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Binge drinking has been shown to be associated with considerable social harm and disease burden. This review aims to give an overview from a European perspective of the socio-demographical, individual, and social factors that affect binge drinking and to identify effective interventions to reduce binge drinking. To this end, a computer-assisted search of relevant articles was conducted. Results showed that males tended to binge drinking more frequently than females. Binge drinking was most prevalent among adolescents and young adults, and prevalence levelled off later in life. Socioeconomic conditions seemed to have an effect on binge drinking, independent of their effects on the volume of alcohol consumed. The early onset of binge drinking was associated with a history of drinking in the family, but pathways into adulthood are less clear. Binge drinking often co-occurred with other substance use. Motives for binge drinking included both social camaraderie and tension reduction. Which aspect prevails may vary according to the type of binge drinker, but to date has not been satisfactorily explained. Binge drinkers were not likely to know enough about or be aware of the potential risks of bingeing. Pressure from peers was one of the strongest influencing factors for binge drinking and seemed to outweigh parental influences, especially from late adolescence onwards. Binge drinking also varied according to both the predominant adult and adolescent drinking culture with more binge drinking in the northern and middle parts of Europe compared to the southern parts. Thus, a variety of socio-demographical, individual, and social characteristics associated with binge drinking have been identified. However, knowledge in this area is limited, as most research has been conducted among particular groups in specific situations, in particular North American college students. More research in Europe is urgently needed, as results from other cultural backgrounds are difficult to generalize. Keywords: Alcohol; Binge drinking; Europe

Introduction: Substance use disorder, depression and sexual minority are well documented risk factors for suicidal behaviour, far less is known about behavioural addictions. Objectives: First, to explore associations between behavioural addictions (gaming, gambling, cybersex, internet, smartphone, work) at age 25 and the incidence and reoccurrence of suicide ideation (SID), suicide attempts (SAT), and suicide attempts among those with suicide ideation (SATID) at age 28. Second, to test whether these associationswere impacted by adjusting for cannabis and alcohol use disorder, nicotine dependence, sexual orientation and depression. Methods: Based on two waves of a prospective cohort study of 5,428 young Swiss men, nested models with and without adjustment for risk factors were used to regress SID, SAT and SATID on preceding behavioural addictions. Results: Without adjustment, each of the behavioural addictions at age 25 significantly predicted the incidence of SIDand SAT at age 28. Gambling and cybersex addiction furthermore predicted SATID. When adjusting for other risk factors, associations with behavioural addictions were reduced, whereas depression and cannabis use disorder were the most important and consistent predictors for the incidence and recurrence of SID, SAT and SATID. Conclusions: Among young Swiss men, behavioural addictions are important predictors of SID and SAT, however a large part of their association is shared with depression and cannabis use disorder. Treatment for addictive behaviors, especially cannabis use can open the door to larger mental health screening and targeted intervention. Crisis intervention among men presenting addictive behaviours with or without substance may therefore be key to preventing suicidal behaviour. [ABSTRACT FROM AUTHOR]

BACKGROUND: In February, 2005, the canton of Geneva in Switzerland prohibited the off-premise sale of alcoholic beverages between 9pm and 7am, and banned their sale in gas stations and video stores. The aim of this study is to assess the impact of this policy change on hospital admission rates for alcoholic intoxication. METHODS: An interrupted time series analysis of this natural experiment was performed with data on hospitalisations for acute alcoholic intoxication during the 2002-2007 period. The canton of Geneva was treated as the experimental group, while all other Swiss cantons were used as the control group. RESULTS: In the experimental site, the policy change was found to have a significant effect on admission rates among adolescents and young adults. Depending on the age group, hospitalisation rates for alcoholic intoxication fell by an estimated 25-40% as the result of restricted alcohol availability. CONCLUSIONS: Modest restrictions on opening hours and the density of off-premise outlets were found to be of relevance for public health in the canton of Geneva. In light of this finding, policy makers should consider such action as a promising approach to alcohol prevention. [ABSTRACT FROM AUTHOR]

