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Background and Objectives: This study describes the prevalence of risky alcohol consumption in Australian women aged 40-45 years. It explores the relationship between demographic factors and access to and usage of primary healthcare services., Method: Data were obtained from the Australian Longitudinal Study on Women's Health, Survey 8 (1973-78 cohort). Descriptive statistics and univariate logistic regression were used to assess associations of specific factors with risky alcohol consumption., Results: Eleven per cent of respondents reported drinking >10 standard drinks per week. These 'risky alcohol drinkers' attend general practice as frequently as low-risk drinkers despite perceived poorer health. They reported 'rarely or never' seeing the same general practitioner (GP) and described themselves as having 'poor' access to a GP that bulk bills., Discussion: This study provides unique insight into the primary healthcare attendance patterns and health status of early middle-aged Australian women who are 'risky alcohol drinkers'. They do not consistently see the same GP, which might present challenges in identifying them in primary care.

Objectives. To examine trends in young adult self-reported driving under the influence of alcohol (DUI-A), cannabis (DUI-C), and simultaneous alcohol and cannabis use (DUI-AC) in a state with legalized nonmedical cannabis use from before to during the COVID-19 pandemic. Methods. We used logistic regression and annual statewide data from the Washington Young Adult Health Survey to assess DUI behaviors from 2016 to 2021. Results. Both prepandemic yearly changes in prevalence and deviations from those trends during the pandemic years were small and not statistically significant. However, prevalence estimates were alarming: 12.0% of participants reported DUI-A, 12.5% reported DUI-C, and 2.7% reported DUI-AC. Exploratory moderation analyses indicated a relative increase in DUI-A during 2020 among 4-year college students relative to young adults not attending 4-year colleges. Conclusions. Young adults in Washington State continued to engage in risky DUI behaviors during the pandemic. College students may have increased their likelihood of DUI-A during COVID-19. Public Health Implications. Young adults, for whom vehicle crashes remain a leading cause of death, showed little change in DUI behaviors during the COVID-19 pandemic. There is continued need for young adult DUI prevention efforts. ( Am J Public Health . 2024;114(S8):S698-S701. https://doi.org/10.2105/AJPH.2024.307767).

Background: This study aimed to estimate time trends in alcohol expenditure among risky drinkers in England over the past decade, to understand whether these trends are driven by changes in prices paid or volumes purchased, and to explore differences between population subgroups., Methods: Nationally-representative monthly cross-sectional survey. Participants were 44,382 adults (≥18y) drinking at risky levels (AUDIT-C ≥ 5; 'risky drinkers'). Linear regression modelled trends between March-2014 and October-2023 in (i) mean weekly inflation-adjusted expenditure on alcohol, (ii) mean weekly alcohol consumption in units, and (iii) mean inflation-adjusted expenditure per unit of alcohol, overall and by age, gender, social grade, region, and smoking status., Results: There was an uncertain decrease in mean weekly expenditure from £18.90 [95 %CI=£18.30-£19.50] in March-2014 to £17.90 [£17.60-£18.30] in May-2016, then an uncertain increase to £18.60 [£18.30-£18.90] between May-2016 and June-2018. This was followed by a further decline to £16.90 [£16.60-£17.30] by April-2021 and subsequent rise to £18.60 [£17.90-£19.40] by October-2023. Changes in weekly alcohol expenditure were more closely mirrored by changes in mean expenditure per unit of alcohol than by changes in mean weekly alcohol consumption in units. Notable subgroup differences included sharp rises in weekly alcohol expenditure since 2021 among younger ages (driven by a rise in expenditure per unit of alcohol) and current smokers (driven by a rise in weekly units of alcohol consumed)., Conclusions: In England, the average amount adult risky drinkers reported spending on alcohol each week has fluctuated since 2014, with a notable decrease around the start of the COVID-19 pandemic in 2020 and a subsequent rise since restrictions were lifted and since the cost-of-living crisis has led to high rates of inflation. Except for current smokers, this pattern appears to have been driven predominantly by changes in the price paid per unit rather than changes in consumption., Competing Interests: Declaration of competing interest JB has received unrestricted research funding from Pfizer and J&J, who manufacture smoking cessation medications. All authors declare no financial links with alcohol companies or their representatives., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: We aimed to assess: (i) trends in alcohol-specific - that is, fully attributable - morbidity and mortality in the German adult population aged 15-69 between 2000 and 2021; and (ii) changes in alcohol-attributable disease burden - that is, fully and partially alcohol-attributable categories - for 2006, 2012, 2018 and 2021., Methods: Morbidity data was pulled from hospitalisation and rehabilitation statistics and mortality data was pulled from the causes of death registry. Alcohol use, adjusted for unrecorded consumption, was estimated using the Epidemiological Survey of Substance Abuse and triangulated with per capita consumption from annual sales data. For major disease categories, alcohol-attributable fractions were estimated for males and females by age groups (15-29, 30-49, 50-69 years) using the comparative risk assessment methodology., Results: For males and females, the age-standardised rate of alcohol-specific morbidity peaked in 2012 and decreased thereafter showing a steep decline from 2019 to 2021. The rates of alcohol-specific mortality decreased constantly from 2000 to 2019 but increased from 2019 to 2021. Compared to 2006 the age-standardised alcohol-attributable morbidity and mortality rates in males and females were lower in 2021. For both sexes, the age-standardised alcohol-attributable morbidity and mortality rates and the proportions of morbidity/mortality rates relative to all-cause morbidity/mortality decreased between 2006 and 2021., Discussion: The declines in alcohol-attributable morbidity and mortality are in line with decreases in consumption and signal that the importance of alcohol in health service utilisation and mortality has weakened. Sex ratios in morbidity and mortality do not indicate a strong converging trend., (© 2024 The Author(s). Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Objective: Some claims on alcohol labels highlight virtuous aspects of brands or products, including in health-, eco-, and cause-oriented domains (including charity partnerships, or ethical or humanitarian certifications). This virtue marketing may create a "halo" whereby consumers generalize from specific attributes to a more favorable overall appraisal of the product, brand, or even alcohol or the alcohol industry in general. This study aims to describe the prevalence of and trends over time in virtue marketing on the packaging of new alcohol (including lower- and zero-alcohol) products on the Australian market., Method: Records of 4,024 new alcohol products released in Australia between 2013 and 2023 were extracted from Mintel Global New Products Database. Health-, eco-, and cause-oriented claims on packaging were summarized across product types and time, and co-occurrence between claims was assessed., Results: Virtue marketing appeared on 36.5% of new alcohol products, of which health-oriented claims were most common (32.5%), followed by eco- (6.3%) and cause-oriented claims (2.0%). The prevalence of each claim category and virtue marketing overall significantly increased over time (each p < .001) and varied by product type. New alcohol products displayed as many as eight different types of claims, and all claims tended to co-occur with at least two others., Conclusions: Virtue marketing is prevalent on new alcohol products in Australia and has recently increased. Although product packaging can provide useful consumer information, health-, eco-, and cause-oriented claims may exploit consumers' motivation to make healthy, sustainable, and socially responsible choices despite alcohol being detrimental in these areas.

Objective: The purpose of this study was to measure the prevalence and overlap of secondhand harms from other people's use of alcohol, cannabis, opioids, or other drugs and examine sociodemographic and other correlates of these secondhand harms., Method: This cross-sectional analysis used data from 7,799 respondents (51.6% female; 12.9% Black, 15.6% Hispanic/Latiné; mean age = 47.6 years) in the 2020 U.S. National Alcohol Survey. Secondhand harms included family/marriage difficulties, traffic accidents, vandalism, physical harm, and financial difficulties. Weighted prevalence estimates provided nationally representative estimates of these harms. Logistic regression assessed associations between individual characteristics and secondhand harms., Results: Lifetime prevalence of secondhand harms from alcohol, cannabis, opioids, or other drugs was 34.2%, 5.5%, 7.6%, and 8.3%, respectively. There was substantial overlap among lifetime harms: Almost 30% of those reporting secondhand alcohol harms also reported secondhand drug harms. Significant correlates of secondhand substance harms included female sex (alcohol, other drugs); White (alcohol, opioids), American Indian/Alaska Native (opioids), and Black (cannabis) race/ethnicity; and separated/divorced/widowed marital status (opioids). Those reporting a family history of alcohol problems had significantly higher odds of reporting secondhand harms across substance types. Individuals who reported frequent cannabis use had higher odds of reporting secondhand alcohol and opioid harms compared to those with no cannabis use (aOR = 1.55; aOR = 2.38) but lower odds of reporting secondhand cannabis harms (aOR = 0.51)., Conclusions: Although less prevalent than secondhand alcohol harms, 14% of participants reported secondhand harms from someone else's drug use and frequently experienced secondhand harms attributed to multiple substances. Population-focused interventions are needed to reduce the total burden of alcohol and other drug use.

