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In China, approximately 70% of beverage alcohol is consumed in the form of spirits. An estimated 25% of all alcohol consumed is unrecorded, mostly spirits (bai jiu), produced outside regulatory systems in small neighborhood distilleries, mostly in rural areas. Unrecorded bai jiu drinkers are generally older, male, prefer higher-strength bai jiu, and drink daily and mostly at home. To explore possible regional differences, researchers used interview data from 2919 bai jiu drinkers in rural areas in Hebei, Anhui, and Hubei provinces in China. Results confirmed that patterns varied by province. The sample in Hubei preferred unrecorded bai jiu with a more stable preference to alcohol type, tended to drink less frequently, and reported experiencing less drinking pressure, suggesting lower-risk drinking patterns in this region. The Hebei and Anhui sample reported higher frequency and greater amount of alcohol consumption, were more likely to experience drinking pressure, indicating higher-risk patterns in alcohol use in these two regions. The results provide needed details about regional differences in unrecorded bai jiu drinking patterns that are not evident in aggregated data and suggest variations in drinking patterns that may reflect local geography, local values, traditions, and ethnic differences.

Objective: To test if precollege drinking data gathered during an online brief intervention are associated with problems and could inform screening for campus alcohol prevention efforts. Participan...

Background In China, there are approximately 70 million children, nearly 25% of the child population, who are left behind in the care of other family members when their parents migrate to urban areas, for increased economic opportunities. This paper presents a systematic review and a meta-analysis of studies that have examined the phenomenon of depression among these left-behind children (LBC). Methods Six hundred three papers published between 2000 and 2017 were retrieved from five databases (China National Knowledge Infrastructure, Wanfang, Weipu, PubMed, and Web of Science). Results Twenty-one studies (18 in Chinese and 3 in English) met the criteria for inclusion in this meta-analysis. The pooled estimate of depression among LBC was 26.4%. A significant heterogeneity has been found in reported findings, and this heterogeneity was associated with three types of study characteristics, including using an unclear definition of LBC and using invalidated depression instruments, and the geographic location. Conclusions The risk of mental health problems among this large number of LBC suggests the need to quantify the extent and distribution of their mental health state. Implications for methodological improvements for future research have been discussed.

To determine whether completing a pre-enrollment Web-based alcohol brief motivational intervention (BMI) increased student retention and reduced student alcohol-related violations.Fall 2011 (3,364) and Fall 2012 (3,111) entering cohorts of all first-year students at a midwestern state university.Students completing the brief intervention (BI) were compared to students not completing the BI. Retention was tracked for four years for the 2011 cohort and three years for the 2012 cohort. Campus and community alcohol violations were tracked for two academic years following enrollment. Kaplan-Meier survival analysis and Cox regression were used to test retention survival. Logistic regression was used to test campus and community violations.Students in both cohorts who completed the BI had significantly higher retention and significantly fewer alcohol-related violations than noncompleters.Population-level Web-based BIs help prevent student dropout and decrease alcohol-related violations, with impacts extending multiple years. Web-based BI is an efficacious population-level prevention tool.

China’s National Physical Fitness and Health Surveillance(NPFHS)survey revealed high levels of sedentary behavior among primary school-aged children. Sedentary behavior is linked to both short-term and long-term physical and mental health conditions. A comprehensive school health education program was designed and its effectiveness to raise physical activity levels in Grade 4 primary school children was evaluated. Twelve schools(6 of program, 6 of control)from six cities in two economically different provinces were selected. Students at program schools received physical activity instruction both in and out of school. Control schools carried on with their usual level of physical activity for students, as required by national educational standards. Program effectiveness was assessed by comparing students’ physical activity behaviors at pre- and post-program, and by comparing students’ physical activity scores at program schools with students’ scores at control schools. The pre-program survey of students’ behaviors was done at the end of Grade 3, and the post-program survey was done at the end of Grade 4. Multi-level modeling was used to evaluate program effectiveness to allow for missing data. Results from 4472 students showed at pre-program there was no difference in control and program schools’ student physical activity scores. At post-program students in program schools did significantly more physical activity compared to students in control schools. Students in program schools were more physically active after the comprehensive school health education program. A school-based comprehensive health education program would effectively increase children’s physical activity level in China. There is a potential to reduce sedentary behavior among children by implementing school programs that are environmental in nature; that is, activities involve not only the students, but also the school administration, teachers, parents, and community members.

This study examined peer group influence on university student drinking in China and the indirect effects of peer pressure and self-efficacy for alcohol self-regulation. A total of 951 undergraduate university students (first, second and third year) from a university in central China completed questionnaires asking about perceived peer pressures, self-efficacy for alcohol self-regulation, and drinking frequency. Analysis of their answers showed that the drinking frequency among physical education (PE) students was higher than among the comparison group (History students). The PE students perceived greater peer pressure, and had lower self-efficacy for alcohol self-regulation, both of which contributed directly to drinking frequency. Path analysis indicated indirect effects of peer pressure and self-efficacy for alcohol self-regulation on the association between peer group membership and drinking frequency. This suggested that skills training to increase self-efficacy for alcohol self-regulation in culturally-specific settings have the potential to both directly and indirectly lower drinking rates in peer groups with high peer pressure and higher than normal drinking.

