25 August 2020 In Drinking Patterns

BACKGROUND: Some of the previously reported health benefits of low-to-moderate alcohol consumption may derive from health status influencing alcohol consumption rather than the opposite. We examined whether health status changes influence changes in alcohol consumption, cessation included.

METHODS: Data came from 571 current drinkers aged >/=60 years participating in the Seniors-ENRICA cohort in Spain. Participants were recruited in 2008-2010 and followed-up for 8.2 years, with four waves of data collection. We assessed health status using a 52-item deficit accumulation (DA) index with four domains: functional, self-rated health and vitality, mental health, and morbidity and health services use. To minimise reverse causation, we examined how changes in health status over a 3-year period (wave 0-wave 1) influenced changes in alcohol consumption over the subsequent 5 years (waves 1-3) using linear/logistic regression, as appropriate.

RESULTS: Compared with participants in the lowest tertile of DA change (mean absolute 4.3% health improvement), those in the highest tertile (7.8% worsening) showed a reduction in alcohol intake (beta: -4.32 g/day; 95% CI -7.00 to -1.62; p trend=0.002) and were more likely to quit alcohol (OR: 2.80; 95% CI 1.54 to 5.08; p trend=0.001). The main contributors to decreasing drinking were increased functional impairment and poorer self-rated health, whereas worsening self-rated health, onset of diabetes or stroke and increased prevalence of hospitalisation influenced cessation.

CONCLUSIONS: Health deterioration is related to a subsequent reduction and cessation of alcohol consumption contributing to the growing evidence challenging the protective health effect previously attributed to low-to-moderate alcohol consumption

03 June 2019 In Drinking Patterns

OBJECTIVE: A retrospective case-control study was conducted to evaluate whether frequent binge drinking between the age of 18 and 25 years was a risk factor for alcohol dependence in adulthood.

SETTING: The Department of Addictive Medicine and the Clinical Investigation Center of a university hospital in France.

PARTICIPANTS: Cases were alcohol-dependent patients between 25 and 45 years and diagnosed by a psychiatrist. Consecutive patients referred to the Department of Addictive Medicine of a university hospital between 1 January 2017 and 31 December 2017 for alcohol dependence were included in the study. Controls were non-alcohol-dependent adults, defined according to an Alcohol Use Disorders Identification Test score of less than 8, and were matched on age and sex with cases. Data on sociodemographics, behaviour and alcohol consumption were retrospectively collected for three life periods: before the age of 18 years; between the age of 18 and 25 years; and between the age of 25 and 45 years. Frequency of binge drinking between 18 and 25 years was categorised as frequent if more than twice a month, occasional if once a month and never if no binge drinking.

RESULTS: 166 adults between 25 and 45 years were included: 83 were alcohol-dependent and 83 were non-alcohol-dependent. The mean age was 34.6 years (SD: 5.1). Frequent binge drinking between 18 and 25 years occurred in 75.9% of cases and 41.0% of controls (p<0.0001). After multivariate analysis, frequent binge drinking between 18 and 25 years was a risk factor for alcohol dependence between 25 and 45 years: adjusted OR=2.83, 95% CI 1.10 to 7.25.

CONCLUSIONS: Frequent binge drinking between 18 and 25 years appears to be a risk factor for alcohol dependence in adulthood. Prevention measures for binge drinking during preadulthood, especially frequent binge drinking, should be implemented to prevent acute consequences as injury and death and long-term consequences as alcohol dependence.

TRIAL REGISTRATION NUMBER: NCT03204214; Results.

26 February 2019 In Cancer

BACKGROUND: We aimed to understand the factors shaping alcohol consumption patterns in middle-aged women (45-64), and to identify participant-driven population- and policy-level strategies that may be used to addresses alcohol consumption and reduce breast cancer risk.

METHODS: Semi-structured interviews (n = 35) were conducted with 'middle-aged' women conversant in English and living in South Australia with no history of breast cancer diagnosis. Data were deductively coded using a co-developed framework including variables relevant to our study objectives. Women were asked about their current level of awareness of the association between alcohol and breast cancer risk, and their personal recommendations for how to decrease consumption in middle-aged Australian women.

RESULTS: Women discussed their previous efforts to decrease consumption, which we drew on to identify preliminary recommendations for consumption reduction. We identified a low level of awareness of alcohol and breast cancer risk, and confusion related to alcohol as a risk for breast cancer, but not always causing breast cancer. Participants suggested that education and awareness, through various means, may help to reduce consumption.

CONCLUSIONS: Participants' description of strategies used to reduce their own consumption lead us to suggest that campaigns might focus on the more salient and immediate effects of alcohol (e.g. on physical appearance and mental health) rather than longer-term consequences. Critical considerations for messaging include addressing the personal, physical and social pleasures that alcohol provides, and how these may differ across socio-demographics.

22 February 2019 In Cancer

BACKGROUND: We aimed to understand the factors shaping alcohol consumption patterns in middle-aged women (45-64), and to identify participant-driven population- and policy-level strategies that may be used to addresses alcohol consumption and reduce breast cancer risk.

METHODS: Semi-structured interviews (n = 35) were conducted with 'middle-aged' women conversant in English and living in South Australia with no history of breast cancer diagnosis. Data were deductively coded using a co-developed framework including variables relevant to our study objectives. Women were asked about their current level of awareness of the association between alcohol and breast cancer risk, and their personal recommendations for how to decrease consumption in middle-aged Australian women.

RESULTS: Women discussed their previous efforts to decrease consumption, which we drew on to identify preliminary recommendations for consumption reduction. We identified a low level of awareness of alcohol and breast cancer risk, and confusion related to alcohol as a risk for breast cancer, but not always causing breast cancer. Participants suggested that education and awareness, through various means, may help to reduce consumption.

CONCLUSIONS: Participants' description of strategies used to reduce their own consumption lead us to suggest that campaigns might focus on the more salient and immediate effects of alcohol (e.g. on physical appearance and mental health) rather than longer-term consequences. Critical considerations for messaging include addressing the personal, physical and social pleasures that alcohol provides, and how these may differ across socio-demographics.

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