Serving Substance Abuse Professionals Since 1993

Last Update: 28.12.07

C O R K O N L I N E

powerpoint presentations
CORK database search
resource materials
bibliographies
clinical tools
user services
newsletters
about cork
home

CORK Bibliography: Binge Drinking

66 citations. January 2007 to present

Prepared: January 2008

Arliss RM. Cigarette smoking, binge drinking, physical activity, and diet in 138 Asian American and Pacific Islander community college students in Brooklyn, New York. Journal of Community Health 32(1): 71-84, 2007. (34 refs.)

Assessment of cigarette smoking, alcohol consumption, physical activity, and diet in the Asian American and Pacific Islander (AAPI) community has been neglected. A questionnaire was used to investigate these health risk behaviors in 466 students at an urban community college and results for the 138 AAPI study participants were compared to the 328 non-Asians. Results for AAPI study participants showed that twenty percent (20.3%) were current cigarette smokers and 7.7% smoked eleven or more cigarettes per day. Ten percent (10.7%) reported binge drinking on one to two days per month and 17.3% reported binge drinking on three or more days per month. With regard to physical activity, 28.8% participated in stretching, 23.6% in strength and toning, 29.4% in moderate exercise, and 25.4% in vigorous exercise. Results indicated that on the day preceding the survey, only 11.9% consumed five or more servings of fruits and vegetables, 88.4% ate no more than two servings of high-fat foods, and 37.6% consumed tofu, soymilk, or other soy food. AAPI study participants were more likely to frequently binge drink (p < .05), less likely to participate in strength and toning exercises (p < .05), and more likely to consume soy foods daily (p < .01) than non-Asian study participants. Recommendations are presented for health promotion program planning.

Birch CD; Stewart SH; Brown CG. Exploring differential patterns of situational risk for binge eating and heavy drinking. Addictive Behaviors 32(3): 433-448, 2007. (61 refs.)

This study was designed to compare risk situations for binge eating vs. heavy drinking among women who struggle with both problems. Participants were 41 women in treatment for an alcohol problem who also self-reported binge eating. Participants completed the Inventory of Binge Eating Situations (IBES; [Baker, J. M. (1998). Binge eating and binge drinking among university women. Unpublished master's thesis, Department of Psychology, Queen's University, Kingston, Ontario, Canada]) and the Inventory of Drinking Situations (IDS-42; [Annis, H. M., Graham, J. M., & Davis, C. S. (1987). Inventory of Drinking Situations (IDS) user's guide. Toronto, Canada: Addiction Research Foundation]) to measure frequency of binge eating and heavy drinking, respectively, in eight categories of situations. A 2 (substance) x 8 (situation) repeated measures ANOVA revealed a significant substance x situation interaction. Further exploration of this interaction indicated that heavy drinking is more likely than binge eating to occur in reward and interpersonal situations involving pleasant emotions, pleasant times with others, social pressure, and conflict with others. In contrast, binge eating and heavy drinking are equally likely to occur in relief situations involving unpleasant emotions, and physical discomfort, as well as in situations involving urges and temptations, and testing control. Implications of findings for the treatment of co-occurring binge eating and heavy drinking in women are discussed.

Bloomfield K; Grittner U; Kramer S; Gmel G. Social inequalities in alcohol consumption and alcohol-related problems in the study countries of the EU concerted action Gender, Culture and Alcohol problems: A multi-national study. Alcohol and Alcoholism 41(Supplement 1): I26-I36, 2006. (35 refs.)

Aims: We investigated the presence of social inequalities of alcohol use and misuse using educational attainment as an indicator of socio-economic status in 15 countries: Sweden, Norway, Finland, Germany, The Netherlands, Switzerland, Hungary, the Czech Republic, Israel, Brazil, and Mexico. Methods: Study surveys were independently conducted and the data centrally analysed. Most samples were national. Survey modes and sample sizes varied. The age range was restricted to between 25 and 59 years of age. Socio-economic status was measured by educational level. Multiple logistic regressions were employed to calculate age-adjusted odds ratios for men and women in each country by educational level for current drinking status, heavy drinking (>= 20 g ethanol per day for women, >= 30 g a day for men), heavy episodic (binge) drinking, and alcohol-related problems (using AUDIT). Results: Men and women demonstrated similar patterns in inequalities with regard to current drinking status within a country. In Germany, The Netherlands, France, Switzerland, and Austria higher educated women were most likely to drink heavily, while among men the lower educated were more at risk in most countries. For heavy episodic drinking, almost no significant differences were evident among women, but for men a social gradient was observable with lower educated being more at risk in several countries. Among five countries with data from the AUDIT, men of lower education in Finland, Czech Republic, and Hungary had higher risks to report problems. Nordic countries shared a common pattern in social inequalities as did two Latin American countries, while a mixed picture was observed for middle European countries. Social inequalities in the two Latin American countries display a pattern emerging in other research on developing countries: namely that those in the higher educated groups are more likely to consume alcohol in a risky manner. Conclusions: Patterns in the distribution of social inequalities are not universal. Social inequalities in alcohol use differ by gender according to alcohol measure used and differ also across groups of countries. These variations should be taken into account when formulating international and cross-cultural alcohol policies.

Brumback T; Cao DC; King A. Effects of alcohol on psychomotor performance and perceived impairment in heavy binge social drinkers. Drug and Alcohol Dependence 91(1): 10-17, 2007. (45 refs.)

Alcohol intoxication often results in negative consequences; however, specific behavioral and subjective effects vary as a function of individual differences. The present study utilized an alcohol challenge paradigm to examine whether heavy binge social drinkers (HD; n = 77), compared to light social drinkers (LD; n = 55), exhibit: (1) greater tolerance in psychomotor task performance under the influence of alcohol, and (2) differential perceptions of the impairing effects of alcohol. The study included three test sessions in which participants consumed either a low (0.4g/kg) or a high (0.8g/kg) dose of ethanol or a placebo beverage administered in random order and counterbalanced within group. Participants completed the Digit-Symbol Substitution Task (DSST) and the Grooved Pegboard at pre-drink baseline and at multiple time points after beverage consumption. They also completed a scale of perceived impairment at several intervals after beverage consumption. Ethanol impaired performance at the high dose, but not at the low dose (ps <.001). The groups exhibited similar alcohol-induced impairment. However, HD reported lower self-perceived impairment compared to LID, particularly during the early portion of the blood alcohol curve when actual impairment was most pronounced (p <.001). Thus, this study extends prior research in that habitual binge social drinking does not appear to be associated with tolerance to alcohol's impairing effects on select psychomotor skills. Further, results may have implications for alcohol-related harm as binge social drinkers regularly consume intoxicating doses of alcohol but may not be aware of the physical and cognitive impairments produced by alcohol.