Background and Aims: Alcohol consumption has decreased in England in recent decades, while alcohol-specific death rates have remained relatively stable. Age-period-cohort (APC) models offer the potential for understanding these paradoxical trends. This study aimed to use an APC model approach to measure long-term trends in alcohol abstention and consumption in England from 2001 to 2019., Design, Setting and Participants: The study used grouped and proxy-variable APC models of repeat cross-sectional survey data, set in England (2001-19). Participants were residents in England aged 13 years or over who took part in the Health Survey for England., Measurements: Outcome variables were alcohol abstention and consumption in units. We created nine age groups (13-15, 16-17, 18-24, 25-34, until 65-74 and 75+, reference 45-54 years), four periods (2001-04, 2005-09, 2010-14 to 2015-19, reference 2005-09) and 18 5-year birth cohorts (1915-19 to 2000-04, reference 1960-64). We proxied age effects (systolic and diastolic blood pressure), period effects (alcohol affordability, internet usage and household alcohol expenditure) and birth cohort effects (prevalence of smoking and prevalence of overweight)., Findings: The odds of abstaining were considerably larger at young ages, 13-15 years [odds ratio (OR) = 5.38; 95% confidence interval (CI) = 4.50-6.43], were lowest during the first period, 2001-04 (OR = 0.83; 95% CI = 0.79-0.86) and had a U-shaped pattern by birth cohort. For units of alcohol, the incidence rate ratio (IRR) increased until age 18-24 years (IRR = 1.41, 95% CI = 1.34-1.48) and decreased afterwards, were highest during the first period, 2001-04 (IRR = 1.07; 95% CI = 1.05-1.08) and showed an inverted J-shape by birth cohort. Our proxy variable approach revealed that using blood pressure measures, alcohol affordability and prevalence of overweight as proxies resulted in APC effects that differed from our base-case model. However, internet usage, household expenditure on alcohol and smoking prevalence resulted in APC effects similar to our base-case model., Conclusions: The discrepancy between decreasing alcohol consumption and increasing alcohol-related deaths observed in England from 2001 to 2019 may, in part, be explained by the halt in abstention trends since 2010 and a slight consumption decline since 2001., (© 2024 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Purpose: To examine trends and potential disparities in North Carolina (NC) driving while impaired by alcohol (alcohol-DWI) license suspensions from 2007-2016. Specific objectives included: 1) examining personal (e.g., race/ethnicity) and contextual (e.g., residential segregation) characteristics of alcohol-DWI license suspensions by suspension duration; and 2) examining trends in annual suspension rates by race/ethnicity, sex, and duration., Methods: We linked NC administrative licensing and county-level survey data from several sources from 2007-2016. Suspensions were categorized by duration: 1 to <4 years and 4 years or longer (proxies for initial and repeat suspensions, respectively). We calculated counts, percentages, and suspensions rates (per 1,000 person-years) with 95% confidence intervals, examined trends in annual suspension rates by race/ethnicity, sex, and suspension duration., Results: We identified 220,471 initial and 41,526 repeat license suspensions. Rates among males were three times that of females. 21-24-year-old (rates: 6.9 per 1,000 person-years for initial; 1.5 for repeat) and Black (4.1 for initial; 1.0 for repeat) individuals had the highest suspension rates. We observed decreases in annual initial and repeat suspension rates among males, but only in repeat suspensions for females during the study period. A substantial decrease in annual initial suspension rates was observed among Hispanic individuals relative to other racial/ethnic groups, while annual repeat suspension rates exhibited large decreases for most racial/ethnic groups. The highest overall suspension rates occurred in counties with higher proportions of the population without health insurance and with the highest levels of Black/White residential segregation., Conclusions: Potential disparities by race/ethnicity and sex existed by alcohol-DWI license suspension duration (i.e., initial vs. repeat suspensions) in NC. Contextual characteristics associated with suspensions, including a high degree of residential segregation, may provide indications of underlying structures and mechanisms driving potential disparities in alcohol-DWI outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Singichetti et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background and Aims: Multiple countries are considering revising cannabis policies. This study aimed to measure long-term trends in cannabis use in the United States and compare them with alcohol use., Design and Setting: Secondary analysis of United States general population survey data., Participants: The national surveys had a total of 1 641 041 participants across 27 surveys from 1979 to 2022., Measurements: Rates of use reported to the US National Survey on Drug Use and Health and its predecessors are described, as are trends in days of use reported. Four milepost years are contrasted: 1979 (first available data and end of relatively liberal policies of the 1970s), 1992 (end of 12 years of conservative Reagan-Bush era policies), 2008 (last year before the Justice Department signaled explicit federal non-interference with state-level legalizations) and 2022 (most recent data available)., Findings: Reported cannabis use declined to a nadir in 1992, with partial recovery through 2008, and substantial increases since then, particularly for measures of more intensive use. Between 2008 and 2022, the per capita rate of reporting past-year use increased by 120%, and days of use reported per capita increased by 218% (in absolute terms from the annual equivalent of 2.3 to 8.1 billion days per year). From 1992 to 2022, there was a 15-fold increase in the per capita rate of reporting daily or near daily use. Whereas the 1992 survey recorded 10 times as many daily or near daily alcohol as cannabis users (8.9 vs. 0.9 M), the 2022 survey, for the first time, recorded more daily and near daily users of cannabis than alcohol (17.7 vs. 14.7 M). Far more people drink, but high-frequency drinking is less common. In 2022, the median drinker reported drinking on 4-5 days in the past month, versus 15-16 days in the past month for cannabis. In 2022, past-month cannabis consumers were almost four times as likely to report daily or near daily use (42.3% vs. 10.9%) and 7.4 times more likely to report daily use (28.2% vs. 3.8%)., Conclusions: Long-term trends in cannabis use in the United States parallel corresponding changes in cannabis policy, with declines during periods of greater restriction and growth during periods of policy liberalization. A growing share of cannabis consumers report daily or near daily use, and their numbers now exceed the number of daily and near daily drinkers., (© 2024 The Author. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Introduction: Alcohol consumption has an impact on the frailty, but current research in China lacks a detailed classification of alcohol use. This study aimed to explore the relationship between different drinking patterns and frailty in older adults., Methodology: The data came from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) study, which included older adults (aged ≧ 60). Their demographic data, drinking status, and frailty index were collected in CLHLS. Through logistic regression models to analyze the correlation between alcohol consumption and frailty., Results: A total of 14,931 participants were included in the analysis. The prevalence of frailty was 29.1%, 35.2%, and 14.9% among risk-free, past risky, and now risky drinkers, respectively. After adjusting for covariates, past risky drinking was a risk factor for frailty ( p = .003)., Discussion: High-risk alcohol consumption is positively correlated with frailty. Prevention and reduction of risky drinking in older adults may help protect them from developing frailty., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Sexual assault in the U.S. Military is a serious concern. Recruiting representative samples of service members to participate in sexual assault research is essential for understanding the scope of the problem and generating data that can inform prevention and intervention efforts. Accordingly, the current study aims to examine response and completion rates of an anonymous survey of sexual assault and alcohol use among active duty sailors aged 18 to 24 with the overarching goal of achieving a representative sample and informing future recruitment efforts., Materials and Methods: This study was approved by the Institutional Review Board at the Naval Health Research Center. The study involved an anonymous survey of sexual assault and alcohol use among 612 active duty sailors aged 18 to 24. Since 79.6% of Navy service members are men and 20.4% are women, women were oversampled to achieve sufficient representation. Survey invitations were emailed to 12,031 active duty sailors: 64.3% (n = 7,738) men and 35.7% (n = 4,293) women., Results: Response rates were disproportionate, with 3.0% (n = 234) of male and 8.8% (n = 377) of female sailors responding to the study invitation. Survey completion rates, however, were similar between male and female sailors (81.2% and 80.1% for male and female personnel, respectively)., Conclusion: Results demonstrated that female sailors were significantly more likely than male sailors to participate in a study of sexual assault and alcohol use. However, once enrolled in the study, male and female sailors completed the 234-item questionnaire at a similar rate. Study findings highlight the challenges of engaging male service members in sexual assault-related research. Despite the disproportionately high representation of men in the military, sexual assault researchers may need to sample according to the overall distribution of gender in the military or perhaps even oversample men to achieve a representative sample., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Objective: In 2017 the Northern Territory (NT) government re-introduced the Banned Drinker Register (BDR) to address the high rates of alcohol related harm. This paper aims to evaluate whether trends in assault, maltreatment and sentinel injuries in children and adolescents were associated with the re-introduction of the BDR, in the context of other local interventions such as police officers stationed in bottle shops being partially removed, Police Auxiliary Liquor Inspectors, and the introduction of a minimum unit price of alcohol., Method: Interrupted time series analysis was used to assess monthly trends in emergency department presentations and inpatient hospital admissions for assault, maltreatment and sentinel injuries between January 2014 and December 2019 in the regions of Greater Darwin, Alice Springs, and Katherine., Results: A significant step increase after the introduction of the BDR in emergency department presentations for assault and maltreatment was present when examining the three regions combined (β = 7.65, 95 % CI = 2.15, 13.16). However, this was not present at the individual community level. Results across a range of other models pointed towards null effects of the BDR introduction., Conclusions: The current study found that the re-introduction of the BDR had minimal impact on rates of assault, maltreatment, or sentinel injuries in children and adolescents. To ensure long-term harm mitigation from alcohol use, a combination of evidence informed alcohol policies that address the price and availability of alcohol in a comprehensive framework, along with measures which address the underlying social determinants of unregulated drinking and health more broadly will assist in reducing alcohol related harm in both children and adults., Competing Interests: Declaration of competing interest The authors declare no conflict of interest. Ryan Baldwin is supported by Deakin University Research Services through an Australian Government Research Training Program Scholarship. Peter Miller receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from NSW Government, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, Cancer Council Victoria, Queensland government, Northern Territory government, and Australian Drug Foundation, travel and related costs from Australasian Drug Strategy Conference. Kerri Coomber currently receives funding from Cancer Council Western Australia. Debbie Scott receives grant funding from Google.org, the Australian Institute of Health and Welfare, the Commonwealth Department of Health and the Victorian Department of Health and Human Services., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Polysubstance use is associated with adverse health outcomes, yet little research has measured changes in polysubstance use. We aimed to 1) estimate trends in marijuana and heavy alcohol use by cigarette smoking and demographic subgroups, and 2) examine patient factors associated with concurrent use among adults who were smoking., Methods: We conducted a repeated cross-sectional analysis of 687,225 non-institutionalized US adults ≥18 years from the 2002-2019 National Survey on Drug Use and Health. Participants were stratified into current, former, and never smoking groups. Main outcomes were prevalence of heavy alcohol use, marijuana use, and concurrent use of both substances., Results: From 2002-2019, heavy alcohol use declined from 7.8 % to 6.4 %, marijuana use rose from 6.0 % to 11.8 %, and concurrent use of alcohol and marijuana remained stable. Among adults who were smoking from 2005 to 2019, higher education was associated with higher odds of heavy alcohol use, while older ages, female gender, non-White race/ethnicity, and government-provided health insurance were associated with lower odds. The odds of marijuana use decreased in females, older ages, and higher incomes while increasing in people with poorer health status, higher education, government-provided or no health insurance, and serious mental illness. Compared to White adults who were smoking, Black counterparts had higher odds of marijuana use (OR=1.23; 95 %CI: 1.15-1.29), while Hispanic (OR=0.68; 95 %CI: 0.63-0.72) and other racial/ethnic identities (OR=0.83; 95 %CI: 0.77-0.90) had lower odds., Conclusions: Our study suggests marijuana use might not be sensitive to changes in the use of tobacco and alcohol., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Jacob James Rich is a policy analyst at Reason Foundation., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Lesbian, gay, bisexual, transgender, queer, intersex, aromantic and asexual (LGBTQIA+) communities in the United States experience higher rates of alcohol use than the general population. While experiencing intimate partner violence (IPV) is thought to lead to increased alcohol use in LGBTQIA+ people, little research has investigated the temporal relationship between IPV and alcohol use in this population., Methods: Data from two annual questionnaires of The Population Research in Identity and Disparities for Equality Study (The PRIDE Study) longitudinal cohort (n=3,783) were included. Overall IPV and three sub-types (physical, sexual, and emotional) - measured in 2021 using the extended Hurt, Insult, Threaten, Scream (E-HITS) screening tool - was examined as a predictor of Alcohol Use Disorders Identification Test (AUDIT) score in 2022 using multivariable linear regression to assess linear and quadratic associations. Models were adjusted for sociodemographic characteristics and history of alcohol use., Results: One-quarter (24.7%) of respondents reported experiencing past-year IPV in 2021. The mean AUDIT score in 2022 was 3.52 (SD = 4.13). In adjusted models, both linear (B: 0.26, 95% CI: 0.14, 0.38) and quadratic (B: -0.03, 95% CI: -0.04, -0.01) terms for overall IPV were significantly associated with next-year AUDIT score. These patterns were mirrored in each IPV sub-type, were not attenuated when accounting for relationship characteristics, and were heterogeneous across gender identity groups., Conclusions: These results provide evidence of a temporal relationship between IPV and alcohol use in LGBTQIA+ communities, suggesting that efforts to prevent and mitigate IPV may help reduce alcohol use disparities in this population., Competing Interests: Declaration of Competing Interest Dr. Lunn has received consulting fees from Hims, Inc and from Folx Health that fall outside the scope of the submitted work. Dr Obedin-Maliver has received consulting fees from Folx Health, Hims, Inc, and Ibis Reproductive Health outside the scope of the submitted work. No other authors have disclosures to report., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: The last 3 years have seen substantial changes in Great Britain (GB) including the COVID-19 pandemic, cost-of-living crisis and policy changes such as minimum unit pricing. We examined changes in purchasing cross-border, illicit and home-brewed alcohol among risky drinkers over this period., Methods: Data were used from 22,086 adult (≥18 years) increasing/higher-risk drinkers (AUDIT-C ≥5) participating in a monthly cross-sectional survey between October 2020 and August 2023. We estimated time trends in the proportion reporting obtaining alcohol from: (i) cross-border (any/within-GB/international); (ii) illicit; and (iii) home-brewed sources in the past 6 months., Results: Between October 2020 and August 2023, the proportion reporting cross-border alcohol purchases increased (from 8.5% to 12.5% overall; prevalence ratio [PR] = 1.47 [95% CI 1.17-1.86]). This was largely driven by an increase in cross-border purchases abroad (PR = 1.52 [1.13-2.05]), with a smaller, uncertain increase in cross-border purchases within GB (PR = 1.37 [0.96-1.95]). The prevalence of cross-border alcohol purchasing was higher in Wales (13.8% [12.3-15.4%]) and Scotland (6.1% [5.4-6.8%]) than England (3.6% [3.3-3.9%]). There was little change in illicit alcohol purchasing in England or Wales (4.1% [3.7-4.4%]; 4.2% [3.2-5.1%]), but in Scotland it fell from 5.7% to 2.4% (PR = 0.42 [0.19-0.81]). Home-brewed alcohol was rare (GB: 3.1% [2.9-3.4]) and stable., Discussion and Conclusions: The proportion of increasing/higher-risk drinkers in GB purchasing cross-border alcohol increased between October 2020 and August 2023, due to an increase in people buying alcohol abroad. Cross-border alcohol purchases within GB were more commonly reported in Wales and Scotland. The small proportion purchasing illicit alcohol did not change substantially in England or Wales, but fell by half in Scotland., (© 2024 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)