Newman, I., Qian, L., Tamrakar, N., Feng, Y., & Xu, G. (2017). Chemical content of unrecorded distilled alcohol (bai jiu) from rural central China: Analysis and public health risk. The International Journal Of Alcohol And Drug Research, 6 (1), 59-67. doi: http://dx.doi.org/10.7895/ijadr.v6i1.236 Aims: To test 47 samples of locally distilled unrecorded beverage alcohol (bai jiu) obtained in rural central China. Methods: Alcohol samples purchased from home-based makers or from small village shops were analyzed for ethanol, methanol, acetaldehyde, ethyl acetate, six higher alcohols, arsenic, cadmium, and lead. Results were judged against the standards for these compounds set by the AMPHORA Project. Findings: Ethanol concentrations ranged from 38.7% to 63.7% (mean 50.4%). Methanol and methyl acetate detected in all samples did not exceed the Alcohol Measures for Public Health Research Alliance (AMPHORA) limits. Acetaldehyde was present in all samples, with three samples exceeding the AMPHORA limit by a small amount. Lead was found in 57.4% of the samples with one sample exceeding the AMPHORA limit; cadmium was found in 89.4% of the samples with two exceeding the AMPHORA limit. Arsenic was found in 46.8% of the samples with none exceeding the AMPHORA limit. Conclusions: The three samples that exceeded AMPHORA limits for cadmium or lead are of concern in terms of the potential of long-term exposure for local people who regularly consume locally made bai jiu. The main health concern from bai jiu appears to be the risk associated with high ethanol concentration—the same health concern as for recorded, commercially produced spirits.

ObjectiveAs part of a national initiative to reduce child obesity, a comprehensive school-based nutrition education intervention to change eating behaviours among grade 4 primary-school students was developed, implemented and evaluated.DesignThe intervention was developed by school staff, with technical assistance from outside health education specialists. The programme included school facility upgrades, school teacher/staff training, curriculum changes and activities for parents. Student scores on nine key eating behaviours were assessed prior to and after the programme. The quality of programme implementation in the schools was monitored by technical assistance teams.SettingShandong Province (high household income) and Qinghai Province (low household income), China. Three programme schools and three control schools in each province.ParticipantsStudents in grade 4 (age 8–9 years).ResultsThere were significant positive changes in self-reported eating behaviour scores from pre- to post-assessment in programme schools. At post-test students in programme schools had significantly higher scores than students in control schools after controlling for other variables. The programme was more effective in the high-income province. Observations by the technical assistance teams suggested the programme was implemented more completely in Shandong. The teams noted the challenges for implementing and evaluating programmes like these.ConclusionsThis intervention increased healthy eating behaviours among 4th graders in both provinces and had more effect in the more affluent province. Results suggest that a scaled-up initiative using existing school and public health resources could change eating practices in a large population over time. The intervention also provided lessons for implementing and evaluating similar nutrition programmes.

About 20% of spirits consumed in China are &ldquo, unrecorded&rdquo, where these spirits are produced in small-scale distilleries and sold outside the systems of taxation and quality control. Researchers visited small distilleries in rural Yunnan, Hubei and Anhui and purchased 56 samples of unrecorded bai jiu. Seven samples of the recorded bai jiu were purchased as reference samples. An independent laboratory conducted a blind analysis of the samples. Results were compared to the standards for unrecorded alcohol adopted by the European Commission&rsquo, s Alcohol Measures for Public Health Research Alliance (AMPHORA). No samples exceeded the AMPHORA guidelines for methanol, ethyl acetate, lead and cadmium, one sample exceeded 1000 g/hL of combined higher alcohols, one sample exceeded 100 mg/L of arsenic, and three samples exceeded 50g/hL of acetaldehyde, but only by relatively small amounts. Low-priced unrecorded bai jiu averaged 9.8 RMB/jin (500 mL), compared to 10.7 RMB/jin for inexpensive recorded bai jiu. The low-priced unrecorded bai jiu samples had a mean alcohol-by-volume of 51.8%, compared to 50.1% for the recorded bai jiu samples. The results did not raise any critical safety issues with unrecorded bai jiu, but there may be long-term health risks related to ethanol, acetaldehyde and arsenic. The social ties between the bai jiu makers and the people who consume their product are a deterrent to adulteration, but when bai jiu is sold outside of the social circle, the deterrent disappears.

