Tools for policy and prevention: The Australian National Alcohol Indicators Project (NAIP)

Alcohol is a leading cause of preventable death, disease, and disability in Australia. The National Alcohol Indicators Project (NAIP) is funded by the Commonwealth Government of Australia to monitor and report on trends in alcohol consumption and related harms across states and communities with special emphasis on the wide dissemination of information and evaluation of policy change. Using aetiologic fraction and surrogate methods, the NAIP has established a minimum set of reliable indictors of alcohol-related harms for monitoring and evaluation purposes, including: alcohol-attributable deaths and hospitalizations; police-reported road crash and violent offences related to alcohol intoxication; alcohol sales data, and national alcohol consumption surveys. The NAIP uses a range of strategies for maintaining policy-relevant outputs that are both scientifically rigorous and readily accessible by non-researchers, including: a range of dissemination modes which potentially appeal to diverse audiences (e.g. bulletins, submissions, journal articles); proactive communication of outputs to potential audiences; timely response to key stake-holder information needs; and a strong commitment to capitalizing on opportunities for alcohol policy evaluation at local, state, and national levels. </jats:p

Age at first use of alcohol and risk of heavy alcohol use: A population-based study

Aim: To examine the association between age at first alcohol use and risk of heavy alcohol use among the adult US general drinking population.Methods: This population-based study used the 2010 National Survey on Drug Use and Health (NSDUH) from United States. Multivariate Poisson regression was employed to predict the frequency of heavy alcohol use (five or more drinks per occasion) in the last 30 days with age at first use of alcohol controlling for potential confounding factors.Results: Younger age at first use of alcohol was associated with increased likelihood of heavy alcohol use in the last 30 days in this population-based sample. This association remained significant when analysis was reperformed for the subgroup of participants who were with desired good health status and Kessler score lower than 12.Conclusion: Younger age at first use of alcohol was associated with increased likelihood of heavy alcohol use

Weekly and daily cycle of alcohol use among the U.S. general population

BACKGROUND: Studies such on alcohol and injuries have defined alcohol-related injury as an injury with a positive self-report of alcohol consumption in the 6h prior to the event. However, there is very limited data on the pattern of alcohol use over time of day and day of week among the general population. The aim of this study is to estimate the rate of alcohol use by time of day, and day of week for the U.S. general adult (≥ 18 years) population. METHODS: This study employed the design of a retrospective cohort study using data collected from three waves (2005-06, 2007-08, 2009-10) of the National Health and Nutrition Examination Survey (NHANES). Incidence rates of overall drinking (≥ 10 g of alcohol) and incidence rates of heavy drinking (≥ 40 g of alcohol) were estimated for day of week, and time of day (in hours). Multivariable Poisson regression models were used to investigate the difference between weekend nights and weekday nights. RESULTS: The incidence rates (95% confidence interval) of all drinking episodes were 30.5 (29.2-32.0) per 100 person-days and 24.4 (22.8-26.2) per 100 person-days for weekend and the rest of the week, respectively. The incidence rates of heavy drinking episodes were 11.0 (10.2-11.9) and 7.7 (6.8-8.7) for weekend and the rest of the week. Multivariable analysis indicated that risks of overall drinking and heavy drinking were significantly higher (18% and 34%, respectively) during the weekend nights when compared to weekday nights. It was also observed young adults (18-29 years old) were more likely to increase their alcohol use during weekend nights compared to older age groups. CONCLUSIONS: The general US population, especially young adults are exposed to alcohol and its acute effects at a much higher level during the night, and this in-turn increases the risk of alcohol-related injuries during that time

Examining the relationship between heavy alcohol use and assaults: With adjustment for the effects of unmeasured confounders

Background. Experimental studies suggest that alcohol can lead to aggression in laboratory settings; however, it is impossible to test the causal relationship between alcohol use and real-life violence among humans in randomized clinical trials. Objectives. (i) To examine the relationship between heavy alcohol use and assaults in a population based study; (ii) to demonstrate the proxy outcome method, as a means of controlling the effects of unknown/unmeasured confounders in observational studies. Methods. This study used data collected from three waves of the National Survey on Drug Use and Health (NSDUH). The effects of heavy alcohol use on assault were measured using multivariable logistic regressions in conjunction with the proxy outcome method. Results. Application of the proxy outcome method indicated that effect sizes of heavy alcohol use on the risk of assault were overestimated in the standard models. After adjusting for the effects of unknown/unmeasured confounders, the risk of assault remained 43% and 63% higher P &lt; 0.05 among participants who consumed 5+ drinks/day for 5-8 days/month and 9-30 days/month, respectively. Conclusions. Even after adjustment for unknown/unmeasured confounders the association between heavy alcohol use and risk of violence remained significant. These findings support the hypothesis that heavy alcohol use can cause violence

Brief report: marital status and alcohol consumption behaviours

Introduction and aims: Divorced people have been found to be more likely to consume alcohol at higher levels than those who are married, with the association varying somewhat by country. However,the effect that remaining unmarried has on alcohol consumption is less clear. This study investigated the association between marital status and alcohol consumption among young and middle-aged Australian adults. Methods: Using a cross-sectional study design, the association between marital status and alcohol consumption behaviour was assessed using data from the Australian 2007 National Drug Strategy Household Survey. Results: Young and middle-aged people who were never married, divorced or separated were more likely to consume alcohol at levels associated with increased risk for both long-term and short-term harm when compared to married people. Discussion: It may be possible that mental health status is one of the factors mediating the association between marital status and alcohol consumption. Conclusions: Being never married, divorced or separated was a strong indicator of hazardous alcohol consumption behaviours. The marital status of young and middle-aged people might serve as a useful screening tool for health professionals wishing to identify patients at elevated risk of alcohol-related problems