Background: Wastewater analysis provides a complementary measure of alcohol use in whole communities. We assessed absolute differences and temporal trends in alcohol consumption by degree of remoteness and socioeconomics indicators in Australia from 2016 to 2023., Methods: Alcohol consumption estimates from 50 wastewater treatment plants (WWTP) in the Australian National Wastewater Drug Monitoring Program were used. Trends were analysed based on 1) site remoteness: Major Cities, Inner Regional and a combined remoteness category of Outer Regional and Remote, and 2) using two socioeconomic indexes from the Australian Bureau of Statistics (ABS) relating to advantage and disadvantage for Income, education, occupation, and housing., Results: Consumption estimates were similar for Major Cities and Inner Regional areas (14.3 and 14.4L/day/1000 people), but significantly higher in Outer Regional and Remote sites (18.6L/day/1000 people). Consumption was decreasing in Major cities by 4.5% annually, Inner Regional by 2.4%, and 3.5% in the combined Outer Regional and Remote category. Consumption estimates were higher in socioeconomically advantaged quartiles than those of lower advantage (0%-25% mean = 13.0, 75%-100% mean = 17.4). Consumption in all quartiles decreased significantly over the 7 year period with annual rates of decrease of 0.9%, 3.7%, 3.6%, and 3.0% for the lowest to highest quartile, respectively., Conclusions: Declines in Australian alcohol consumption have been steeper in large urban areas than regional and remote areas. There were smaller annual decreases in the most socioeconomically disadvantaged areas. If continued, these trends may increase Australian health inequalities. Policy and prevention work should be appropriately targeted to produce more equitable long-term outcomes., Competing Interests: Declaration of Competing Interest The study sponsor had no role in analysis and interpretation of data; writing the report; and the decision to submit the report for publication., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Introduction: This study investigated the prevalence of past 30-day cannabis use among U.S. youth by cigarette use, alcohol use, demographics, and state-of-residence cannabis legal status in 2021 and examined whether changes in cannabis use prevalence were modified by these factors from 2013 to 2021., Methods: Data were drawn from the 24 states that collected cannabis use data participating in the Youth Risk Behavior Surveillance System from 2013 to 2021. Logistic regression analyses estimated past 30-day cannabis prevalence in 2021 and produced AORs by current cigarette, alcohol, and state-of-residence cannabis legal status. The same method was used with year as the exposure, adjusting for sex, race, and ethnicity, to assess trends in prevalence from 2013 to 2021., Results: In 2021, cannabis use was more common among female youth (16.75% vs 13.83% [AOR=1.26, 95% CI=1.16, 1.37]) and non-Hispanic Black and Hispanic youth than among non-Hispanic White youth (17.19%, 16.14% vs 14.60% [AOR=1.25, 95% CI=1.12, 1.39 and AOR=1.16, 95% CI=1.04, 1.29, respectively]). Cannabis use was much more common among youth who reported any past 30-day cigarette or alcohol use (44.90% vs 6.48% [AOR=11.80, 95% CI=10.57, 13.18]). Declines in cannabis use were observed independent of state-level cannabis law from 2013 to 2021, and cannabis use prevalence did not differ significantly by state-of-residence cannabis legal status among the 24 participating states in 2021., Conclusions: Public health officials should carefully consider the potential impact of expanding commercialization of cannabis as a wellness product on youth cannabis use, especially with regard to minoritized populations and co-use with tobacco and alcohol. National and state-level public health education on cannabis use and youth-oriented prevention of cannabis uptake are long overdue., (Copyright © 2024 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Aims: The aim of the present study was to assess the relationship between adolescent IQ and midlife alcohol use and to explore possible mediators of this relationship., Methods: Study data were from 6300 men and women who participated in the Wisconsin Longitudinal Study of high-school students graduating in 1957. IQ scores were collected during the participants' junior year of high school. In 2004, participants reported the number of alcoholic beverages consumed (past 30 days) and the number of binge-drinking episodes. A multinomial logistic regression was conducted to determine the relationship between adolescent IQ and future drinking pattern (abstainer, moderate drinker, or heavy drinker), and Poisson regression was used to examine the number of binge-drinking episodes. Two mediators-income and education-were also explored., Results: Every one-point increase in IQ score was associated with a 1.6% increase in the likelihood of reporting moderate or heavy drinking as compared to abstinence. Those with higher IQ scores also had significantly fewer binge-drinking episodes. Household income, but not education, partially mediated the relationship between IQ and drinking pattern., Conclusions: The present study suggests that higher adolescent IQ may predict a higher likelihood of moderate or heavy drinking in midlife, but fewer binge-drinking episodes. The study also suggests that this relationship is mediated by other psychosocial factors, specifically income, prompting future exploration of mediators in subsequent studies., (© The Author(s) 2024. Medical Council on Alcohol and Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Prior studies have linked fall-related emergency department (ED) visits among older adults to alcohol use. Characteristics related to falls in the working age population (WAP; 15-64 years) may vary with alcohol and substance use. This study aimed to identify factors associated with fall-related ED visits related to alcohol and substance use in the WAP., Method: Using nationally representative 2019-2020 National Hospital Ambulatory Medical Care Survey data, fall-related ED visits within 72 hours were stratified by indication of alcohol use, substance use, and concurrent alcohol and substance use. Descriptive statistics accounting for the survey's complex design were used along with multivariable logistic regression to identify associated factors., Results: Between 2019 and 2020, an estimated 10,800,000 fall-related ED visits occurred among the WAP, with 51.7% related to alcohol use, substance use, or both. Multivariable logistic regression analysis revealed that the WAP with fall-injury ED visits were associated with alcohol use (adjusted odds ratio [AOR] = 2.3, 95% CI [1.0, 5.9]) or concurrent alcohol and substance use (AOR = 8.5, 95% CI [1.6, 43.0]), and individuals with alcohol and substance use with a depression diagnosis are twice as likely to visit EDs with fall injuries., Conclusions: Individuals with alcohol and substance use with depression were twice as likely to visit EDs for fall injuries. Higher fall-related ED visits in the WAP were attributed to alcohol and substance use. Identified factors could improve injury prevention and timely intervention among the WAP in the United States.