This study explored bystanders’ willingness to help a friend who flushes when drinking to reduce his/her drinking. Alcohol-related facial flushing is an indicator of an inherited variant enzyme, aldehyde dehydrogenase (ALDH), that impairs alcohol metabolism and increases drinkers’ lifetime risk of certain aerodigestive cancers. Individuals who flush should reduce their alcohol exposure, but they may continue to drink if social pressures and rules of etiquette make not drinking socially risky. The analysis used data from 2912 undergraduate students from 13 universities in southwestern, central and northeastern China from a survey asking how they respond to someone’s flushing in various scenarios. Latent class analysis grouped students by similar responses to flushing. A multinomial logistic regression explored how class membership was associated with knowledge, drinking status, and reactions to one’s own flushing. Five classes were derived from the latent class analysis, ranging from always intervene to mostly hesitate to help; in between were classes of students who were willing to help in some scenarios and hesitant in other scenarios. Only 11.6% students knew the connection between facial flushing and impaired alcohol metabolism, and knowledgeable students were somewhat more likely to assist when they saw someone flushing. In the absence of knowledge, other factors—such as drinking status, the gender of the bystander, the gender of the person who flushed, and degree of friendship with the person who flushed—determined how willing a person was to help someone reduce or stop drinking. Class membership was predicted by knowledge, gender, drinking status, and reactions to one’s own flushing. Of these 4 factors, knowledge and reactions to one’s own flushing could be influenced through alcohol education programs. It will take some time for alcohol education to catch up to and change social and cultural patterns of drinking. Meanwhile, motivational strategies should be developed to increase the willingness of bystanders to assist friends and to create a social expectation that flushers should stop or reduce their drinking.

For both smokers and nonsmokers, tobacco can determine one’s daily activities, livelihood, relationships, and health. Tobacco can determine matters from as important as keeping or losing one’s job to matters as trivial as deciding where to have lunch. If one is allergic or addicted, the entire day’s routine, indeed, one’s whole life must take into account this fact: A chronic smoker cannot leave the house without her cigarettes and lighter and can only go where she will be able to smoke; a nonsmoker with severe allergies must also plan his daily activities to avoid exposure to smoke and other irritants.

For many smokers, the act of smoking is enough to indict them as bad parents, and many recount instances when subjected to the humiliation and abuse of public indictment. It is difficult for smoking parents who must deal with personal pressures to quit as well as the guilt and shame of addiction to be constantly vulnerable to public abuse from strangers.

On both sides of the issue, smokers and nonsmokers alike believe that they have inviolable rights and many invoke the rhetoric of the Civil Rights Movement and American Independence in their narratives.

Silence, or perhaps more accurately, secrecy, is an integral part of any addiction. The very complex issues and emotions on “either side” of the tobacco issue unfortunately often disintegrate into a volatile, angry discussion of rights and choice, discourses that do not take into account the intricacies of the issues at hand.

Tobacco use significantly affects and can determine the shape of all familial relationships. Given the complexity of family relationships and range of family types, we will limit our examination here to how tobacco use affects two types of familial relationships in particular: marital and couple relationships and parent–child relationships.

In this final chapter, we will briefly summarize what the participants in our project told us about smoking in the USA; then we will offer some ideas on how people can move toward more openly and honestly communicating about smoking.

About 70% of the beverage alcohol consumed in China annually is spirits. Recorded spirits make up most spirit consumption, but about 25% of total alcohol consumption (1.7 L pure alcohol per capita annually) is unrecorded spirits (bai jiu), either homemade or made in unregulated distilleries. In some parts of China, the consumption of unrecorded spirits is higher than average. This paper compares the patterns of use of unrecorded distilled spirits and recorded distilled spirits among rural residents in Central China. Interviews were conducted with 3298 individuals in 21 towns/villages in 10 counties in the Hubei, Anhui, and Hebei provinces in the People’s Republic of China. Unrecorded bai jiu drinkers chose it because of its taste and its low price. It was consumed mostly by older men, mostly at home with family, more regularly and at higher alcohol by volume (ABV) compared to recorded alcohol. Recorded bai jiu drinkers were more likely to drink away from their homes, consumed more bai jiu at memorable drinking occasions, and reported feeling sick after drinking more often than unrecorded bai jiu drinkers. This comparison of patterns of use of unrecorded bai jiu and recorded bai jiu does not suggest that unrecorded bai jiu is more problematic for drinkers.

Alcohol-related facial flushing is a sign of compromised alcohol metabolism and increased risk of certain cancers. This project examined how facial flushing might be used to reduce alcohol use to lower cancer risks. Interviews with Chinese university students identified gender, friendship, and drinking purpose as important variables related to whether someone would encourage a person who flushes when drinking alcohol to stop or reduce their drinking. A questionnaire was developed that incorporated these variables into 24 drinking scenarios in which someone flushed while drinking. Students responded whether they would (a) encourage the flusher to stop or drink less; (b) do nothing while wishing they could; or (c) do nothing because there was no need. Analysis of survey responses from 2912 university students showed a three-way interaction of the variables and implied that the probability students will intervene when a drinker flushes was highest when the flusher was a female, a close friend, and the drinking purpose was for fun and lowest if the flusher was a male, the friendship was general, and the drinking purpose was risky. The results provide important details about the social factors affecting how other people respond to a person who flushes when drinking alcohol. This information is useful for those considering ways to reduce and prevent aerodigestive cancers through education and information programs.

