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The use of screening questionnaires to detect early problem drinking has been stimulated by the development of the AUDIT (Alcohol-Use Disorders Identification Test). A comparison of a computerized version of the test and its paper and pencil original was conducted on 110 consecutive attenders at an alcoholism day-treatment facility. The findings suggest that the computer version is as acceptable as the paper and pencil one and that scores on the two formats are comparable. [ABSTRACT FROM PUBLISHER]

A letter to the editor is presented in response to the articles related to alcohol consumption model under alcohol control policies by Kari Poikolainen in the previous issues of the periodical.

Aims: We compared the effect of three different modes of questionnaire administration on screening for hazardous drinking and acquiescence to trial participation. Methods: A quasi-randomized controlled trial among injured patients seen in acute care clinics compared self-administered paper-and-pencil, self-administered electronic, and orally-administered interview questionnaires. Outcomes included positive AUDIT-C screens for hazardous drinking, willingness to participate in a (hypothetical) lifestyle intervention trial, and recruitment success. Differences were analyzed with nonlinear mixed models, controlling for age, sex, and facility. Structured interviews with staff explored levers and barriers to screening. Results: Of the 370 participants, 22.7% scored ⩾4 and 7.8% ⩾6 on the AUDIT-C. Electronic questionnaires were more likely than paper questionnaires to identify an AUDIT-C ⩾6 (OR = 1.96; 95% Cl 1.10-3.48), but not ⩾4 (OR = 0.83; 95% Cl 0.43 1.62). Oral questionnaires were as likely as paper questionnaires to identify an AUDIT-C ⩾4 (OR = 1.00; 95% Cl 0.40-2.51) or ⩾6 (OR = 1.94; 95% Cl 0.83-4.50). Electronic and oral questionnaires were more likely to elicit acquiescence to trial participation (OR = 1.59; 95% Cl 1.23-2.07, and OR = 1.66; 95% Cl 1.22-2.26, respectively). Oral questionnaires created problems with confidentiality, privacy, and disruption of patient flow, and reduced recruitment success (OR = 0.51; 95% Cl 0.42-0.62). Conclusions: Among acutely injured patients in clinics who consented to screening, nearly one-fourth reported hazardous drinking, Compared to paper questionnaires, electronic screening produced less social desirability bias mid greater acquiescence to trial participation. Oral questionnaires produced greater acquiescence, but barriers to use adversely affected recruitment. Electronic questionnaires may be preferable for screening for hazardous drinking and recruitment into intervention trials in acute care clinics. [ABSTRACT FROM AUTHOR]

A large number of observational studies have found a J-shaped relationship between alcohol intake and ischemic heart disease (IHD) risk. However, some studies suggest that the alleged cardio-protective effect may be an artifact in the way that the elevated risk for abstainers is due to self-selection on risk factors for IHD. The aim of this paper is to estimate the association between alcohol and IHD-mortality on the basis of aggregate time-series data, where the problem with selection effects is not present. In addition, we will analyze SES-specific mortality to investigate whether there is any socio-economic gradient in the relationship at issue. SES was measured by educational level. We used IHD-mortality in three educational groups as outcome. Per capita alcohol consumption was proxied by Systembolaget's alcohol sales (litres of alcohol 100% per capita 15+). Swedish quarterly data on mortality and alcohol consumption spanned the period 1991Q1–2020Q4. We applied SARIMA time-series analysis. Survey data were used to construct an indicator of heavy SES-specific episodic drinking. The estimated association between per capita consumption and IHD-mortality was positive and statistically significant in the two groups with primary and secondary education, but not in the group with postsecondary education. The association was significantly stronger the lower the educational group. Although the associations were generally stronger for males than for females, these differences were not statistically significant (P  > 0.05). Our findings suggest that the detrimental impact of per capita consumption on IHD-mortality was stronger the lower the educational group. [ABSTRACT FROM AUTHOR]

Objective: The goal of our article was to systematise studies that investigated the impact of living conditions in large national regions on individual alcohol consumption. Methods: The objectives of the scoping review, the criteria and methods for selecting articles were defined in advance and recorded in the protocol PROSPERO CRD42021234874. We sought publications on the research topic in PubMed, Google Scholar, OpenGrey, Crossref and eLibrary databases from the moment they were created until December 31, 2021. The final sample included 81 publications. Results: The majority of ultimately selected papers were published after 2010 (62 articles), represented the USA (68 articles), and considered samples of children and youths, either the younger population or the general adult population (65 articles). High quality was characteristic for 19 studies, whereas satisfactory quality was exhibited by 46 publications. The most consistent associations with individual alcohol consumption were revealed for the legislative environment (especially for integral scales and indices), alcohol pricing policy, the prevalence of alcohol consumption and binge drinking in the population, and unemployment rate. Conclusion: The review made it possible to systematise the results of studies on the impact of the characteristics of large national regions on alcohol consumption, including a description of these characteristics and results, samples and designs of studies, their quality, as well as to summarise the results of these studies. [ABSTRACT FROM AUTHOR]

Aims: To determine whether socio-economic status (SES) influences (i) willingness to participate in brief intervention (BI) research, (ii) attendance to receive BI once allocated, and (iii) treatment outcome. Methods: Systematic review of published, randomised controlled trials of BI for non-dependent alcohol misuse in primary health care settings. Results: Eighteen papers met inclusion criteria. There is evidence that once recruited, and following attendance for intervention, participants' SES does not influence treatment outcome. However, the effect of choosing to participate remains unclear, and the generalizability of results to the whole primary care population remains equivocal. Socio-economic status may influence willingness to participate in BI treatment research, and may influence attendance to receive such interventions where allocated. Conclusion: Brief interventions should remain available to all non-dependent hazardous and harmful drinkers in primary care. However, fidelity to research design is suggested to allow for any participation effects to occur. Benefits of such an approach exist for both clinicians and patients. The characteristics of those who participate in BI trials, compared to those who do not, should be studied in detail. Socio-economic variables should be included as potentially important characteristics. The impact of BI on drinking style as well as consumption needs further attention. [ABSTRACT FROM AUTHOR]

In this article the author discusses the study by S. Moore on the unknown impact of alcohol policy with substance use. He mentions that Moore should take into consideration the systematic approach on the evidence of the study as well as addressing the questions clearly such as getting the evidence into the existing polydrug users. He states relevant studies which support the studies of Moore in terms of alcohol substitution with marijuana and complement of alcohol with other drug use.