Introduction: Acute alcohol toxicity is a significant component of alcohol-related mortality. The study aimed to: (i) determine the circumstances of death and characteristics of fatal alcohol toxicity cases, 2011-2022; (ii) determine their toxicological profile and major autopsy findings; and (iii) determine trends in population mortality rates., Methods: Retrospective study of acute alcohol toxicity deaths in Australia, 2011-2022, retrieved from the National Coronial Information System., Results: A total of 891 cases were identified, with a mean age of 49.2 years, 71.0% being male. Alcohol use problems were noted in 71.3%. In 57.5% death was attributed solely to acute alcohol toxicity, and combined acute alcohol toxicity/disease in 42.5%. There was evidence of sudden collapse in 24.9% of cases. The mean BAC was 0.331 g/100 mL (range 0.107-0.936), and spirits were the most commonly reported beverages (35.8%). Cases of combined toxicity/disease had significantly lower BACs than those attributed solely to alcohol toxicity (0.296 vs. 0.358 g/100 mL). Cardiomegaly was diagnosed in 32.5%, and severe coronary artery disease in 22.1%. Aspiration of vomitus was noted in 18.0%, and chronic obstructive pulmonary disease in 19.6%. Severe liver steatosis was present in 33.4% and 13.6% had cirrhosis. There was an average annual percentage increase in deaths of 7.90., Discussion and Conclusions: The 'typical' case was a long-standing, heavy spirits drinker. BACs showed enormous variation and no arbitrary concentration may be deemed lethal. Clinically significant disease was associated with death at a lower BAC and people with such disease may be at increased risk of alcohol poisoning., (© 2024 Australasian Professional Society on Alcohol and other Drugs.)

Objective: Governments generate substantial revenue from the distribution and sale of alcoholic beverages. However, the use of this alcohol results in considerable public costs for health care, criminal justice, and economic loss of production. Because comparisons of these two sides of the same coin are limited, this study aims to estimate this net alcohol surplus or deficit in Canada and each province/territory for a 14-year study period., Method: Net government revenue from alcohol sales and net social costs of alcohol use were estimated for Canada and each province/territory for all years of study from 2007 to 2020, and all dollar figures were Consumer Price Index-adjusted to 2020 Canadian dollars (CAD). The net alcohol surplus/deficit was estimated as the difference. Per capita recorded alcohol sold was from administrative sources and used as proxy to calculate alcohol used by adding an estimate of unrecorded use and converting to Canadian standard drinks (CSDs). The per-drink net deficit was the net deficit divided by CSDs., Results: In Canada in 2020, governments generated CAD $13.3 billion in revenue from alcohol sales, but this was offset by $19.7 billion in social costs attributable to alcohol use. This "alcohol deficit" increased by 122.0% in real-dollar terms over the study period and reached a high of $6.4 billion in 2020. In 2020, the magnitude of the alcohol used in Canada was 16.8 billion CSDs. Each of these drinks resulted in a public net deficit of $0.379., Conclusions: Both alcohol use and the resulting public alcohol deficit are high in Canada. To mitigate these losses to the well-being of Canadians and their economy, government planners, regulators, and policymakers must urgently deploy evidence-based alcohol policies toward reducing the magnitude of alcohol used in Canada.

