgroup analyses and meta‐regressions were conducted to explore heterogeneity. Small study effects were examined using the 'funnel plot', the Egger test, Duval & Tweedie's trim‐and‐fill method and the precision‐effect test–precision‐effect estimate with standard error (PET‐PEESE) method. The risk of bias and the quality of evidence were assessed. Results: Ten studies (12 analysis units with 2671 cases and 4532 controls) met the selection criteria. An overall effect size of moderate magnitude was found (d+ = −0.63; 95% CI = −1.00 and −0.26; P = 0.0008). A potential small study effect was detected, as well as large heterogeneity between studies (Q‐statistic P < 0.001, I2 = 97.3%). Selection of controls, reporting laboratory quality control procedures and total sample size significantly affected the effect size. The quality of the evidence was very low, based on risk of bias analysis and the grading of recommendations assessment, development and evaluation (GRADE) system. Conclusions: People with substance use disorders appear to have shorter telomere length than controls; however, this finding should be interpreted with caution due to the poor quality of the evidence. [ABSTRACT FROM AUTHOR]

Aims To test whether exposure to party-related alcohol advertising is associated with drinking behavior in a national US sample of adolescents and young adults, independently of exposure to other alcohol advertising. Design Longitudinal telephone- and web-based surveys conducted in 2011 and 2013. Setting All regions of the United States, participants selected via mixed-mode random-digit-dial landline and cellphone frames. Participants A sample of 705 respondents who never had a whole drink of alcohol at baseline (mean age 16.9 years, 53.3% female) and a sample of 1036 who never had six or more drinks during one drinking occasion (mean age 17.4 years, 55.8% female). Measurements Outcome measures were onset of alcohol use and binge drinking during the study interval. Primary predictor was exposure to television alcohol advertising, operationalized as contact frequency and brand recall for 20 randomly selected alcohol advertisements. Independent post-hoc analyses classified all advertisements as 'party' or 'non-party' advertisements. Socio-demographics, sensation-seeking, alcohol expectancies and alcohol use of friends and family were assessed as covariates. Findings Onset rates for having the first whole drink of alcohol and for first binge drinking were 49.2% and 29.5%, respectively. On average, approximately half (median = 10.2) of the 20 alcohol advertisements in each individual survey were 'party' advertisements. If both types of exposures ('party' and 'non-party') were included in the regression model, only 'party' exposure remained a significant predictor of alcohol use onset [adjusted odds ratio (AOR) = 19.17; 95% confidence interval (CI) = 3.72-98.79] and binge drinking onset (AOR = 3.87; 95% CI = 1.07-13.99) after covariate control. Conclusions Adolescents and young adults in the United States appear to have higher rates of alcohol use and binge drinking onset if they have higher exposure to alcohol advertisements using a partying theme, independently of the amount of exposure to alcohol advertisements with non-party themes. [ABSTRACT FROM AUTHOR]

Background and aims Retrospective measures of alcohol intake are becoming increasingly popular; however, the reliability of such measures remains uncertain. This study assessed the reliability of a retrospective decade-based life-course alcohol consumption questionnaire, based on the standardized Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) administered in older age in a well-characterized cohort study. Design, setting, participants and measurements A retrospective alcohol life-grid was administered to 5980 participants (72% male, mean age 70 years) in the Whitehall II study covering frequency of drinking, number of drinks in a typical drinking day and frequency of consuming six or more drinks in a single drinking occasion in the teens (16-19 years) through to the 80s. A subsample of 385 individuals completed a repeat survey to determine test-retest reliability. Retrospective measures were also compared with prospectively ascertained information and used to predict objectively measured systolic blood pressure to test their predictive validity. Findings Across all decades of life, test-retest reliability was generally good (κ range = 0.62-0.78 for frequency, 0.55-0.62 for usual number of drinks and 0.57-0.65 for frequency of consuming six or more drinks in a single occasion). The concordance between prospective and retrospective measures was consistently moderate to high. The life-grid method performed better than a single question in identifying life-time abstainers. Retrospective measures were also related to systolic blood pressure in the manner anticipated. Conclusion A retrospective decade-based AUDIT-C grid administered in older age provides a relatively reliable measure of alcohol consumption across the life-course. [ABSTRACT FROM AUTHOR]