Aim To investigate whether different sequences of 'change talk' utterances within a brief motivational intervention (BMI) are associated with drinking outcomes. Design Speech content analysis of recorded BMI. Setting BMI delivered in an emergency department for at-risk drinking. Participants Ninety-seven subjects who received a BMI. Measurements Ninety-seven BMI were coded in duplicate by two psychologists with the Motivational Interviewing Skill Code (MISC), a Hidden Markov Model was used to identify three different patient states reflecting attitudes regarding changing their drinking behaviour within a BMI: towards change, away from change and non-determined. Adjusted regression models were used to predict drinking at 12 months' follow-up using patient attitudes regarding changing drinking at the beginning, during the intervention and at the end. Findings The dynamic process at place within a BMI was marked mainly by stability: at each point during the intervention, staying in the same attitude was far more likely than transitioning from one attitude to another. When subjects did change from one attitude to another, they were more likely to move from an 'away from change' to a 'towards change' state. At 12 months, subjects with an attitude towards change at the end of the BMI drank significantly less (13.1 drinks per week) than subjects with an attitude away from change, independent of their attitude at the beginning of the intervention. Conclusions Transition in 'change talk' between 'away from change' and 'towards change' appears to be rare in brief motivational intervention for excessive alcohol consumption. Moreover, change talk 'towards change' at the end of the intervention is associated with improved outcomes at follow-up, independently of the type of change talk at the beginning of the intervention, suggesting that it is important to end a BMI session with a positive attitude towards change by the client. [ABSTRACT FROM AUTHOR]

In alcohol epidemiology surveys, there is a tradition of measuring alcohol-related consequences using respondents' attribution of alcohol as the cause. The authors aimed to compare the prevalence and frequency of self-attributed consequences to consequences without self-attribution using alcohol-attributable fractions (AAF). In 2007, a total of 7,174 Swiss school students aged 13-16 years reported the numbers of 6 alcohol-related adverse consequences (e.g., fights, injuries) they had incurred in the past 12 months. Consequences were measured with and without attribution of alcohol as the cause. The alcohol-use measures were frequency and volume of drinking in the past 12 months and number of risky single-occasion (> or =5 drinks) drinking episodes in the past 30 days. Attributable fractions were derived from logistic (> or =1 incident) and Poisson (number of incidents) regression analyses. Although relative risk estimates were higher when alcohol-attributed consequences were compared with nonattributed consequences, the use of AAFs resulted in more alcohol-related consequences (10,422 self-attributed consequences vs. 24,520 nonattributed consequences determined by means of AAFs). The likelihood of underreporting was higher among drinkers with intermediate frequencies than among either rare drinkers or frequent drinkers. Therefore, the extent of alcohol-related adverse consequences among adolescents may be underestimated when using self-attributed consequences, because of differential attribution processes, especially among infrequent drinkers. [ABSTRACT FROM AUTHOR]

The objectives of this study were to analyse (a) the distribution of risky single-occasion drinking (RSOD) among 19-year-old men in Switzerland and (b) to show the percentage of all alcohol consumption in the form of RSOD. Methods: The study was based on a census of Swiss francophone 19-year-old men consecutively reporting for processing. The study was conducted at Army Recruitment Center. The participants were 4116 recruits consecutively enrolling for mandatory army recruitment procedures between 23 January and 29 August in 2007. The measures were alcohol consumption measured in drinks of ~10 g of pure alcohol, number of drinking occasions with six or more drinks (RSOD) in the past 12 months and a retrospective 1 week drinking diary. Results: 264 recruits were never seen by the research staff, 3536 of the remaining 3852 conscripts completed a questionnaire which showed that 7.2% abstained from alcohol and 75.5% of those drinking had an RSOD day at least monthly. The typical frequency of drinking was 1-3 days per week on weekends. The average quantity on weekends was about seven drinks, 69.3% of the total weekly consumption was in the form of RSOD days, and of all the alcohol consumed, 96.2% was by drinkers who had RSOD days at least once a month. Conclusion: Among young men, RSOD constitutes the norm. Prevention consequently must address the total population and not only high-risk drinkers. [ABSTRACT FROM AUTHOR]

This paper examines the drinking behaviour of young adults aged 24-32 who were married or were cohabiting. Data on this subject were available from surveys in 10 European countries. These were carried out under the auspices of the major investigation entitled 'Gender, Alcohol and Culture: An International Study (GENACIS)'. In general married people were similar to those cohabiting on annual frequencies of alcohol consumption, but lower on amounts consumed on each occasion and, therefore, on annual volumes. However, the extent of these differences varied in different countries. On the usual consumption per occasion measure, there were larger differences between married and cohabiting in Sweden, Spain, the United Kingdom, the Czech Republic and Norway than in Germany, Finland, Denmark, Iceland and Hungary. The differences between married and cohabiting people were, however, not associated with gender or with the presence of children. At the aggregate country level no associations could be shown with women's empowerment, age of first marriage or per capita alcohol consumption. [ABSTRACT FROM AUTHOR]