Bryant-Jefferies R. Counselling Young Binge Drinkers: Person-centred Dialogues. Abingdon UK: Radcliffe Medical Press, 2006. (88 refs.)

This book endeavors to demonstrate the application of the person-centred approach (a widely used psychotherapeutic approach developed by Carl Rogers) to clinical work with adolescents and young adults involved in binge drinking, a problem of growing concern. The volume is organized into three sections. The first, an introduction, describes drinking among young people, the problems attendent to binge drinking, referral pathways and access to counseling, as well as outlining the fundamental features of the person-centred approach, and the role and importance of clinical supervision for the therapist. The remainder of the book is then organized into two parts, each devoted to examination of a particular case. For each of these case presentations, key sessions are presented, including the dialogue of clinical and client, and discussion of central themes and issues that are exemplified. There are also transcripts of supervision sessions. Accompaning each of these chapters are points for discussion, as well as reflections by the clnician and supervisor.

Caudill BD; Crosse SB; Campbell B; Howard J; Luckey B; Blane HT. High-risk drinking among college fraternity members: A national perspective. Journal of American College Health 55(3): 141-155, 2006. (51 refs.)

This survey, with its 85% response rate, provides an extensive profile of drinking behaviors and predictors of drinking among 3406 members of one national college fraternity, distributed across 98 chapters in 32 states. Multiple indexes of alcohol consumption measured frequency, quantity, estimated blood alcohol concentration levels (BACs), and related problems. Among all members, 97% were drinkers, 86% binge drinkers, and 64% frequent binge drinkers. On the basis of self-reports concerning the 4 weeks preceding the time of survey, the authors found that members drank on an average of 10.5 days and consumed an average of 81 drinks. Drinkers had an average BAC of 0.10, reaching at least 0.08 on an average of 6 days. These fraternity members appear to be heavier drinkers than previously studied fraternity samples, perhaps because they were more representative and forthright. All 6 preselected demographic attributes of members and 2 chapter characteristics were significantly related to the drinking behaviors and levels of risk, identifying possible targets for preventive interventions.

Cavanagh SE. Peers, drinking, and the assimilation of Mexican American youth. Sociological Perspectives 50(3): 393-416, 2007. (55 refs.)

Drinking alcohol, a normative behavior during adolescence in the United States, has significant consequences for health and wellbeing in adolescence and beyond. Highly social in nature, it is also a domain in which to assess the implications of the assimilation of immigrant youth into American peer culture. Using a Mexican American sample drawn from the National Longitudinal Study of Adolescent Health (N = 1,034), this study found generational differences in adolescent drinking behaviors, with more recent immigrants less likely to drink or binge drink. It also found generational differences in the social ecology of friendship groups, with first- and second-generation youth in friendship groups with higher concentrations of coethnic and other immigrant youth who engaged in less party behaviors. These differences did not explain generational differences in adolescent drinking behaviors but did condition the drinking behaviors of second-generation Mexican Americans. More specifically, second-generation youth with more White friends and friends who engaged in more party behaviors were more likely to binge drink than all others.

Centers for Disease Control and Prevention; Hughes E; McCraken M; Roberts H; Mokdad AH; Valluru B; Goodson R et al. Surveillance for Certain Health Behaviors among States and Selected Local Areas -- Behavioral Risk Factor Surveillance System, United States, 2004. MMWR. Morbidity and Mortality Weekly Report 55(No. SS-7): 1-126, 2006. (38 refs.)

Problem: Continuous monitoring of behaviors that increase the risk for chronic diseases and use of preventive practices are essential for the development, implementation, and evaluation of health promotion programs and policies, and other intervention strategies to prevent morbidity and mortality. Data from states/territories, selected metropolitan and micropolitan statistical areas (MMSAs), and counties provide the impetus for policymakers and other stakeholders to develop and promote the improvement of their community's overall health status. Reporting Period Covered: Data in this report were collected during January 1--December 31, 2004, from states/territories, MMSAs, and counties that participated in the 2004 Behavioral Risk Factor Surveillance System (BRFSS). Description of the System: BRFSS is an ongoing, state-based, telephone survey. It collects information on health risk behaviors and preventive health practices related to the leading causes of death. It is restricted to noninstitutionalized population aged >18 years. Results: Prevalence of high-risk behaviors for chronic diseases, awareness of specific medical conditions, screening for certain cancers, and use of preventive health services varied substantially by state/territory, MMSA, and county. The proportion of the population that achieved Healthy People 2010 (HP 2010) objectives also varied by state/territory, MMSA, and county. In 2004, HP 2010 objectives for 100% health-care coverage and vaccination for pneumonia and influenza among persons aged >65 years were not achieved by any state/territory, MMSA, or county. Twelve states/territories, 47 MMSAs, and 74 counties achieved the HP 2010 objective of <20% of adults engaged in no leisure-time physical activity or exercise. The HP 2010 objective to reduce the proportion of adults who currently smoke cigarettes to <12% was achieved by two states/territories, four MMSAs, and six counties. One MMSA and one county achieved the HP 2010 target of <6% who engage in binge drinking during the month preceding the survey. The HP 2010 target of <15% of adults who are obese was obtained by one MMSA and eight counties. Results related to dental health, having had various screening procedures is reported. There is also inclusion of heavy alcohol consumption.

Public Domain

Coffin PO; Latka MH; Latkin C; Wu Y; Purcell DW; Metsch L; INSPIRE Study Group. Safe syringe disposal is related to safe syringe access among HIV-positive injection drug users. AIDS and Behavior 11(5): 652-662, 2007. (39 refs.)