Background: In recent years, the online gambling market has rapidly developed, and betting has become one of the most popular forms of gambling. The aim of this study was to analyse the interest of the Malawian population in terms related to betting, sports betting, alcohol, cigarettes, and some psychoactive drugs through the relative search volumes of Google Trends., Methods: Internet search query data related to betting, sports betting, alcohol, cigarettes, and psychoactive drugs were obtained monthly from Google Trends for the period 2010-2022. Comparisons of interest levels in these topics were conducted in Malawi, and correlation coefficients were calculated., Results: In Malawi, relative search volumes for betting and sports betting terms were the highest (average RSVs: 66% and 30%). It was found that from 2019 onwards, the interest in betting and sports-related search topics and keywords increased significantly (p < 0.001). Strong positive correlations were found between betting-related keywords and alcohol and gross domestic product (r = 0.831 and r = 0.901, p < 0.001). A positive correlation was found between betting and psychoactive drug-related terms (minimum r = 0.417, p < 0.01)., Conclusions: This study concludes that the interest of the Malawian population in betting has increased in recent years, while interest in psychoactive drugs and alcohol remains high. Gross domestic product is highly correlated with society's interest in betting. It was additionally found that Google Trends can be used as a tool to predict and monitor future risky behaviours, such as gambling disorder., Competing Interests: The authors has no relevant financial or non-financial interests to disclose., (© 2024 Kamuzu University of Health Sciences.)

Introduction. Alcohol is the most widely used drug worldwide. Medical students should be aware of its possible harmful properties although they are known to consume large amounts of alcohol. Therefore analysis of their drinking patterns is important for public health. Aim of the study. Analysis of alcohol consumption patterns among Polish medical universities students. Material and methods. Students of different Polish medical universities were asked to fill a self-prepared survey on alcohol consumption. 852 fulfilled questionnaires were gathered. The statistical analysis was performed with Statistica 13 (Statsoft, USA). Results. 99.19% of students (N=860) have declared trying alcohol. 35,35% (N=304) of respondents declared the age of first alcohol consumption as between 15 and 18 years. 31,28% (N=269) of respondents admitted drinking once a week, (27,33%, N=235) twice a week. Beer was pointed as the most frequently consumed alcohol – (51,28%, N=441). 241 students (28,02%) admitted participating in classes under the influence of alcohol. Conclusions. Study reveals some risky alcohol drinking behavior, for example attending classes under the influence of alcohol. During classes they often have contact with patients therefore it can be really dangerous tendency.

Aim: This article presents cross-sectional data collected from the population of first-year students at the University of Warmia and Mazury in Olsztyn in 2000-2016. The aim of the study was to investigate changes in the following trends among university students after Poland's accession to the European Union (2004): (1) alcohol consumption, (2) alcoholic beverage preferences, and (3) attitudes towards alcohol. Method: The study relied on data from anonymous surveys conducted every two years between 2000 and 2016 among a representative sample of first-year university students. A total of 9778 individuals (4264 males and 5514 females) completed anonymous questionnaires during the period under analysis. Statistical analyses were performed by comparing the frequency of answers given by male and female students in the first and last year of the study. Results: There was a steady linear decrease in the percentages of abstainers of both genders and a regular linear increase in the number of female students abusing alcohol to blackout level in the analysed period of 2000 to 2016. The respondents' preferences for alcohol brands became more diversified (with foreign types of strong liquors becoming more popular), and their attitudes towards alcohol availability on campus were liberalised. Conclusions: Our data complement the gaps in empirical research on alcohol consumption among university students in European countries. They point to greater homogenisation of Polish drinking culture and convergence in male and female drinking behaviours. [ABSTRACT FROM AUTHOR]

It has been estimated that alcohol, tobacco, and illicit drugs were responsible for more than 10 million deaths worldwide in 2016, and there are many opportunities for improvement. Regarding innovative data analysis, advances have been made in the extraction of information from administrative databases for analytics purposes. We studied trends in hospitalization rates for alcohol and drug abuse over eleven years with Joinpoint Trend Analysis software. This is a descriptive study of cross-associations in 3,758 hospital admissions of patients admitted with a main diagnosis of alcohol and drug abuse or dependence in psychiatry units of public health centres of Castilla y León (Spain) between 2005 and 2015. Hospitalization trends for alcohol and drug related conditions declined over the eleven-year period. Separately, there was a statistically significant decrease in alcohol and cocaine related conditions, but a strong upward trend in cannabis related conditions between 2013 and 2015. Alcohol was the main cause of admission to psychiatric units with a diagnosis of addiction. In the 11 years researched, there was a progressive and constant reduction in admissions for substance use except for cannabis. The innovative statistical methodology has already proven to be useful for identifying trends and changes in different pathologies over time.

British supermarket-panel data suggest no increases in overall sales and purchases of alcohol following COVID-19 lockdowns, yet survey and mortality data suggest otherwise. This paper attempts to unravel the paradox. Based on purchase data of 79,417 British households from Kantar Worldpanel, we undertake controlled interrupted time series analysis of the impact of COVID-19 confinement introduced on 23rd March 2020, and variably applied during 2020, compared to purchases during 2015 to 2019 as controls. We also undertook Poisson regression analyses to estimate if changes in purchases differed by household socio-demographic and economic factors. Excess off-trade household alcohol purchases (expressed as grams of ethanol) following the introduction of confinement, were 29.2% higher (95% CI = 25.8% to 32.5%) for the post-confinement months of 2020, being larger until mid-July 2020 (37.5%, 95%CI = 33.9 to 41.26%) when pubs re-opened with restrictions, and smaller (24.6%, 95%CI = 21.6 to 27.7) thereafter. During the time of complete pub closures, and fully adjusting for no on-trade purchases, household purchases of alcohol did not change when compared with the same time period during 2015-2019 (coefficient = -0.9%, 95%CI = -5.6 to 3.8). Excess purchases from 23rd March to 31st December 2020 varied by region of Great Britain, being higher in the north of England, and lower in Scotland and Wales. Excess purchases were greater in the most deprived households, compared with the least deprived households. Excess purchases increased substantially as the amount of alcohol normally purchased by a household increased, with the top one fifth of households that normally bought the most alcohol increasing their purchases more than 17 times than the bottom one fifth of households that bought the least alcohol. That the heaviest buyers of alcohol increased their purchases the most, with some independent impact of socio-economic disadvantage, might explain why reported alcohol problems and recent alcohol-related death rates might have increased. A conclusion of this is that alcohol policy to reduce high consumption of alcohol, and the availability of help and treatment to reduce alcohol consumption become more important during extraordinary times, such as COVID lockdowns., Competing Interests: E.J.L., A.O.’D. and E.K. declare no competing interests and declare no financial relationships with any organizations that might have an interest in the submitted work in the previous three years. Within the previous five years, P.A. has received financial support from AB InBev Foundation outside the submitted work, which does not alter our adherence to PLOS ONE policies on sharing data and materials.

This study aims to establish a biological age (BA) predictor and to investigate the roles of lifestyles on biological aging. The 14,848 participants with the available information of multisystem measurements from the Dongfeng-Tongji cohort were used to estimate BA. We developed a composite BA predictor showing a high correlation with chronological age (CA) (r = 0.82) by using an extreme gradient boosting (XGBoost) algorithm. The average frequency hearing threshold, forced expiratory volume in 1 second (FEV 1 ), gender, systolic blood pressure, and homocysteine ranked as the top five important features for the BA predictor. Two aging indexes, recorded as the AgingAccel (the residual from regressing predicted age on CA) and aging rate (the ratio of predicted age to CA), showed positive associations with the risks of all-cause (HR (95% CI) = 1.12 (1.10-1.14) and 1.08 (1.07-1.10), respectively) and cause-specific (HRs ranged from 1.06 to ∼1.15) mortality. Each 1-point increase in healthy lifestyle score (including normal body mass index, never smoking, moderate alcohol drinking, physically active, and sleep 7-9 h/night) was associated with a 0.21-year decrease in the AgingAccel (95% CI: -0.27 to -0.15) and a 0.4% decrease in the aging rate (95% CI: -0.5% to -0.3%). This study developed a machine learning-based BA predictor in a prospective Chinese cohort. Adherence to healthy lifestyles showed associations with delayed biological aging, which highlights potential preventive interventions., (© 2021 New York Academy of Sciences.)