Aims: To identify communication characteristics of patients and counsellors during brief alcohol intervention (BAT) which predict changes in alcohol consumption 12 months later. Methods: Tape-recordings of 97 BAT sessions with hazardous drinkers were analysed using the Motivational Interviewing Skill Code (MISC). Outcome measures were (i) baseline to a 12-month difference in the weekly drinking quantity, and (ii) baseline to a 12-month difference in heavy drinking episodes per month. Bivariate analyses were conducted for all MISC measures, and significant variables were included in multiple linear regression models. Results: Patient communication characteristics (ability to change) during BAT significantly predicted the weekly drinking quantity in the multiple linear regression model. There were significant differences for some of the counsellor skills in bivariate analyses but not in the multiple regression model adjusting for patients' talk characteristics. Changes in heavy drinking showed no significant association with patient or counsellor skills in the multiple linear regression model. Conclusion: Findings indicate that the more the patient expresses ability to change during the intervention, the more weekly alcohol use decreases. The role of the counsellor during the interaction, and influence on the outcomes was not clearly established. Implications for BAT and related research are discussed. [ABSTRACT FROM AUTHOR]

In addition to volume, patterns of drinking have an effect on disease and injury. Depending on the prevailing way alcohol is coghnsumed (i.e. on drinking patterns), mortality and morbidity should vary across cultures even if per capita consumption is about the same. In a Comparative Risk Analysis (CRA), the WHO estimated for the year 2000 the Global Burden of Disease stemming from alcohol consumption by including both dimensions of intake (volume and patterns). For this purpose, a detrimental drinking pattern scale was developed. This scale used expert ratings of six dimensions of the prevailing drinking patterns in each country. The present study attempts first to replicate the expert ratings based on survey data from 13 countries. Secondly, it compares the scaling of individual level data with the scaling of aggregate level data. For the latter, such survey measures as percentage usually drinking with meals and percentage usually getting drunk when drinking to approximate the pattern scoring system used in CRA were constructed. Aggregate and individual level analyses resulted in similar orderings of countries on a one-dimensional scale. There was a good correspondence between the orderings and country's values on the CRA detrimental drinking pattern scale. The ordering of countries varied if men and women were scaled separately. The results indicated a bias of expert ratings towards focusing on male drinking patterns. From analysis of the survey data, the patterns in Nigeria appeared relatively more detrimental than the CRA score based on expert ratings, while the patterns in Finland appeared less detrimental. Future attempts to include drinking patterns in addition to volume should take gender differences into account. [ABSTRACT FROM AUTHOR]

AIMS: To evaluate the effectiveness of brief alcohol intervention (BAI) in reducing alcohol use among hazardous drinkers treated in the emergency department (ED) after an injury; in addition it tests whether assessment of alcohol use without BAI is sufficient to reduce hazardous drinking. DESIGN: Randomized controlled clinical trial with 12-month follow-up conducted between January 2003 and June 2005. SETTING: Urban academic emergency department (ED) of the Lausanne University Hospital, Lausanne, Switzerland. PARTICIPANTS: A total of 5136 consecutive patients attending ED after an injury completed a seven-item general and a three-item alcohol screen and 1472 (28.7%) were positive for hazardous drinking according to the National Institute on Alcohol Abuse and Addiction definition; of these 987 (67.1%) were randomized into a BAI group (n = 310) or a control group with screening and assessment (n = 342) or a control group with screening only (n = 335) and then a total of 770 patients (78.0%) completed the 12-month follow-up procedures. INTERVENTION: A single 10-15-minute session of standardized BAI conducted by a trained research assistant. MEASUREMENTS: Percentage of participants who have changed to low-risk drinking at follow-up. FINDINGS: Data obtained at 12 months indicated that similar proportions were low-risk drinkers in BAI versus control groups with and without assessment (35.6%, 34.0%, 37.0%, respectively, P = 0.71). Data also indicated similar reductions in drinking frequency, quantity, binge drinking frequency and Alcohol Use Disorders Identification Test (AUDIT) scores across groups. All groups reported similar numbers of days hospitalized and numbers of medical consults in the last 12 months. A model including age groups, gender, AUDIT and injury severity scores indicated that BAI had no influence on the main alcohol use outcome. CONCLUSIONS: This study provides the evidence that a 10-15-minute BAI does not decrease alcohol use and health resource utilization in hazardous drinkers treated in the ED, and demonstrates that commonly found decreases in hazardous alcohol use in control groups cannot be attributed to the baseline alcohol assessment. [ABSTRACT FROM AUTHOR]

