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AbstractBackground and Objectives: We examined associations between sources of social influence (i.e. close friends, other underage people present) within specific settings with the number of drinks underage youth consumed. Methods: Data were collected through a cross-sectional survey with 422 underage youth in California (14 to 19 years old) who reported past-6-month alcohol use. Participants were asked to think about the last time they drank alcohol in the past 6 months at: restaurants, bars/nightclubs, own home, another’s home, outdoors, and fraternities/sororities. Outcomes were the number of whole drinks participants drank the last time in each setting. Independent measures were social characteristics of these drinking events including number of people <21 years old present, number of close friends present, number of <21 years old who consumed alcohol, and number of close friends who consumed alcohol. We also assessed socio-demographics and accounted for the overall exposure to each setting in the past 6 months. Results: Using negative binomial regression models, the number of close friends was positively associated with number of drinks consumed at restaurants, another’s home, and outdoors. The number of close friends drinking was positively associated with the number of drinks at restaurants, own home, another’s home, and outdoors. Number of people <21 years old was positively associated with number of drinks at own home, and number of people <21 years old who consumed alcohol was positivity associated with number of drinks consumed at restaurants, own home, another’s home, and outdoors. Conclusions: Results suggest that social influence from close friends and from other underage youth are context-specific. [ABSTRACT FROM AUTHOR]

This study examined the relative contribution of alcoholic beverage types to overall alcohol consumption and associations with heavy alcohol use and alcohol-related harms among adults. Cross-sectional survey data were collected from adult samples in two cities involved in the Global Smart Drinking Goals (GSDG) initiative in each of five countries (Belgium, Brazil, China, South Africa, United States). Survey measures included past-30-day consumption of beer, wine, flavored alcoholic drinks, spirits, and homemade alcohol; past-30-day heavy drinking; 14 alcohol-related harms in the past 12 months; and demographic characteristics. Within in each country, we computed the proportion of total alcohol consumption for each beverage type. Regression analyses were conducted to estimate the relative associations between consumption of each alcoholic beverage type, heavy alcohol use, and alcohol-related harms, controlling for demographic characteristics. Beer accounted for at least half of total alcohol consumption in GSDG cities in Belgium, Brazil, the U.S., and South Africa, and 35% in China. Regression analyses indicated that greater beer consumption was associated with heavy drinking episodes and with alcohol-related harms in the cities in Belgium, Brazil, South Africa, and the U.S. Significant increases in heavy drinking and alcohol-related harms were also consistently observed for spirits consumption. Beer accounts for the greatest proportion of total alcohol consumption in most of the GSDG cities and was consistently associated with more heavy drinking episodes and alcohol-related harms. Reducing beer consumption through evidence-based interventions may therefore have the greatest impact on hazardous drinking and alcohol-related harms. [ABSTRACT FROM AUTHOR]

College student drinking in on-premises establishments has been associated with heavy alcohol consumption and a range of problems including assault, fighting, risky sex, and drinking and driving. Although more strictly enforcing overservice laws might reduce heavy drinking in on-premises establishments, law enforcement agencies have few resource-efficient tools for doing so, resulting in these laws seldom being enforced. In this paper, we report the results of an evaluation of the Stop Service to Obviously-impaired Patrons (S-STOP) program that was implemented in 303 bars and restaurants in 18 university communities in California using a randomized cross-over design (early vs. delayed implementation). The S-STOP program: (a) deployed pseudo-intoxicated patrons who attempted to purchase a drink when showing obvious signs of intoxication; (b) provided feedback to owners and managers on staff performance; and (c) offered free online refresher training for staff. Overall, alcohol servers in bars and restaurants in these college communities were willing to serve a pseudo-intoxicated mystery shopper 90% of the time. The study found no evidence that S-STOP reduced the prevalence of alcohol sales to apparently impaired patrons during the two intervention stages of the study. The findings highlight the need for developing effective interventions to prevent overservice and should prompt college and university leaders to take the lead in addressing the problem of alcohol overservice at on-premises establishments by working with community leaders, law enforcement, and retailers. [ABSTRACT FROM AUTHOR]

