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The article is a call for papers on the topic of psychedelic-assisted treatment for substance use disorders (SUDs). It highlights the growing interest in psychedelics as a potential treatment for SUDs and the increase in their use. Concerns about the risks and harms associated with psychedelics are also mentioned. The article emphasizes the need for further research and invites submissions on various types of studies, including systematic reviews, case series, qualitative studies, and observational cohort studies. The deadline for submissions is March 31, 2025. [Extracted from the article]

Comments on methodological issues linked to the alcohol Stroop paradigm in the paper of Sharma, Albery and Cook. Assessment on the attentional bias of drinkers for alcohol-related stimuli; Objections to the card format used in the presentation of the Stroop stimuli; Employment of the Alcohol Use Disorders Identification Test.

Aims The publication of the Journal of Inebriety (1876–1914) chronicled the rise and fall of the first era of organized addiction medicine in the United States. Methods Findings from historical research, a content analysis of the Journal's 35 volumes and 141 issues and images from the Journal illustrate visually the medical treatment of addiction in the United States in the late 19th and early 20th centuries. Results Under the editorial direction of Dr T. D. Crothers, the Journal of Inebriety published papers and reviews focused primarily on the medical treatment of alcohol and opiate addiction within a growing international network of inebriate homes and asylums. Conclusions The history of the Journal of Inebriety mirrors efforts in America to forge a legitimized field of addiction medicine amid conflicting conceptualizations of the nature of severe alcohol and other drug problems. [ABSTRACT FROM AUTHOR]

Background and Aims: Organizational change interventions involve systems and cultural change within health‐care services to make smoking cessation care delivery part of usual treatment. Six strategies for organizational change have been proposed. This study examined the evidence for organizational change interventions in the alcohol and other drug (AOD) setting on: (a) smoking cessation care; and (b) smoking cessation and cessation‐related outcomes. Methods: A systematic review with narrative synthesis was conducted. MEDLINE, PsycINFO, CINAHL, EMBASE and Scopus were searched using keywords and MeSH terms from database inception to 1 June 2018. Interventions were assessed against the six organizational change strategies. Results: Of the 5155 papers identified, 14 publications from seven unique studies were included. Most studies employed four or fewer organizational change strategies. The majority (n = 11) were rated weak to moderate in methodological quality. Nine published papers, four unique studies, examined staff reported provision of smoking cessation care; eight reported an increase, one found no change. Three papers, two unique studies, examined client receipt of care; all found significant increases. Three papers, two unique studies, assessed staff smoking prevalence from pre‐ to post‐intervention. Only one study reported a significant reduction in staff smoking prevalence (35.2 versus 21.8%, P = 0.005). Nine papers, six unique studies, assessed client smoking cessation and smoking‐related outcomes. Seven papers reported on client smoking prevalence; two found a significant decrease and five found no change to smoking. Four papers reported on number of cigarettes per day, three found a significant decrease and one found no change. Two papers reported on smoking cessation finding a 10% and a 25% seven‐day point prevalence abstinence post‐discharge from the AOD service. Conclusions: Organizational change interventions within health‐care services to make smoking cessation care delivery part of usual treatment offer promise for increasing smoking cessation care and reducing smoking prevalence. [ABSTRACT FROM AUTHOR]

Background and aims: The ability to regulate emotions effectively has been associated with resilience to psychopathology. Individuals with substance use disorders (SUDs) have been shown to have higher levels of negative emotionality, with some evidence suggesting impairment in emotion regulation compared with individuals without SUDs. However, no previous attempt has been made to systematically review the literature to assess the magnitude of this difference. We aimed to assess the association between SUD diagnosis and emotion regulation as measured by the Difficulties in Emotion Regulation Scale (DERS) and Emotion Regulation Questionnaire (ERQ) through a systematic review and meta‐analysis of existing findings. Methods: The systematic review was conducted using PubMed, PsycINFO and Embase. We examined cross‐sectional studies that compared a SUD group with a control group and measured emotion regulation using the DERS or the ERQ. The primary analysis focused on papers using the DERS, as this was the predominant instrument in the literature. Results: Twenty‐two studies met our primary analysis criteria, representing 1936 individuals with a SUD and 1567 controls. Individuals with SUDs relative to controls had significantly greater DERS scores, with a mean difference of 21.44 [95% confidence interval (CI) = 16.49–26.40, P < 0.001] and Hedges' g = 1.05 (95% CI = 0.86–1.24, P < 0.001). The difference was robust, remaining significant after removing outliers and studies with high risk of bias. Individuals with SUDs demonstrated poorer emotion regulation on each subscale of the DERS, with the largest deficits in the Strategies and Impulse subscales. The ERQ analysis revealed greater use of expressive suppression in those with SUDs relative to controls (Hedges' g = 0.76, 95% CI = 0.25–1.28, P = 0.004). Conclusions: People with substance use disorders appear to have greater difficulties in emotion regulation than people without substance use disorders. [ABSTRACT FROM AUTHOR]

Background and aims: Population‐level alcohol use data are available from high‐income countries, but limited research has been conducted in sub‐Saharan Africa. This systematic review and meta‐analysis aimed to summarize population‐level alcohol use in sub‐Saharan Africa. Method: Databases searched included PubMed, EMBASE, PsycINFO and AJOL, without language restrictions. Searches were also conducted in the Global Health Data Exchange (GHDx) and Google Scholar. Search terms encompassed 'substance' or 'substance‐related disorders' and 'prevalence' and 'sub‐Saharan Africa'. We included general population studies on alcohol use (including any use, high‐risk alcohol use and alcohol use disorders) from 2018 onwards. Prevalence data for alcohol use among sub‐Saharan African adolescents (10–17) and adults (18+) were extracted. Analyses included life‐time and past 12‐ and 6‐month alcohol use. Results: We included 141 papers. Among adolescents, the life‐time prevalence of alcohol use was 23.3% [95% confidence interval (CI) = 11.3–37.1%], 36.2% (CI = 18.4–56.1%) in the past year and 11.3% (CI = 4.5–20.4%) in the past 6 months. Among adolescents, 12‐month prevalence of alcohol use disorder and alcohol dependence were 7.7% (CI = 0.0–27.8%) and 4.1% (CI = 1.4–7.9%), respectively. Among adults, the life‐time prevalence of alcohol use was 34.9% (CI = 17.7–54.1%), 27.1% (CI = 5.0–56.4%) in the past year and 32.2% (CI = 19.8–46.0%) in the past 6 months. Among adults, the 12‐month prevalence of alcohol use disorder and alcohol dependence were 9.5% (CI = 0.0–30.4%) and 4.3% (CI = 0.8–9.8%), respectively. The highest weighted life‐time prevalence of alcohol use, 86.4%, was reported in Tanzania among adults. The highest weighted past 6‐month prevalence of alcohol use, 80.6%, was found in Zambia among adolescents. Conclusion: Alcohol use patterns vary across countries and subregions within sub‐Saharan Africa, and comprehensive population‐level data on alcohol use remain scarce in numerous sub‐Saharan African countries. The prevalence of alcohol use disorder is common among adolescents in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]