Aims This paper analyses the content of news media messages on drinking during pregnancy in Australia over an 18-year period to understand whether and how the nature of messages communicated to women has changed over time. Methods Factiva was used to search Australian newspapers from 2000 to 2017, resulting in a sample of 1394 articles from the 18 major national and state-based newspapers. Content analysis of articles was undertaken, and Poisson regression analysis was used to assess changes over time. Results The largest number of articles on drinking during pregnancy was published in 2007. Themes that significantly increased over time included Harms to the Child (from 0.97% in 2008 to 29.69% in 2015) and Prevention Initiatives (from 0% in 2005 to 12.50% in 2017). Articles endorsing women not consuming alcohol during pregnancy significantly increased over time (from 20.69% in 2001 to 53.78% in 2013), matched by a decreasing trend in the proportion of articles presenting mixed advice (from 15.93% in 2009 to 0% in 2017). The largest number of articles adopted no position in relation to women's consumption. Conclusions A stronger abstinence message during pregnancy has been communicated through Australian newspaper media over time. The mixed messaging and large number of articles not endorsing a position on consumption may reflect the inconclusiveness of the evidence on harms from low to moderate levels of alcohol consumption during pregnancy. Opportunities remain for researchers to work with public health advocates to disseminate balanced messages based on evidence-based research. [ABSTRACT FROM AUTHOR]

Aims This paper aimed to explore perceptions of alcohol health warning labels amongst a large international sample of people who drink alcohol. Methods The Global Drug Survey (GDS) is the world's largest annual cross sectional survey of drug use. Seven health warning labels were presented (relating to heart disease, liver, cancer, calories, violence, taking two days off and the myth of benefits to moderate drinking). People were asked if they were aware of the information, believed it, if it was personally relevant, and if it would change their drinking. This paper included data from 75,969 respondents from 29 countries/regions who reported the use of alcohol in the last 12 months, collected during November–December 2017 (GDS2018). Results The fact that drinking less can reduce the risk of seven types of cancer was the least well known, and yet was demonstrated to encourage almost 40% of drinkers to consider drinking less. Women and high risk drinkers were more likely to indicate they would reduce their drinking in response to all labels. Personal relevance was identified as a key predictor of individual responses. Conclusion Findings highlight the potential of a range of health messages displayed on alcoholic beverages to raise awareness of alcohol-related harms and potentially support a reduction in drinking. Further research should explore what influences personal relevance of messages as this may be a barrier to effectiveness. [ABSTRACT FROM AUTHOR]

Aims Alcohol consumption (AC) may cause workplace absence, but the findings of individual studies vary markedly. To date, no dose–response meta-analysis (DRMA) of the relationship between AC and sickness absence (SA) has been completed. This paper aims to estimate the dose–response relationship between AC and the risk of SA based on published observational studies. Methods We used DRMA and modelling to investigate the effects of varying doses of AC (including heavy episodic drinking (HED)) on SA. Results The meta-analysis included 21 studies (12 cohort studies and 9 cross-sectional). It showed that HED, risky (20–40 g of alcohol/day) and high-risk (>40 g of alcohol/day) drinkers had an elevated risk of SA when compared with light-to-moderate drinkers for both sexes. Those who abstained from alcohol had a higher risk of SA than those who drink moderately. Conclusions Our results indicate that risky, high-risk drinking and HED may increase the risk of absenteeism. The implementation of population-based strategies may be appropriate to address the burdens of alcohol-related SA. Additionally, economic evaluations of alcohol policies should incorporate their impacts on SA. However, the current literature has substantial limitations, relying on modestly designed studies from just a few settings and more studies are needed—especially those that measure abstention in more nuanced ways. [ABSTRACT FROM AUTHOR]

Risk-taking propensity has been crucial to the investigation of alcohol use and consequences. One measure, the balloon analogue risk task (BART), has been used consistently over the past two decades. However, it is unclear how this measure is related to alcohol outcomes. This paper systematically reviews the literature on the BART and alcohol outcomes. First, direct associations between the BART and alcohol use are reviewed including correlations, group comparisons, the BART's prediction of alcohol outcomes and BART performance after consuming alcohol. Then, potential moderators that explain when and for whom the BART is related to alcohol outcomes are reviewed. Finally, potential mechanisms that explain how the BART and alcohol outcomes are related are reviewed. This review reveals patterns in the BART suggesting risk-taking propensity may be related to changes in alcohol use over time; however, there is little evidence to suggest BART scores increase after consuming alcohol. Yet, additional research suggests adjusted average pump scores may be too simplistic for the amount of information the BART captures and understanding individual's patterns of responses on the BART is important for investigating its relation to alcohol outcomes. Finally, this review opens up several future directions for research to understand how risk-taking propensity is related to alcohol outcomes. [ABSTRACT FROM AUTHOR]

Aims Primary aim: to determine the efficacy of FAST (the Fast Alcohol Screening Test) for detecting harmful and dependent levels of alcohol use. Secondary aim: to compare the performance of the FAST to two short forms of the Alcohol Use Disorder Identification Test (AUDIT): the AUDIT-C and AUDIT-3. Methods Data from 3336 individuals in South Wales, compiled from full AUDIT datasets, were examined. AUROC analysis, alongside measures of sensitivity and specificity of the FAST, AUDIT-C and AUDIT-3 were utilized for the identification of harmful and dependent alcohol use. Results The FAST demonstrated efficacy in the identification of harmful and dependent levels of alcohol use, with superior performance to both the AUDIT-C and AUDIT-3. Conclusion The present paper demonstrates the potential of the FAST as a cost- and time-effective method for appropriate screening and signposting in the stepped care model utilized by many health care and treatment services. Further studies are needed to ensure validity, both within the general population and for specific services and populations. [ABSTRACT FROM AUTHOR]

Aim: The aim of this current study was to systematically review the literature on brief alcohol interventions for incarcerated individuals to ascertain the efficacy or effectiveness in making changes to either consumption of alcohol or other social outcomes. Short summary: Levels of risky drinking and dependency are high amongst incarcerated individuals. Eleven studies from nine articles were included in the systematic review. Six of the studies included brief intervention and three extended interventions. Interventions have the potential to positively impact on risky drinking. More studies are needed in this setting. Introduction: It has been shown that around three times as many incarcerated individuals are risky drinkers and alcohol dependency is ten times higher than in the general population. Methods: Systematic review of randomised controlled trials or matched group trials of the efficacy of psychosocial alcohol interventions for incarcerated individuals: we searched seven databases, with no restrictions on language, year or location from inception through to August 2017. The Critical Appraisal Skills Programme tool was used to assess the quality of included studies. The Template for Intervention Description and Replication checklist was used to ascertain intervention descriptions. Results: Nine studies from 11 papers were included in the analysis. Six of the studies included brief interventions and three extended interventions. Every study used a different measure of alcohol consumption. Three of the studies that looked at brief interventions and all of the three extended intervention studies found significant reductions in relation to alcohol outcomes. Conclusions: Results show that interventions in the prison setting have the potential to positively impact on alcohol use; however, because of small numbers and the use of different outcome measures we could not conduct a meta-analysis or generalise findings. Future studies are needed to standardise approaches to ensure greater rigour and efficacy. [ABSTRACT FROM AUTHOR]

To systematically review evidence on the influence of specific marketing components (Price, Promotion, Product attributes and Place of sale/availability) on key drinking outcomes (initiation, continuation, frequency and intensity) in young people aged 9-17.~Aim~Objective~MEDLINE, EMBASE, SCOPUS, PsychINFO, CINAHL and ProQuest were searched from inception to July 2015, supplemented with searches of Google Scholar, hand searches of key journals and backward and forward citation searches of reference lists of identified papers.~Methods~Methods~Forty-eight papers covering 35 unique studies met inclusion criteria. Authors tended to report that greater exposure to alcohol marketing impacted on drinking initiation, continuation, frequency and intensity during adolescence. Nevertheless, 23 (66%) studies reported null results or negative associations, often in combination with positive associations, resulting in mixed findings within and across studies. Heterogeneity in study design, content and outcomes prevented estimation of effect sizes or exploration of variation between countries or age subgroups. The strength of the evidence base differed according to type of marketing exposure and drinking outcome studied, with support for an association between alcohol promotion (mainly advertising) and drinking outcomes in adolescence, whilst only two studies examined the relationship between alcohol price and the drinking behaviour of those under the age of 18.~Results~Results~Despite the volume of work, evidence is inconclusive in all four areas of marketing but strongest for promotional activity. Future research with standardized measures is needed to build on this work and better inform interventions and policy responses.~Conclusion~Conclusions [ABSTRACT FROM AUTHOR]