Background and Aims Alcohol and nicotine dependence are associated with considerable morbidity and mortality, especially when cases are persistent. The risk for alcohol and nicotine dependence is increased by childhood maltreatment. However, the influence of childhood maltreatment on dependence course is unknown, and is evaluated in the current study. Design Physical, sexual and emotional abuse, and physical and emotional neglect, were evaluated as predictors of persistent alcohol and nicotine dependence over 3 years of follow-up, with and without control for other childhood adversities. Setting National Epidemiologic Survey on Alcohol and Related Conditions ( NESARC). Participants NESARC participants completing baseline and follow-up who met criteria at baseline for past-year alcohol dependence ( n = 1172) and nicotine dependence ( n = 4017). Measurements Alcohol Use Disorder and Associated Disabilities Interview Schedule ( AUDADIS) measures of alcohol/nicotine dependence, childhood maltreatment and other adverse childhood experiences (e.g. parental divorce). Findings Controlling for demographics only, physical, sexual and emotional abuse and physical neglect predicted 3-year persistence of alcohol dependence [adjusted odds ratio ( AOR) = 1.50-2.99; 95% CI = 1.04-4.68] and nicotine dependence ( AOR = 1.37-1.74; 95% CI = 1.13-2.11). With other childhood adversities also controlled, maltreatment types remained predictive for alcohol persistence ( AOR = 1.53-3.02; 95% CI = 1.07-4.71) and nicotine persistence ( AOR = 1.35-1.72; 95% CI = 1.11-2.09). Further, a greater number of maltreatment types incrementally influenced persistence risk ( AOR = 1.19-1.36; 95% CI = 1.11-1.56). Conclusions A history of childhood maltreatment predicts persistent adult alcohol and nicotine dependence. This association, robust to control for other childhood adversities, suggests that maltreatment (rather than a generally difficult childhood) affects the course of dependence. [ABSTRACT FROM AUTHOR]

Background and aims British alcohol consumption and abstinence rates have increased substantially in the last 3 decades. This study aims to disentangle age, period and birth cohort effects to improve our understanding of these trends and suggest groups for targeted interventions to reduce resultant harms. Design Age, period, cohort analysis of repeated cross-sectional surveys using separate logistic and negative binomial models for each gender. Setting Great Britain 1984-2009. Participants Annual nationally representative samples of approximately 20 000 adults (16+) within 13 000 households. Measurements Age (eight groups: 16-17 to 75+ years), period (six groups: 1980-84 to 2005-09) and birth cohorts (19 groups: 1900-04 to 1990-94). Outcome measures were abstinence and average weekly alcohol consumption. Controls were income, education, ethnicity and country. Findings After accounting for period and cohort trends, 18-24-year-olds have the highest consumption levels (incident rate ratio = 1.18-1.15) and lower abstention rates (odds ratio = 0.67-0.87). Consumption generally decreases and abstention rates increase in later life. Until recently, successive birth cohorts' consumption levels were also increasing. However, for those born post-1985, abstention rates are increasing and male consumption is falling relative to preceding cohorts. In contrast, female drinking behaviours have polarized over the study period, with increasing abstention rates accompanying increases in drinkers' consumption levels. Conclusions Rising female consumption of alcohol and progression of higher-consuming birth cohorts through the life course are key drivers of increased per capita alcohol consumption in the United Kingdom. Recent declines in alcohol consumption appear to be attributable to reduced consumption and increased abstinence rates among the most recent birth cohorts, especially males, and general increased rates of abstention across the study period. [ABSTRACT FROM AUTHOR]

Aim To examine the association between alcohol in school environments and adolescent alcohol use over the previous 6 months. Design A multi-level logistic regression analysis was performed of cross-sectional surveys conducted in 2004, 2005 and 2006. Participants and setting A total of 52 214 students aged 11-19 years from 387 middle or high schools were selected from a nationally representative, multi-stage, stratified probability sampling across Taiwan. Measurements Information on socio-demographic features and substance use experiences was collected using self-administered questionnaires. The alcohol in the environment was measured using the availability of convenience stores surrounding the schools. Using geographical information systems, the weighted numbers of convenience stores within 1 km, a 12-15-minute walk, of a school were calculated. The schools were later categorized into three subgroups via the tertile of nearby convenience stores. Findings Considering the compositional characteristics, the availability of convenience stores was found to account for 1.5% of the school-level variance of youthful drinking. The odds ratios (95% confidence interval) of alcohol use over the previous 6 months among youth attending schools with medium and high availability were 1.04 (0.96-1.13) and 1.08 (1.00-1.17), respectively, with a P-value of 0.04 in the trend test. Conclusion The greater availability of convenience stores near a school is associated with an increased risk of alcohol use among adolescents over the previous 6 months. [ABSTRACT FROM AUTHOR]