Background and Aims: The Scottish Government introduced minimum unit pricing (MUP) for alcohol on 1 May 2018. This means retailers in Scotland cannot sell alcohol to consumers for less than £0.50 per unit (1 UK unit = 8 g ethanol). The Government intended the policy to increase the price of cheap alcohol, cut alcohol consumption overall and particularly among those drinking at hazardous or harmful levels, and ultimately reduce alcohol‐related harm. This paper aims to summarise and assess the evidence to date evaluating the impact of MUP on alcohol consumption and related behaviours in Scotland. Argument: Evidence from analyses of population‐level sales data suggest, all else being equal, MUP reduced the volume of alcohol sold in Scotland by ~ 3.0% to 3.5%, with the largest reductions affecting cider and spirits sales. Analyses of two time series datasets on household‐level alcohol purchasing and individual‐level alcohol consumption suggest reductions in purchasing and consumption among those drinking at hazardous and harmful levels, but offer conflicting results for those drinking at the most harmful levels. These subgroup analyses are methodologically robust, but the underlying datasets have important limitations as they rely on non‐random sampling strategies. Further studies identified no clear evidence of reduced alcohol consumption among those with alcohol dependence or those presenting to emergency departments and sexual health clinics, some evidence of increased financial strain among people with dependence and no evidence of wider negative outcomes arising from changes in alcohol consumption behaviours. Conclusions: Minimum unit pricing for alcohol in Scotland has led to reduced consumption, including among heavier drinkers. However, there is uncertainty regarding its impact on those at greatest risk and some limited evidence of negative outcomes, specifically financial strain, among people with alcohol dependence. [ABSTRACT FROM AUTHOR]

Aims Despite recognition of the harms related to alcohol misuse and its potential to interfere substantially with sustained recovery from drug dependency, research evaluating drug treatment outcomes has not addressed the issue comprehensively. It has been overlooked possibly because treatment research has been framed according to the primary drug of choice, rather than investigating the interactions between different combinations of drugs and/or alcohol use. This paper reports on a systematic review investigating whether concurrent alcohol use could impede recovery from illicit drug use in two potential ways: first, alcohol could become a substitute addiction and/or secondly, alcohol misuse post-treatment may place an individual at risk for relapse to their primary drug problem. Method A systematic search of four relevant databases was undertaken to identify peer-reviewed, quantitative drug treatment outcome studies that reported alcohol use pre-, post-treatment and follow-up. Results The search revealed 567 papers, of which 13 were assessed as fulfilling the key inclusion criteria.The review indicated inconsistent and therefore inconclusive support for the substitution hypothesis. However, the data revealed consistent support for the hypothesis that alcohol use increases relapse to drug use. Conclusions (i) The potential negative impact of alcohol misuse on drug treatment outcomes remains under-researched and overlooked; (ii) alcohol consumption post-drug treatment may increase the likelihood that an individual will relapse to their primary drug; (ii) existing evidence regarding the substitution hypothesis is inconclusive, although there was an indication that a subgroup of participants will be vulnerable to alcohol becoming the primary addiction instead of drugs. We argue that future drug treatment outcome studies need to include detailed analysis of the influence of alcohol use pre- and post-drug treatment. [ABSTRACT FROM AUTHOR]

The Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS) was established in 1987 and is an independent organization open to all scientists working on problems related to social and epidemiological research on alcohol. The aim of the Society is to promote social and epidemiological research which fosters a comparative understanding of the social aspects of alcohol use and alcohol problems. In line with this the Society also aims at promoting a spirit of international collaboration. The Kettil Bruun Society is based on individual membership and, by 2003, has 197 fully paid-up members, representing 34 different countries over five continents. The main activities include an annual meeting as well as thematic meetings. In these meetings, discussions are emphasized by having precirculated papers and assigned discussants. The KBS also serves as a basis for organizing international collaborative projects. Project meetings or work-shops are often organized around the annual meetings, and the projects tend to run over several years. The Society's primary influence is through the mutual influence of its members on each others’ thinking, the work of the projects that KBS sponsors and the influence its members have collectively on the development of the field. [ABSTRACT FROM AUTHOR]

Abstract: Background and aims: Resilience and recovery are of increasing importance in the field of alcohol dependence (AD). This paper describes how imaging studies in man can be used to assess the neurobiological correlates of resilience and, if longitudinal, of disease trajectories, progression rates and markers for recovery to inform treatment and prevention options. Methods: Original papers on recovery and resilience in alcohol addiction and its neurobiological correlates were identified from PubMed and have been analyzed and condensed within a systematic literature review. Results: Findings deriving from functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) studies have identified links between increased resilience and less task‐elicited neural activation within the basal ganglia, and benefits of heightened neural pre‐frontal cortex (PFC) engagement regarding resilience in a broader sense; namely, resilience against relapse in early abstinence of AD. Furthermore, findings consistently propose at least partial recovery of brain glucose metabolism and executive and general cognitive functioning, as well as structural plasticity effects throughout the brain of alcohol‐dependent patients during the course of short‐, medium‐ and long‐term abstinence, even when patients only lowered their alcohol consumption to a moderate level. Additionally, specific factors were found that appear to influence these observed brain recovery processes in AD, e.g. genotype‐dependent neuronal (re)growth, gender‐specific neural recovery effects, critical interfering effects of psychiatric comorbidities, additional smoking or marijuana influences or adolescent alcohol abuse. Conclusions: Neuroimaging research has uncovered neurobiological markers that appear to be linked to resilience and improved recovery capacities that are furthermore influenced by various factors such as gender or genetics. Consequently, future system‐oriented approaches may help to establish a broad neuroscience‐based research framework for alcohol dependence. [ABSTRACT FROM AUTHOR]