Aims: Alcohol consumption is a major cause of premature mortality in countries of the former Soviet Union (fSU). Despite the unique social profile of the region, we could find no published systematic review of studies of social factors and alcohol consumption in formerly Soviet countries. We aim to critically review the current evidence for social factors associated with alcohol consumption in the fSU and to identify key gaps in the literature. Methods: We searched MEDLINE, EMBASE and Global Health databases for cross-sectional, case–control, longitudinal or qualitative studies of demographic, socio-economic, psycho-social and contextual factors associated with alcohol consumption, in any language, published from 1991 until 16 December 2011. Additional studies were identified from the references of selected papers and expert consultation. Our review followed PRISMA guidelines for the reporting of systematic reviews. Results: Our search strategy resulted in 26 articles for review. Although there is strong evidence in the literature that males and smokers in the fSU are more likely to engage in hazardous alcohol consumption, findings regarding other social factors were mixed and there were almost no data on the association of contextual factors and alcohol consumption in this region. Conclusion: This review highlights the extremely limited amount of evidence for social factors associated with heavy alcohol consumption in the fSU. Given the unique social environment of countries of the fSU, future research should take these factors into account in order to effectively address the high levels of alcohol-related mortality in this region. [ABSTRACT FROM PUBLISHER]

Aims: To compare treatment outcomes between clients preferring abstinence and those preferring non-abstinence at the screening stage of a randomized controlled trial of treatment for alcohol problems (the United Kingdom Alcohol Treatment Trial) and to interpret any differential outcome in light of baseline differences between goal preference groups outlined in an accompanying paper. [ABSTRACT FROM PUBLISHER]

Aims The objective of this paper was to examine 20-year trends of the socioeconomic status (SES) measures income and employment and their association with current alcohol use behaviors in Danish adults aged 60–70. Methods Data from The Danish National Health Survey 2013 and the baseline assessment of the Elderly Study (2013–2016) were combined to form four groups from the general population with various drinking patterns, but with no recent treatment for alcohol use disorder (AUD), and one group seeking treatment: Abstinent (n  = 691), low- (n  = 1978), moderate- (n  = 602), and high-risk (HR) drinkers (n  = 467), and DSM-5 AUD seeking treatment (n  = 262). For all groups, Danish national register data were linked at the individual level obtain find annual information on income and employment during the 20 years prior to interview. Mixed effects models were utilized to model trajectories of income and employment for the five groups. Results Lower income and employment status was observed from middle-aged adulthood when comparing 12-month abstinence or AUD to individuals with low or moderate alcohol consumption. At the end of the study period, moderate-risk drinkers experienced an increase, and HR drinkers a decrease, in income and rate of employment relative to the low-risk drinkers. Conclusions Alcohol use behaviors observed in older adults are related to distinct long-term trajectories regarding income and employment status, which are observable already in middle-aged adulthood. [ABSTRACT FROM AUTHOR]

Aims: This paper examines implementation of the 2005 federal alcohol control law in the Russian Federation. Methods: The documents on the Russian Federation federal legislation on the control of the production and turnover of ethyl alcohol, and ethyl alcohol containing products, news reports, research, and historical documents were gathered and analysed for implementation barriers. Results: Consumption of alcoholic beverages, especially spirits, has been one the most significant public health problems in Russia for many centuries. Prior attempts to control alcohol consumption have been unsuccessful, in part due to the government's reliance on alcohol revenue, and its inability to implement creative and manageable solutions in the light of the high drinking rates, Implementation of this legislation has been a challenge in Russia because of administrative oversight, lack of organizational preparation, and corruption. Conclusions: The law discussed in this paper presented a window of opportunity to ameliorate the deteriorating health status and reverse the impending mortality crisis. However. a number of barriers presented substantial setbacks toward realization of this legislation. [ABSTRACT FROM AUTHOR]

Aims An updated Cochrane systematic review assessed effectiveness of screening and brief intervention to reduce hazardous or harmful alcohol consumption in general practice or emergency care settings. This paper summarises the implications of the review for clinicians. Methods Cochrane methods were followed. Reporting accords with PRISMA guidance. We searched multiple resources to September 2017, seeking randomised controlled trials of brief interventions to reduce hazardous or harmful alcohol consumption in people attending general practice, emergency care or other primary care settings for reasons other than alcohol treatment. Brief intervention was defined as a conversation comprising five or fewer sessions of brief advice or brief lifestyle counselling and a total duration of less than 60 min. Our primary outcome was alcohol consumption, measured as or convertible to grams per week. We conducted meta-analyses to assess change in consumption, and subgroup analyses to explore the impact of participant and intervention characteristics. Results We included 69 studies, of which 42 were added for this update. Most studies (88%) compared brief intervention to control. The primary meta-analysis included 34 studies and provided moderate-quality evidence that brief intervention reduced consumption compared to control after one year (mean difference −20 g/wk, 95% confidence interval −28 to −12). Subgroup analysis showed a similar effect for men and women. Conclusions Brief interventions can reduce harmful and hazardous alcohol consumption in men and women. Short, advice-based interventions may be as effective as extended, counselling-based interventions for patients with harmful levels of alcohol use who are presenting for the first time in a primary care setting. [ABSTRACT FROM AUTHOR]

Aims This paper examines: (a) change over time (2001–2013) in recently reducing or ceasing drinking in the Australian population and (b) the reasons given for reducing or ceasing drinking in the most recent survey (2013); stratified by sex and age group. Short summary Rates of reducing and ceasing drinking increased between 2001 and 2013 in Australia. Young people were more likely to modify drinking due to lifestyle and enjoyment reasons; older groups were more likely to report health reasons. These trends contribute to the broader context of declining alcohol consumption in Australia. Methods Data are from five waves of the National Drug Strategy Household Survey (N = 119,397). Logistic regression models with interaction terms were used to identify a shift in sex or age over time in predicting reduction or cessation of drinking and to predict motivations for reducing or ceasing drinking by sex and age. Results Reports of recently reducing the quantity or frequency of drinking increased from 2001 to 2007 and remained stable between 2007 and 2013. There was a steady increase in the number of Australians reporting recently ceasing drinking from 2001 to 2013, with a significant effect for age (younger groups more likely than older groups to cease drinking in the past two waves). Reasons for reducing or ceasing drinking varied by age, with older people more likely to report health reasons and younger people more likely to report lifestyle reasons or enjoyment. Conclusion Increases over time in reports of reduction or cessation of drinking due to health, lifestyle, social and enjoyment reasons suggest that the social position of alcohol in Australia may be shifting, particularly among young people. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to review systematically, research investigating an association between the continuous performance task (CPT) in children and exposure to alcohol in utero, in order to identify any evidence of a specific deficit in performance. Methods: Seven electronic databases and three websites were searched. Papers were selected in accordance with specific inclusion criteria and scored in terms of the methodological quality using the Newcastle–Ottawa score. Marked methodological heterogeneity limited the validity of any statistical meta-analysis and a descriptive synthesis was performed instead. Results: A total of 14 papers were identified for inclusion. There was no consistent evidence of any association between prenatal alcohol exposure and correct responses, reaction time, commission or omission errors during CPT testing. Apparent trends in the reported results, however, suggest that a potential effect might have been missed. Conclusions: Identifying a specific profile of CPT performance may assist in the detection and management of attention deficits amongst children with prenatal alcohol exposure. Future research with more consistent measures of exposure and outcome is, however, required before any valid generalizations about CPT performance can be made. [ABSTRACT FROM PUBLISHER]