We evaluated the effect of syringe acquisition on syringe disposal among HIV-positive injection drug users (IDUs) in Baltimore, New York City, and San Francisco (N = 680; mean age 42 years, 62% male, 59% African-American, 21% Hispanic, 12% White). Independent predictors of safe disposal were acquiring syringes through a safe source and ever visiting a syringe exchange program. Weaker predictors included living in San Francisco, living in the area longer, less frequent binge drinking, injecting with an HIV+ partner, peer norms supporting safe injection, and self-empowerment. Independent predictors of safe "handling"-both acquiring and disposing of syringes safely-also included being from New York and being older. HIV-positive IDUs who obtain syringes from a safe source are more likely to safely dispose; peer norms contribute to both acquisition and disposal. Interventions to improve disposal should include expanding sites of safe syringe acquisition while enhancing disposal messages, alternatives, and convenience.

Coleman L; Cater S. Changing the culture of young people's binge drinking: From motivations to practical solutions. Drugs: Education, Prevention and Policy 14(4): 305-317, 2007. (24 refs.)

Aims: This paper explores young people's own opinions about how the `drinking to get drunk' culture can be changed. More precisely, the two objectives of this study were to explore: (1) whether young people viewed binge drinking as a real 'problem'; and (2) what they thought could be done to reduce binge drinking. Methods: Forty in-depth interviews and four focus group discussions were held with young binge drinkers aged 18 - 25 years. Participants were recruited from nine different community-based sites in Caerphilly Borough County, South Wales (a binge drinking 'hot- spot'). Findings: On the whole, most young people did not classify themselves as binge drinkers, with drinking considered to be part of a normal and fun existence. Although some people thought nothing would work to stop binge drinking, other responses included: shock-tactics that young people could relate to (i. e. experiences of peers rather than 'diseased livers'), witnessing and reflecting on antisocial and embarrassing behaviour, acknowledging the likelihood of regretted sexual experiences, and greater enforcement of not purchasing alcohol when drunk. Conclusion: These findings highlight the importance of a more understandable definition of binge drinking, perhaps based on being drunk rather than units. Also, opinions suggest that youth-, culturally- and ethnically- specific interventions are likely to be more effective. To close, the paper emphasizes the importance of any intervention having the full support of a methodologically sound and rigorous evaluation.

Daeppen JB; Gaume J; Bady P; Yersin B; Calmes JM; Givel JC; Gmel G. Brief alcohol intervention and alcohol assessment do not influence alcohol use in injured patients treated in the emergency department: A randomized controlled clinical trial. Addiction 102(8): 1224-1233, 2007. (39 refs.)

Aims: To evaluate the effectiveness of brief alcohol intervention (BAI) in reducing alcohol use among hazardous drinkers treated in the emergency department (ED) after an injury; in addition it tests whether assessment of alcohol use without BAI is sufficient to reduce hazardous drinking. Design: Randomized controlled clinical trial with 12-month follow-up conducted between January 2003 and June 2005. Setting: Urban academic emergency department (ED) of the Lausanne University Hospital, Lausanne, Switzerland. Participants A total of 5136 consecutive patients attending ED after an injury completed a seven-item general and a three-item alcohol screen and 1472 (28.7%) were positive for hazardous drinking according to the National Institute on Alcohol Abuse and Addiction definition; of these 987 (67.1%) were randomized into a BAI group (n = 310) or a control group with screening and assessment (n = 342) or a control group with screening only (n = 335) and then a total of 770 patients (78.0%) completed the 12-month follow-up procedures. Intervention: A single 10-15-minute session of standardized BAI conducted by a trained research assistant. Measurements: Percentage of participants who have changed to low-risk drinking at follow-up. Findings: Data obtained at 12 months indicated that similar proportions were low-risk drinkers in BAI versus control groups with and without assessment (35.6%, 34.0%, 37.0%, respectively, P = 0.71). Data also indicated similar reductions in drinking frequency, quantity, binge drinking frequency and Alcohol Use Disorders Identification Test (AUDIT) scores across groups. All groups reported similar numbers of days hospitalized and numbers of medical consults in the last 12 months. A model including age groups, gender, AUDIT and injury severity scores indicated that BAI had no influence on the main alcohol use outcome. Conclusions: This study provides the evidence that a 10-15-minute BAI does not decrease alcohol use and health resource utilization in hazardous drinkers treated in the ED, and demonstrates that commonly found decreases in hazardous alcohol use in control groups cannot be attributed to the baseline alcohol assessment.

DeSimone J. Fraternity membership and binge drinking. Journal of Health Economics 26(5): 950-967, 2007. (32 refs.)

This paper examines the relationship that social fraternity and sorority membership has with binge drinking incidence and frequency among 18-24 year old full-time 4-year college students who participated in the 1995 National College Health Risk Behavior Survey. To net out unobserved heterogeneity, several measures of situational and total alcohol use are entered into the regressions as explanatory variables. Fraternity membership coefficients are substantially reduced in size, but remain large and highly significant, suggesting a causal effect on binge drinking. Otherwise, the estimates identify idiosyncratic selection into fraternities and binge drinking across students with similar overall drinking profiles. Particularly notable is that behavior by underage students appears to drive the relationship.

Doshi SR; Jiles R. Health behaviors among American Indian/Alaska native women, 1998-2000 BRFSS. Journal of Women's Health 15(8): 919-927, 2006. (37 refs.)

Background and objective: Minority populations, including American Indians and Alaska Natives (AI/AN), in the United States generally experience a disproportionate share of adverse health outcomes compared with whites. The prevalence of risk behaviors associated with these adverse health outcomes among AI/AN women is not well documented, especially for those who live outside areas serviced by Indian Health Service. We sought to describe the prevalence of selected health risk behaviors among AI/AN women, document the disparities between AI/AN women and all U. S. women, and demonstrate the efforts needed for AI/AN women to reach Healthy People 2010 goals. Methods: Age-adjusted prevalence estimates for selected sociodemographic characteristics, current smoking, obesity, lack of leisure time physical activity, and binge drinking were calculated using Behavioral Risk Factor Surveillance System (BRFSS) data from 1998 to 2000, combined. Comparisons were made between prevalence estimates for AI/AN women and all women who participated in the BRFSS and Health People 2010 goals Results: The prevalences of current smoking (27.8%) and obesity (26.8%) were significantly higher among AI/AN women than among all U. S. women. AI/AN women did not meet Healthy People 2010 goals for current smoking, obesity, leisure time physical activity, or binge drinking. Conclusions: These data highlight both disparities in health risk behaviors between AI/AN women and all U. S. women and improvements needed for AI/AN women to meet Healthy People 2010 goals. This project demonstrates the overwhelming need for culturally appropriate and accessible prevention programs to address health risk behaviors associated with the leading causes of death among urbanized AI/AN women.

