BACKGROUND: A strict high legal age limit for alcohol purchases decreases adolescents' access to alcohol, but little is known about long-term health effects. The aim was to estimate the effect of increased alcohol availability during adolescence on alcohol-related morbidity and mortality.

METHODS: A nationwide register-based study using data from a natural experiment setting. In two regions of Sweden, strong beer (4.5%-5.6% alcohol by volume) became temporarily available for purchase in grocery stores for individuals 16 years or older (instead of 21) in 1967/1968. The intervention group was defined as all individuals living in the intervention area when they were 14-20 years old (n=72 110). The remaining Swedish counties excluding bordering counties, without the policy change, were used as the control group (n=456 224). The outcomes of alcohol-related morbidity and mortality were collected from the Hospital Discharge Register and Cause of Death Register, in which average follow-up times were 38 years and 41 years, respectively. HRs with 95% CIs were obtained by Cox regression analysis.

RESULTS: In the fully adjusted model, no clear evidence of an association between increased alcohol availability during adolescence and alcohol-related morbidity (HR: 0.99, 95% CI 0.96 to 1.02) or mortality (HR: 1.02, 95% CI 0.95 to 1.10) was found.

CONCLUSION: The initial elevated risk of alcohol-related morbidity and mortality later in life among adolescents exposed to increased access to strong beer in Sweden vanished when a regional measure population density of locality was included in the model, which is important to consider in future research.

Published in General Health

BACKGROUND: Previous studies have revealed inconsistent findings regarding the association of light to moderate alcohol consumption with cardiovascular disease (CVD) and cancer mortality.

OBJECTIVES: The aim of this study was to examine the association between alcohol consumption and risk of mortality from all causes, cancer, and CVD in U.S. adults. METHODS: Data were obtained by linking 13 waves of the National Health Interview Surveys (1997 to 2009) to the National Death Index records through December 31, 2011. A total of 333,247 participants >/=18 years of age were included. Self-reported alcohol consumption patterns were categorized into 6 groups: lifetime abstainers; lifetime infrequent drinkers; former drinkers; and current light, moderate, or heavy drinkers. Secondary exposure included participants' binge-drinking status. The main outcome was all-cause, cancer, or CVD mortality.

RESULTS: After a median follow-up of 8.2 years (2.7 million person-years), 34,754 participants died of all causes (including 8,947 CVD deaths and 8,427 cancer deaths). Compared with lifetime abstainers, those who were light or moderate alcohol consumers were at a reduced risk of mortality for all causes (light-hazard ratio [HR]: 0.79; 95% confidence interval [CI]: 0.76 to 0.82; moderate-HR: 0.78; 95% CI: 0.74 to 0.82) and CVD (light-HR: 0.74; 95% CI: 0.69 to 0.80; moderate-HR: 0.71; 95% CI: 0.64 to 0.78), respectively. In contrast, there was a significantly increased risk of mortality for all causes (HR: 1.11; 95% CI: 1.04 to 1.19) and cancer (HR: 1.27; 95% CI: 1.13 to 1.42) in adults with heavy alcohol consumption. Binge drinking >/=1 d/week was also associated with an increased risk of mortality for all causes (HR: 1.13; 95% CI: 1.04 to 1.23) and cancer (HR: 1.22; 95% CI: 1.05 to 1.41).

CONCLUSIONS: Light and moderate alcohol intake might have a protective effect on all-cause and CVD-specific mortality in U.S. adults. Heavy or binge drinking was associated with increased risk of all-cause and cancer-specific mortality.

Published in General Health

BACKGROUND: Several studies have investigated the predictors of alcohol consumption behavior among adolescents and young adults. However, the body of evidence about the relationship between in particular psychological factors and alcohol consumption among individuals in the second half of life is still limited. Hence, we aimed at identifying factors associated with alcohol consumption among individuals aged 40 and above, especially focusing on psychological correlates.

METHODS: Data were derived from a population-based sample of community-dwelling individuals aged 40 to 95 years (n = 7820) in Germany. Alcohol consumption was rated as 'never' (never drinkers), 'rarer than once a month', 'one to three times a month', 'once a week', 'several times a week' (occasional drinkers), and 'daily' (daily drinkers). Socio-economic factors, the illness level and physical activity were considered as possible determinants of alcohol consumption. In addition, positive and negative affect, life satisfaction, optimism, self-esteem, self-efficacy, and self-regulation were included as psychological factors. Multinomial regressions were used to identify factors associated with drinking behavior.

RESULTS: 12.0% of the individuals were daily drinkers, 76.5% were occasional drinkers, and 11.5% of the individuals never drank alcohol. After adjusting for various potential confounders, multinomial logistic regressions revealed that, compared with never drinking, occasional and daily drinking were positively associated with a decreased loneliness, a higher life satisfaction, a higher positive affect, a higher optimism, a higher self-efficacy (occasional drinkers), a higher self-esteem, and less perceived stress. In addition, occasional and daily drinking were positively associated with less physical illnesses, male gender, and income as compared with never drinking.

CONCLUSIONS: The current study extends the existing literature on alcohol consumption behavior by new insights of correlates of drinking behavior among individuals in the second half of life. Since interventions are available to address this risk factor, this might help to identify individuals with increased alcohol consumption.

Published in Drinking Patterns

'Responsible drinking' campaigns emerged in the early 1970s as a means of addressing hazardous drinking and its related consequences. While these were initially the product of public health agencies and health-related NGOs, they are increasingly being developed and disseminated by the alcohol industry. There is considerable debate as to whether industry-generated campaigns are designed to reduce hazardous drinking and related problems (as argued by their developers) or are designed to avoid government regulation or even to increase sales. The aim of the present study was to explore the way that recent industry-developed responsible drinking campaigns are perceived and interpreted by the general public. That is, do they promote low-risk drinking, promote risky drinking, or just muddy the waters. Two sub-studies were conducted. The first, a mall intercept study with 180 adults in two Australian shopping districts, explored participants' understanding of slogans/taglines. The second, an online survey with 480 Australian adults, explored understandings and interpretations of television/online commercials. The results of the two studies revealed diversity in participants' interpretation of the 'responsible drinking' advertisements. Terminology utilised in industry-developed advertisements was found to be ambiguous; for example, what age group was being referred to in the tagline 'Kids and alcohol don't mix', and whether 'Drink Properly' meant not drinking to excess or drinking in a way that made you look more sophisticated. In Study Two, the government-developed campaign ('Know when to say when') was clearly interpreted as warning against risky consumption of alcohol; whereas the industry-developed campaigns ('How to drink properly', 'Kids absorb your drinking', 'Friends are waiting') were interpreted to have a range of different meanings, including some seemingly unrelated to alcohol. These findings are consistent with the literature evaluating anti-smoking campaigns developed by the tobacco industry, and previous research showing that industry communications serve to soften public opinion and create the impression of a 'socially responsible' industry but are likely to be less effective than initiatives focused on the availability and promotion of alcohol.

Published in Drinking Patterns
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The authors have taken reasonable care in ensuring the accuracy of the information herein at the time of publication and are not responsible for any errors or omissions. Read more on our disclaimer.