Background In 1977 the World Health Organization (WHO) published a report entitled ‘Alcohol-Related Disabilities’. The crucial contribution of this report was to differentiate between alcohol dependence, on one hand, and alcohol-related disabilities (or problems) on the other hand. Essentially, it offered a bi-axial mapping of the field of concern. Aims This paper seeks to identify the multiple influences which shaped the evolution of this report. Methods Use is made of unpublished archival material and recall of personal involvement, together with relevant published material. Results Three major influences made it possible to move beyond the confines of previous WHO thinking on alcohol: the multi-disciplinary nature of the input; the internationality of the enterprise; and the expectations set that the concepts developed should speak to the practical world. Conclusions The arena of drug and alcohol policy has, for more than a century, been rich in its reports. This case study, although limited in its immediate content, points to the need for further analysis of the history of such reports. [ABSTRACT FROM AUTHOR]

Background and aim: New Zealand has recently legalized medicinal cannabis and has explored the possibility of legalizing large‐scale recreational cannabis supply. In the process, concerns have emerged regarding whether corporations involved in the large‐scale production and sale of legalized cannabis will invest in tactics of influence with policymakers and the public. This paper aimed to examine the various ways a legalized cannabis industry could seek to influence governments and the public in the New Zealand reform context. Method: Based on the study of industry tactics with alcohol, tobacco and gambling, we applied a three‐chain model of industry influence that breaks tactics into the 'public good', 'knowledge' and 'political' chains. Results: Exploratory analysis of the nascent cannabis industry's activity in New Zealand provided signs of industry influence strategies related to all three chains. The medicinal cannabis industry has associated the establishment of a legal cannabis sector with regional economic development and employment, supported lobbying for recreational law reform, funded NGOs involved in lobbying for law reform, established research partnerships with universities, invited ex‐politicians on advisory boards, and participated in government public sector partnerships. Conclusion: There is emerging evidence that the legal cannabis industry is using strategies to influence the regulatory environment in New Zealand. [ABSTRACT FROM AUTHOR]

Compiled by Andrea I. Mitchell, Librarian, Alcohol Research Group and SALIS Substance Abuse Librarians and Information Specialists. (;;)Note those with** in front of citation are government documents.Entry in this list neither precludes nor guarantees later review. [ABSTRACT FROM AUTHOR]

Background This paper reviews the early work of Griffith Edwards and his colleagues on alcohol in the criminal justice system and outlines the direction of research in this area in the Addiction Research Unit in the 1960s and 1970s. The paper outlines the link between that work and work undertaken in the more recent past in this area. Methods The key papers of the authors are reviewed and the impact of this work on policy and practice is discussed. Conclusions There is a rich seam of work on deprived and incarcerated populations that has been under way at the Addiction Research Unit and subsequently the National Addiction Centre, Institute of Psychiatry, London. Griffith Edwards initiated this work that explores the risks and problems experienced by people moving between the health and criminal justice system, and demonstrated the need for better care and continuity across this system [ABSTRACT FROM AUTHOR]

This paper offers some reflections on Griffith Edwards' continuing legacy with particular reference to his and Milton Gross's formulation of alcohol dependence as a 'provisional' clinical syndrome. The ideas and language from this seminal paper have heavily influenced international diagnostic classification systems. However, it is observed that there has also been significant (and increasing) divergence-in particular around the original proposal that dependence and negative alcohol-related consequences are independent, if inevitably inter-related dimensions. This is most apparent in the conflation of alcohol-related problems and dependence phenomena implicit in DSM-V. It is also argued that the alcohol dependence syndrome (ADS) has substantial continuing influence and relevance to current clinical practice. The hypothesis that degree of alcohol dependence is a useful indicator of the possibility of a return to controlled drinking continues to receive support, and underpins the widespread implementation of brief interventions for 'early stage' problem drinkers. It is suggested that the kind of careful clinical observations that underpinned the original concept of alcohol dependence have continuing relevance to the formulation of improved understanding, measurement instruments, diagnostic systems and clinical responses. [ABSTRACT FROM AUTHOR]

The situation with regard to drinking is particularly complex for young adults: they are typically faced with pressures on one hand to abstain or drink small quantities, and on the other hand there may be expectations to drink heroic amounts and engage in risk-taking while drinking. Furthermore, in some cultures a very short transition period time is evident between condoned occasional experimentation with alcohol and the expectations of being able to manage alcohol use in a wide range of settings. Also, the perceived invincibility among youth stands in sharp contrast to their high rates of traumatic events involving alcohol. The paper by Barbara Leigh examines the nature and dimensions of risk-taking particularly among young adults. For example, her analysis encourages us to look beyond preliminary associations about the proportion of certain events where drinking was involved, and consider whether drinking was a correlate or a contributing cause. The paper by James Mosher points to the importance of obtaining information about the population, situation and drinker as a basis for population-level interventions, involving environmental changes in the promotion and distribution of alcoholic beverages. The papers point to a search for interventions that are distinguished by their effectiveness in reducing harm, and not necessarily by their faddish value. An essential step is drawing the younger drinker into an accurate documentation of risk-taking experiences, and also in collaborating in developing humane, reasonable and effective approaches in reducing drinking-related harm. [ABSTRACT FROM AUTHOR]

This paper explores and develops issues raised by recent debates about the cost of alcohol to England and Wales. It advances two arguments. First, that the commonly used estimates for alcohol harm in England and Wales are outdated, not fully reliable and in need of revisiting. These estimates rely on data that are between 4 and 12 years out of date and sensitive to questionable assumptions and methodological judgements. Secondly, it argues that policymakers, academics and non-governmental organizations should be more careful in their use of these numbers. In particular, it is imperative that the numbers quoted fit the argument advanced. To help guide such appropriate usage, the different types of cost of alcohol are surveyed, alongside some thoughts on the questions they help us to answer and what they imply for policy. For example, comprehensive estimates of the total social cost of alcohol provide an indication of the scale of the problem, but have limited policy relevance. External cost estimates represent a 'lowest common denominator' approach acceptable to most, but require additional assumptions to guide action. Narrower perspectives, such as fiscal, economic or health costs, may be relevant in specific contexts. However, optimal policy should take a holistic view of all the relevant costs and benefits. Similarly, focusing solely on tangible costs may be less controversial, but will result in an under-estimate of the relevant costs of alcohol. [ABSTRACT FROM AUTHOR]