Duncan GJ; Wilkerson B; England P. Cleaning up their act: The effects of marriage and cohabitation on licit and illicit drug use. Demography 43(4): 691-710, 2006. (29 refs.)

We use data from the National Longitudinal Survey of Youth to estimate changes in binge drinking, marijuana use, and cigarette smoking surrounding young adults' first experiences of cohabitation and marriage. Both marriage and cohabitation are accompanied by decreases in some risk behaviors, but reductions surrounding marriage are larger and most consistent, particularly for men. Binge drinking and marijuana use respond to these events, especially marriage, but smoking does not.

Ehlers CL; Phillips E; Finnerman G; Gilder D; Lau P; Criado J. P3 components and adolescent binge drinking in Southwest California. (review) Indians. Neurotoxicology and Teratology 29(1): 153-163, 2007. (138 refs.)

In adolescence, consuming a large number of drinks over a short interval of time (e.g. hinging) is not an uncommon occurrence. Since adolescence is an important neurodevelopmental period, the effect of binge drinking on brain and behavior has become a significant health concern. The present study evaluated event-related potentials (ERPs) in young adult Southwest California Indians who had a history of binge drinking during their adolescence. One hundred twenty five participants who were currently 18-25 yrs of age who were free of Axis I psychiatric diagnoses were categorized as: 1) reporting no binge drinking during adolescence (> 5 drinks per occasion before age 18) or drug dependence diagnoses 2) reporting binge drinking during adolescence with no drug dependence diagnoses 3) reporting binge drinking during adolescence and drug dependence diagnoses. ERPs were collected using a facial discrimination task. Adolescent alcohol and drug exposure was found to be associated with decreases in the latency of an early P3 component (P350). Decreases in a later component amplitude (P450) were also found in young adults exposed to alcohol, and those exposed to alcohol and drugs. However, that finding appears to be a combined result of predisposing factors such as family history of alcoholism and presence of other extemalizing diagnoses. Taken together these preliminary studies suggests that adolescent binge drinking may result in a decreases in P3 component latencies and amplitudes perhaps reflecting a loss or delay in the development of inhibitory brain systems.

Enoch MA. Genetic and environmental influences on the development of alcoholism: Resilience vs. risk. Annals of the New York Academy of Sciences: Resilience in Children 1094: 193-201, 2006. (41 refs.)

The physiological changes of adolescence may promote risk-taking behaviors, including binge drinking. Approximately 40% of alcoholics were already drinking heavily in late adolescence. Most cases of alcoholism are established by the age of 30 years with the peak prevalence at 18-23 years of age. Therefore the key time frame for the development, and prevention, of alcoholism lies in adolescence and young adulthood. Severe childhood stressors have been associated with increased vulnerability to addiction, however, not all stress-exposed children go on to develop alcoholism. Origins of resilience can be both genetic (variation in alcohol-metabolizing genes, increased susceptibility to alcohol's sedative effects) and environmental (lack of alcohol availability, positive peer and parental support). Genetic vulnerability is likely to be conferred by multiple genes of small to modest effects, possibly only apparent in gene-environment interactions. For example, it has been shown that childhood maltreatment interacts with a monoamine oxidase A (MAOA) gene variant to predict antisocial behavior that is often associated with alcoholism, and an interaction between early life stress and a serotonin transporter promoter variant predicts alcohol abuse in nonhuman primates and depression in humans. In addition, a common Met158 variant in the catechol-O-methyltransferase (COMT) gene can confer both risk and resilience to alcoholism in different drinking environments. It is likely that a complex mix of gene(s)-environment(s) interactions underlie addiction vulnerability and development. Risk-resilience factors can best be determined in longitudinal studies, preferably starting during pregnancy. This kind of research is important for planning future measures to prevent harmful drinking in adolescence.

Feldstein SW; Forcehimes AA. Motivational interviewing with underage college drinkers: A preliminary look at the role of empathy and alliance. American Journal of Drug and Alcohol Abuse 33(5): 737-746, 2007. (24 refs.)

This study evaluated the impact of a motivational interview (MI) on alcohol use in underage college drinkers, and examined the specific role of empathy and alliance in MI. Fifty-five underage heavy drinkers were randomized to a one-session MI or no-treatment control. Empathy and alliance were evaluated through the MITI, participant, and therapist ratings. At two-month follow-up, multivariate tests reveal no significant interaction effects. Means comparisons indicated that both groups showed reductions in alcohol-related problems, however, only the MI sample evidenced significant reductions in binge drinking. In addition, despite the reductions of both groups, effect sizes indicated that the MI group outperformed the control in terms of binge-drinking and alcohol-related problems. Contrary to predictions, empathy and alliance showed no relationships with outcomes.

Fisher LB; Miles IW; Austin B; Camargo CA; Colditz GA. Predictors of initiation of alcohol use among US adolescents - Findings from a prospective cohort study. Archives of Pediatrics & Adolescent Medicine 161(10): 959-966, 2007. (77 refs.)

Objective: To identify precursors of adolescent alcohol initiation and binge drinking. Design: Prospective cohort study. Setting: Self-report questionnaires. Participants: A total of 5511 Growing Up Today Study participants aged 11 to 18 years in 1998. Main Exposures: Individual, family, and social factors. Main Outcome Measures: First whole drink of alcohol and binge drinking. Results: Between 1998 and 1999, 611 girls (19%) and 384 boys (17%) initiated alcohol use. Older age, later maturational stage, smoking, adults drinking in the home, underage sibling drinking, peer drinking, possession of or willingness to use alcohol promotional items, and positive attitudes toward alcohol were associated with an increased likelihood of alcohol initiation. Girls who ate family dinner at home every day were less likely to initiate alcohol use than girls who ate family dinner only on some days or never (odds ratio, 0.66; 95% confidence interval, 0.50-0.87). Girls with higher social self-esteem and boys with higher athletic self-esteem were more likely to initiate alcohol use than those with lower self-esteem. Among teens who initiated alcohol use, 149 girls (24%) and 112 boys (29%) further engaged in binge drinking. Among girls, positive attitudes toward alcohol, underage sibling drinking, and possession of or willingness to use alcohol promotional items were associated with binge drinking; among boys, positive attitudes toward alcohol and older age were associated with binge drinking. Conclusions: Eating family dinner at home every day may delay alcohol uptake among some adolescents. Alcohol promotional items appear to encourage underage alcohol initiation and binge drinking; this may warrant marketing restrictions on the alcohol industry.