Aim: Investigate changes in alcohol use and related harm using the first multisite, controlled, longitudinal study of Managed Alcohol Programs (MAPs). MAPs provide regular doses of alcohol, accommodation, social supports and healthcare to unstably housed people with alcohol dependence., Methods: A multisite, quasi-experimental, longitudinal study was conducted in day centres, shelters and residential programs for unstably housed people. There were 59 MAP participants from six Canadian cities and 116 local controls. Self-reported alcohol consumption and harms were assessed at 0-2, 6 and 12 months. Liver function test results were accessed for MAP participants., Results: Both groups had similar reductions in mean drinks per day (MAP: -8.11; controls: -8.54 controls, P < 0.001) and days drinking per month (MAP: -2.51 days, P < 0.05; control: -4.81 days, P = 0.0001) over 6--12 months. Both reduced non-beverage alcohol consumption. MAP participants reported significantly fewer harms at both 0-2 and 6 months than controls. MAP participants had similar total consumption to controls, but spread out over more days (25.41 versus 19.64 days per month, P = 0.001). After leaving a MAP, participants' liver status deteriorated, with increases in both aspartate transaminase and bilirubin levels. MAP sites with effective policies on outside drinking drank less and had fewer harms., Conclusion: MAP participants drank less hazardously than controls, especially with effective management of non-MAP drinking. Reductions in alcohol use and harms occurred for both groups, although MAP participants reported fewer harms at 0-6 months. Departing an MAP was associated with deterioration in liver status. Although providing stable housing, MAPs did not worsen health or increase alcohol use., (© The Author(s) 2021. Medical Council on Alcohol and Oxford University Press. All rights reserved.)

Alcohol consumption and smoking pose a significant risk for esophageal squamous cell neoplasia (ESCN) development in males; however, ESCN is often diagnosed in non-drinking and non-smoking females. The mechanisms underlying these differences remain elusive, and understanding them can potentially identify novel pathways involved in ESCN development. We performed short-read sequencing to identify somatic variants on a cancer panel targeting 409 genes using DNA extracted from the superficial squamous cell carcinoma (ESCC) tissues and adjacent non-neoplastic epithelium (NE), and immunohistochemical staining of the protein encoded by the target gene. All male patients (n = 117) were drinkers or smokers, whereas 45% of the female patients (n = 33) were not. Somatic variants were compared among three age-matched groups: 13 female ESCC patients with smoking and drinking habits (known-risk group, F-KR), 13 female ESCC patients without these habits (unknown-risk group, F-UR), and 27 males with ESCC and smoking and drinking habits (M-KR). In the NE, the frequencies of CDKN2A variants were significantly higher in F-UR than in F-KR and M-KR. In both ESCC and NE, p14ARF was significantly overexpressed in F-UR than in the other groups. In conclusion, CDKN2A might be important in ESCC development, independent of known risk factors., (© 2021. The Author(s).)

Alcoholism and alcohol abuse can lead to memory loss and cognitive dysfunction. The neuroinflammatory response plays an important role in the neurotoxic mechanism of chronic alcohol exposure. Additionally, the phosphorylation status of the tau protein is closely related to neurotoxicity and synaptic function. As inflammatory cytokines have been shown to regulate tau phosphorylation, in the present study, the aim was to determine whether cognitive impairment caused by chronic alcohol exposure is associated with neuroinflammation and tau hyperphosphorylation in the hippocampus. We established a chronic alcohol exposure model of C57BL/6J mice. The Y maze was used to assess the spatial recognition ability of mice, and ELISA was used to detect the levels of inflammatory cytokines IL-1β and IL-6 in the serum. Immunohistochemical and western blot assays were used to assess the expression levels of IL-1β and IL-6, as well as tau protein and its phosphorylation status in the hippocampus. We also analyzed the mRNA and protein expression of the synapse-associated proteins PSD95 and synaptophysin in the hippocampus. Our results showed that chronic alcohol exposure impaired the spatial recognition ability of mice upregulated the expression of IL-1β and IL-6 in the serum and hippocampus and increased the phosphorylation of tau protein in the hippocampus. In addition, chronic alcohol exposure downregulated PSD95 and synaptophysin protein levels. The present results indicate that hippocampal IL-1β, IL-6, and phosphorylated tau proteins may be involved in the neurotoxic mechanism of chronic alcohol exposure by mediating synaptic dysfunction., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Aims: Restrictions to alcohol availability during the first and second waves of the COVID-19 pandemic in Australia included closures of businesses where alcohol is sold for on-premises consumption (pubs, bars, restaurants and cafes), but not where alcohol is sold for off-premises consumption (take-away and home delivery). This study aimed to compare beer consumption before and after restrictions to alcohol availability during the first and second waves of COVID-19 in Australia., Design: Interrupted time-series analysis., Setting: Australia., Participants: Estimated resident population aged 15+ years., Measurements: Seasonally adjusted estimates of beer per capita consumption measured in litres of alcohol (LALs) per week, disaggregated by on- and off-premises sales., Findings: First-wave restrictions (week beginning 23 March 2020) were associated with a significant immediate reduction in on-premises beer per capita consumption [-0.013 LALs, 95% confidence interval (CI) = -0.013 to -0.012, P = < 0.001], but no significant change in off-premises beer per capita consumption. Partial removal of first-wave restrictions (week beginning 18 May 2020) was associated with a significant immediate increase in on-premises beer per capita consumption (+0.003 LALs, 95% CI = 0.001 to 0.004, P = 0.006), but no significant change in off-premises beer per capita consumption. Second-wave restrictions (week beginning 06 July 2020) were associated with a significant immediate reduction in on-premises beer per capita consumption (-0.004 LALs, 95% CI = -0.006 to -0.002, P = 0.001) but, again, no significant change in off-premises beer per capita consumption., Conclusion: Restricting the availability of on-premises alcohol during the first and second waves of the COVID-19 pandemic in Australia was associated with significant reductions in on-premises beer consumption, but no significant changes in off-premises beer consumption., (© 2020 Society for the Study of Addiction.)

Rationale: Aberrant approach-avoidance conflict processing may contribute to compulsive seeking that characterizes addiction. Exploration of the relationship between drugs of abuse and approach-avoidance behavior remains limited, especially with ethanol., Objectives: To investigate the effects of voluntary ethanol consumption on approach-avoidance conflict behavior and to examine the potential approach/avoidance bias to predict drinking in male and female rats., Methods: Long-Evans rats consumed ethanol for 5 weeks under the intermittent access two-bottle choice (IA2BC) paradigm. Approach-avoidance tendencies were assessed before and after IA2BC drinking using a previously established cued approach-avoidance conflict maze task and the elevated plus maze (EPM)., Results: Female rats displayed higher consumption of and preference for ethanol than males. In the conflict task, males showed greater approach bias towards cues predicting conflict than females. In females only, a median split and regression analysis of cued-conflict preference scores revealed that the more conflict-avoidant group displayed higher intake and preference for ethanol in the first few weeks of drinking. In both sexes, ethanol drinking did not affect cued-conflict preference, but ethanol exposure led to increased time spent in the central hub in the males only. Finally, anxiety levels in EPM predicted subsequent onset of ethanol drinking in males only., Conclusions: Our results highlight sex and individual differences in both drinking and approach-avoidance bias in the face of cued conflict and further suggest that cued-conflict preference should be examined as a potential predictor of ethanol drinking. Ethanol exposure may also affect the timing of decision-making in the face of conflict.

Objective: Little is known about change over time in the prevalence of World Health Organization (WHO) risk drinking levels (very high, high, moderate, low) and their association with health conditions, overall and by gender. The authors used two sets of nationally representative U.S. survey data to determine whether changes over time varied by gender and to examine whether health conditions related to alcohol were associated with WHO risk drinking level within each survey, and whether these associations differed by gender., Methods: Data on current drinkers from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N=26,655) and the 2012-2013 NESARC-III (N=25,659) were analyzed using logistic regression. Prevalence differences between surveys were estimated for each drinking level overall and by gender. Within each survey, prevalence differences by WHO risk drinking level were estimated for alcohol use disorder (AUD), drug use disorders, functional impairment, liver disease, and depressive and anxiety disorders., Results: In the 2012-2013 survey, the prevalences of moderate, high, and very high risk drinking were 5.9%, 3.2%, and 3.5%, respectively, representing significant increases from the prevalences in the 2001-2002 survey, which were 1.0%, 0.6%, and 0.9%, respectively. The increase for very high risk drinking among men (0.5%) was smaller than the increase among women (1.4%). Within both surveys, compared with low risk, health conditions were significantly associated with very high risk (range of prevalence differences, 2.2%-57.8%), high risk (2.6%-41.3%), and moderate risk (0.6%-29.8%) drinking. Associations were similar by gender, except that there were stronger effects for AUD in men and for functional impairment and depressive and anxiety disorders in women., Conclusions: The increase in potentially problematic drinking levels among U.S. adults emphasizes the need for better prevention and treatment strategies. The study results support the validity of the WHO risk drinking levels, which show clinical utility as nonabstinent drinking reduction treatment goals. Such goals could engage more people in treatment, improving public health by decreasing personal and societal consequences of risk drinking.

