Relation between number of siblings and adult mortality and stroke risk: 25 year follow up of men in the Collaborative study

<b>Study objective</b>: To investigate the relation between number of siblings, mortality risk, and stroke risk. <b>Design</b>: Prospective cohort study. <b>Setting</b>: 27 workplaces in Scotland. <b>Participants</b>: 5765 employed men aged 35–64 from a variety of different workplaces, screened between 1970 and 1973. <b>Main results</b>: There were strong relationships between number of siblings and socioeconomic variables and also with adult behavioural measures. Men with greater numbers of siblings had an increased risk of dying of all causes, coronary heart disease, lung cancer, stomach cancer, and respiratory disease over a 25 year follow up period. Adjustment for risk factors could explain these associations, excepting stomach cancer mortality. With the definition of stroke as either a hospital admission for stroke or death from stroke, there was a strong relation between number of siblings and haemorrhagic stroke, but not ischaemic stroke. <b>Conclusions</b>: Number of siblings is strongly related to mortality risk, but as it is also related to many risk factors, adjustment for these can generally explain the relation with mortality. The exceptions are stomach cancer mortality and haemorrhagic stroke, which are known to be related to deprivation in childhood, and, in the case of stomach cancer to childhood infection

‘Goodbye mindless drinking and hello mindful living’: A feminist analysis of women’s sobriety as a practice of self-care

Since 2004 there has been a reduction in alcohol consumption and an increase in teetotalism in the UK, particularly amongst young people and women. This has coincided with the emergence of Western discourses regarding wellbeing and self-care, and a greater awareness of mental health. This article considers how women experience and reframe sobriety as a form of self-care, drawing on data collected as part of a wider project on women’s identities in sobriety, including participant interviews, ethnographic observations and social media posts. Findings suggest that women utilise sobriety as a strategy of self-care; to manage physical and mental health conditions, including the menstruating and (peri)menopausal body. Sobriety is used as a tool by women to strengthen their bodies and enhance feelings of control within a neoliberal society that promotes and privileges self-responsibility for health and wellbeing. This article informs understanding of the connections between feminism, sobriety and self-care. It highlights the opportunity and value of future research to investigate current online sobriety communities as a contemporary source, and practice, of feminist thinking and (lifestyle) activism

Alternative, online treatment paths for women’s problematic alcohol use: a review of existing qualitative and quantitative research

The increase in women's drinking is one of the most prominent trends in alcohol consumption in the UK in recent history, possibly exacerbated by COVID-19 lockdown measures. Higher rates of drinking are associated with substantial economic, health, and social costs. However, women are less likely to seek treatment for Alcohol Use Disorder (AUD) than men and have less successful treatment outcomes from traditional treatment paths, such as 12-step programs and in-patient care. Female heavy drinkers may also experience particular forms of gendered stigma that affect their experiences of addiction and recovery and their desire or ability to access these more “traditional” services. This review provides an overview of existing qualitative and quantitative research regarding online sobriety communities that are predominantly utilised by women, such as non-12-step alcohol online support groups (AOSGs) and temporary abstinence initiatives (TAIs). This is a small—but expanding—body of literature emerging as “sober curiosity” and “mindful drinking” are trending in Western contexts such as the UK, particularly amongst young women who do not identify with traditional, binary recovery language such as “alcoholic” and “addict.” This review highlights the gaps in research and concludes that further research regarding these new treatment pathways, and women's experiences when utilising them, must be conducted to provide more evidence-based options for women who want to address problematic drinking. Public health bodies could also learn more effective strategies from these innovative solutions to reduce alcohol consumption generally

Patterns of consumption at the UK’s first “alcohol-free off- licence”: Who engaged with no- and low-alcohol drinks and why?

No- and low-alcohol beverages are currently experiencing high sales growth in the UK, but academic research regarding the production, regulation, marketing and consumption of these drinks remains limited. This article presents research findings from ethnographic customer observations and semi-structured staff interviews at Club Soda’s temporary "alcohol-free off-licence” in London – the UK’s first shop that sold exclusively no- and low-alcohol drinks. I analyse the demographics of who came to the off-licence, and how and why they engaged with no- and low-alcohol drinks. Findings suggest that relatively equal numbers of non-drinkers and current drinkers were customers of the off-licence, but there were differences across gender, ethnicity, and age groups. No- and low-alcohol drinks supported customers’ alcohol-free lifestyles or attempts to drink mindfully. However, whether customers were former drinkers, lifelong abstainers or current drinkers influenced what products they sought from the off-licence and shaped how these products were used in (non-)drinking practices. This paper also highlights the role of the off-licence as a stigma-free, sober space where customers could try no- and low-alcohol products, prior to purchase, and find connection with others

“It’s kind of like weaning. I had to wean myself off of wine”: Navigating no- and low-alcohol drinks as potential harm reduction tools and relapse triggers by women in recovery in the UK