Aims This study examined how family, peer and school factors are related to different trajectories of adolescent alcohol use at key developmental periods. Design Latent class growth analysis was used to identify trajectories based on five waves of data (from grade 6, age 12 to grade 11, age 17), with predictors at grades 5, 7 and 9 included as covariates. Setting Adolescents completed surveys during school hours. Participants A total of 808 students in Victoria, Australia. Measurements Alcohol use trajectories were based on self-reports of 30-day frequency of alcohol use. Predictors included sibling alcohol use, attachment to parents, parental supervision, parental attitudes favourable to adolescent alcohol use, peer alcohol use and school commitment. Findings A total of 8.2% showed steep escalation in alcohol use. Relative to non-users, steep escalators were predicted by age-specific effects for low school commitment at grade 7 ( P = 0.031) and parental attitudes at grade 5 ( P = 0.003), and age-generalized effects for sibling alcohol use ( Ps = 0.001, 0.012, 0.033 at grades 5, 7 and 9, respectively) and peer alcohol use ( Ps = 0.041, < 0.001, < 0.001 at grades 5, 7 and 9, respectively). Poor parental supervision was associated with steep escalators at grade 9 ( P < 0.001) but not the other grades. Attachment to parents was unrelated to alcohol trajectories. Conclusions Parental disapproval of alcohol use before transition to high school, low school commitment at transition to high school, and sibling and peer alcohol use during adolescence are associated with a higher risk of steep escalations in alcohol use. [ABSTRACT FROM AUTHOR]

Aim To test the effectiveness of motivational interviewing ( MI) to reduce the risk of an alcohol exposed pregnancy ( AEP) in a high-risk population. Design Randomized controlled trial. Setting Rural population in the Western Cape, South Africa. Participants A total of 165 women aged 18-44 years at risk of AEP. Intervention Five-session MI intervention. Measurements Structured questionnaires were administered pre-intervention and at 3 and 12 months follow-up. The primary outcome measure was AEP at 12 months. Secondary outcomes were AEP at 3 months, and alcohol use and effective contraception at 3 and 12 months. Findings There was a significant difference in the decline in the proportion of women at risk for an AEP in the MI group at 3 months (50 versus 24.59%; P = 0.004), maintained at 12 months (50.82 versus 28.12%; P = 0.009). In an intention-to-treat analysis these differences were also significant (32.93 versus 18.07%; P = 0.029; and 37.80 versus 21.69%; P = 0.024, respectively). The odds ratio for no longer being at risk of an AEP ( MI versus control) at 12 months was 2.64 [95% confidence interval ( CI): 1.18-5.94]. In the intention-to-treat analysis this ratio was 2.19 (95% CI: 1.05-4.65). Conclusions A five-session motivational interviewing intervention was found to be effective with women at risk of an alcohol-exposed pregnancy, and could be implemented as part of routine primary care clinic services in similar populations. The message of 'no alcohol in pregnancy' should be adapted to include better family planning and early recognition of pregnancy. [ABSTRACT FROM AUTHOR]

Aims The aim of the current study was to examine the mediating role of alcohol-related memory associations in the relation between perceived parental drinking and the onset of adolescents' alcohol use. Gender and grade were also included in the analyses. Design We tested a mediation model within a structural path modelling framework using longitudinal data (two waves). Setting and Participants The sample consisted of 608 Canadian adolescents (42.9% boys), who did not have any alcohol experiences at the first measurement. The adolescents were recruited from all grades 7-9 classes in a large school district in western Canada. Measurements Alcohol-related memory associations were tested with the Word Association Test. We used adolescent self-reports of alcohol use and parental drinking. Findings Results clearly showed a mediation effect of alcohol-related memory associations [estimate = 0.023, 95% confidence interval ( CI): 0.002-0.044). That is, parental drinking as perceived by the adolescent was related positively to alcohol-related memory associations, which in turn predicted adolescents' alcohol use a year later. Gender and grade were related to alcohol-related memory associations. That is, boys and adolescents of higher grades had more memory associations. Conclusions Children appear to form memory associations related to alcohol before they ever drink alcohol themselves, and these associations appear to mediate the link between their perceptions of their parents' drinking and their own initial alcohol use. [ABSTRACT FROM AUTHOR]