Prevention research concerning alcohol, tobacco and other drugs faces a number of challenges as the scientific foundation is strengthened for the future. Seven issues which the prevention research field should address are discussed: lack of transparency in analyses of prevention program outcomes, lack of disclosure of copyright and potential for profit/income during publication, post-hoc outcome variable selection and reporting only outcomes which show positive and statistical significance at any follow-up point, tendency to evaluate statistical significance only rather than practical significance as well, problem of selection bias in terms of selecting subjects and limited generalizability, the need for confirmation of outcomes in which only self-report data are used and selection of appropriate statistical distributions in conducting significance testing. In order to establish a solid scientific base for alcohol, tobacco and drug prevention, this paper calls for discussions, disclosures and debates about the above issues (and others) as essential. In summary, the best approach is always transparency. [ABSTRACT FROM AUTHOR]

The article discusses a research that utilizes a case-series method to synthesize the current alcohol issues across 18 countries. The study focuses on how different nation states respond to alcohol-related problems. It presents various insights concerning the role of different historical, social and cultural factors on alcohol consumption and alcohol-related problems. Moreover, the research focuses solely on the immediate causes and consequences of alcohol consumption, particularly in genetic and biomedical field.

Background and Aims: Previous twin research suggests relationship status can moderate underlying genetic liability towards alcohol misuse. This paper examined: (1) whether genome‐wide polygenic scores (GPS) for alcohol consumption are associated with alcohol misuse; (2) whether these GPS are moderated by romantic relationships (gene–environment interaction; G × E) and (3) whether G × E results are consistent across sex. Design: Linear mixed‐effects models were used to test associations between genome‐wide polygenic scores, relationship status and alcohol use/misuse. Setting: Finnish twins born between 1983 and 1987 identified through Finland's central population registry. Participants: An intensively studied subset of Finnish Twin Study (FinnTwin12) during the young adult phase (aged 20–26 years). The analytical sample includes those with complete interview and genetic data (n = 1201). Measurements Key measurements included involvement in a romantic partnership, drinking frequency, intoxication frequency and DSM‐IV alcohol dependence (AD) symptoms. Genome‐wide polygenic scores (GPS) were created from available summary statistics from a large genome‐wide association study (GWAS) of drinks per week. Results: GPS predicted drinking frequency [b = 0.109; 95% confidence interval (CI) = 0.050, 0.168], intoxication frequency (b = 0.111; 95% CI = 0.054, 0.168) and AD symptoms (b = 0.123; 95% CI = 0.064, 0.182). Having a romantic relationship negatively influenced the association between GPS and drinking frequency (b = −0.105; 95% CI = −0.211, −0.001), intoxication frequency (b = −0.118; 95% CI = −0.220, −0.016) and AD symptoms (b = −0.119; 95% CI = −0.229, −0.009). There was a three‐way interaction between sex, relationship status and GPS for intoxication frequency (b = 0.223; 95% CI = 0.013, 0.433), such that the reduced association between GPS and intoxication frequency for those in a relationship was only apparent in males. We found no evidence of three‐way interactions for drinking frequency or AD symptoms. Conclusions: Being in a romantic relationship reduced the association between genetic predisposition and drinking, high‐risk drinking and alcohol problems. However, for high‐risk drinking the protective effect was limited to males, mapping onto earlier findings suggesting that males benefit more from romantic partnerships. [ABSTRACT FROM AUTHOR]

Aims The focus of this paper is on psychometric issues related to the measurement of alcohol problems. Methods Taking a broad perspective, this paper first examines several issues around the use of instruments to provide diagnostic categories in surveys, including dimensionality, severity and alcohol consumption. Secondly, a discussion of some of the political issues surrounding measurement of alcohol problems is presented, including some of the conflicts that arise when the psychometric properties of commonly used instruments are questioned. Finally, newer statistical techniques that can be applied to scale development in the alcohol field are examined, including non-linear multivariate analyses and confirmatory/hypothesis-based methods. Results and conclusions Continued scholarly discussion needs to be encouraged around these psychometric issues so that instrument development and maintenance in the addiction sciences becomes an ongoing academic pursuit as we strive to measure alcohol problems in the best way possible. [ABSTRACT FROM AUTHOR]

This paper describes the profile of the Israel Society for the Prevention of Alcoholism (ISPA), which is a nation-wide, public, non-profit association. It portrays various aspects of ISPA treatment and rehabilitation facilities-the residential treatment center, the rehabilitative hostel and the 'warm home' for homeless alcoholics. It depicts ISPA prevention activities, prevention materials and its usage of the media, and deals with ISPA involvement in policy issues. The paper also addresses the research reality of ISPA and its scientific journal, and refers to the society's structure and its future. [ABSTRACT FROM AUTHOR]

This paper argues that if scarce resources are to be allocated efficiently and to greatest advantage then it is necessary to have explicit monetary measures of the benefits of reduced accident rares so that these benefits can be weighed against costs in the process of determining the appropriate amount to expend on alcohol-related accident prevention programmes. The conceptual issues related to the definition and estimation of monetary values of safely are discussed and the case in favour of basing such values on individual willingness to pay for safety is developed. The paper then summarises existing empirical estimates of willingness-to-pay based values for the prevention of fatalities and reports the preliminary results of recent work aimed at estimating willingness-to-pay based values for the prevention of non-fatal injuries. The paper concludes by examining the applicability of existing empirical estimates of the value of safety in the alcohol-related accident context and the transferability of estimates derived in developed countries to the developing country context. [ABSTRACT FROM AUTHOR]

Comments on a critique of an article on the preventive paradox in relation to alcoholism. Allegation that the article has excluded critical information relating to frequency of occurrence of adverse consequences; Effect of unemployment on the study's analyses; Degree of unreporting in small scale surveys.