Aim: This paper describes Chinese university students' understanding of the meaning of the alcohol-related flushing response and how they reacted to their own and someone else's flushing in a group drinking situation. Method: The researcher surveyed 530 Chinese university students about their understanding of flushing and their perception of how people respond to a person who visibly flushes while drinking alcohol. Findings: Most students did not know about the physiological cause of flushing. There were significant gender differences in both reactions to and perception of responses to a person who flushes. There was no direct relationship between flushing and drinking behaviour. Conclusions: This description of flushing behaviour and responses to a flushing person is discussed in terms of educational opportunities to change behaviours that could reduce the cancer related risks of this visibly at-risk group.

Background Unrecorded traditional distilled spirits (bai jiu, 白酒) are made and used throughout rural China for everyday use and special occasions. Nearly every town or village has a distiller to supply the demand. In rural China, distilling bai jiu is legal and regulated lightly or not at all. The World Health Organization estimates that as much as 25% of all alcohol consumed in China is unrecorded alcohol, of which an unknown portion is unrecorded bai jiu. Little is known about the composition of unrecorded Chinese spirits from rural parts of the country. This study focused on white spirits because the high ethanol (EtOH) concentration makes them more likely to contribute to health risks compared to other types of lower alcohol by volume (ABV) Chinese unrecorded alcohol. Methods Researchers purchased samples of Chinese white spirits from small-factory distillers in central China. An independent laboratory conducted the analysis. Alcohol strength (ABV) was determined by hydrometer. Gas chromatography was used to determine the concentration of volatile organic compounds: EtOH, methanol, acetaldehyde, ethyl acetate, and higher alcohols. Samples were tested for 3 heavy metals—arsenic, cadmium, and lead. We used the guidelines developed by the Alcohol Measures for Public Health Research Alliance (AMPHORA) of the European Commission to assess risk. Results ABV ranged from 35.7 to 61.4%, and 58 of the 61 samples exceeded 40% ABV. The concentration of methanol, ethyl acetate, lead, arsenic, and cadmium was below AMPHORA guideline. The sum of higher alcohols exceeded the AMPHORA maximum in just 1 sample. Forty of the 61 samples had acetaldehyde levels beyond the AMPHORA guideline. Conclusions The unrecorded Chinese alcohols we analyzed had a high EtOH concentration—a public health concern that is also presented by recorded alcohols. The high percentage of samples (65.5%) that had elevated acetaldehyde suggests the need to investigate the causes for this result and the need for steps to reduce acetaldehyde levels. The cumulative long-term risks of using high EtOH and high acetaldehyde Chinese spirits are heightened by the percentage of people in China who have a genetic trait for impaired acetaldehyde metabolism.

This study explored drinking patterns, alcohol-related flushing, and ways students themselves and other people respond to flushing in drinking situations. Of 1080 Chinese undergraduate university students given the survey questionnaire, 725 (67.1%) returned the completed surveys. Eighty percent of the students were drinkers (93% of males and 69% of females); 68% of the drinkers were flushers. Most of the students (59.3%) said flushing had no special meaning, that is, would ignore flushing; 54% of the flushers said they could keep drinking “but less” when they flush; 27% of the students said that a flushing person should stop drinking; however, if the flushing person is a girl, 89% of the students said the girl should drink less or stop. If the flushing person was a boy, 61% of students said he should drink less or stop. The data do suggest gender differences in the understanding of and social reaction to alcohol-related flushing, and these differences raise interesting questions as to how flushing acts as a potential protective factor against alcohol misuse.

A nonrandom sampIe of 2972 Kuwaitis answered a questionnaire about smoking behaviour and beliefs. More than one-third (35%) were nonsmokers, 45% smoked only the waterpipe, 12% only cigarettes and 8% both waterpipe and cigarettes. Compared with cigarette smokers, waterpipe smokers were more likely to be female and to be unskilled manual workers than professionals or students. Waterpipe smokers started the habit at an older age on average than cigarette smokers. Most waterpipe smokers smoked only 1 bowl per day, and smoked mostly at coffee houses. Factor analysis of beliefs about waterpipe smoking resulted in 4 groups of beliefs which explained 50% of the variance. The results are discussed in terms of public health policy and possible risk reduction strategies.