Ford JA. Alcohol use among college students: A comparison of athletes and nonathletes. Substance Use & Misuse 42(9): 1367-1377, 2007. (39 refs.)

This study examines alcohol use among college students, focusing on variation in binge drinking based on involvement in athletics. Prior research indicates that college students who participate in athletics are more likely to report binge drinking than are students who are not involved in athletics. However, existing research has not offered an explanation why college athletes are at a greater risk for binge drinking. Using data from the 1999 Harvard School of Public Health College Alcohol Study, a national study examining substance use and other health risk behaviors of college students in the United States, the current research examines social norms as a possible source of the elevated levels of binge drinking among college athletes. Findings indicate that athletes are more likely to report binge drinking, in part, because they view alcohol use as being more normative.

French DP; Cooke R; McLean N; Williams M; Sutton S. What do people think about when they answer theory of planned behaviour questionnaires? A 'think aloud' study. Journal of Health Psychology 12(4): 672-687, 2007. (33 refs.)

Two studies aiming to identify the nature and extent of problems that people have when completing theory of planned behaviour (TPB) questionnaires, using a cognitive interviewing approach are reported. Both studies required participants to 'think aloud' as they completed TPB questionnaires about: (a) increasing physical activity (six general public participants); and (b) binge drinking (13 students). Most people had no identifiable problems with the majority of questions. However, there were problems common to both studies, relating to information retrieval and to participants answering different questions from those intended by researchers. Questions about normative influence were particularly problematic. The standard procedure for developing TPB questionnaires may systematically produce problematic questions. Suggestions are made for improving this procedure.

Goebert D; Morland L; Frattarelli L; Onoye J; Matsu C. Mental health during pregnancy: A study comparing Asian, Caucasian and Native Hawaiian women. Maternal and Child Health Journal 11(3): 249-255, 2007. (59 refs.)

Objective: This study examines perinatal mental health issues, ethnic differences, and comorbidity among pregnant women in Hawaii. Methods: Eighty-four participants were recruited from women, ages 18-35, seeking prenatal care on Oahu. They were interviewed at their initial prenatal visit about substance use, depression, and anxiety. Results: Sixty-one percent of women screened positive for at least one mental health issue. Thirteen percent of all pregnant women reported drinking during pregnancy with 5% reporting problem drinking, 15% reported smoking cigarettes on a regular basis, 5% of pregnant women had probable depression, and 13% of pregnant women had probable anxiety. Significant ethnic differences were found in cigarette smoking, with the highest rate among Native Hawaiian women (35%). Native Hawaiian women were also more likely to binge drink. Conclusion: Given the high rates of potential mental health issues in our sample, our findings highlight the importance of screening and treatment for mental health issues early in pregnancy in Hawaii.

Goudriaan AE; Grekin ER; Sher KJ. Decision making and binge drinking: A longitudinal study. Alcoholism: Clinical and Experimental Research 31(6): 928-938, 2007. (61 refs.)

Background: Behavioral decision making, as measured by the Iowa Gambling Task (IGT) is found to be diminished in individuals with substance dependence and other types of disinhibitory psychopathology. However, little is known regarding the relation between heavy alcohol use and decision-making skills in young adults. This study therefore investigated whether binge drinking is related to disadvantageous decision making, as measured by the IGT. We also examined the relation between decision making and impulsivity. Methods: Latent class growth analysis was used to classify college students into 4 groups (each group n=50, 50% male), based on their binge drinking trajectories over a 2-year time period (precollege through second year of college). Participants were 200 college students, divided in 4 subgroups: (1) low binge drinkers, (2) stable moderate binge drinkers, (3) increasing binge drinkers, and (4) stable high binge drinkers. A measure of decision making, the IGT, impulsivity questionnaires, and multiple indicators of heavy alcohol use were included. Results: The stable high binge-drinking group made less advantageous choices on the IGT than the low binge-drinking group. Impulsivity was not related to decision-making performance. Decision-making performance did not differ by gender, but deck preferences and decision time patterns did differ; women preferred low frequency, high amount punishments to a greater extent than men. Conclusions: Although disadvantageous decision making is related to binge-drinking patterns in emerging adulthood, this relation is independent of impulsivity. Additionally, the association appears attributable to those who engage in heavy (binge) drinking at an early age, but not to age of onset of drinking in general.

Gronbaek M. Confounders of the relation between type of alcohol and cardiovascular disease. Annals of Epidemiology 17(5, Supplement S): S13-S15, 2007. (20 refs.)

There have been numerous reports from epidemiologic studies showing that moderate drinkers have lower rates of cardiovascular disease (CVD) than do those who drink heavily or not at all. A number of scientific reports from scientists around the world suggest confounding may play a role in the reported beneficial health effects associated with moderate drinking. Among potentially confounding variables for these reported associations are the frequency of alcohol consumption, drinking pattern (steady or binge drinking), type of beverage, and differences in the pattern of drinking associated with different types of beverages. In some papers, individuals who report primarily wine consumption have been shown to be at lower risk of CVD and total mortality, and there is evidence for greater beneficial effects from more frequent, regular drinking. However, other potential confounders include better cognitive function, higher socioeconomic status, better subjective health, and a healthier diet, including food purchases, all of which are more common in regular drinkers and wine drinkers. Thus, the question of whether the beneficial effects of beverage types differ, with additional benefits for wine, remains unresolved.

Harper S; Lynch J. Trends in socioeconomic inequalities in adult health behaviors among US states, 1990-2004. Public Health Reports 122(2): 177-189, 2007. (58 refs.)