Little is known about adults in China who drink homemade alcohol, and whether they are at elevated risk of harms relative to those who drink alcohol from commercial sources. Purpose: We describe and contrast adults in China who regularly consume either homemade or commercially available alcohol, or both. Methods: Household-based in-person interviews were conducted in 2018 with adults in Jiangshan and Lanxi. We examined the characteristics of 833 adults who had consumed alcohol within the previous 30 days, comparing those who drank commercial alcohol only with those who drank homemade alcohol only and alcohol from both sources. Results: Regression analyses revealed that drinkers of both homemade and commercial alcohol consumed more drinks and were more likely to report heavy drinking than did drinkers of commercial or homemade alcohol only and were also more likely to meet criteria for alcohol use disorder. We also found that homemade-only alcohol drinkers were at elevated risk for this disorder. Conclusions: Drinkers of both homemade and commercial alcohol in China may be at risk for alcohol-related problems and constitute a little understood population for whom further research is needed. The AB InBev Foundation supported this study. [ABSTRACT FROM AUTHOR]

Objective: We investigated whether recreational marijuana legalization (RML) in Oregon in 2015 and recreational marijuana and alcohol retail outlet density levels in Oregon counties were associated with increased alcohol and marijuana co-use and beliefs supportive of alcohol and marijuana use among adolescents. Method: We conducted secondary analyses of biennial data collected from 11th graders who participated in the Student Wellness Survey (SWS) in 36 Oregon counties from 2010 to 2018 (N = 71,870). Multi-level logistic regression analyses assessed changes in past-30-day co-use of alcohol and marijuana, and alcohol- and marijuana-related beliefs after RML in counties with low, medium, and high densities of licensed recreational marijuana and alcohol retail outlets. We used post-RML 2016 and 2018 SWS data to examine whether beliefs accounted for any relationship of recreational marijuana and alcohol outlet density with alcohol and marijuana co-use. Results: We found a significant post-RML increase in past-30-day alcohol and marijuana co-use in 2016 in counties with the highest density of recreational marijuana and alcohol retail outlets. There were significant post-RML increases in perceived risk and parent approval of alcohol and marijuana use. Analyses with 2016 and 2018 SWS data indicated that the relationship between level of recreational marijuana and alcohol retail outlet density and past-30-day alcohol and marijuana co-use was accounted for beliefs about marijuana and alcohol availability, approval by parents, and risk. Conclusion: RML and greater retail availability of recreational marijuana and alcohol were positively associated with alcohol and marijuana co-use among adolescents, and with beliefs favorable to alcohol and marijuana use. [ABSTRACT FROM AUTHOR]

This research contributes to the extant literature on television influence by pairing a stimulus-side approach documenting how information is presented within a television series with a response-side assessment of whether connectedness and exposure to a series influence the processing of that information differently depending on its format. The inquiry focuses on the nature and impact of messages about alcohol contained within a youth-oriented television program. The findings indicate that the recall and perception of the more overt negative messages increase with exposure and that receptiveness to the subtle and less remembered positive messages increases with levels of program connectedness. Highly connected viewers are both more receptive to and in greater agreement with the underlying positive alcohol message communicated in the series. [ABSTRACT FROM AUTHOR]

Background: Mechanisms underlying associations between early drinking and problems are largely unknown. Objectives: We investigated (a) associations between early age of first intoxication (≤15 years) and past year drinking in different contexts and (b) whether early age of first intoxication is differentially associated with problems in these contexts. Methods: We used survey data collected in 2013–2014 from 405 past-year adolescent drinkers in 24 midsized California cities. Data included demographics; drinking behaviors; age of first intoxication; frequency of being at and drinking at restaurants, bars/nightclubs, outdoor places, and home; and problems. We used multilevel logistic and negative binomial models to account for the clustering of adolescents within cities. Probabilities were corrected to maintain family-wise error rates. Results: Early age of first intoxication was associated with a 120% increase in the odds of drinking at outdoor settings (OR = 2.20, pc <.05). Early age of first intoxication was associated with increased numbers of problems related to drinking in restaurants (IRR = 5.72, pc <.001), outdoor settings (IRR = 3.40, pc <.001), and homes (IRR = 2.84, pc <.001). Later intoxication (≥16 years) was not significantly associated with increased drinking or problems in any of these contexts. Conclusions: Results suggest that underage drinkers who report early intoxication are more likely to drink at outdoor settings, but not other contexts. However, they may differentially experience drinking problems across contexts. To target youths who have experienced intoxication at an early age and to reduce problems, prevention interventions should focus on outdoor settings. [ABSTRACT FROM AUTHOR]