Background: Before the COVID-19 pandemic, very little was known about the impact of social isolation on individuals' alcohol use and misuse. This study examines how socially isolated individuals with a history of heavy drinking used alcohol during the pandemic., Methods: Data for this study came from an add-on to the Managing Heavy Drinking (MHD) longitudinal study of drivers convicted of DWI that was conducted in Erie County, New York. Pre-COVID information (October 2019-March 2020) was augmented with a COVID-19 questionnaire collected between July and August 2020. A total of 92 participants completed the COVID-19 survey., Results: The sample of problem drinkers showed a significant increase after the pandemic outbreak in the average number of drinking days from 1.99 to 2.49 per week (p = 0.047), but a significant decrease in the average number of drinks per drinking day, from 3.74 to 2.74 (p = 0.003). The proportion of individuals who drank more frequently was greater among those who, before the outbreak had an Alcohol Use Disorders Identification Test (AUDIT) score <8 (26% increase) compared with those with an AUDIT score of >8 (13%). Alcohol treatment was also associated with the frequency of drinking, with individuals who were not in alcohol treatment showing a 16% increase in frequency compared with a 10% increase among those in treatment. Further, individuals who, after the outbreak worried about their health (30%) or finances (37%) reported greater increases in the frequency of drinking than those who did not worry about their health (17%) or finances (10%)., Conclusions: Overall, the individuals in our sample showed small changes in the frequency andheaviness of drinking after the outbreak of COVID-19, effects that opposite in direction from one another and thus resulted in no overall change in drinks consumed. Nonetheless, we identified factors that influenced the effects of the pandemic on drinking behavior among individuals convicted of DWI, which emphasizes the need to individualize these individuals' treatment, particularly in the context of dramatic environmental change., (© 2021 by the Research Society on Alcoholism.)

Aim: To assess the effects of social distancing and social isolation policies triggered by COVID-19 on alcohol consumption using wastewater analysis in Adelaide, South Australia., Design: Longitudinal quantitative analysis of influent wastewater data for alcohol concentration., Setting: Adelaide, South Australia., Participants: Wastewater catchment area representative of 1.1 million inhabitants., Measurements: Twenty-four hour composite influent wastewater samples were collected from four wastewater treatment plants in Adelaide, South Australia for 7 consecutive days (Wednesday-Tuesday) every 2 months from April 2016-April 2020. The alcohol metabolite ethyl sulfate was measured in samples using chromatography-tandem mass spectrometry. Data were population-weighted adjusted with consumption expressed as standard drinks/day/1000 people. Weekly consumption and weekend to mid-week consumption ratios were analysed to identify changes in weekday alcohol use pattern., Findings: Estimated weekend alcohol consumption was significantly lower (698 standard drinks/day/1000 people) after self-isolation measures were enforced in April 2020 compared with the preceding sampling period in February 2020 (1047 standard drinks/day/1000 people), P < 0.05. Weekend to midweek consumption ratio was 12% lower than the average ratio compared with all previous sampling periods. April 2020 recorded the lowest alcohol consumption relative to April in previous years, dating back to 2016., Conclusions: Wastewater analysis suggests that introduction of social distancing and isolation policies triggered by COVID-19 in Adelaide, South Australia, was associated with a decrease in population-level weekend alcohol consumption., (© 2020 Society for the Study of Addiction.)

Background and Aim: The effect of the COVID-19 pandemic on alcohol consumption is currently unclear. This study aimed to provide early estimates of how stress and demographics will interact with shifts in harmful alcohol consumption from before the COVID-19 outbreak to 2 months into social distancing., Design: Cross-sectional convenience sample., Setting: Australia., Participants: A total of 1684 Australians aged 18-65 years who drink at least monthly., Measurements: Items from the Alcohol Use Disorders Identification Test (AUDIT) and the stress subscale of the Depression Anxiety and Stress Scale (DASS)., Findings: Overall, harmful drinking decreased during social distancing measures in our sample [2019 score = 8.2, 95% confidence interval (CI) = 7.9-8.4; during the pandemic = 7.3, 95% CI = 7.1-7.6]. Younger drinkers, particularly young women, decreased their consumption the most, but there was a small increase in consumption in middle-aged women. Drinkers experiencing high levels of stress also reported a relatively higher shift in harmful consumption compared with those with low levels of stress (β = 0.65, P = 0.003), despite reporting a small decrease overall., Conclusions: The closure of licensed premises and social distancing measures in Australia in response to the COVID-19 outbreak appear to have reduced harmful alcohol consumption in younger drinkers, particularly young women., (© 2020 Society for the Study of Addiction.)

Background: Depression has been associated with decreased regional grey matter volume, which might partly be explained by an unhealthier lifestyle in depressed individuals which has been ignored by most earlier studies. Also, the longitudinal nature of depression, lifestyle and brain structure associations is largely unknown. This study investigates the relationship of depression and lifestyle with brain structure cross-sectionally and longitudinally over up to 9 years., Methods: We used longitudinal structural MRI data of persons with depression and/or anxiety disorders and controls (N unique participants  = 347, N observations  = 609). Cortical thickness of medial orbitofrontal cortex (mOFC), rostral anterior cingulate cortex (rACC) and hippocampal volume were derived using FreeSurfer. Using Generalized Estimating Equations, we investigated associations of depression and lifestyle (Body mass index (BMI), smoking, alcohol consumption, physical activity and sleep duration) with brain structure and change in brain structure over 2 (n = 179) and 9 years (n = 82)., Results: Depression status (B = -.053, p = .002) and severity (B = -.002, p = .002) were negatively associated with rACC thickness. mOFC thickness was negatively associated with BMI (B = -.004, p < .001) and positively with moderate alcohol consumption (B = .030, p = .009). All associations were independent of each other. No associations were observed between (change in) depression, disease burden or lifestyle factors with brain change over time., Conclusions: Depressive symptoms and diagnosis were independently associated with thinner rACC, BMI with thinner mOFC, and moderate alcohol consumption with thicker mOFC. No longitudinal associations were observed, suggesting that regional grey matter alterations are a long-term consequence or vulnerability indicator for depression but not dynamically or progressively related to depression course trajectory., Competing Interests: Declaration of Competing Interest BP has received (non-related) research grants from Boehringer Ingelheim and Jansen Research. None of the other authors declare conflicts of interest., (Copyright © 2021. Published by Elsevier Inc.)

Changes in endothelial function may contribute to the positive and negative effects of alcohol consumption on cardiovascular conditions, such as hypertension and coronary artery disease. Numerous studies have used brachial artery flow-mediated dilation (FMD) to examine the effects of alcohol consumption on endothelial function in humans. However, the findings are inconsistent and may be due to multiple factors such as heterogeneity in subject characteristics, the alcohol use pattern, and amount/dose of alcohol consumed. Therefore, the aim of this systematic review was to investigate the effect of alcohol consumption on brachial artery FMD in humans considering the above-mentioned factors. This review found that while light to moderate alcohol consumption may have minimal effects on FMD, heavy alcohol consumption was associated with a decrease in FMD. However, most of the published studies included healthy, younger, and male individuals, limiting generalizability to other populations. Future studies should include more women, older subjects, and those from diverse and underrepresented backgrounds., (© 2021 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Aims: The global crisis caused by the outbreak of a novel coronavirus rapidly increased working remotely in many countries. The aim of this study was to analyze psychological stressors predicting increased drinking during the COVID-19 crisis. Also, individual and socio-demographic differences were analyzed., Methods: A nationally representative sample of Finnish workers (N = 1308) was collected before the crisis in September-October 2019 and 82.02% of them responded to a follow-up survey conducted in March-April 2020. Increased drinking was the outcome variable and it was measured with the AUDIT-C before and during the COVID-19 crisis. Predictors measured before the crisis included cyberbullying victimization at work, psychological distress, burnout and work climate. Additional measures included personality factors, socio-demographic factors and occupational information., Results: One-fourth of Finnish workers (25.37%) reported increased drinking during the COVID-19 crisis. Cyberbullying victimization at work and psychological distress before the crisis predicted increased drinking during the crisis. Conscientious workers and those working in educational and health and welfare sectors were less likely to increase drinking, while increased drinking was most common among workers under 30 years of age., Conclusions: Psychological stressors are risk factors for increased drinking in unusual times such as the COVID-19 crisis. Cyberbullying victimization at work and psychological distress were found as major risk factors. The results suggest that preventive work should be done at workplaces. This is particularly important if alcohol consumption is used as a means of coping during a stressful time., (© The Author(s) 2020. Medical Council on Alcohol and Oxford University Press. All rights reserved.)