Objective. The purpose of this study was to measure state trends in educational inequalities in smoking, binge alcohol use, physical inactivity, obesity, and seatbelt use. Methods. The authors calculated the Relative Concentration Index of educational inequality for five health behaviors on adults from all 50 states and the District of Columbia using data from 1990 to 2004 in the Behavioral Risk Factor Surveillance System (n=2,118,562). Linear regression was used to measure changes and trends in the Relative Concentration Index of heath inequality across education groups in each state. Results. Except for binge alcohol use, poorer health behaviors were concentrated among the less educated. The largest educational inequalities were for physical inactivity. From 1990 to 2004, significant increases in relative educational inequalities occurred in 40 states for smoking and 31 states for physical inactivity. For binge alcohol use, 27 states showed significant declining inequality trends, but educational inequalities reversed direction and binge alcohol use is now more prevalent among the less educated in 19 states. Significant decreases in educational inequalities occurred in 36 states for obesity and 24 states for seat belt use. Changes in educational inequalities across the different health behaviors were not associated, except for a modest correlation between changes in inequality in smoking and binge alcohol use (r=0.40; p=0.004). Similarly, there was little association between changes in the population prevalence of health behaviors and changes in educational inequality in health behaviors, with substantial heterogeneity among states. Conclusions. State trends in relative educational inequality among health behaviors were mixed, increasing for smoking and physical inactivity and decreasing for obesity and seat belt use. The factors influencing relative inequality trends may differ from those affecting overall prevalence trends.

Hayward K; Hobbs D. Beyond the binge in 'booze Britain': Market-led liminalization and the spectacle of binge drinking. (review). British Journal of Sociology 58(3): 437-456, 2007. (116 refs.)

The contemporary night-time economy has transformed British town centres into liminal spaces where transgression does not subvert normative space, but establishes public drunkenness as integral to a negotiated order. The focus of this paper is the wider dialectic surrounding contemporary 'binge drinking', and in particular the relationship between aesthetic processes aimed at encouraging alcohol-related excitement and excess, and those that seek to exert a measure of rational control over the drink 'problem'. It is the logic of the market that informs governmental policy on alcohol, and the binge drinker is central to the spectacle of the night-time economy as a form of self gratification which also embodies forms of repression.

Higgins GE; Tewksbury R. Sports fan binge drinking: An examination using low self-control and peer association. Sociological Spectrum 27(4): 389-404, 2007. (56 refs.)

Research has shown a connection between being a college sports fan and binge drinking; however, no research uses criminological theories when examining this connection. The purpose of the present study is to examine the ability of self-control and differential association theories to determine whether the relationship between college sports fans and binge drinking is individual or group situated. Using self-report data from (n = 693) college students from four southern universities, the results show that the connection between being a college sports fan and binge drinking can be accounted for by both low self-control and differential association. These results are discussed and policy implications are presented.

Hines DA; Straus MA. Binge drinking and violence against dating partners: The mediating effect of antisocial traits and behaviors in a multinational perspective. Aggressive Behavior 33(5): 441-457, 2007. (60 refs.)

Research has consistently shown a link between alcohol use and partner violence (PV). Little is known concerning the strength of this association across cultures and genders, and few have assessed possible mediators. This study assesses the link between binge drinking and PV among 7,921 college students in 38 sites around the world, and investigates the mediating role of antisocial traits and behaviors (ASTB). A significant association was found between binge drinking and PV, the strength of which differed by site but not by gender. ASTB full), mediated this association. The mean level of binge drinking at each site did not significantly influence the strength of the association between binge drinking and PV.

Holt JB; Miller JW; Naimi TS; Sui DZ. Religious affiliation and alcohol consumption in the United States. Geographical Review 96(4): 523-542, 2006. (68 refs.)

Levels of alcohol consumption are a major public health issue. This study aims to gain a better understanding of how geographical patterns of religious affiliation in the United States relate to geographical patterns of alcohol consumption. We explored state-level correlations between alcohol consumption and religious adherence. Although we found no statistically significant correlation between overall religious adherence rates and current or binge drinking rates, states with higher adherence rates were significantly more likely to have high proportions of binge drinking among current drinkers. Yet, regionally, we found a strong inverse correlation in the Southeast and a strong positive correlation in the Midwest and Northeast between adherence rates and current and binge drinking rates. These geographical differences were largely explained after stratifying by major religious denominational groupings. States with high Catholic adherence rates tended to have higher drinking rates, whereas states with high Evangelical Protestant adherence rates tended to have lower drinking rates. These findings suggest that the relationship between religion and alcohol may be denomination-specific and challenge the lay perception that religious adherence per se is associated with less alcohol consumption and less excessive drinking among those who drink.

Keller S; Maddock JE; Laforge RG; Velicer WF; Basler HD. Binge drinking and health behavior in medical students. Addictive Behaviors 32(3): 505-515, 2007. (48 refs.)

Objectives: The objective of this study was to assess the prevalence of binge drinking and its relation to other health behaviors, drinking-related attitudes and perceived social norms among German medical students. Methods: 271 first-year German medical students completed a cross-sectional, self-administered survey. A total of 252 (62% female and 38% male) students provided useable surveys. The mean age was 20.6 years (S.D.=1.7). Results: Most students reported heavy drinking with 24% having one episode in the past 2 weeks (Infrequent Bingers) and 28% having two or more episodes (Frequent Bingers). Men were more likely than women to have had a binge drinking episode. Frequent binge drinkers saw more pros of drinking and reported a higher temptation to drink than students in the other groups. Additionally, they were more likely to smoke, use cannabis, not exercise and not eat fruits and vegetables. All students overestimated their peers' alcohol intake and binge drinking frequency. Conclusions: Binge drinking was highly prevalent in this sample and clearly related to other health risk behaviors. Drinking rates were similar to college students in other Western countries. Future research needs to assess the consequences of this multiple risk behavior among medical students regarding academic and professional performance as well as personal health.

Kelley-Baker T; Was RB; Johnson MB; Furr-Holden CDM; Compton C. Multimethod measurement of high-risk drinking locations: Extending the portal survey method with follow-up telephone interviews. Evaluation Review 31(5): 490-507, 2007. (20 refs.)