Aims: To assess the impact of alcohol advertising and media exposure on future adolescent alcohol use. Methods: We searched MEDLINE, the Cochrane Library, Sociological Abstracts, and PsycLIT, from 1990 to September 2008, supplemented with searches of Google scholar, hand searches of key journals and reference lists of identified papers and key publications for more recent publications. We selected longitudinal studies that assessed individuals' exposure to commercial communications and media and alcohol drinking behaviour at baseline, and assessed alcohol drinking behaviour at follow-up. Participants were adolescents aged 18 years or younger or below the legal drinking age of the country of origin of the study, whichever was the higher. Results: Thirteen longitudinal studies that followed up a total of over 38,000 young people met inclusion criteria. The studies measured exposure to advertising and promotion in a variety of ways, including estimates of the volume of media and advertising exposure, ownership of branded merchandise, recall and receptivity, and one study on expenditure on advertisements. Follow-up ranged from 8 to 96 months. One study reported outcomes at multiple time-points, 3, 5, and 8 years. Seven studies provided data on initiation of alcohol use amongst non-drinkers, three studies on maintenance and frequency of drinking amongst baseline drinkers, and seven studies on alcohol use of the total sample of non-drinkers and drinkers at baseline. Twelve of the thirteen studies concluded an impact of exposure on subsequent alcohol use, including initiation of drinking and heavier drinking amongst existing drinkers, with a dose response relationship in all studies that reported such exposure and analysis. There was variation in the strength of association, and the degree to which potential confounders were controlled for. The thirteenth study, which tested the impact of outdoor advertising placed near schools failed to detect an impact on alcohol use, but found an impact on intentions to use. Conclusions: Longitudinal studies consistently suggest that exposure to media and commercial communications on alcohol is associated with the likelihood that adolescents will start to drink alcohol, and with increased drinking amongst baseline drinkers. Based on the strength of this association, the consistency of findings across numerous observational studies, temporality of exposure and drinking behaviours observed, dose-response relationships, as well as the theoretical plausibility regarding the impact of media exposure and commercial communications, we conclude that alcohol advertising and promotion increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol. [ABSTRACT FROM AUTHOR]

This paper reports the results of a 3-week drinking experiment in 51 healthy male subjects, examining the value of %CDT (carbohydrate-deficient transferring in the context of different levels of alcohol intake. All healthy persons were urine-tested drug-free and underwent daily breath alcohol tests for the 7 days preceding, and during the whole 3 weeks of, the experiment. Subjects were divided into five groups, consuming different amounts of alcohol daily over a 3-h period in the presence of the investigators. The five groups consisted of 10, 9, 10, 16 and 6 subjects respectively and consumed a daily dose of ethanol of 20, 40, 60, 80 and 80 g respectively for 3 weeks. No significant changes in %CDT were detected in most subjects, even in the 80 g alcohol-consuming groups. The results suggest that CDT is not sensitive for the detection of short-term heavy drinking by healthy subjects. [ABSTRACT FROM PUBLISHER]

Aims: The aim of the study was to assess the cumulative evidence on the effectiveness of brief alcohol interventions in primary healthcare in order to highlight key knowledge gaps for further research. Methods: An overview of systematic reviews and meta-analyses of the effectiveness of brief alcohol intervention in primary healthcare published between 2002 and 2012. Findings: Twenty-four systematic reviews met the eligibility criteria (covering a total of 56 randomized controlled trials reported across 80 papers). Across the included studies, it was consistently reported that brief intervention was effective for addressing hazardous and harmful drinking in primary healthcare, particularly in middle-aged, male drinkers. Evidence gaps included: brief intervention effectiveness in key groups (women, older and younger drinkers, minority ethnic groups, dependent/co-morbid drinkers and those living in transitional and developing countries); and the optimum brief intervention length and frequency to maintain longer-term effectiveness. Conclusion: This overview highlights the large volume of primarily positive evidence supporting brief alcohol intervention effects as well as some unanswered questions with regards to the effectiveness of brief alcohol intervention across different cultural settings and in specific population groups, and in respect of the optimum content of brief interventions that might benefit from further research. [ABSTRACT FROM AUTHOR]

Aims: Given the variety of relationships found between alcohol consumption and health using individual data (both negative and positive), the likely impact of changes in population-level alcohol consumption on health at the population level is not clear. This paper uses historical data from 1911 to 2006 to assess the relationship between changes in per-capita alcohol consumption on total male mortality in Australia. Methods: A longitudinal aggregate study using Australian per-capita alcohol consumption and mortality data from 1911 to 2006. Analysis is undertaken using autoregressive integrated moving average time-series methods. Results: Per-capita pure alcohol consumption has a significant association with male all-cause mortality, with an increase (decrease) of 1 l per-capita per year associated with a 1.5% increase (decrease) in male mortality (controlling for female mortality and smoking rates). The association between per-capita consumption and mortality was significant for all age groups, with a particularly strong effect among 15–29 year olds. Conclusion: These results place Australia in the group of countries for which a positive association between per-capita alcohol consumption and total mortality can be demonstrated. Thus, despite the beneficial effects of alcohol consumption on health found in many studies, increases in consumption at the population level in Australia are associated with declines in population health. Thus, per-capita alcohol consumption in Australia is a significant contributor to rates of male mortality, particularly among young adults, suggesting an interaction between per-capita consumption and risky episodic drinking. The policies aiming to reduce population-level alcohol consumption and episodic risky drinking have the potential to substantially improve population-health outcomes in Australia, particularly among young men. [ABSTRACT FROM PUBLISHER]

Aims: To provide an overview of studies of the effects of alcohol portrayals in movies, music videos and soap operas on alcohol consumption among young people. Moreover, we highlight important issues that need to be addressed in future research. Methods: This paper reviews the current literature on alcohol portrayals on-screen and the associated gaps and challenges in alcohol media research. Results: Thirteen longitudinal studies, 8 cross-sectional studies and 6 experimental studies examined the effects of alcohol portrayals on-screen on alcohol consumption among young people. They showed a relation between on-screen alcohol exposure and onset and progression of alcohol consumption. A distinction can be made between long-term effects and immediate effects on alcohol consumption. Only lately, more attention has been paid to processes underlying the effects of on-screen alcohol exposure. Conclusion: Replication of findings and development of new research designs is essential. On-screen alcohol exposure does not affect everyone. It is important to test individual differences in susceptibility to on-screen alcohol portrayals. Further, not all media alcohol portrayal might provoke similar effects. It is therefore essential to test the effect of different types of alcohol portrayals. [ABSTRACT FROM AUTHOR]