This paper presents a descriptive analysis of data gathered by personal interviews from a multistage random sample of 1640 residents aged 18&ndash, 34 years in Wuhan, China. First, alcohol drinkers and abstainers were compared based on demographic, attitude, and belief variables. Next, the drinkers from the sample were classified into four groups based on frequency-quantity of alcohol use, and the frequency-quantity groups were compared on the same variables. For Abstainers versus Drinkers, we found no difference by age or gender in this sample. Married people and people with children were more likely to be abstainers. University-educated, currently-employed individuals in mid-level jobs were more likely to abstain from alcohol. Vocational/Technical graduates, people who were currently attending college, currently unemployed and never-employed individuals were more likely to be drinkers. Abstainers also responded with less-positive attitudes and beliefs about drinking and attached more importance to reasons for not drinking compared to drinkers. When the drinking frequency-quantity groups were compared, gender differences became significant: more high-quantity drinkers were women, however the guideline for quantity for women was &gt, 1 drink at a time compared to &gt, 2 drinks at a time for men. Quantity and frequency of drinking was significantly associated with having children, educational level, employment status, and type of occupation. Age, marital status, and being in college did not relate significantly with quantity and frequency of drinking alcohol. Attitudes and beliefs about drinking tended to be more positive among high-frequency and high-quantity drinkers. Drinkers in all frequency-quantity groups attached greater importance to social reasons for drinking compared to personal/psychological reasons for drinking. Drinkers in the lowest frequency-quantity group attached the most importance to reasons for not drinking. These findings confirmed that in China drinking plays an important role in socializing and celebrating, and that there are important differences between alcohol drinkers and abstainers and between frequency/quantity groups of drinkers. Western models of individualized motivation of behaviors may not accurately explain alcohol use in China. We believe the findings from this study suggest the need for more detailed studies of alcohol drinking and abstaining.

Objective We hypothesized that the drinking behavior of adolescents in China is influenced by expectancies and self-efficacy and that adolescents' cultural orientation towards western versus traditional Chinese values influences expectancies, self-efficacy and drinking behavior, with western values leading to more dysfunctional patterns of beliefs and drinking, and that these beliefs are influenced by students' gender and school environment. Methods A total of 1020 high school students from Beijing completed the Chinese Adolescent Alcohol Expectancy, the Chinese Cultural Orientation and the Chinese Self-regulation Self-efficacy questionnaires. Results Results generally confirmed our hypotheses. Higher negative expectancies and higher self-efficacy reduced the likelihood of drinking significantly. Higher positive expectancies increased the likelihood of regular drinking but not occasional drinking. Having western cultural orientation increased the likelihood of drinking. Higher levels of western cultural orientation also increased positive expectancies, lowered negative expectancies and lowered self-efficacy. Having more western (less traditional) views towards traditional Chinese values decreased positive and negative expectancies. Gender influenced beliefs, with males having higher positive and lower negative expectancies, lower self-efficacy and more traditional cultural orientation. Students in key and general schools had less traditional cultural orientation and key school students had higher self-efficacy. Conclusions Results indicate that cultural orientation influences adolescent drinking and this influence is mediated partially through cultural orientation influences on adolescent drinking expectancies and self-efficacy. Having more western and less traditional Chinese cultural orientation leads to more drinking, lower self-efficacy for regulating drinking and more risk-promoting alcohol expectancies. Language: en

Background: Arthritis is a common disease in China, but few studies have been conducted to explore the associated health-related quality of life (HRQoL) and its influencing factors in Chongqing, China. This study aimed to explore the association of arthritis and HRQoL and probe factors affecting HRQoL among arthritis patients. Methods: A cross-sectional survey was conducted in Chongqing, China. A total of 1224 adults were included in the analysis. Medical Outcomes Study Short Form 36 Health Survey (SF-36) was used to measure HRQoL. Multiple linear regression models (stepwise) and covariance analysis models were used to examine the association of arthritis with HRQoL and analyze factors associated with HRQoL among arthritis patients. Results: Participants with arthritis had poorer HRQoL than those without. Among arthritis patients, the female was associated with a poorer state of physical functioning (p < 0.05); unemployed patients had a poorer state of role-physical than employed patients (p < 0.05); low average monthly income was associated with a poorer state of physical functioning (p < 0.01); childhood non-breastfeeding history was associated with a poorer state of social functioning (p < 0.01); average or dissatisfied attitude to current living conditions was associated with a poorer state of vitality and mental health (p < 0.05 for all); moreover, poor or general appetite was associated with a poorer state of role-physical, general health, social functioning, bodily pain, and role-emotional (p < 0.01 for all). Conclusions: Arthritis patients have worse HRQoL than those without in the Chinese population. Female, low socioeconomic status, childhood non-breastfeeding history, average or dissatisfied attitude to current living conditions and poor or general appetite were associated with poorer state of HRQoL among Chinese arthritis patients.