PURPOSE: To determine changes in the prevalence of reasons for drinking and their associations with alcohol use among adolescents in Switzerland from 1994 to 2002. METHOD: Based on national representative samples of 3792 alcohol-using students in 8th and 9th grades in Switzerland (mean age 15.5 years, SD .7), chi-square tests were used to determine changes in reasons for drinking over time. To determine associations between reasons and alcohol use and changes in these associations over time, multiple regression models were estimated separately for the frequency of alcohol consumption and drunkenness. RESULTS: Most adolescents reported drinking to celebrate special occasions, because they wanted to try alcohol, or because they liked the taste of alcoholic drinks. From 1994 to 2002, an increase in all reasons was observed. In multiple regressions, nearly all reasons were significantly related to alcohol consumption and drunkenness. With two exceptions, no interaction with the study year was found. Furthermore, the number of reasons cited by the adolescents surveyed is important: the more reasons they indicated, the more often they drank. The highest alcohol use in 2002 was found among adolescents who indicated all or nearly all reasons, a group that did not exist in 1994. CONCLUSIONS: There appears to be a new group of adolescents who indicated a high number of different reasons for drinking, who often consumed alcohol, and who were frequently drunk. Prevention approaches should be especially targeted at this new risk group. [ABSTRACT FROM AUTHOR]

BACKGROUND: An association between alcohol consumption and injury is clearly established from volume of drinking, heavy episodic drinking (HED), and consumption before injury. Little is known, however, about how their interaction raises risk of injury and what combination of factors carries the highest risk. This study explores which of 11 specified groups of drinkers (a) are at high risk and (b) contribute most to alcohol-attributable injuries. METHODS: In all, 8,736 patients, of whom 5,077 were injured, admitted to the surgical ward of the emergency department of Lausanne University Hospital between January 1, 2003, and June 30, 2004, were screened for alcohol use. Eleven groups were constructed on the basis of usual patterns of intake and preattendance drinking. Odds ratios (ORs) comparing injured and noninjured were derived, and alcohol-attributable fractions of injuries were calculated from ORs and prevalence of exposure groups. RESULTS: Risk of injury increased with volume of drinking, HED, and preattendance drinking. For both sexes, the highest risk was associated with low intake, HED, and 4 (women), 5 (men), or more drinks before injury. At the same level of preattendance drinking, high-volume drinkers were at lower risk than low-volume drinkers. In women, the group of low-risk non-HED drinkers taking fewer than 4 drinks suffered 47.5% of the alcohol-attributable injuries in contrast to only 20.4% for men. Low-volume male drinkers with HED had more alcohol-attributable injuries than that of low-volume female drinkers with HED (46.9% vs 23.2%). CONCLUSIONS: Although all groups of drinkers are at increased risk of alcohol-related injury, those who usually drink little but on occasion heavily are at particular risk. The lower risk of chronic heavy drinkers may be due to higher tolerance of alcohol. Prevention should thus target heavy-drinking occasions. Low-volume drinking women without HED and with only little preattendance drinking experienced a high proportion of injuries; such women would be well advised to drink very little or to take other special precautions in risky circumstances. [ABSTRACT FROM AUTHOR]

AIMS: To analyse whether recommendations for the graduated frequency (GF) approach to measure alcohol consumption are justified in a multi-cultural comparative study. DESIGN: Representative surveys, conducted between 1995 and 2003, of 10 countries participating in the GENACIS project (Gender, Alcohol and Culture: an International Study). MEASUREMENTS: Usual quantity, usual frequency and mean consumption per day measured with three instruments: GF, generic quantity-frequency (QF) and beverage-specific quantity-frequency (QFBS). FINDINGS: The GF did not consistently yield higher volumes and quantities across all countries compared with the generic QF, while the QFBS resulted in higher quantities and higher volumes compared with the GF (in all but one country) and the QF. Frequencies were mostly higher on the GF compared with the QF and QFBS but there was also evidence of over-reporting of frequencies with the GF. Results for the GF suggested that it was implemented improperly in at least three of the 10 countries. CONCLUSION: The GF does not appear to be appropriate for cross-cultural research. It results in over-reporting of frequencies and appears to be too complex to be administered correctly in many countries. The best measure for these purposes appeared to be the QFBS particularly because it captures more effectively the variability of different alcoholic beverages with different ethanol contents and consumption with different vessel sizes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To classify adolescents according to risky single occasion drinking (RSOD) and their level of social integration, and to test whether these groups (social non-RSODs, social RSODs, solitary non-RSODs, solitary RSODs) differ in terms of emotional well-being and violence-related variables. METHOD: K-means cluster and multiple logistic regression analyses were performed based on a cross-sectional national representative sample of 3861 8th and 9th graders in Switzerland (mean age 15.3; SD = 0.88). RESULTS: Although RSODs in general appear to be more violent, social RSODs tend to be more violent than solitary RSODs. Although RSODs reveal a lower life satisfaction generally and tend to have more depressive moods, solitary RSODs are even less satisfied and more depressive. In addition, the latter tend to have lower self-esteem and are more often victims of bullying. CONCLUSIONS: RSODs are not a homogeneous group of adolescents and preventive efforts, such as competence-enhancing and social resistance programmes, should be applied in accordance with the constellation of associated problems: solitary RSODs appear to be socially inhibited, depressive and often victims of bullying, whereas social RSODs appear to be socially accepted but are prone to be violent offenders. [ABSTRACT FROM AUTHOR]