Recent changes in alcohol availability and access in the United States are reviewed and the role public policy research played in such changes are discussed. The paper finds that there are two concurrent trends, i.e. increased alcohol availability through changes in wine and spirits structural availability, lower prices and increased outlet densities, and decreased availability and access through higher minimum drinking ages, server intervention and training, server liability, low- and no-alcohol beverages, and warning labels on alcohol containers. This paper discusses these trends and the implications for policy development to which research is an input. [ABSTRACT FROM AUTHOR]

Aims The alcohol beverage industry has been expanding its corporate social responsibility and other business activities in sub-Saharan Africa. The aim of this paper is to evaluate the effects of these activities on the physical, economic, psychological and social availability of alcohol in the region. Methods Narrative review. Source materials came from the business press, industry sources (websites, annual reports, press releases, conference proceedings) and the scientific literature published since 2000. Results The alcohol industry has intensified its activities in the African region, through their funding of social aspect organizations, technical publications, policy workshops and other corporate social responsibility activities. Marketing campaigns, new product designs and the development of industry-civil society partnerships have increased. There is evidence that the alcohol industry also engages in lobbying, information dissemination and legal action to thwart effective public health measures. Conclusions The corporate social responsibility activities of the global alcohol industry have provided a vehicle to promote industry-favorable policies and increase the physical, economic, social and psychological availability of alcohol. [ABSTRACT FROM AUTHOR]

Background and aims: Estimated alcohol consumption from national self‐report surveys is often only 30–40% of official estimates based on sales or taxation data. Global burden of disease (GBD) estimates for alcohol adjust survey estimates up to 80% of total per capita consumption. This assumes that cohort studies needed to estimate relative risks for disease suffer less from under‐reporting than typical national surveys. However, there is limited evidence on which to base that assumption. This paper aims to assess the extent of underestimation of alcohol consumption in cohort studies concerning alcohol and mortality compared with official total consumption estimates. Design Comparisons of estimated per capita consumption from a comprehensive sample of cohort studies against official estimates by country and year. Participants: A total of 1 876 046 participants in 40 cohort studies from 18 countries on alcohol use and all‐cause mortality identified by systematic review. Measurements Alcohol consumption data from the cohort studies were converted into usual grams of ethanol per day and then to total age 15+ per capita consumption. Matched estimates were sourced from the World Health Organization (WHO) Global Health Observatory. Findings The cohort studies had mean coverages of age 15+ per capita alcohol consumption of 61.71% (ranging from 29.19% for Russia to 96.53% for Japan), after weighting estimates by sample size for within‐country estimates and by number of studies per country for the overall estimate. Regional estimates were higher for the United States (66.22%) and lower for western European countries (55.35%). Conclusions: Underestimation of alcohol consumption in cohort studies is less than in typical population surveys. Because some under‐coverage is caused by under‐sampling heavier drinkers, the current practice of uplifting survey estimates to 80% of total population consumption in global burden of disease studies appears to be appropriate. [ABSTRACT FROM AUTHOR]

The article comments on a paper by G. Bischof and colleagues on the secondary health impacts of people living and not living with a person's substance use disorder. Topics mentioned include the two elements that can show societal estimates of the people who are seriously affected with person's substance use disorder, the structural factors related to harm to others, and the effect of alcohol consumption.

Aims Although prenatal screening for problem drinking during pregnancy has been recommended, guidance on screening instruments is lacking. We investigated the sensitivity, specificity and predictive value of brief alcohol screening questionnaires to identify problem drinking in pregnant women. Methods Electronic databases from their inception to June 2008 were searched, as well as reference lists of eligible papers and related review papers. We sought cohort or cross-sectional studies that compared one or more brief alcohol screening questionnaire(s) with reference criteria obtained using structured interviews to detect ‘at-risk’ drinking, alcohol abuse or dependency in pregnant women receiving prenatal care. Results Five studies (6724 participants) were included. In total, seven instruments were evaluated: TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), T-ACE [Take (number of drinks), Annoyed, Cut down, Eye-opener], CAGE (Cut down, Annoyed, Guilt, Eye-opener], NET (Normal drinker, Eye-opener, Tolerance), AUDIT (Alcohol Use Disorder Identification Test), AUDIT-C (AUDIT-consumption) and SMAST (Short Michigan Alcohol Screening Test). Study quality was generally good, but lack of blinding was a common weakness. For risk drinking sensitivity was highest for T-ACE (69-88%), TWEAK (71–91%) and AUDIT-C (95%), with high specificity (71–89%, 73–83% and 85%, respectively). CAGE and SMAST performed poorly. Sensitivity of AUDIT-C at score ≥3 was high for past year alcohol dependence (100%) or alcohol use disorder (96%) with moderate specificity (71% each). For life-time alcohol dependency the AUDIT at score ≥8 performed poorly. Conclusion T-ACE, TWEAK and AUDIT-C show promise for screening for risk drinking, and AUDIT-C may also be useful for identifying alcohol dependency or abuse. However, their performance as stand-alone tools is uncertain, and further evaluation of questionnaires for prenatal alcohol use is warranted. [ABSTRACT FROM AUTHOR]

Aim The aim in this methodological paper is to demonstrate, using Bayes' Theorem, an approach to estimating the difference in prevalence of a disorder in two groups whose test scores are obtained, illustrated with data from a college student trial where 12-month outcomes are reported for the Alcohol Use Disorders Identification Test (AUDIT). Method Using known population prevalence as a background probability and diagnostic accuracy information for the AUDIT scale, we calculated the post-test probability of alcohol abuse or dependence for study participants. The difference in post-test probability between the study intervention and control groups indicates the effectiveness of the intervention to reduce alcohol use disorder rates. Findings In the illustrative analysis, at 12-month follow-up there was a mean AUDIT score difference of 2.2 points between the intervention and control groups: an effect size of unclear policy relevance. Using Bayes' Theorem, the post-test probability mean difference between the two groups was 9% (95% confidence interval 3–14%). Interpreted as a prevalence reduction, this is evaluated more easily by policy makers and clinicians. Conclusion Important information on the probable differences in real world prevalence and impact of prevention and treatment programmes can be produced by applying Bayes' Theorem to studies where diagnostic outcome measures are used. However, the usefulness of this approach relies upon good information on the accuracy of such diagnostic measures for target conditions. [ABSTRACT FROM AUTHOR]

Abstinence from alcohol is a way of life for many American evangelicals, with rates of abstention running at over 70% among some Pentecostal denominations. This paper examines the religious beliefs that, historically, have supported teetotalism. The most notable of these is Christian perfection, a doctrine that originated in 18th-century England, that was then radicalized in America in the early 19th century. Abstinence from alcohol is highest among denominations that make Christian perfection the cornerstone of their teachings, and lowest among those that discount human agency. The paper also argues that 19th-century American evangelicals were by no means committed uniformly to temperance as a way of life, and that this was especially true of the various Methodist churches. [ABSTRACT FROM AUTHOR]