Aims: This paper describes changes in alcohol consumption among Swedish youth over the past decade with the aim of exploring the polarization hypothesis, which asserts that while a majority of young drinkers have reduced their alcohol consumption, a subgroup have increased their drinking substantially, resulting in greater harm. Methods: We analysed repeated cross-sectional self-report data from 45,841 15–16-year olds and 40,889 18–19-year-old high-school students living in the Stockholm municipality between 2000 and 2010. The questionnaire assessed alcohol and drug use, and risk factors for alcohol misuse. Changes over time at different levels of consumption are presented by age and gender. Results: We find evidence of a polarization effect in youth drinking, with consumption reducing significantly over the past 10 years among all young people, except the heaviest drinkers, where consumption and binge drinking tended to increase. The dispersion in per capita consumption also increased over time, indicating more heavy drinkers. The total number of risk factors for alcohol misuse decreased among most survey participants from 2000 to 2010, but with variability between years. Conclusion: Polarized drinking habits are a likely explanation for the recent divergence between per capita alcohol consumption, which has decreased, and alcohol-related hospitalizations, which have increased sharply among Swedish youth in recent years. We suggest that ongoing social changes could be affecting young people in the form of greater disparities, which are associated with a higher incidence of social problems generally, including heavy drinking. [ABSTRACT FROM PUBLISHER]

Aim: Policy responses to the growing burden of alcohol-related disease fail to consider the interrelated nature of substance misuse and the potential for complex interactions in response to alcohol-specific interventions. This paper considers possible aggregate level responses to the alcohol policy and whether alcohol policy can be expected to reduce overall harm. Methods: A review and discussion of the relevant literature was conducted. Results: Evidence indicates that those at greatest risk consume stronger alcoholic beverages more frequently, that they are likely to complement their consumption with a range of intoxicants and that they are more likely to substitute alcohol with other substances. Conclusions: Policies aimed at reducing alcohol consumption can be successful. However, evidence suggests a significant minority of consumers are likely to substitute or complement consumption with a range of intoxicants suggesting that policy is unlikely to reduce all-cause mortality and morbidity. Further research into the nature of substitution and complementarity is required. [ABSTRACT FROM PUBLISHER]

Aim: The aim of this study was to explore the logistical and methodological strengths and weaknesses of some of the more common research designs which can be used to evaluate the impact of system- or population-level approaches for reducing alcohol-related harms. Method: This paper identifies studies that have evaluated system or population approaches to reduce alcohol-related harms. It highlights the tension caused by a desire for the most rigorous research designs, such as randomized controlled trials (RCTs), the most potentially efficacious interventions and the practical problems in applying the RCT to population-level research. Alternative research designs, which possess methodological rigour and are more feasible, are identified and described. The design with the strongest methodological characteristics and feasibility in allowing the evaluation of population interventions is considered to be the multiple baseline. Results: The multiple baseline design addresses potential problems of sample sizes, selection bias, the suitability and baseline stability of outcome measures, statistical analyses and the practicalities of conducting rigorous research in system- or population-level settings. Conclusion: The multiple baseline design has the capacity to allow methodologically and statistically stringent evaluations with relatively small sample sizes, low cost and fewer of the complications imposed by RCTs. Like all research designs it has limitations, but arguably represents the most practical and methodologically rigorous approach to the evaluation of system- or population-level strategies. [ABSTRACT FROM PUBLISHER]

Aims: The National Household Survey for Substance and Alcohol Use is a periodic survey of the Thai population with the aim of estimating the number of people who use licit and illicit substances. This paper reports the findings regarding alcohol consumption from the 2007 survey. Methods: A multistage sampling scheme was used. Provinces, districts, sub-districts, villages and households were randomly selected in sequence. All residents aged 12–65 years who had lived in their current household for >3 months were included. Altogether, 11,348 households and 26,633 respondents from 29 provinces were selected. A structured interview questionnaire, including information on pattern of alcohol consumption, Alcohol Use Disorder Identification Test (AUDIT) and consequences of drinking, was used. Results: Of Thais aged 12–65 years, 63% were abstainers (men—40.9% and women—81.5%). The prevalence of current drinkers (defined as individuals who drank at least 10 g of alcohol in 12 months before the survey) was 28.6% (men—48.4% and women—12.7%). Based on the AUDIT score, 6.7% of the Thai population could be classified as hazardous drinkers, 0.9% as harmful drinkers and 0.6% as probable alcohol dependents. The median drinking intensity was 50.8 g in men and 25.4 g in women. After adjusting for other variables, predictors of being hazardous–harmful or probably dependent drinkers included male gender, age groups of 20–24 and 25–44 years, not married and living in Bangkok. Conclusion: The present study highlights the gender and age differences in drinking patterns and drinking consequences in Thailand. These issues should be taken into consideration when planning preventive measures to reduce alcohol consumption and related problems. [ABSTRACT FROM PUBLISHER]

Aims: The aim of this paper is to investigate two possible explanations for the higher levels of psychological distress observed among alcohol abstainers relative to light and moderate drinkers, and to investigate possible moderating effects of age on this association. The possible explanations were that: (i) the higher level of psychological distress among abstainers is due to the presence of a subset of former heavy drinkers in this group; and (ii) abstainers have poorer social relationships than light/moderate drinkers. Methods: A national cross-sectional survey yielded data from 2856 Australians aged 20–22, 30–32 and 40–42 years (response rate 15.9%). Results: The sample was representative for many socio-demographic factors but under-represented people not in the labour force and over-represented those with university qualifications. In the oldest but not the younger age groups, abstainers reported significantly higher psychological distress relative to light/moderate drinkers. While abstainers in the oldest age group who were former heavy drinkers showed the highest levels of distress, excluding them from the analysis did not account for differences in distress between current abstainers and light/moderate drinkers. Abstainers aged 40–42 years were less socially integrated, less extraverted and had lower social support than light/moderate drinkers, and controlling for these factors partially explained their increased distress. Conclusions: Significantly increased psychological distress of abstainers compared to light/moderate drinkers was demonstrated only in the oldest age group (40–42 years). The higher distress reported by abstainers in this age group was partially explained by abstainers having poorer social relationships than light/moderate drinkers. [ABSTRACT FROM PUBLISHER]

Background: Abstinent alcoholics have deficits in comprehending the affective intonation in speech. Prior work suggests that these deficits are due to alcohol exposure rather than preexisting risk factors for alcoholism. The present paper examines whether family history of alcoholism is a contributor to affective prosody deficits in alcoholics. Methods: Fifty-eight healthy, nonabusing young adults with and without a family history of alcoholism or other substance abuse (29 FH+ and 29 FH−) were compared on affective prosody comprehension using the Aprosodia Battery. A secondary analysis was done comparing affective prosody comprehension in FH+ and FH− detoxified alcoholics from an earlier study (17 FH+ and 14 FH−). Results: Performance on the Aprosodia Battery was not related to FH status in either the healthy, nonabusing sample or in the detoxified alcoholic group. Conclusions: The present study lends support to previous research suggesting that deficits in affective prosody comprehension observed in detoxified alcoholics are associated with a history of heavy drinking rather than with a family history of alcoholism. [ABSTRACT FROM PUBLISHER]