Portal survey techniques involve multimodal assessments (e.g., self-report, biologic, and observational) in high-risk drinking and drug-use settings. Our investigation expanded the portal survey methodology to include follow-up assessments of emerging adult women recruited at the border as they cross to and from Mexico south of San Diego, California. The feasibility of the follow-up procedure was established, and the limitations of the technique clarified. Follow-up participants and nonparticipants did not differ by age or reported victimization. Data indicated that 8% of women experience negative events on their return to the United States after a night of binge drinking. These experiences could only be captured in a follow-up survey, as they happened after participants left the border area.

Kim SY; Breslow RA; Ahn J; Salem N. Alcohol consumption and fatty acid intakes in the 2001-2002. National Health and Nutrition Examination Survey. Alcoholism: Clinical and Experimental Research 31(8): 1407-1414, 2007. (43 refs.)

Background: Alcohol consumption has the potential to affect dietary intakes of nutrients; however, little is known about fatty acid intakes among alcohol consumers in the U.S. population. Method: We examined the relation between self-reported alcohol consumption and dietary fatty acid intake in 4,168 adults in the cross-sectional National Health and Nutrition Examination Survey 2001-2002. Fatty acid intake was determined from a single, interviewer-administered 24-hour recall. The adjusted, weighted mean level of dietary fatty acid intakes, as characterized by nutrient density, was calculated as grams of fatty acid per 1,000 kcal of energy consumed according to average daily alcohol consumption and binge-drinking episodes. Results: Energy intake showed a significant increasing trend across alcohol consumption categories in both genders and binge-drinking categories in men. Women binge drinkers also showed a higher energy intake compared with nonbinge drinkers. Among men, decreased nutrient densities of saturated, monounsaturated, polyunsaturated, linoleic, and alpha-linolenic acids were associated with increasing alcohol consumption. Binge-drinking men but not women had significantly decreased intakes of total saturates, monounsaturates, polyunsaturates and linoleic, alpha-linolenic, eicosapentaenoic, and docosahexaenoic acid. When alcohol energy was excluded from calculation of nutrient densities, the results were similar to those with alcohol energy included, except that total saturated and monounsaturated fatty acid differences were no longer significant. In addition, there was an inverse relationship among men between binge-drinking frequency and total polyunsaturates, linoleic, alpha-linolenic, and eicosapentaenoic acids. Conclusions: Our cross-sectional results suggest that alcohol consumption may impact the dietary intake of essential fatty acids (EFAs). Given the public health importance of both alcohol consumption and intakes of EFAs, prospective studies of the relation should be considered.

LaBrie JW; Pedersen ER; Tawalbeh S. Classifying risky-drinking college students: Another look at the two-week drinker-type categorization. Journal of Studies on Alcohol and Drugs 68(1): 86-90, 2007. (26 refs.)

Objective: The present study examined the effectiveness of the 2-week period currently used in the categorization of heavy episodic drinking among college students. Two-week drinker-type labels included the following: nonbinge drinker, binge drinker, and frequent binge drinker. Method: Three samples of college student drinkers (104 volunteers, 283 adjudicated students, and 238 freshmen male students) completed the 3-month Timeline Followback assessment of drinking. Drinking behavior during the last 2 weeks of the month before the study was compared with drinking behavior during the first 2 weeks of the same month to compare behavior and resulting labels during both 2-week periods. Results: Inconsistencies existed in drinker-type labels during the first 2 weeks of the month and the last 2 weeks of the month for all three samples. Between 40% and 50% of participants in the three samples were classified as a different drinker type across the month. Nonbinge drinkers experienced a wide range of alcohol-related problems, and much variation existed among the frequent-binge-drinker label. Conclusions: The results suggest that the current definition needs to be modified to accurately identify risky-drinking college students. Expanding the assessment window past 2 weeks of behavior, as well as developing different classification schemes, might categorize risky drinkers more accurately.

Lande RG; Marin BA; Chang AS; Mason S; Lande GR. A survey of alcohol consumption among first-year military medical students. American Journal of Drug and Alcohol Abuse 33(4): 605-610, 2007. (12 refs.)

First- year medical students (n= 138) at the U. S. Military's Medical School report frequent binge drinking. Nearly one fifth of female and one third of male students report at least one episode of binge drinking in the two weeks preceding a survey of alcohol use. Only one fifth of the medical students reported an interest in an expanded addiction medicine curriculum. The authors' promoted the use of a survey to bridge the gap between self assessment and learning.

Lee MJ; Bichard SL. Effective message design targeting college students for the prevention of binge-drinking: Basing design on rebellious risk-taking tendency. Health Communication 20(3): 299-308, 2006. (46 refs.)

This study examined the responses of college students who were exposed to different types of episodic stories related to drinking (gender-consistent vs. gender-inconsistent condition) and their intention to modify risky behavior (binge drinking) based on their rebellious risk-taking tendency. Self-report measures, such as intention to modify drinking behavior and reaction to the message were measured. Eighty-two college students between the ages of 19 and 23 years participated in a posttest-only group design experiment. Results suggested that rebellious participants were less afraid of the dangers of binge drinking than those who were low in rebelliousness for the gender-consistent condition. Regardless of the level of rebelliousness, the participants who were in the gender-consistent (increased relevance) condition produced higher recognition scores than those who were in the gender-inconsistent condition. However, the rebellious participants who were in the gender-inconsistent condition exhibited a higher level of intention to change their drinking behavior than did those in the gender-consistent condition.

Lemon J. Comment on the concept of binge drinking. Journal of Addictions Nursing 18(3): 147-148, 2007. (19 refs.)

The concept of binge drinking and other similar behaviors is discussed in relation to its history, clinical significance and theoretical relevance. It is argued that the term conveniently describes a pattern of behavior that is central to substance abuse and that the attempt to use the term as an indication of absolute quantity consumed or level of subjective effect is misguided. A suggested definition of consumption that is excessive relative to the individual's usual pattern, sporadic in occurrence and aimed at producing a powerful effect is offered.

Leppel K. College binge drinking: Deviant versus mainstream behavior. American Journal of Drug and Alcohol Abuse 32(4): 519-525, 2006. (8 refs.)

College binge drinking is examined from the perspectives of two cultures. The traditional culture views binging as deviant; the second culture promotes it. In this context, logit regression is used to explore the effects of various factors, including student employment and parental education. Employed students are less likely to binge than are students who are not employed. Also, students whose mother is a college graduate, but whose father is not, are more likely to binge than other students. The prescriptions for reducing binge drinking are different when the behavior is perceived as mainstream rather than deviant. The research calls for the development of a process for promoting cultural change in an environment of continually changing student leadership.