This experimental study assessed whether alcohol television storylines impact youth drinking attitudes and intentions and whether corrective epilogues can potentially moderate this impact. Television episodes were professionally produced to depict heavy drinking leading to either positive or negative consequences. The pro- and anti-alcohol episodes were shown alone or with an epilogue where a main character discussed the deleterious effects of excessive drinking. Attitudes toward drinkers and drinking intentions were measured subsequently, along with reactions to the episode and demographic data, among participants aged 14-17 using an online study. Exposure to the pro-alcohol episode was related to more positive attitudes toward drinkers. Including an epilogue after a pro-alcohol episode was related to more negative viewers' attitudes toward drinkers and lower drinking intentions compared to a pro-alcohol episode with no epilogue. By contrast, including an epilogue after an anti-alcohol episode was unrelated to attitudes toward drinkers or drinking intentions. Viewing a single television episode with a pro-alcohol message may lead to more positive attitudes toward drinkers. The finding that a brief epilogue may reduce the impact of the pro-alcohol storyline suggests easily implemented preventive strategies to counter the adverse impact of substance use portrayals in entertainment programming. [ABSTRACT FROM AUTHOR]

Objective: Evaluations of drink-driving crash interventions and crash burden in middle-income countries often rely on assumptions supported by data from the United States. We described crashes using pooled survey data across 2 Chinese agricultural cities in the 600,000 population range and then assessed comparability of selected crash characteristics to those in the United States.Methods: We conducted household interviews on drinking and related harms with representative samples of 1,500 people aged 18 and over in both Jiangshan and Lanxi, China. Near the end of the survey, 2,962 people responded to questions about motor vehicle crashes during the past year. We report survey data weighted to match the population demographically.Results: Across the 2 cities, 28% of adults were licensed drivers and 24% drove a motorized vehicle. Fifty-three respondents (unweighted) reported that they personally were involved in at least one crash in the past year. Among these, 32% (weighted) were driving a car, truck, or bus; 7.5% were driving a motorcycle; 9.5% were pedalcyclists; 17% were pedestrians; and 34% were passengers. Of the crashes, 42% involved just one motorized vehicle. Most crashes (62%) occurred in broad daylight, followed by at dawn or dusk (19%) and at night (19%). Only 4% were single-vehicle nighttime crashes. Someone was injured or killed in 22% of crashes. Respondents thought it likely that at least one driver was drinking alcohol in 21% of the crashes and thought it unlikely in 51%; the remaining 28% were unsure whether anyone was drinking or refused this question. Alcohol involvement was similar in injury and no-injury crashes. Respondents thought a driver had been drinking in 24% of daytime crashes, 34% of crashes at dawn or dusk, and 36% of nighttime crashes. All 3 crashes involving an alcohol-involved pedestrian or pedalcyclist also included an alcohol-involved driver. Respondents said that 40% of the crashes were reported to the police and 40% were not reported; the remaining 20% of respondents did not know whether anyone reported their crash. Among crashes where reporting status was known, all crashes with injuries were reported.Conclusions: Compared to published data, crash rates are similar among licensed drivers in the United States and these Chinese cities. The percentage of crashes that involved injury did not differ significantly between the 2 countries. Injury crashes were well reported in both. Crashes involving property damage only were significantly less likely to be reported to the police in the Chinese cities. Alcohol involvement rates in crashes were similar. Although our crash sample was small, some crash parameters appear to be transferable between these 2 countries. [ABSTRACT FROM AUTHOR]