Aim: The aim of this paper is to study the relationship between alcohol, selenium and oxidative stress in breastfeeding rat pups exposed to ethanol during gestation and lactation. We have also studied how a Se-supplemented diet among mothers could prevent different oxidative liver disorders in the pups. Method: Pups of 21 days were randomized into four groups: control group (C), alcohol group (A), alcohol selenium group (AS) and control selenium group (CS). Alcohol was supplied to their mothers for 13 weeks (induction, reproduction, gestation and lactation periods). The selenium-supplemented diet contained 0.5 ppm as selenite. We determined serum and liver selenium by graphite-furnace atomic absorption spectrometry. We measured antioxidant enzyme activities: glutathione peroxidase (GPx), glutathione reductase (GR), catalase (CAT) and superoxide dismutase (SOD); and lipid peroxidation (TBARS) and protein carbonyl (PC) by a spectrophotometric method in the liver. Results: In the liver of pups, exposure to ethanol provoked a decrease in selenium and GPx activity and an increase in GR and CAT activity, as well as in carbonyl groups in protein. A pups had higher Se levels and GPx activity in serum than C pups. Administering Se with alcohol balances the activities of scavenging enzymes and reduces peroxidation protein products. Conclusion: These results suggest that selenium could be effective in neutralizing the damage of ethanol consumption during gestation and lactation in pups since it repairs selenium levels in liver as well as the activity of scavenging enzymes and peroxidation protein products. In serum, Se also recovers GPx activity and increases the levels of Se that are available to other organs. [ABSTRACT FROM AUTHOR]

Aims: In the scientific literature it has been repeatedly hypothesized that there is a heritable susceptibility to thiamine deficiency comparable to other hereditary metabolic disorders. The aim of this paper is to review the most recent knowledge on the genetic susceptibility to the development of alcohol-related Wernicke-Korsakoff syndrome (WKS). Methods: A literature review was carried out looking at the molecular genetics studies performed in alcohol-dependent patients affected by WKS. Results: A genetic component in the pathogenesis of WKS has been postulated since the late seventies. Since then, very few genetic studies have been carried Out on candidate genes such as thiamine-dependent enzymes, alcohol-metabolizing enzymes and GABA receptors. The findings are controversial and not conclusive. Several authors reported the important role of the thiamine transporters in the pathogenesis of the thiamine deficiency disorders. Our findings on SLC19A2 and SLC19A3 suggest a potential role of these two genes in the pathophysiology of alcohol-related thiamine deficiency but further studies need to be carried out. Conclusions: The WKS may be a very complex, multifactorial disorder where the interaction of multiple genes and environment plays an important role in the pathogenesis. However, it is still plausible that megaphenic gene effects are responsible for WKS susceptibility and the thiamine transport genes are good candidates for having such a role. Further genetic studies are definitely needed to investigate the association with candidate genes or linkage with hot spot areas. [ABSTRACT FROM AUTHOR]

Aims: The Korsakoff syndrome is a preventable memory disorder that usually emerges (although not always) in the aftermath of an episode of Wernicke's encephalopathy. The present paper reviews the clinical and scientific literature on this disorder. Methods: A systematic review of the clinical and scientific literature on Wernicke's encephalopathy and the alcoholic Korsakoff syndrome. Results: The Korsakoff syndrome is most commonly associated with chronic alcohol misuse, and some heavy drinkers may have a genetic predisposition to developing the syndrome. The characteristic neuropathology includes neuronal loss, micro-haemorrhages and gliosis in the paraventricular and peri-aqueductal grey matter. Lesions in the mammillary bodies, the mammillo-thalamic tract and the anterior thalamus may be more important to memory dysfunction than lesions in the medial dorsal nucleus of the thalamus. Episodic memory is severely affected in the Korsakoff syndrome, and the learning of new semantic memories is variably affected. 'Implicit' aspects of memory are preserved. These patients are often first encountered in general hospital settings where they can occupy acute medical beds for lengthy periods. Abstinence is the cornerstone of any rehabilitation programme. Korsakoff patients are capable of new learning, particularly if they live in a calm and well-structured environment and if new information is cued. There are few long-term follow-up studies, but these patients are reported to have a normal life expectancy if they remain abstinent from alcohol. Conclusions: Although we now have substantial knowledge about the nature of this disorder, scientific questions (e.g. regarding the underlying genetics) remain. More particularly, there is a dearth of appropriate long-term care facilities for these patients, given that empirical research has shown that good practice has beneficial effects. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper was to compare the quantity and frequency of alcohol use and its associated negative consequences between two groups of college students who were identified as being "risky drinkers." Subjects were randomly allocated in a clinical trial to intervention or control groups. Methods: Risky drinking use was defined as Alcohol Use Disorders Identification Test (AUDIT) ⩾8 and/or Rutgers Alcohol Problem Index (RAPI) ⩾5 problems in the previous year. Students who had undergone the Brief Alcohol Screening and Intervention for College Students (BASICS) (N = 145 at baseline; 142 at 12 months, and 103 at 24 months, loss of 29.7%) were compared with a control group (N = 121 at baseline; 121 at 12 months and 113 at 24 months, loss of 9.3%), the nonintervention group. Variables included drinking frequency, quantity and peak consumption, dependence assessment, and family and friends' abuse assessment. Results: Treated students at a 24-month follow-up decreased quantity of alcohol use per occasion and lowered AUDIT and RAPT scores. Conclusions: This is the first brief intervention work on risky drinking with college students in Brazil and the results are encouraging. However, it is difficult to conduct individual prevention strategies in a country where culture fosters heavy drinking through poor public policy on alcohol and lack of law enforcement. [ABSTRACT FROM AUTHOR]

Aims: Alcohol misuse is a prime social and health problem in the UK. This paper presents a critical review of literature on the performance effects in the morning after binge drinking — during the alcohol hangover. Several pathophysiological changes that both follow and outlast acute intoxication may give rise to alcohol hangover effects. We have identified 27 English language peer-reviewed studies that investigate aspects of psychological performance during alcohol hangover following controlled alcohol ingestion. However, the majority of studies had basic methodological shortcomings. Of eight laboratory studies rigorous enough to warrant serious attention, only two showed effects. We interpret these largely negative findings as evidence of an insensitivity that is intrinsic to laboratory- based studies of performance under the influence of alcohol. Several studies have investigated the cognitive consequences of hangover subsequent to naturalistic consumption, where participants have chosen what and where to drink. Although these studies have tended to show effects, participants were always informed at the outset that hangover effects were to be assessed, and participants knew which was the hangover condition. Under these circumstances expectancy effects have possibly contaminated the results significantly. Therefore, naturalistic alcohol consumption studies (and laboratory studies that did not employ a placebo) can be considered as being suggestive of hangover effects, but should not be interpreted as providing definitive evidence of such effects. In conclusion, although there is empirical evidence showing impaired performance as a result of the alcohol hangover, future studies should confirm these findings and overcome the shortcomings of previous research. [ABSTRACT FROM AUTHOR]