Objective: Cannabis and alcohol use are correlated behaviors among youth. It is not known whether discontinuation of cannabis use is associated with changes in alcohol use. This study assessed alcohol use in youth before, during, and after 4 weeks of paid cannabis abstinence., Methods: Healthy, non-treatment seeking, cannabis users (n = 160), aged 14-25 years, 84% of whom used alcohol in the last month, were enrolled for a 4-week study with a 2-4 week follow-up. Participants were randomly assigned to 4 weeks of either biochemically-verified cannabis abstinence achieved through a contingency management framework (CB-Abst) or monitoring with no abstinence requirement (CB-Mon). Participants were assessed at baseline and approximately 4, 6, 10, 17, 24, and 31 days after enrollment. A follow-up visit with no cannabis abstinence requirement for CB-Abst was conducted after 2-4 weeks., Results: Sixty percent of individuals assigned to the CB-Abst condition increased in frequency and quantity of alcohol consumption during the 4-week period of incentivized cannabis abstinence. As a whole, CB-Abst increased by a mean of 0.6 drinking days and 0.2 drinks per day in the initial week of abstinence (p's < 0.006). There was no evidence for further increases in drinking frequency or quantity during the 30-day abstinence period (p's > 0.53). There was no change in drinking frequency or quantity during the 4-week monitoring or follow-up periods among CB-Mon., Conclusions: On average, 4 weeks of incentivized (i.e., paid) cannabis abstinence among non-treatment seeking youth was associated with increased frequency and amount of alcohol use in week 1 that was sustained over 4 weeks and resolved with resumption of cannabis use. However, there was notable variability in individual-level response, with 60% increasing in alcohol use and 23% actually decreasing in alcohol use during cannabis abstinence. Findings suggest that increased alcohol use during cannabis abstinence among youth merits further study to determine whether this behavior occurs among treatment seeking youth and its clinical significance., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: The SARS-CoV-2 pandemic created disruptions and stressors which may have influenced alcohol consumption frequency trends. Varying COVID-19 health burden and alcohol policies may have contributed to different consumption trends between states. The aim of this study is to assess trends in alcohol consumption and moderation by state of residence., Methods: We examined trends in adult drinking days, during the first wave of the pandemic (March 10 to June 8) using longitudinal data from the Understanding America Study (N = 6,172 unique participants; N = 28,059 observations). Because state mandates were responsive to disease burden, we modeled the interaction of time by COVID-19 burden, defined as whether the state had the median (or higher) daily incidence of COVID-19 cases on the survey date, and state random effects. We controlled for individual sociodemographics, perceived personal/familial COVID-19 burden, mental health symptomology, and risk avoidance., Results: Drinking days increased throughout the duration (incidence risk ratio [IRR] for drinking per increase in one calendar day = 1.003, 95% CI 1.001, 1.004); trends were heterogeneous by disease burden, with individuals living in states with lower COVID-19 burden increasing (IRR = 1.005, 95% CI 1.003, 1.007) faster than those living in states with higher COVID-19 burden (IRR = 1.000, 95% CI 0.998, 1.002). Trends were heterogeneous between states, but there was no evidence of systematic geographic clustering of state trends., Conclusions: Drinking days increased during the first months of the COVID-19 pandemic, particularly among residents of states with lower disease burden., (© 2021 by the Research Society on Alcoholism.)

Background: Heavy alcohol consumption often co-occurs with mental health problems; this could be due to confounding, shared biological mechanisms, or causal effects. Polygenic risk scores (PRS) for alcohol use can be used to explore this association at critical life stages., Design: We characterized a PRS reliably associated with patterns of adult alcohol consumption by 1) validating whether it predicts own alcohol use at different life-stages (pregnancy, adolescence) of interest for mental health impact. Additionally, we explored associations of alcohol PRS on mental health phenotypes 2) within-individuals (using own alcohol PRS on own phenotypes) and 3) intergenerationally (using maternal alcohol PRS on offspring phenotypes). We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 960-7841). Additional substance abuse behaviors and mental health/behavioral outcomes were investigated (alcohol phenotypes n = 22; health phenotypes n = 91)., Findings: Maternal alcohol PRS was associated with consumption during pregnancy (strongest signal: alcohol frequency at 18 weeks' gestation: β = 0.041, 95%CI = 0.0.02-0.06), p = 1.01 × 10 -5 , adjusted R 2  = 1.6 %), offspring alcohol PRS did not predict offspring alcohol consumption. We found evidence for an association of maternal alcohol PRS with own perinatal depression (OR  = 1.10, 95% CI = 1.02 to 1.18, p = 0.022) and decreased offspring intellectual ability (β=-0.209, 95% CI -0.38 to -0.04, p= 0.016)., Conclusions: These alcohol PRS are a valid proxy for maternal alcohol use in pregnancy. Offspring alcohol PRS was not associated with drinking in adolescence. Consistently with results from different study designs, we found evidence that maternal alcohol PRS are associated with both prenatal depression and decreased offspring intellectual ability., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: In Thailand, alcohol is consumed in social setting. The Thai government introduced a ban on alcohol sales and other measures at the beginning of COVID-19 lockdown with gradual lifts. However, drinking behaviors, behaviors of community members, and alcohol marketing activities during the ban and lifts have not been described., Methods: We contracted a survey research firm to conduct four phone-based cross-sectional surveys between April and July 2020 (n = 6239 participants in total). Participants were recruited from all regions and Bangkok. We also summarized alcohol control measures as reported by multiple sources. We analyzed data from Waves 1 thru 4 using descriptive statistics with adjustment for sampling weight., Results: A total of 6239 persons participated in the 4 waves of surveys. Among survey respondents who were drinkers, half did not drink alcohol during the alcohol sale ban while one-third reported drinking less than usual in the past 30 days. Almost no participant reported drinking more than usual. During the ban (Wave 1), one-sixth of respondents noticed social drinking in their areas while less than 6 percent reported witnessing alcohol sale. Online parties were the predominant alcohol marketing activity, but became less common during Wave 3 compared to Wave 2., Discussion and Conclusions: Ever drinkers either abstained from alcohol or drank less than usual during the ban on alcohol sale. However, social drinking and alcohol sale persisted despite the ban., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Sexual and gender minority (SGM) young persons are experiencing compounding effects of COVID-19 due to unique social inequalities and existent mental health and substance use challenges. Given that 41% of all young persons are enrolled in universities, and the increased vulnerabilities faced by SGM young persons during the pandemic, it is imperative to understand the effects of alcohol use on mental health among SGM university students amid COVID-19. This study aims to examine the associations between changes in alcohol use since the start of COVID-19 and mental distress among SGM university students in the U.S., and to explore sex-stratified differences., Methods: A nonprobability cross-sectional sample of 509 SGM university students (M age = 22.04 years, SD = 3.99) were retrospectively surveyed online between May-August 2020 and asked if their alcohol use had changed since the start of COVID-19. Statistical analyses explored the association between changes in alcohol use since the start of COVID-19 and mental distress., Results: Average psychological distress (M = 27.79, SD = 7.82) was relatively high as per existing research and established clinical cutoff scores. Roughly 32% had increased alcohol use since the start of COVID-19. Subsequently, greater alcohol use (p < .05) since the start of COVID-19 was associated with higher psychological distress among SGM university students, and among females but not males assigned at birth., Conclusions: Higher education, medical, and behavioral health professionals should consider how to adapt their practice to address alcohol use and psychological burdens among SGM university students (especially females) who are facing health inequities during and beyond COVID-19, requiring SGM-affirmative care., (Copyright © 2021 Elsevier B.V. All rights reserved.)