A foundational assumption in the fields of addiction and developmental psychopathology is that child and adolescent experiences set the stage for adult functioning and adjustment. However, the empirical literature documenting life-span linkages with adult alcohol (and other drug) use and abuse is sparse. This gap is due to a slow adoption of life-span developmental conceptualizations and the lack of long-term prospective longitudinal studies. This supplemental issue provides evidence for such linkages from six long-term longitudinal studies, which together follow individuals from birth through to the late 40s. The data sets include national and regional samples from Britain, Finland and the United States. In this introductory paper, we consider conceptual issues concerning linkages across the life-span culminating in adult alcohol use and disorders, and provide a summary of the purposes and common themes. [ABSTRACT FROM AUTHOR]

Aims The purpose of this paper is to outline alcohol availability, alcohol consumption and related harm, alcohol control policy and prevention programmes in Japan, few of which have been discussed in either the Japanese or English literature. Methods Data were collected primarily from the following two sources: statistics and survey results issued by the national government, including surveys funded by the government; and papers published since 2000, identified by searching the MEDLINE and Igaku-Chuo-Zasshi databases. These data were assessed regarding their quality and summarized. Some data presented here were produced specifically for this review. Results Although per capita alcohol consumption has tended to decline for more than 10 years, it has remained at a high level. Diversification of the drinking population has progressed rapidly, specifically in women, among whom alcohol consumption has increased sharply. Cross-sectional data suggest that alcohol consumption is associated with serious health and social consequences. Existing longitudinal data suggest that alcohol-related problems, especially health problems, have increased steadily over the past several decades, with few exceptions, including alcohol-related fatal road traffic accidents. Alcohol policy and prevention programmes have not developed to a level that can control these problems adequately. Specifically, the high availability of alcoholic beverages, including the lack of restrictions on sales and advertising and decreasing prices, are noted. Conclusions This review provides basic information regarding alcohol availability and alcohol consumption and related harm that may facilitate the improvement of existing alcohol control measures in Japan and encourage the development of new alcohol control measures. This research revealed the scarcity of longitudinal data regarding alcohol consumption and its consequences, and the lack of several important variables, such as disability adjusted life years, for improving our understanding of the comprehensive status of alcohol in Japan. [ABSTRACT FROM AUTHOR]

Aims As discussed in the following literature review, the relative advantages of categorical and dimensional criteria for classifying the substance use disorders (SUDs) have been debated for many years. The scheduled revision of the Diagnostic and Statistical Manual (DSM) offers an opportunity to re-examine this question. Both categorical and dimensional approaches to diagnosis offer advantages, both may in fact be necessary for a comprehensive taxonomy. Methods One means of resolving debate about the direction to take in revising DSM-V and simultaneously of achieving maximum taxonomic utility is to include both categorical and dimensional criteria in DSM-V. This could be accomplished by first defining a set of categorical criteria, as in the previous editions of the DSM. Corresponding dimensional criteria could then be created using a more empirical methodology. In this paper we review some of the relevant literature, offer a specific proposal for a dimensional component for the DSM-V substance use disorders that also preserves the categorical definitions and suggest areas for additional research relevant the this agenda. Results There is evidence that alcohol and other forms of substance abuse and dependence are heterogeneous categories and that the SUDs can be conceptualized viably as arrayed along a continuum. Amplifying clinically derived categorical definitions with more empirically derived dimensional components to better capture this variability is a particularly important consideration for a substance use research agenda for DSM-V. Conclusion It is crucial that a dimensional approach be offered in some form in DSM-V; but it is also vital that any dimensional approach be linked to the categorical definition. The proposal offered herein provides a model for amplifying categorical definitions with a dimensional component in a way that is evolutionary and not disruptive to the existing taxonomy. [ABSTRACT FROM AUTHOR]

The article describes various alcohol related collections and images at the Brown University Library in Rhode Island. The Chester H. Kirk Collection on Alcoholism and Alcoholics Anonymous is a collection of literatures by Charles Bishop, a book dealer. The Dr. Bob Archives is a collection of books, photographs and manuscripts and letter related to the history of Alcoholics Anonymous. The Rutgers Anti-Saloon League Collection of Foreign Temperance and Addictions Studies Periodicals is a collection of items from the Anti-Saloon League.

An important factor that has thus far limited the effectiveness of pharmacotherapies for patients with alcohol and opioid dependence is poor adherence to medication regimens. This paper presents a review of issues related to medication adherence in patients with these substance use disorders.A literature review was conducted of English language publications relating to medication adherence among patients with alcohol or opioid dependence.The paper places the topic in the context of adherence difficulties among patients with a variety of chronic medical and psychiatric illnesses. Difficulties measuring adherence are discussed, and strategies to improve medication adherence are reviewed. These include specific interventions that prescribing clinicians can implement in their individual meetings with patients; the use of external reinforcers, such as positive and negative contingencies, and involvement of family members or significant others; and specific prescribing and dosing practices that may improve adherence.As the use of pharmacotherapy for substance-dependent patients increases, rigorous and innovative approaches to encourage medication adherence should be sought. [ABSTRACT FROM AUTHOR]

Aims To evaluate a large drunk-driving enforcement program at the US/Mexican border to reduce the number of youths crossing the border to drink in Tijuana. This paper also describes the research data used to develop and manage the program. Data from a border breath-test survey were used to dramatize the problem and gain public support for action. The data were also used to help design the enforcement effort and measure progress in reducing the cross-border drinking problem. Design The number of news events generated around the occurrence of special enforcement efforts were used to measure project activity and to predict changes in the numbers of youths crossing into Mexico, their returning BACs and reductions in alcohol-related crashes during a 3-year period. Setting An urban county on the Mexican border. Participants Underage youths aged 18-20 years and young adults aged 21-30 years residing in San Diego County. Measurements Immigration and Naturalization Services provided population counts of the number of individuals crossing each weekend night from Tijuana into the United States through the San Ysidro border facility. Breath-test surveys of a random sample of these returning crossers provided data on the number of US residents visiting bars and nightclubs in Tijuana and on alcohol consumption at Tijuana bars and nightclubs. Night-time had-been-drinking crash data involving young drivers in several California counties served as an outcome measure of public health and safety. Findings Analysis of data involving more than 2 million pedestrians returning from Tijuana indicated that the Operation Safe Crossing program reduced the number of late-night crossers by 31.6%. Conclusions Effective use of data through media advocacy programs to support an enforcement effort can reduce alcohol-related crashes. [ABSTRACT FROM AUTHOR]