Aims: The prevalence of smoking among individuals with alcohol use disorders (AUD) and other substance use disorders is alarmingly high, and long-term success rates of smoking cessation interventions in this group are low. One way to improve treatment efficacy for this population is through a more comprehensive understanding of individual- and treatment-level variables that affect the motivation to quit as well as the outcomes of smoking cessation attempts. In this paper, we review the relevant research on factors that may influence readiness to quit and the efficacy of smoking cessation interventions in this population and highlight gaps in the knowledge base that require further investigation. Methods: We conducted a review of the literature on smoking among adults with AUD in order to examine predictors of motivation to quit smoking and outcome of cessation attempts. Results: No consistent predictors of motivation for smoking cessation were identified. Although the results were not unanimous, a greater length of abstinence from alcohol and other substances predicted smoking cessation success. Conclusions: Empirical work identifying factors associated with the motivation and ability to quit smoking among individuals with AUD is in its early stages. Mixed results and a dearth of research in this area prohibit strong conclusions from being made. Future researchers are encouraged to consider alternative methods of conceptualizing and measuring motivations to quit in this group and to routinely include analyses that examine predictors of Outcome in intervention studies. [ABSTRACT FROM AUTHOR]

Aim: This paper describes adolescents' exposure to alcohol advertising in stores and to alcohol-branded promotional items and their association with self-reported drinking. Methods: A cross-sectional survey was administered in non-tracked required courses to sixth, seventh, and eighth graders (n = 2125) in three California middle schools. Logistic regressions compared the odds of ever (vs. never) drinking and current (vs. ever) drinking after controlling for psychosocial and other risk factors for adolescent alcohol use. Results: Two-thirds of middle school students reported at least weekly visits to liquor, convenience, or small grocery stores where alcohol advertising is widespread. Such exposure was associated with higher odds of ever drinking, but was not associated with current drinking. One-fifth of students reported owning at least one alcohol promotional item. These students were three times more likely to have ever tried drinking and 1.5 times more likely to report current drinking than students without such items. Conclusions: This study provides clear evidence of an association of adolescent drinking with weekly exposure to alcohol advertising in stores and with ownership of alcohol promotional items. Given their potential influence on adolescent drinking behaviour, retail ads, and promotional items for alcohol deserve further study. [ABSTRACT FROM AUTHOR]

Aims: To clarify alcohol and illicit drug use within the emergency room population in three different regions in The Netherlands, focusing on whether interventions for these substances should be region specific. Methods: Alcohol and illicit drug use were assessed using a self-report questionnaire filled in by the patients, and by combining self-report with staff judgement on alcohol and illicit drug use. Results: Data on alcohol use (self-reported and staff judgement combined) resulted in prevalence rates of 4.9-18.2%. Patients positive for alcohol are more likely to be male, aged 48-58 years, more likely to be a frequent excessive drinker, and to have injuries as a result of violence. Patients positive for illicit drugs are more likely to be male, aged 28-38 years, unemployed, and frequent excessive drinkers. Among men aged 18-35 years with a Dutch cultural background, some differences emerge regarding alcohol consumption between the various hospitals, but most variation exists in the case of illicit drug use. Conclusions: This paper confirms that the emergency room seems to provide an opportunity to initiate interventions regarding alcohol use and seems to suggest that this is independent of the region concerned. However, in the case of illicit drug use interventions seem to be more region specific. [ABSTRACT FROM AUTHOR]

Aims: Despite recent small reductions in overall suicide rates, rates among those aged 25-44 have remained high. The aim of this paper was to examine the evidence for a link between alcohol misuse/consumption and suicidal behaviour, explore the reasons for this association, and consider the implications for reducing rates of suicidal behaviour. Methods: A medline search was performed to find relevant research evidence. Results: There is evidence to suggest alcohol misuse predisposes to suicidal behaviour through its depressogenic effects and promotion of adverse life events, and both behaviours may share a common genetic predisposition. Acute alcohol use can also precipitate suicidal behaviours through induction of negative affect and impairment of problem-solving skills, as well as aggravation of impulsive personality traits, possibly through effects on serotonergic neurotransmission. Conclusions: Effective interventions for problem drinking may help reduce suicide rates. At a public health level, reducing overall alcohol consumption may be beneficial, and the measures shown to be most effective in this regard are those that aim to restrict availability of alcohol. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue, including one by John Littleton and colleagues on the clinical and basic science aspects of alcohol/nicotine interactions and another by Timothy C. Durazzo on the neurobiological and neurocognitive consequences of excessive alcohol use.

Aims: This paper examines the interaction of intention to change drinking behaviour with comorbid depression and anxiety in pro-actively recruited individuals with a range of thinking problems. Methods: Cross-sectional data of 408 general practice (GP) patients aged 18-64 years, who meet the diagnostic criteria of alcohol dependence or abuse according to DSM-IV, criteria of at-risk drinking or binge drinking, were drawn from a brief intervention study. Of the sample, 89 participants were diagnosed with comorbid anxiety and/or depressive disorders. The Transtheoretical Model (TTM) of behaviour change constructs: stages and processes of change, self-efficacy, and decisional balance were assessed in relation to presence and absence of the respective psychiatric disorders. Results: Analysis including all categories of problematic drinking revealed comorbid anxiety and/or depression to be significantly related to later stages of change. Within subgroups, this was only true for alcohol abuse, not for dependence, at-risk or binge drinking. In addition, comorbidity was related to higher use of processes of change and more pros and cons of drinking, when compared to non-comorbid participants. Comorbid individuals showed higher temptation to drink and lower self-efficacy to abstain from drinking. Separate analyses of readiness to change drinking between the categories anxiety/no comorbidity and depression/no comorbidity both obtained significance, while for anxiety disorders, this was more profound. A multinomial logistic regression analysis revealed that adverse consequences better predicted readiness to change when compared to comorbidity. Discussion: Individuals with problematic drinking and comorbid anxiety or depression may be well accessible for pro-active intervention to reduce drinking. Strategies should focus on the enhancement of coping skills to control temptation and self-efficacy. [ABSTRACT FROM AUTHOR]

Aims: To describe recent research focusing on the analysis of gene and protein expression relevant to understanding ethanol consumption, dependence and effects, in order to identify common themes. Methods: A selective literature search was used to collate the relevant data. Results: Over 160 genes have been individually assessed before or after ethanol administration, as well as in genetically selected lines. Techniques for studying gene expression include northern blots, differential display, real time reverse transcriptase-polymerase chain reaction (RT-PCR) and in situ hybridization. More recently, high throughput functional genomic technology, such as DNA microarrays, has been used to examine gene expression. Recent gene expression analyses have dramatically increased the number of candidate genes (nine array papers have illuminated 600 novel gene transcripts that may contribute to alcohol abuse and alcoholism). Conclusions: Although functional genomic experiments (transcriptome analysis) have failed to identify a single alcoholism gene, they have illuminated important pathways and gene products that may contribute to the risk of alcohol abuse and alcoholism. [ABSTRACT FROM AUTHOR]