AIMS: To discover what changes in alcohol consumption had occurred in subgroups defined by age, sex, volume of drinking and drinking occasions, following a reduction in the price of spirits in Switzerland in July 1999. DESIGN: Quasi-experimental. Longitudinal general-population survey with baseline 3 months before and follow-up 3 months after price change. PARTICIPANTS: Probabilistic telephone sample of 1347 individuals with at least monthly consumption on average in the previous 6 months at both interviews. The response rate at baseline was 74,8% and the attrition rate from baseline to follow-up 20.2%. MEASUREMENTS: Alcohol consumption was assessed by means of a beverage-specific graduated-frequency measure. High volume of drinking was defined as 40 + g/day for men and 20 + g/day for women. Binge drinking was defined as six + drinks on an occasion for men and four + drinks for women. FINDINGS: Spirits consumption increased significantly (by 28.6%) in the total sample, and specifically in young males and in individuals who were low-volume drinkers at baseline. Consumption of alcohol overall, or of wine or beer, did not change significantly. No indication of effects of substitution was found. CONCLUSIONS: Spirits consumption showed price-responsiveness in the early postintervention period. This finding is of particular interest, as (a) the increase in spirits consumption took place at a time of generally declining consumption of alcohol in Switzerland; and (b) in contrast to the findings of most studies, the intervention, namely price reduction, increased availability. [ABSTRACT FROM AUTHOR]

Alcohol misuse can harm people other than the drinker, and can have negative consequences for society as a whole. It is commonly believed to play a role in decreased worker productivity, increased unintentional injuries, aggression and violence against others, and child and spouse abuse. Research findings support the idea that drinking is involved in or associated with many of these social harms, but do not offer evidence that it causes these effects. Methodological flaws characterize much of the research in this area. Use of better design and statistical methodology is necessary in order to clarify the relationship between drinking and the harmful consequences it is believed to cause. [ABSTRACT FROM AUTHOR]

Alcohol use is related to a wide variety of negative health outcomes including morbidity, mortality, and disability. Research on alcohol-related morbidity and mortality takes into account the varying effects of overall alcohol consumption and drinking patterns. The results from this epidemiological research indicate that alcohol use increases the risk for many chronic health consequences (e.g., diseases) and acute consequences (e.g., traffic crashes), but a certain pattern of regular light-to-moderate drinking may have beneficial effects on coronary heart disease. Several issues are relevant to the methodology of studies of alcohol-related morbidity and mortality, including the measurement of both alcohol consumption and the outcomes studied as well as study design. Broad summary measures that reflect alcohol's possible effects on morbidity, mortality, and disability may be more useful than measures of any one outcome alone. [ABSTRACT FROM AUTHOR]

The 'gin epidemic' of 1720 to 1751 in England was the first time that government intervened in a systematic fashion to regulate and control sales of alcohol. The epidemic therefore provides an opportunity to gauge the effects of multiple legislative interventions over time. Toward that end, we employed time series analysis in conjunction with qualitative methodologies to test the interplay of multiple independent variables, including real wages and taxes, on the consumption of distilled spirits from 1700 through 1771. The results showed that each of the 3 major gin acts was successful in the short term only, consistent with the state's limited resources for enforcement at the local level, and that in each instance consumption actually increased shortly thereafter. This was true even of the Gin Act of 1751, which, contrary to the assumptions of contemporaries and many historians, succeeded by accident rather than by design. The results also suggest that the epidemic followed the inverse U-shaped trajectory of more recent drug scares and that consumption declined only after the more deleterious effects of distilled spirits had been experienced by large numbers of people. [ABSTRACT FROM AUTHOR]