This paper describes an empirically based method for defining the role of attitudes in health education planning. An explicit assumption underlying this method is that the professional health educator is an agent for behavior change who works, primarily via other health professionals, to enhance the health of the target population. To effect change, the health educator must be skilled in (a) problem definition, (b) program development or the treatment of the problem, (c) program implementation and (d) program evaluation. To illustrate this approach we present a model for measuring attitudes and social normative factors which seems useful in defining education need, illustrate its use in a cross-culture comparison of a sample of adolescent cigarette smokers in Australia and United States of America and suggest some further steps to aid in planning and evaluating health education activities. While this paper emphasizes the role of attitude, attitudes are but one of a number of factors to be considered in health education program development. Anderson1 and Green2 suggest that attitudes and knowledge contribute to a predisposition to a particular behavior but that the ultimate behavior is also influenced by a set of factors best described as enabling the behavior and a set of factors which reinforce the behavior.

Background An estimated 25 % of the alcohol consumed in China is traditional unrecorded alcohol produced and distributed informally. Consequently there is concern about its safety and its contribution to public health risk. Little has been written about this type of alcohol in China. Methods Researchers observed the manufacture of traditional bai jiu in a rural area of Hubei Province, Central China. Two hundred fifty-nine individuals were interviewed, either individually or in small groups, about their use of and attitudes toward bai jiu. Individuals who made or sold bai jiu were interviewed about local production, distribution, and sale. Key community leaders were asked about risks from local bai jiu production, sale, and use. Results All of the bai jiu makers followed the same basic traditional procedure. Most had learned their craft from a family member or by apprenticeship, and their product was sold to neighbors or nearby villagers. Bai jiu makers typically had a business license and a health certificate. The shops that bought and sold traditional bai jiu were family-run businesses that sold both traditional bai jiu and commercial alcohol to clientele within a close social network. Alcohol (all types) was consumed by 79.9 % of interviewed villagers (89.7 % of males, 50.0 % of females). Of the 207 drinkers in the sample, 72.9 % drank bai jiu, 59.4 % drank beer, and 22.7 % drank commercial spirits. Bai jiu was most often consumed at mealtimes. Bai jiu drinkers believed moderate drinking was healthy and that drinking improved the social atmosphere, and about one-third of them believed drinking too much could result in quarrels and family problems. The bai jiu business provided two sources of income for makers because spent grain from the distillation process could be fed to livestock. Conclusions Production, sale, and use of traditional bai jiu occurred within the context of local traditions, values, customs, and social networks. The data did not suggest any significant issues related to contamination. Drinking patterns were similar to those found in other studies of alcohol use in China. Bai jiu was sold mainly to middle-aged or older men, suggesting bai jiu production and use could gradually disappear without intervention.

This paper describes a programme, conducted over a 5-year period, that effectively reduced heavy drinking and alcohol-related harms among university students. The programme was organised around strategies to change the environment in which binge drinking occurred and involved input and cooperation from officials and students of the university, representatives from the city and the neighbourhood near the university, law enforcement, as well as public health and medical officials. In 1997, 62.5% of the university's approximately 16,000 undergraduate student population reported binge drinking. This rate had dropped to 47% in 2003. Similar reductions were found in both self-reported primary and secondary harms related to alcohol consumption.

A sample of 2019 Thai secondary school students in grades equivalent to U.S. 10 through 12 completed a 43-item alcohol expectancy questionnaire in June 2000. Factor analysis revealed four factors: (a) positive expectancies, (b) negative expectancies, (c) sex and power expectancies, and (d) religious expectancies. Practicing Buddhists were less likely to drink than nonpracticing Buddhists and had fewer positive and more negative expectancies about alcohol. Among students who did drink, Buddhist beliefs did not appear to influence whether or not they were binge drinkers. Buddhist beliefs may influence decisions to drink but not decisions related to drinking patterns.

Our primary research question was whether teens obtaining their intermediate-level provisional operators permit (POP) in a graduated driver licensing (GDL) environment through driver education differed in crashes and traffic violations from teens who obtained their POP by completing a supervised driving certification log without taking driver education. A descriptive epidemiological study examining a census of all teen drivers in Nebraska (151,880 teens, 48.6% girls, 51.4% boys) during an eight year period from 2003 to 2010 was conducted. The driver education cohort had significantly fewer crashes, injury or fatal crashes, violations, and alcohol-related violations than the certification log cohort in both years one and two of driving following receipt of the POP. Hierarchical logistic regression was conducted, controlling for gender, race/ethnicity, median household income, urban–rural residence, and age receiving the POP. In both year one and two of driving, teens in the certification log cohort had higher odds of a crash, injury or fatal crash, violation, or alcohol-related violation. Findings support that relative to a supervised driving certification log approach, teens taking driver education are less likely to be involved in crashes or to receive a traffic violation during their first two years of driving in an intermediate stage in a graduated driver licensing system. Because teen crash and fatality rates are highest at ages 16–18, these reductions are especially meaningful. Driver education appears to make a difference in teen traffic outcomes at a time when risk is highest.