Trends in Youth Alcohol Consumption and Related Harms in Australian Jurisdictions, 1990-2002

Tanya Chikritzhs and Richard Pascal document trends in harms due to risky and high risk drinking for young people across Australia. They report annual rates for males and females aged between15 and 24 years for all states and territories have been presented, as well as comparisons between Indigenous and non-Indigenous youth and metropolitan and non-metropolitan regions

Age at first use of alcohol predicts the risk of heavy alcohol use in early adulthood: A longitudinal study in the United States

Background: Two ecological cross-sectional studies which relied on national survey data (U.S. and Australia) have shown that starting drinking at a younger age increases the frequency of heavy drinking in the general population, including those with good mental and physical health status. This study further investigates the hypothesis that age at first use of alcohol increases the risk of heavy alcohol use by applying data from a longitudinal study. Method: This study used public-use data collected from Wave I, Wave III and Wave IV of the National Longitudinal Study of Adolescent Health in the United States. The association between age at first use of alcohol and heavy alcohol use (5+ drinks per occasion) was examined with two different multivariate analysis approaches with data from 2316 participants: ordered logistic regression models and Poisson regression models with longitudinal data settings. In addition, the newly developed proxy outcome approach was further used to estimate and adjust for unmeasured/unobserved confounding factors. Results: Age at first use of alcohol before 18 years was associated significantly higher risk of heavy alcohol use at follow-up. Conclusion: After adjusting for known and residual confounders, younger age at first use of alcohol was associated with significantly higher risk of heavy alcohol use, moreover, we posit that the association observed from this longitudinal study is probably causal. Abstinence from alcohol until the age of 18 years will likely reduce individual risk of alcohol-related problems in adulthood. In the longer term, delayed onset of exposure with widespread abstinence among this age group is also likely to reduce the overall prevalence of alcohol-related problems in the general population

Motives for romantic relationships and the risk of heavy alcohol use, regular smoking and cannabis use during adolescence and early adulthood: a longitudinal study

BACKGROUND: Engaging in sexual activities at a younger age is associated with higher risk of substance misuse among adolescents. It could be hypothesized that substance misuse and certain romantic relationship related behaviors may be influenced by similar hormone and other inner physiological factors that are affected by related motives. This study investigated the association between motives for romantic relationships and the risk of heavy alcohol use, regular smoking and cannabis use from adolescence through to early adulthood.METHOD: A population-based longitudinal study using data collected from Wave I and Wave III of the National Longitudinal Study of Adolescent Health. Characteristics of romantic relationship ideals (as the proxy of motives) measured in Wave I (mean age: 16 yrs) were applied to predict substance use indicated at Wave III (mean age: 22 yrs) using multivariate analyses.RESULTS: Adolescents who included sexual activities as part of their romantic relationship ideals were at significantly higher risk of cannabis use among males and heavy alcohol use among females. Romantic ideals that included, gift giving (female) or receiving (male), declaration of love (male), marriage (male) and becoming pregnant (female) were associated with reduced risk of one or more types of substance use.CONCLUSION: In adolescence, sexual motives for romantic relationships were associated with higher risk of substance use and misuse, while motives related to intimacy and commitment in romantic relationships were associated with lower risk

Asthma history predicts the risk of affective disorders and anxiety disorders

Background: Positive associations between asthma and a range of mental disorders have been increasingly reported in cross-sectional studies. It is important to determine whether the association between asthma and mental disorders may be causal. Objectives: We conducted a retrospective cohort study using data collected from the 2007 Australia Mental Health and Wellbeing survey (MHW) to examine whether preexisting asthma may predict the likelihood of various types of anxiety disorders and affective disorders. Design, Settings and Subjects: The 2007 MHW survey was a nationally representative household survey. Its data included 8841 Australian adults aged 18 - 85 yrs. Age at first onset of asthma and mental disorders were used to reveal the order of occurrence of asthma and mental disorders, and to define time at risk and asthma exposure. Kaplan-Meier failure function and multivariate Poisson regression models were employed in analysis. Results: Participants who had a history of asthma that lasted six months or more were at higher risk of panic disorder, obsessive compulsive disorder, posttraumatic stress disorder, bipolar disorder, mania and hypomania. The association between asthma history and risk of mental disorder subtypes differed by gender. Conclusion: The findings of this study support the hypothesis that pre-existing asthma increases the risk of a number of anxiety disorders and affective disorders. Predisposition to carbon dioxide hypersensitivity and corticosteroid therapy may partly explain the observed associations

Alcohol Consumption during Adolescence and Risk of Diabetes in Young Adulthood

Background. There is very limited data available on the association between underage drinking and risk of diabetes. The aim of this study is to investigate the association between alcohol use during adolescence and the risk of diabetes while controlling for a wide range of confounders, including parental alcohol use. Methods. This population-based study used data collected from the National Longitudinal Study of Adolescent Health (Add Health). Participants were initially recruited in 1994-1995 (Wave I), then followed up in 1996 (Wave II) and in 2001-2002 (Wave III), and in 2008-2009 (Wave IV). Analysis included 2,850 participants (46% male) who were successfully followed up at Waves I, III, and IV without a known diagnosis of diabetes at Waves I and III and who provided all necessary information for the analysis. Results. During adolescence, frequent alcohol consumption at levels reaching 5 or more drinks, 3–7 days/week, substantially increased the risk of diabetes in young adulthood, with an odds ratio of 12.57 (95% CI 4.10–38.61) compared to current abstainers. Conclusions. Heavy alcohol use during adolescence may increase the risk of diabetes in young adulthood. The Significant finding of the Study