Aims: There is evidence of a non-linear relationship between alcohol Consumption and mental health status, and of an association between tobacco use and poor mental health. This paper examines the nature of the association between usual alcohol consumption, tobacco use and symptoms of anxiety and depression in Emergency Department patients in Queensland Australia Methods: A cross sectional survey of patients aged 16-84 presenting for treatment over a 14 day period to Gold Coast Hospital Emergency Department using socio-demographic items, the Alcohol Use Disorders Identification Test (AUDIT) to measure moderate, hazardous and harmful alcohol consumption, and the Hospital Anxiety and Depression Scale (HADS) to measure state anxiety and depression. Results: 812 patients were interviewed. Gender differences in results were evident. For men, there was a U-shaped relationship between alcohol consumption and anxiety/depression, and a linear association between smoking and anxiety. For women, alcohol consumption and anxiety/depression showed a more linear relationship, but there was no significant relationship between tobacco use and anxiety/depression Conclusion: There may be important gender differences in the relationships between alcohol consumption, tobacco use and mental health status. This study supports previous evidence that mental health status of non-drinkers is Worse than that of moderate drinkers, but only among males. [ABSTRACT FROM AUTHOR]

Aims: To examine the extent to which problem alcohol users' self reports of drinking pattern and symptomatology derive primarily from a functional, learned social-cognitive schema (referred to as a `script' in this paper), rather than from acts of recall or memory. Methods: Using a between-groups design with one repeated (within-subjects) measure, problem drinkers and non-problem drinkers were asked to complete a questionnaire about drinking behaviour and symptoms. Each group filled in the questionnaire twice, under both of two conditions. In condition one, they used the questionnaire to describe their own drinking and in condition two they were asked to describe the drinking of the other group (i.e. the problem drinkers filled out the questionnaire to describe non-problem drinking and the non-problem drinkers described problem drinking). Results: Using analyses of variance for the different sub-scales of the questionnaire, no overall differences were found between the two groups on four of the five subscales. However, clear and significant differences were found between the two conditions. That is, both groups were able to produce clearly differentiated scripts for both problem drinking and non-problem drinking. Conclusions: These data, together with related data from other sources, suggest that `scripts' for problem drinking and for non-problem drinking can be elicited from both problem-drinking and non-problem-drinking groups. The data support conclusions from an earlier study, suggesting that subjects may use learned `scripts' rather than recall when responding to certain types of questionnaire instruments. [ABSTRACT FROM AUTHOR]

Aims: This paper describes a new stage in the ongoing evaluation of the original families of sons of alcoholics and controls where we now focus on the relationships among relevant domains of functioning in their young sons and daughters. Methods: The data were gathered from the 15-year follow-up of the families of the original probands (the fathers of these offspring) who had been selected from among students and non-academic staff at a university at approximately age 20. At the 15-year evaluation of these families, a structured interview and the Child Behavioral Checklist (CBCL) questionnaire were administered to a parent, usually the mother, of 145 offspring age seven through 17. The eight domains evaluated here included the extended family histories of alcohol use disorders, parental alcoholism, independent mood or anxiety disorders in the grandparents and parents, the history of potential brain insults early in life, the absence of a biological parent in the home, and scores for internalizing symptoms, with externalizing symptoms as the dependent variable. Results: Correlations among the domains were all in the predicted direction, a structural equation model revealed empirical results with an R2 of 0.26, and there were high goodness of fit characteristics for hypothesized and empirical models. The results were similar for boys and girls and older versus younger offspring. Conclusions: An understanding of the relationships among characteristics in the offspring of the original probands offers the opportunity of establishing levels of functioning in relevant domains before the onset of alcohol-related problems or related disorders. The data presented here represent a baseline upon which future follow-ups will evaluate substance-related problems and disorders as this population matures. [ABSTRACT FROM AUTHOR]

— Aims: Little is known about age and gender distributions in alcohol-attributable mortality (AAM). The aim of this paper is to describe age and gender in AAM in a high per capita consumption country. Methods: The AAM was determined using national mortality statistics and data on the prevalence of alcohol risk drinking from Germany. According to this approach, alcohol-attributable fractions (AF) of causes of death are estimated. Results: In males, as well as females, more than 70% of the AAM cases are due to alcohol consumption as well as smoking. The mortality rates are highest in the age range 35–64 years with 25% of the total mortality in males, and 13% in females. The median age at death in AAM exclusively based on alcohol is 15 years below the median age at death in the male and 24 years below that in the female population. Conclusions: Early intervention should be stressed. [ABSTRACT FROM PUBLISHER]

— Aims: This paper reports the long-term recovery rate among 100 alcoholic doctors over a 21-year period. Included are 20 doctors who relapsed and re-recovered, 10 who died of non-alcohol related causes and eight who died of alcohol-linked causes. Also reported are abstinence, attendance at self-help group meetings, mortality and employment. Methods: Selected doctors were the first 100 consecutive alcoholic doctors to become members of the North West Doctors and Dentists Group (NWDDG) between 1980 and 1988. Information sources combine prospective data obtained from each doctor at the time of first contact with the results of questionnaires distributed in 1988 and 2001 and continuing prospective reporting of mortality by relatives. Results: There is a 9% incidence of oral or oesophagopharyngeal cancer. Reported mortality, mostly by relatives, revealed that 24 doctors died directly of their alcoholism. We observed a 73% recovery rate for a 17-year average duration, over a 21-year period. Comparison of recovery with abstinence showed a strong correlation. For the first 6 months of recovery, there was also a strong relationship between recovery and attending meetings of self-help groups. This relationship is not sustained in the long term, though 14 doctors with an average recovery of 20 years still attend meetings regularly. Of 56 doctors currently known to have survived, 29 have retired and 27 are still working as doctors. Three doctors have been drinking normally for an average of 17 years. [ABSTRACT FROM PUBLISHER]

This paper analyses the alcohol consumption patterns in Spanish drivers, the incidence of alcohol-related problems and attempts to ascertain whether, in the end, drivers with alcohol-related problems are considered fit or unfit to drive. In accordance with Spanish and European Union legislation, driving licences cannot be issued or renewed to people suffering from alcohol-related problems. A medical, psychological and eyesight evaluation was performed to test the driving fitness of 8043 drivers attending 25 Medical Driving Test Centres on a national scale. Among other things, information was collected on the patterns of alcohol consumption, the AUDIT and CAGE tests, the incidence of alcohol-related problems (DSM-IV criteria for abuse, dependence and alcohol-induced disorder), as well as an evaluation of their fitness to drive. In all, 60.3% of drivers drink alcohol on a regular basis; 7.3% of drivers scored ≥8 points in the AUDIT test, and 2% met criteria for DSM-IV alcohol abuse, dependence or induced disorder. Drivers with alcohol-related problems have been involved in traffic accidents (23.2%) and have infringed driving regulations (18.7%) more frequently (P < 0.0001) than those without alcohol-related problems. Of those with alcohol-related problems, 72.2% were considered fit to drive. The study reveals that alcohol consumption is common among drivers, that a significant number of drivers have alcohol-related problems, and that three in four of the latter were considered fit to drive. [ABSTRACT FROM PUBLISHER]