OBJECTIVES: This study examines the association between cultural orientation and drinking behaviors among university students. Cultural orientation is the measure of how the cultural values of individuals living in their own society are influenced by cultural values introduced from the outside. METHODS: In 2011, a cross-sectional survey collected data from 1279 university students from six universities in central China. Participants used a likert scale to rank a series of statements reflecting cultural values from the previously validated Chinese Cultural Orientation Scale and answered questions about their drinking behaviors and socio-demographic characteristics. RESULTS: Statistically significant differences in cultural orientation were observed for gender, hometown and type of university attendance. Traditional-oriented students were more likely to be occasional drinkers or nondrinkers, while marginal-oriented students, bicultural-oriented students and western-oriented students were more likely to be regular drinkers. Bicultural orientation (OR = 1.80, P

Cultural orientation is defined as an individual's cultural preferences when encountering imported culture while still living in the native culture. Data was analyzed from 1305 Chinese university students attending universities in Beijing, Kunming, and Wuhan. Cultural orientation was assessed with the Chinese Cultural Orientation Questionnaire, which assesses both Western and Traditional Chinese cultural orientations. The analysis used hierarchical logistic regression with nondrinkers as the reference group and controlling for demographic factors (age, gender, and urban/rural background). Western cultural orientation was found to significantly increase the odds of recent drinking. The results indicated that higher Western cultural orientation was, after gender, the second most important factor associated with Chinese college student drinking frequency. Traditional Chinese cultural orientation was not associated with drinking frequency. This study highlights an unexpected outcome of globalization on students who have not left their home cultures.

The authors present results of a comparative analysis that addressed two primary questions: Has there been a change in frequency of alcohol advertising in the college newspaper from 1984 to 1992? and Has there been a change in the message content of alcohol advertising from 1984 to 1992?

Objective To determine if the Information-Motivation-Behavioral Skills model was effective for development of a smokeless tobacco educational unit (STEU) and analysis of STEU effects. Methods Structural equation modeling was used to test component relations proposed by the IMB model and STEU effects on parallel growth of IMB components. Results Results confirmed IMB model component relationships and indicated that STEU effects were primarily on information with indirect effects on expectancies and self-efficacy change through information. Conclusions Prevention programming needs to address all IMB model components. Organizing analysis around the IMB model provides better understanding of program outcomes.

The Delphi Technique was used to identify areas of faculty/staff and student support for a comprehensive campus alcohol abuse initiative. Through a series of mailed questionnaires, 54 faculty/staff and 35 student leaders identified 20 campus alcohol-related problems and 15 potential solutions. The same group of faculty/staff and students then ranked the problems in terms of seriousness and changeability, and the solutions in terms of priority to the individual and to the institution. The process clearly exposed areas of agreement and support for a comprehensive campus alcohol abuse initiative. The utility of this technique as a means to identify areas of agreement and conflict and as a means of generating support is discussed.

BACKGROUND: Using the Chinese version of the Global School-based Health Survey (GSHS), this article describes the prevalence of being bullied among a nationally representative sample of Chinese students in grades 6-10 and explores the relationships between being bullied and selected indicators of psychosocial adjustment. METHODS: A total of 9015 students in middle schools in Beijing, Hangzhou, Wuhan, and Urumqi completed the Chinese version of the GSHS. Researchers analyzed the results from 2 questions about the frequency and form of being bullied and 11 questions about psychosocial adjustment. Descriptive statistics and logistic regression were used in the analysis. RESULTS: About 25.7% of middle school students reported being bullied on 1 or more of the past 30 days. Rates of being bullied were similar for males and females, but the forms of being bullied were different. Being bullied was significantly lower in Beijing than in the other 3 cities. There were significant psychosocial differences between students who had been bullied and students who had not been bullied. Students who had been involved in a physical fight, often felt lonely, or had considered suicide in the past 30 days were more likely to report being bullied. Students who thought that other students in their school were often kind and helpful, who felt parents often understood their troubles, or who were taught in school how to handle stress were less likely to report being bullied. CONCLUSIONS: Being bullied is not uncommon in Chinese middle schools. Chinese schools typically place great emphasis on academic achievement, perhaps at the expense of the social climate of the school. Results indicated schools could implement changes to the school climate to reduce the likelihood of students' being bullied. Language: en

The authors present data concerning alcohol consumption at one commuter university and discuss the data’s implications for reaching educational goals.

Objective. This study examines differences in Chinese high school students’ alcohol expectancies by drinking status (nondrinker, occasional drinker, regular drinker) and gender (male, female). Method . The authors administered the Chinese Adolescent Alcohol Expectancy Questionnaire (CAEQ) to a convenience sample of 1244 high school students (M = 627; F = 617) from schools in Huhhot City and Tongliao City in Inner Mongolia, China. Results . Differences were found in the 8 CAEQ factors (3 negative and 5 positive factors). Regular drinkers had lower negative consequences and higher positive perception expectancies than nondrinkers or occasional drinkers. Nondrinkers had higher harm to person/reputation expectancies than occasional or regular drinkers. Occasional drinkers had higher beneficial/moderation and lower harm to person/ reputation expectancies than nondrinkers. Boys had higher positive perception expectancies than girls. Conclusions . Expectancies are associated with Chinese adolescents’ drinking. Identifying the characteristics of alcohol consuming youth can inform the development of prevention interventions and alcohol policies.