Founded in 1969, SOCIDROGALCOHOL is a reference point for professionals interested in drug dependencies, both for Spaniards and for professionals belonging to Spanish-speaking areas. In its 32 years of existence SOCIDROGALCOHOL has spread to all the regions of Spain and most of the Latin-American countries. In the past 5 years SOCIDROGALCOHOL has undergone notable growth, increasing the number of members (from 460 to 816), as well as the number of scientific activities carried out. The National Conferences represent an annual meeting point for the members, where multiple scientific sessions take place, as well as the ordinary general assembly. They are usually held in the spring and last 3 days, with an attendance of around 400 professionals. Within the field of ongoing training, SOCIDROGALCOHOL also carries out other activities: the Autumn School, the Latin-American Virtual Congress of Drug Dependence, distance learning courses, etc. Special mention should be made to the official journal of the Society, Adicciones, founded in 1989. Adicciones is published quarterly in Spanish and its articles are subjected to peer review; 2000 copies of each issue are published. The abstracts can be accessed free on the website of the Society, www.SOCIDROGALCOHOL.org. In this paper the most relevant historical aspects of SOCIDROGALCOHOL will be summarized, along with its current activities and future perspectives. [ABSTRACT FROM AUTHOR]

The transtheoretical model (TTM) is still enormously popular with practitioners, clinicians and many researchers in the addictions field. However, in a recent years a number of commentators have criticized aspects of the model and the research based on it. This paper extends a recent critique of the TTM as applied to smoking cessation to include applications of the model to cessation or reduction of alcohol or drug use. The first section discusses measures of the central construct of stages of change and notes a number of serious problems. Staging algorithms are based on arbitrary time periods and some are logically flawed. In the case of multi-dimensional questionnaires (the URICA, the SOCRATES and the RCQ), the pattern of correlations among the subscales shows that they are not measuring discrete stages of change. The one study to date that has compared the two different methods found low concordance, which is probably due to incompatible stage definitions. In the second section of the paper, the evidence base for the TTM is reviewed. The review is organized by the four research designs that have been used to test predictions from stage models: cross-sectional comparisons of people in different stages; examination of stage sequences; longitudinal prediction of stage transitions; and experimental studies of matched and mismatched interventions. It concludes that current evidence for the model as applied to substance use is meagre and inconsistent. Researchers are urged to develop better stage models. [ABSTRACT FROM AUTHOR]

The nature of drug craving and its role in the addictive process is a contentious issue in the addiction sciences. There are numerous disputes regarding the definition, assessment, manipulation and interpretation of craving, and progress toward resolving the enigmas of craving confronts numerous conceptual and methodological challenges. Greater attention to certain fundamental principles of measurement and manipulation should generate immediate and substantial improvements in efforts to understand and control alcohol craving. This paper provides suggestions for enhancing the measurement of self-reported alcohol craving and improving the manipulation of alcohol craving under controlled laboratory conditions. With regard to measurement, single-item scales commonly employed in craving research tend to be handicapped by limited reliability and validity. Multi-item craving scales are more likely to provide the accuracy required to accurately discriminate between different levels of craving across individuals or across different settings. Conceptual and practical considerations for the selection of multi-item craving instruments are discussed. With regard to the manipulation of alcohol craving in the laboratory, recent meta-analyses suggest that alcohol craving effects in such research may be relatively weaker than craving effects found in similar research with other addicts. Therefore, laboratory-based investigations into the nature of alcohol craving should utilize procedures and assessments that are particularly sensitive to the detection of alcohol craving. This paper offers methodological recommendations for enhancing the magnitude of alcohol craving effects generated in laboratory research. [ABSTRACT FROM AUTHOR]

Editorial. Focuses the European Conference on Health, Society and Alcohol held in Paris on December 12-14, 1995. What the conference adopted as a tool for policy implementation; Three policy issues presented within the conference; Structure of supplements prepared for the conference.

The present paper analyzes data from the 1988 National Health Interview Survey (NHIS88) of US adults. This general population survey is important in that it is the largest survey to date that collects detailed information on alcohol consumption and alcohol problems. The NHIS88 is a multi-stage complex sample household study with a sample size of about 44 000 adults of which about 20 000 reported that they were current drinkers. Symptom items were used for classification of individuals into categories of alcohol abuse and alcohol dependence based on the DSM-III-R, DSM-IV, and ICD-10 classification. The present analyses are based on 20 items corresponding to the ICD-10 classification, the elements of which are closely related to the Edwards-Gross alcohol dependence syndrome concepts. A single dimension corresponding to alcohol problems in general accounted for much of the correlations among these items, but additional dimensions of interest were also identified. Of the ICD-10 elements only Impaired Control, Tolerance, and Withdrawal could be identified as separate dimensions. [ABSTRACT FROM AUTHOR]

This paper examines some of the major ethical end research issues associated with the measurement and recording of alcohol-related problems. Because self-reports of the history of the amount of alcohol ingested are sometimes unreliable, the assessment of the role of alcohol in casualties often relies on a variety of methods which are both diverse and interrelated. The unique measurement problems posed by the diversity of alcohol measures are reviewed and issues in selection and recording bias of alcohol's involvement in injury are discussed. A number of fundamental ethical and moral issues related to measurement are identified. [ABSTRACT FROM AUTHOR]

This paper discusses issues related to the cognitive and communicational activity of ascribing a causal role to alcohol use in accidents. It is argued that in addition to the empirical relationships to be explained causal attribution is limited by two other types of empirical contingencies: the cognitive processing of information available for causal attribution, and the representation of this information in language (encoding and decoding as part of communication). Only the latter two types of restrictions in causal attribution are discussed, since its logical requirements are covered by well known methodological principles. On the linguistic and communicative side, limitations and biases in causal ascription are introduced by (1) the three central concepts ('alcohol', 'cause', 'accidents') due to properties inherent in language; (2) the (often implicit) selection of boundary conditions; (3) heuristic inference rules; and (4) the tendency towards thematic closure in describing and explaining phenomena. It is suggested that social, psychological and interactional causal processes have been overlooked in attributing causal links between alcohol use, hazardous behaviour and accidents. This paper discusses issues related to the cognitive and communicational activity of ascribing a causal role to alcohol use in accidents. It is argued that in addition to the empirical relationships to be explained causal attribution is limited by two other types of empirical contingencies: the cognitive processing of information available for causal attribution, and the representation of this information in language (encoding and decoding as part of communication). Only the latter two types of restrictions in causal attribution are discussed, since its logical requirements are covered by well known methodological principles. On the linguistic and communicative side, limitations and biases in causal ascription are introduced by (1) the three central concepts ('alcohol', 'cause',... [ABSTRACT FROM AUTHOR]