Abstract We examined associations of the 2016 legalization of recreational marijuana (RML) in California with marijuana and alcohol co-use among race/ethnic groups using successive cross-sections from 7th, 9th, and 11th graders (N = 3,319,329) in the 2010-11 to 2018-19 California Healthy Kids Surveys. Multilevel logistic regressions indicated a stronger positive association between RML and co-use among non-Hispanic/Latine White youth (OR = 1.21) relative to Hispanic/Latine (OR = 1.02) or Black youth (OR = 0.85). Among drinkers who had not consumed five or more drinks on any occasion in the past 30-days (non-heavy drinkers), the positive association between RML and co-use was stronger among American Indian/Alaska Native youth (OR = 2.19) compared to non-Hispanic/Latine Whites (OR = 1.56). For heavier drinkers it was stronger for Native Hawaiian/Pacific Islanders (OR = 1.47). Among marijuana users, there was a stronger inverse association between RML and co-use among Black youth (OR = 0.72) compared to non-Hispanic/Latine White youth (OR = 0.84). RML may increase the risk of co-use to a greater extent among non-Hispanic/Latine White youth than other race/ethnic groups in California, but broadly increases the risk among youth who engage in alcohol use or heavy drinking. [ABSTRACT FROM AUTHOR]

This study examined whether differences in the perceived neighborhood and school environments account for differences in drinking behavior among Native American and White youths. Findings indicate that being Native American was indirectly related to drinking through perceived school and community variables. Higher drinking rates among Native Americans appear to be accounted for by lower school involvement, weaker neighborhood antidrug norms, greater neighborhood disorganization, and lower levels of perceived police enforcement. Results of this study highlight the potential importance of perceived school and neighborhood environments in drinking behavior among youths. [ABSTRACT FROM AUTHOR]

Cultivation research has shown that heavy television viewing is linked to audiences' generalized, and often skewed, views of reality. This research investigates whether television viewing is related to adolescents' views about the consequences of drinking and whether psychological trait reactance moderates this cultivation effect. Results from a survey of 445 American teenagers show that cumulative exposure to television is linked to reduced beliefs about alcohol's negative consequences and greater intentions to drink. These effects were greater for adolescents low on trait reactance. This research adds to the general psychological research on trait reactance as a moderator of media influences and makes a substantive contribution toward furthering our understanding of the media and public health concerns that surround risky adolescent behaviors. [ABSTRACT FROM AUTHOR]

Aim: This study examined the relationship of youth marijuana use and perceived ease of access with the number of medical marijuana cards at the county-level, and marijuana norms as indicated by per cent of voters approving legalization of medical marijuana in 2004. Methods: Survey data from 17,482 youths (aged 13-19) in Montana and county-level archival data, including votes for the legalization of medical marijuana and the number of medical marijuana cards were analysed using hierarchical linear modelling. Findings: Living in a county with more medical marijuana cards was not related to lifetime or 30-day marijuana use. However, voter approval of medical marijuana was positively related to lifetime and 30-day use. Perceived ease of access to marijuana was positively related to medical marijuana cards, but this relation became non-significant when voter approval was controlled. Among marijuana users, marijuana cards and voter approval were positively related to perceived ease of access. Conclusions: The relation between medical marijuana cards and youth use may be related to an overall normative environment that is more tolerant of marijuana use. Interventions to prevent youth marijuana use should focus on adult norms regarding use by and provision of marijuana to youths. [ABSTRACT FROM AUTHOR]

Background: Underage drinking is associated with a number of social and public health consequences. Preventing access to alcohol is one approach to reducing underage drinking . Objectives: This study assesses the efficacy of a culturally tailored 'reward and reminder' program aimed at reducing convenience store alcohol sales to youth living on or near nine American Indian reservations. Methods: First, tribal council proclamations were sought to support underage drinking prevention, including reward and reminder efforts. Then, decoys (volunteers over 21 years of age but judged to look younger) attempted to purchase alcohol without identification. Clerks who asked for identification were given 'rewards' (gift cards and congratulatory letters), whereas clerks who did not were given 'reminders' of the law regarding sales to minors. Following an initial baseline of 12 purchase attempts, three repeated reward and reminder visits were made to 13 convenience stores selling alcohol within 10 miles of the reservations ( n = 51 total attempts). Results: Five of nine tribal councils passed resolutions in support of the program. The baseline sales rate without requesting ID was 33%. Similarly, 38% of stores in the first reward and reminder visit round failed to request identification. However, in the following two reward and reminder rounds, 0% of the stores failed to request identification. Conclusions: These results indicate that environmental community-level underage drinking prevention strategies to reduce alcohol sales near rural reservations are feasible and can be effective. Scientific Significance: Environmental prevention strategies within reservation communities support integrated supply and demand reduction models for reducing underage drinking. [ABSTRACT FROM AUTHOR]