Aims To investigate differences in the presence of drugs, by gender, when considering deaths attributable to homicides and suicides. Design Logistic regression analysis of mortality data collected by the Colorado Violent Death Reporting System. Participants and setting A total of 5791 Colorado decedents who died of violent causes from 2004 to 2009. Measurement Forensic pathologist autopsy data on drug presence at time of death, coded as present, not present or missing. Findings Postmortem presence of drugs is associated strongly with the specific cause of violent death. Compared with suicide decedents, homicide decedents are significantly more likely to test positive for amphetamines [odds ratio ( OR): 1.79; confidence interval ( CI): 1.34, 2.39], marijuana ( OR: 2.03; CI: 1.60, 2.58) and cocaine ( OR: 2.60; CI: 2.04, 3.31), and are less likely to test positive for opiates ( OR: 0.27; CI: 0.18, 0.39) and antidepressants ( OR: 0.17; CI: 0.10, 0.28). When other drugs are controlled for the influence of alcohol is abated dramatically. The patterns of drug prevalence associated with homicide (particularly marijuana) are stronger among males; the patterns of drug prevalence associated with suicide are stronger among females. Conclusions Suicide and homicide decedents are characterized by varying patterns of licit and illicit drug use that differ by gender. Drugs associated with homicide (marijuana, cocaine and amphetamines) are stronger among males, while drugs associated with suicide are stronger among females (antidepressants and opiates). Taking these differences into consideration may allow for targeted interventions to reduce violent deaths. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims This study investigated associations between self-reported illness, social factors and health behaviours and non-drinking among young people aged 18-34 years. Design Logistic regression analysis of cross-sectional national survey data, collected from the Health Survey for England 2006 and 2008. Data were collected through face-to-face interviews and are self-reported. Participants and settings A total of 2826 male and 3618 females aged 18-34 years drawn from a nationally representative multi-stage stratified probability sampling design across England. Measurements Non-drinkers were based on those who reported 'no' to drinking alcohol currently. Exposure measures included self-reports of having a limiting long-standing illness, long-standing illness or self-reported poor health. We adjusted for ethnicity, income, education, general physical activity and other factors. Findings Having a limiting long-standing illness during early adulthood increased the odds of being a non-drinker 1.74 times for men ( P < 0.01) and 1.45 times for women ( P < 0.01). In both men and women belonging to the lowest income quintile or having no qualifications was associated with increased odds of being a non-drinker ( P < 0.001), indicating that the social gradient in non-drinking begins at an early age. Men and women aged 18-34 years with the lowest activity levels were also more likely to be non-drinkers ( P < 0.01). Conclusion Young adults who have a limiting long-standing illness are more likely not to drink alcohol even after adjusting for a range of social and demographic measures. Studies on the putative health benefits of moderate alcohol consumption later in life need to take account of early life history. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Marital dissolution is associated with increased risk of problematic drinking. However, marriage to a problem drinker also increases this risk, and ending this type of relationship may actually decrease risk of problematic drinking. This study tested whether women ending their marriage to a problem drinker exhibited improvements in drinking. Design National Epidemiologic Survey on Alcohol and Related Conditions, a two-wave nationally representative survey of the US adult population. Setting In-person interviews conducted in US households. Participants Females married or living as if married at wave 1 at least 18 years of age. Measurements Socio-demographics, drinking frequency, drinking quantity, alcohol use disorders, problem drinking, partner problem drinking and relationship dissolution. Findings Ending marriage to a non-problem drinker predicted increased frequency of drinking [risk ratio (RR) = 1.55; 95% confidence interval (CI) = 1.43, 1.67], heavier drinking (RR = 1.30; 95% CI = 1.71, 1.45), more problematic drinking (RR = 2.45; 95% CI = 2.17, 2.77) and a greater likelihood of use disorder diagnosis [odds ratio (OR) = 2.2; 95% CI = 1.67, 2.91]. Ending a relationship with a problem drinker predicted less frequent drinking (RR = 0.94; 95% CI = 0.90, 0.98), less heavy drinking (RR = 0.84; 95% CI = 0.78, 0.90) and fewer alcohol-related problems (RR = 0.77; 95% CI = 0.62, 0.95). Conclusions Ending a marriage with a husband who drinks problematically may decrease risk of alcohol-related problems among women, substantiating the need for alcohol treatments to address a problem drinking partner. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims This study seeks to establish the prevalence alcohol-related harms to children (ARHC) that occur because of others' drinking in the general population and examine how this varies by who was reported to have harmed the child and socio-demographic factors. Design and setting A randomly selected cross-sectional national population telephone survey undertaken in 2008 in Australia. Participants A total of 1142 adult respondents who indicated they lived with or had a parental/carer role for children. Measurements Questions included whether children had been negatively affected in any way, left unsupervised or in an unsafe situation, verbally abused, physically hurt or exposed to serious family violence because of others' drinking in the past year. Findings Twenty-two per cent of respondents reported children had been affected because of another's drinking in the past year; 3% reported substantial harm. Respondents most commonly reported that children were verbally abused because of others' drinking (9%). Participants in single-carer households were more likely to report ARHC than participants in households with two carers, and participants who drank weekly were more likely to report ARHC than those who did not drink. Conclusions Almost a quarter of those with a caring role for children in Australia reported that a child or children with whom they lived or for whom they were responsible have been affected adversely by others' alcohol consumption in the past year. The problem extends across the social spectrum, but children in single-parent homes may be at higher risk. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To assess the association between access to off-premises alcohol outlets and harmful alcohol consumption. Design, setting and participants Multi-level study of 2334 adults aged 18-75 years from 49 census collector districts (the smallest spatial unit in Australia at the time of survey) in metropolitan Melbourne. Measurements Alcohol outlet density was defined as the number of outlets within a 1-km road network of respondents' homes and proximity was the shortest road network distance to the closest outlet from their home. Using multi-level logistic regression we estimated the association between outlet density and proximity and four measures of harmful alcohol consumption: drinking at levels associated with short-term harm at least weekly and monthly; drinking at levels associated with long-term harm and frequency of consumption. Findings Density of alcohol outlets was associated with increased risk of drinking alcohol at levels associated with harm. The strongest association was for short-term harm at least weekly [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.04-1.16]. When density was fitted as a categorical variable, the highest risk of drinking at levels associated with short-term harm was when there were eight or more outlets (short-term harm weekly: OR 2.36, 95% CI 1.22-4.54 and short-term harm monthly: OR 1.80, 95% CI 1.07-3.04). We found no evidence to support an association between proximity and harmful alcohol consumption. Conclusions The number of off-premises alcohol outlets in a locality is associated with the level of harmful alcohol consumption in that area. Reducing the number of off-premises alcohol outlets could reduce levels of harmful alcohol consumption. [ABSTRACT FROM AUTHOR]