This paper describes the relationship between severity of dependence and medical and social consequences in a clinical sample. Respondents constitute a sample of 219 men and 162 women interviewed in nine alcohol programs in a Northern California county. Results suggest that the number of dependence indicators reported by respondents is a valid indicator of severity of alcohol dependence, and that there is a positive relationship between the number of indicators and the number of medical and social consequences reported by respondents. When specific medical and social consequences are examined, an analysis restricted to men only, the number of dependence indicators is associated with stomach, heart and liver problems, DTs, hallucinations, public drunkenness, family arguments and serious accidents, but it is not associated with drunk driving arrests and job problems. [ABSTRACT FROM AUTHOR]

The present paper addressed the problem of the origin of alcohol-related social norms in the Saami minority in northern Norway. Based on data from studies of comparable ethnic minorities in Greenland, North America and Australia it could be expected that alcohol use- and abuse would be more prevalent in the Saami than in the Norwegian populations of northern Norway. No data to support this hypothesis exist. On the contrary, available data suggest that drinking problems in this group are similar to those of the majority in the area. The present paper developed the hypothesis that Saami alcohol-related social norms originated in the Laestadian religious revival. The paper investigated the impact of the Laestadian culture in the formation of alcohol-related social norms. It was concluded that the Laestadian sobriety norm, and the norm of abstinence from the use of adiafora, have influenced alcohol-related behaviour in the Saami group in such a way that this group does not conform to the drinking behaviour found in comparable minorities. [ABSTRACT FROM AUTHOR]

This paper examines the proposition that increased treatment for alcohol abuse and Alcoholics Anonymous (AA) membership can account for a large part of the recent declines in cirrhosis mortality and morbidity. Data on treatment and AA membership in the USA between 1979 and 1987 and in Ontario between 1975 and 1986 are used, together with estimates of cirrhosis risk and the likely impact of treatment and AA membership. The results show that increased treatment levels and AA membership could account for all of the reductions in cirrhosis deaths and hospital admissions in Ontario. In the USA all of the deaths and about 40% of the admissions could be accounted for by these factors. [ABSTRACT FROM AUTHOR]

This paper describes the political origins of the National Treatment Outcomes Research Study (NTORS) and the outputs and impacts of the study. NTORS was designed to meet the request of the Health Secretary and of a Government Task Force for evidence about the effectiveness of the national addiction treatment services. NTORS was a prospective cohort study which investigated outcomes over a 5-year period of drug users admitted to four major treatment modalities: in-patient treatment, residential rehabilitation, methadone reduction and methadone maintenance programmes. The study investigated treatments delivered under day-to-day operating conditions. Outcomes showed substantial reductions in illicit drug use and reduced injecting risk behaviours. These changes were accompanied by improved psychological and physical health and by reductions in criminal behaviour. However, not all outcomes were so positive. There was a continuing mortality rate in the cohort of about 1% per year, and many clients continued to drink heavily throughout the 5-year follow-up. NTORS findings informed and influenced UK addiction treatment policy both at the time and subsequently. The findings were influential in supporting an immediate increase in funding for treatment, and Government Ministers have repeatedly cited NTORS as evidence of the effectiveness of addiction treatment. One finding that received political attention was that of the cost savings provided by treatment through reductions in crime. This important finding led to an unanticipated consequence of NTORS; namely, the greater focus on crime reduction that has increasingly been promoted as a political and social priority for drug misuse treatment. [ABSTRACT FROM AUTHOR]

In 1976 Edwards & Gross proposed the concept of the alcohol dependence syndrome, based on the clinical observation that heavy drinkers manifested an inter-related clustering of signs and symptoms. That this modest 'provisional description' turned out to be so significant and influential is perhaps unsurprising when the context in which it was made is appreciated. Griffith Edwards and his colleagues at the Maudsley Hospital had undergone a rigorous 3-year training in clinical psychiatry, during which they had been taught to think critically and were grounded in the art of clinical observation. As he assessed patients for various alcohol research studies he realized that there was a clustering of certain elements. Thus clinical observation and an appreciation of the patient's drinking history contributed to the genesis of the concept. This paper reflects on the integration of his rigorous training at the Maudsley, his enquiring mind and encyclopaedic knowledge of the historical and research literature which enabled him to formulate a testable hypothesis about the alcohol dependence syndrome. [ABSTRACT FROM AUTHOR]

Background and aims Addictive behaviours are among the greatest scourges on humankind. It is important to estimate the extent of the problem globally and in different geographical regions. Such estimates are available, but there is a need to collate and evaluate these to arrive at the best available synthetic figures. Addiction has commissioned this paper as the first of a series attempting to do this. Methods Online sources of global, regional and national information on prevalence and major harms relating to alcohol use, tobacco use, unsanctioned psychoactive drug use and gambling were identified through expert review and assessed. The primary data sources located were the websites of the World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC) and the Alberta Gambling Research Institute. Summary statistics were compared with recent publications on the global epidemiology of addictive behaviours. Results An estimated 4.9% of the world's adult population (240 million people) suffer from alcohol use disorder (7.8% of men and 1.5% of women), with alcohol causing an estimated 257 disability-adjusted life years lost per 100 000 population. An estimated 22.5% of adults in the world (1 billion people) smoke tobacco products (32.0% of men and 7.0% of women). It is estimated that 11% of deaths in males and 6% of deaths in females each year are due to tobacco. Of 'unsanctioned psychoactive drugs', cannabis is the most prevalent at 3.5% globally, with each of the others at < 1%; 0.3% of the world's adult population (15 million people) inject drugs. Use of unsanctioned psychoactive drugs accounts for an estimated 83 disability-adjusted life years lost per 100 000 population. Global estimates of problem gambling are not possible, but in countries where it has been assessed the prevalence is estimated at 1.5%. Conclusions Tobacco and alcohol use are by far the most prevalent addictive behaviours and cause the large majority of the harm. However, the quality of data on prevalence and addiction-related harms is mostly low, and comparisons between countries and regions must be viewed with caution. There is an urgent need to review the quality of data on which global estimates are made and coordinate efforts to arrive at a more consistent approach. [ABSTRACT FROM AUTHOR]