Understanding the role of drinking games in college student life is critical for program planners who wish to develop education and prevention programs to reduce abusive drinking. Drinking games are popular social activities that provide a focus for social interactions but place students at considerable risk for serious consequences. This article reports preliminary results of a study using participant observation and in-depth interviews to develop a typology of drinking games and describe patterns and practices associated with the games.

Objective: The authors investigated the use and perceived use of anabolic androgenic steroids (AAS) among nonathlete college students. Participants: The authors surveyed a sample of 485 nonathlete college students at a major metropolitan university. Methods: They administered a survey on use and perceived use of AAS to the students. Results: Forty-two participants (9%) reported using AAS (37 men, 5 women). Seniors were the most likely to use AAS (36%), and freshman the least likely (7%). Thirty-four percent of nonusers and 41% of users indicated they knew between 1 and 5 AAS users. Of the total sample, 36% perceived that 5% to 10% of nonathlete college students used AAS. Reasons for AAS use were because friends were using (7%), a desire to enhance physical appearance (45%), and a desire to increase physical performance (48%). Conclusions: These findings may have significant implications in planning strategic preventive educational programs, and health educators should target incoming college freshmen with...

OBJECTIVE To examine the role of expectancies in adolescent smokeless tobacco (ST) use. METHODS Self-report measures of students' ST expectancies, cigarette and ST use, and peer and family tobacco use were collected from a sample of 978 rural high school students. RESULTS Student expectancy beliefs significantly predicted ST use and intention to try ST in the next year. Student expectancies about ST were influenced by gender, cigarette use, and peer tobacco use. Family-member tobacco use did not strongly affect expectancies. CONCLUSION Expectancies play a meaningful role in students' current and future decisions whether to use ST.

Photographs are used as a research tool by anthropologists and as a technique to empower special populations, advocacy groups, and policy makers. This case describes how photography was used to develop a survey to study alcohol expectancies among Thai adolescents. A multi-cultural research team faced generational, linguistic, and cultural barriers in understanding Thai adolescent alcohol use well enough to write useful questions about alcohol expectancies. Asking adolescents to take and then discuss their photographs about alcohol allowed them to express themselves without the imposition of an organizational framework by the investigators. Group discussions of the photographs revealed nuances and subtleties of interpretation of behavior and expectancies involving alcohol that might otherwise have not emerged. The results of this activity were used to refine an expectancy scale used in a large-scale survey of alcohol expectancies and use.

Background: Gaps exist in knowledge about the production and use of traditional alcohols, particularly in Asia. This study adds new information about the nature, production and sale of traditional distilled spirit alcohol in Vietnam. Method: This was an ethnographic study of traditional distilled spirit alcohol production in rural areas of three provinces in Vietnam. Researchers interviewed more than 300 individuals and recorded responses to general open-ended questions about local alcohol production. Interviews were recorded, transcribed, and studied to discern what information about traditional alcohol was important to the speakers. Results: Methods of production followed long-held traditions. Participants listed both personal and community benefits (economic, health, and social) from traditional alcohol making. Older people favoured traditional alcohol, while younger people favoured brand-name beer. Typically people consumed 2-4 drinks daily, mainly at meal times. People consumed more alcohol at special events and festivals. Distribution patterns ranged from low-risk distribution to family and neighbours to high-risk distribution by an agent who might combine alcohol from several producers, which increases the opportunity for dilution and adulteration. The most commonly listed health risks associated with locally-made alcohol were local air pollution and water pollution; participants also mentioned traffic crashes and bad public behaviour. Depending on the location, community leaders reported that production may be relatively stable or it may be declining. Conclusions: Traditional alcohol manufacture, sale, and use in Vietnam is a long-standing practice and low- to moderate-risk to health. There do not appear to be instances of accidental or intentional contamination. Urbanization seems to be affecting the market share of traditional alcohol as urbanized youth turn to branded products, mainly beer, making traditional alcohol making and consumption an activity mainly linked to older people in rural areas. In the rural areas surveyed, significant economic and social benefits are derived from traditional alcohol manufacture, sale, and use. Policy makers designing ways to reduce alcohol-related risks and harms need to give thoughtful consideration to the role traditional alcohol plays in the local society and to suggest changes that do not create unintended problems.

An alcohol/drug education curriculum was tested in twenty-five Nebraska junior high schools involving 1,800 students in grades seven to nine. Using teacher training and student age as independent variables, gains in knowledge and decision-making ability were assessed. There was an interaction between age level and training, with older students taught by fully trained teachers making significantly greater gains in knowledge and decision-making ability than students who were exposed to the curriculum via untrained teachers and those not exposed to the curriculum at all. Teacher training was shown to be a critical variable in curriculum innovation, especially for older students.