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Aims Many individuals with substance use disorders are opposed to seeking formal treatment, often leading to disruptive relationships with concerned significant others (CSOs). This is disturbing, as untreated individuals are often associated with a variety of other addiction-related problems. Community Reinforcement and Family Training (CRAFT) provides an option to the more traditional treatment and intervention approaches. The objective of this systematic review was to compare CRAFT with the Alcoholics Anonymous/Narcotics Anonymous (Al-Anon/Nar-Anon) model and the Johnson Institute intervention in terms of its ability to engage patients in treatment and improve the functioning of CSOs. Methods The electronic databases PubMed, PsycINFO, EMBASE, CINAHL and the Cochrane Library were consulted. Four high-quality randomized controlled trials were identified, with a total sample of 264 CSOs. Data were synthesized to quantify the effect with 95% confidence intervals, using the random effects model. Results CRAFT produced three times more patient engagement than Al-Anon/Nar-Anon [relative risk (RR) 3.25, 95% confidence interval (CI) 2.11-5.02, P < 0.0001; numbers needed to treat (NNT) = 2] and twice the engagement of the Johnson Institute intervention (RR 2.15, 95% CI 1.28-3.62, P = 0.004; NNT = 3). Overall, CRAFT encouraged approximately two-thirds of treatment-resistant patients to attend treatment, typically for four to six CRAFT sessions. CSOs showed marked psychosocial and physical improvements whether they were assigned to CRAFT, Al-Anon/Nar-Anon or the Johnson Institute intervention within the 6-month treatment window. Conclusion CRAFT has been found to be superior in engaging treatment-resistant substance-abusing individuals compared with the traditional programmes. [ABSTRACT FROM AUTHOR]

The authors comment on a study "Time pattern of reduction in risk of oesophageal cancer following alcohol cessation-a metaanalysis," by J. Jarl and U. G. Gerdtham, which revealed 15 to 20 years for a complete reversal of the effects of alcohol-related risk of oesophageal cancer, however the effect of stopping alcohol consumption appears shortly after cessation. They find the results encouraging and mention that it will provide extra motivation for the promotion of life-style change.