This qualitative study focused on the discrepancies in messages concerning alcohol use presented by adults to young people. The purpose was to investigate how these discrepancies might impact adolescents’ drinking, and drinking and driving behavior. The data consisted of semi-structured interviews with 44 adolescents who in a previous survey had admitted having been involved in drinking and driving, riding with a drunk driver, or both. The analysis of the interviews focused on the discrepancies between messages presented by adult authorities and the respondents’ experience of actual behavior from these authorities. The findings indicate that there are serious problems in the communication between adult authorities and adolescents. Parents, schools, and police are not consistent and persistent in their communication with adolescents concerning alcohol and drinking and driving. This inconsistency seems to prevent teenagers from understanding the extent of the problem of drinking and driving. Implications for research and prevention are discussed. [ABSTRACT FROM AUTHOR]

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The authors report on the frequency and nature of alcohol advertisements in a representative sample of college newspapers from 1984/85 and compare these with results of a similar study conducted 7 years earlier, in 1977/78. On average, nearly 24 column inches of space per issùe were devoted to national alcohol advertisements in 1984/85. This represents a significant decrease from an earlier period. The space devoted to national alcohol advertisements, however, still far exceeded that for comparison products (books, soft drinks). Local alcohol advertisements averaged 20 column inches per issue and were somewhat more frequent than in the previous study. The content of the advertisements differed markedly from the messages presented 7 years earlier. Although national alcohol advertisements in 1977/78 frequently ridiculed education and study, none did so in 1984/85, when appeals were to taste and product quality instead. Fantasy themes also were relatively common. Very few national alcohol advertisements featured athletes or group drinking. Sponsorship of campus activities by the alcohol industry, however, had increased since the earlier study. In contrast to national advertisements, many local advertisements consisted of inducements to drink through special offers and happy hours. Some encouraged irresponsible and heavy drinking. Interestingly, alcohol advertisements were just as frequent in papers from states with higher minimum drinking ages and were more frequent in papers from campuses with higher proportions of women students. [ABSTRACT FROM AUTHOR]

Despite high rates of youth drinking in Mexico, little is known about the availability and consumption of specific types of alcoholic beverages within this population or the contexts in which alcohol is consumed. Objectives: This descriptive study examined alcohol consumption, perceived availability, and purchase of different types of alcoholic beverages (i.e., beer, wine, tequila, other spirits, pre-mixed cocktails, alcohol energy drinks, homemade alcohol), and drinking contexts. Methods: The sample comprised 594 students aged 12-17 in three cities in central Northeastern Mexico, where the legal drinking age is 18. Results: Over half had consumed alcohol in the past year. Of past-year drinkers, almost 57% had consumed alcohol in the past 30 days. Over half of these students reported that they or their friends had purchased alcohol at an off-premise establishment for their personal consumption, and 40% had consumed it at an on-premise establishment. Beer, which almost 60% of the study's adolescents thought was either fairly or very easy to get, was the most commonly consumed type of alcoholic beverage in the past 30 days. The majority of youth (70%) reported that their last drinking location was at home, someone else's home, or a public place. Importantly, however, 39% of young drinkers reported that the last time they consumed alcohol was at an on-premise establishment, and most of these youth (90%) did so in the absence of their parents. Conclusions/Importance: The findings suggest the need to implement and enforce measures to decrease retail and social alcohol availability to Mexican youth. [ABSTRACT FROM AUTHOR]