Introduction: Concerns have been raised that consumption of no- and low-alcohol drinks by those who are in recovery could lead to a relapse to past drinking behaviours. However, little is known regarding how individuals use these products to substitute alcohol and support their sobriety. Methods: This article draws on an ethnographic study of women’s experiences of recovery within online sobriety communities in which semi-structured interviews were conducted with 25 UK-based women. The dataset was analysed and coded from a pragmatist feminist standpoint using a grounded theoretical approach to specifically address the research question: ‘How do women in recovery navigate the protective and risk factors associated with no- and low-alcohol drinks through practices of consumption?’. Results: Women in recovery navigate no- and low-alcohol drinks as potential harm reduction tools and relapse triggers by engaging in nuanced practices of substitution. Contrasting examples include direct substitution and temporary avoidance in early recovery. Discussion: Substitution practices are informed by the temporality of participants’ recovery journeys, the social situation, and the products. Participants selectively replicate and resist their former drinking practices to balance their perceived harm reduction benefits and relapse triggers of no- and low-alcohol drinks. Conclusion: Important considerations are raised for those in recovery who may want to use no- and low-alcohol drinks as a harm reduction tool, and for recovery modalities who promote them. It concludes with calls for more clarity regarding the definition and labelling of no- and low-alcohol drinks, and for greater understanding of their use across different recovery cultures

Reevaluating evaluative conditioning: A nonassociative explanation of conditioning effects in the visual evaluative conditioning paradigm

In 2 studies, the authors investigated whether evaluative conditioning (EC) is an associative phenomenon. Experiment 1 compared a standard EC paradigm with nonpaired and no-treatment control conditions. EC effects were obtained only when the conditioned stimulus (CS) and unconditioned stimulus (UCS) were rated as perceptually similar. However, similar EC effects were obtained in both control groups. An earlier failure to obtain EC effects was reanalyzed in Experiment 2. Conditioning-like effects were found when comparing a CS with the most perceptually similar UCSs used in the procedure but not when analyzing a CS rating with respect to the UCS with which it was paired during conditioning. The implications are that EC effects found in many studies are not due to associative learning and that the special characteristics of EC (conditioning without awareness and resistance to extinction) are probably nonassociative artifacts of the EC paradigm

Is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men

Both subjective and objective measures of lower social position have been shown to be associated with poorer health. A psychosocial, as opposed to material, aetiology of health inequalities predicts that subjective social status should be a stronger determinant of health than objective social position. In a workplace based prospective study of 5232 Scottish men recruited in the early 1970s and followed up for 25 years we examined the association between objective and subjective indices of social position, perceived psychological stress, cardiovascular disease risk factors and subsequent health. Lower social position, whether indexed by more objective or more subjective measures, was consistently associated with an adverse profile of established disease risk factors. Perceived stress showed the opposite association. The main subjective social position measure used was based on individual perceptions of workplace status (as well as their actual occupation, men were asked whether they saw themselves as “employees”, “foremen”, or “managers”). Compared to foremen, employees had a small and imprecisely estimated increased risk of all cause mortality, whereas managers had a more marked decreased risk. The strongest predictors of increased mortality were father's manual as opposed to non-manual occupation; lack of car access and shorter stature, (an indicator of material deprivation in childhood). In the fully adjusted analyses, perceived work-place status was only weakly associated with mortality. In this population it appears that objective material circumstances, particularly in early life, are a more important determinant of health than perceptions of relative status. Conversely, higher perceived stress was not associated with poorer health, presumably because, in this population, higher stress was not associated with material disadvantage. Together these findings suggest that, rather than targeting perceptions of disadvantage and associated negative emotions, interventions to reduce health inequalities should aim to reduce objective material disadvantage, particularly that experienced in early life

Carboxyhaemoglobin concentration, smoking habit, and mortality in 25 years in the Renfrew/Paisley prospective cohort study

Objective: To investigate how carboxyhaemoglobin concentration is related to smoking habit and to assess whether carboxyhaemoglobin concentration is related to mortality. Design: Prospective cohort study. Setting: Residents of the towns of Renfrew and Paisley in Scotland. Participants: The whole Renfrew/Paisley study, conducted between 1972 and 1976, consisted of 7048 men and 8354 women aged 45–64 years. This study was based on 3372 men and 4192 women who were screened after the measurement of carboxyhaemoglobin concentration was introduced about halfway through the study. Main outcome measures: Deaths from coronary heart disease (CHD), stroke, chronic obstructive pulmonary disease (COPD), lung cancer, and all causes in 25 years after screening. Results: Carboxyhaemoglobin concentration was related to self reported smoking and for each smoking category was higher in participants who reported inhaling than in those who reported not inhaling. Carboxyhaemoglobin concentration was positively related to all causes of mortality analysed (relative rates associated with a 1 SD (2.93) increase in carboxyhaemoglobin for all causes, CHD, stroke, COPD, and lung cancer were 1.26 (95% confidence interval (CI) 1.19 to 1.34), 1.19 (95% CI 1.13 to 1.26), 1.19 (95% CI 1.13 to 1.26), 1.64 (95% CI 1.47 to 1.84), and 1.69 (95% CI 1.60 to 1.79), respectively). Adjustment for self reported cigarette smoking attenuated the associations but they remained relatively strong. Conclusions: Self reported smoking data were validated by the objective measure of carboxyhaemoglobin concentration. Since carboxyhaemoglobin concentration remained associated with mortality after adjustment for smoking, carboxyhaemoglobin seems to capture more of the risk associated with smoking tobacco than does self reported tobacco consumption alone. Analysing mortality by self reported cigarette smoking underestimates the strength of association between smoking and mortality