Marczinski CA; Combs SW; Fillmore MT. Increased sensitivity to the disinhibiting effects of alcohol in binge drinkers. Psychology of Addictive Behaviors 21(3): 346-354, 2007. (55 refs.)

Heavy episodic alcohol use, or binge drinking, is a serious public health problem. Binge drinking is endemic in college students and has resulted in numerous alcohol-related tragedies, including acute alcohol poisonings, falls, and automobile collisions. Such negative outcomes might occur because binge drinkers are generally more impulsive, and this impulsivity might be exacerbated under alcohol. The purpose of this study was to examine this hypothesis by comparing the acute effects of alcohol on a cognitive measure of behavioral control in binge and nonbinge drinkers. The results indicated that binge drinkers act more impulsively and report feeling more stimulated under an acute 0.65 g/kg dose of alcohol compared to nonbinge drinkers. The present finding of a heightened disinhibitory reaction to alcohol in binge drinkers may help explain the link between impulsivity and problem drinking at a more fundamental level of behavioral control.

Mcalaney J; McMahon J. Establishing rates of binge drinking in the UK: Anomalies in the data. Alcohol and Alcoholism 41(4): 355-357, 2006. (13 refs.)

Aims: Several studies funded by the UK government have been influential in understanding rates of 'binge drinking' in the UK. This analysis aims to establish consistency between results and clarify UK rates of binge drinking. Method: The relevant sections of these surveys were compared: the Scottish Health Survey (SHS) 1998, the General Household Survey (GHS) 2002, and the Health Survey for England (HSE) 2003. In addition the methodology used by the Health Protection Agency in the Adult Drinking Patterns in Northern Ireland (2003) was compared with the approach used by the SHS, GHS, and HSE. Results: Marked differences were observed between the results of the GHS 2002 and both the SHS 1998 and the HSE 2002 despite each using a similar methodology, with the HSE 2003 reporting a rate of 'binge drinking' in young males of 57%, and the GHS reporting a rate of 35%. This difference may be largely attributed to variations in the criteria in binge drinking in each study. These differences in interpretation do not appear to have been acknowledged. Indeed several key documents on alcohol harm reduction made inaccurate citations of previous surveys. Conclusion: The media rhetoric on escalating rates of binge drinking in the UK should be regarded with caution until trends are based on standardized recording and reporting.

McMahon J; McAlaney J; Edgar F. Binge drinking behaviour, attitudes and beliefs in a UK community sample: An analysis by gender, age and deprivation. Drugs: Education, Prevention and Policy 14(4): 289-303, 2007. (32 refs.)

Binge drinking has sparked considerable interest and concern. However, despite this interest little is known about the lay understanding of binge drinking and whether there are differences in understanding by gender, age and level of deprivation. Aims: This study investigated the beliefs and attitudes to binge drinking of a sample in the Inverclyde area. Methods: Using both cluster and quota sampling, 586 subjects completed a structured interview, using open questions about their beliefs on binge drinking and whether it was a problem generally and locally. Findings: Definitions of binge drinking tended to concentrate on intoxication and some described a dependent drinking pattern. Causes and solutions offered were varied but pointed-up levels of deprivation in respect of jobs and entertainment. More subjects regarded binge drinking as a problem in society than locally, which is consistent with research suggesting that misperceptions of others' drinking increases with social distance. Differences in beliefs were found by age and level of deprivation but not gender. It was marked that no subject offered the `official' definition of bingeing or even an approximation of it. Conclusions: Further research is required if future mass-media campaigns and interventions are to be relevant to the population.

Mehta MM; Moriarty KJ; Proctor D; Bird M; Darling W. Alcohol misuse in older people: Heavy consumption and protean presentations. Journal of Epidemiology and Community Health 60(12): 1048-1052, 2006. (24 refs.)

Background: Alcohol misuse, especially binge drinking in young people, and alcoholic liver disease are major public health concerns. However, alcohol misuse in older people is underestimated and often goes undetected. Objective: To document alcohol consumption and clinical presentation of alcohol misuse in hospital inpatients aged >= 60 years. Methods: 208 inpatients aged >= 60 years, referred to the alcohol liaison nurse between 1998 and 2003 at the Royal Bolton Hospital, Bolton, UK, were assessed for sex, alcohol intake, primary and secondary reasons for admission, and other concurrent health problems and death. Results: 90% of men drank > 21 units weekly and 93% of women drank > 14 units weekly. Median weekly alcohol intake was 78.5 units for men and 47 units for women. Acute intoxication, falls, circulatory problems and alcoholic liver disease were the main primary reasons for admission. Neglect or malnutrition, alcoholic liver disease and hypertension were the main secondary reasons and concurrent health problems. 30% of patients died between 1998 and 2003. Conclusion: In inpatients aged > 60 years who were referred to the alcohol liaison nurse in a district general hospital, heavy alcohol consumption, often to very high levels, was characteristic in both men and women and was associated with a wide variety of primary and secondary clinical presentations, including death.

Miller T; Snowden C; Birckmayer J; Hendrie D. Retail alcohol monopolies, underage drinking, and youth impaired driving deaths. Accident Analysis and Prevention 38(6): 1162-1167, 2006. (20 refs.)

Objective: To explore associations of state retail alcohol monopolies with underage drinking and alcohol-impaired driving deaths. Data: Surveys on youth who drank alcohol and binge-drank recently and their beverage choices; census of motor vehicle fatalities by driver blood alcohol level. Methods: Regressions estimated associations of monopolies with under-21 drinking, binge drinking, alcohol-impaired driving deaths, and odds a driver under 21 who died was alcohol-positive. Results: About 93.8% of those ages 12-20 who consumed alcohol in the past month drank some wine or spirits. In states with a retail monopoly over spirits or wine and spirits, an average of 14.5% fewer high school students reported drinking alcohol in the past 30 days and 16.7% fewer reported binge drinking in the past 30 days than high school students in non-monopoly states. Monopolies over both wine and spirits were associated with larger consumption reductions than monopolies over spirits only. Lower consumption rates in monopoly states, in turn, were associated with a 9.3% lower alcohol-impaired driving death rate under age 21 in monopoly states versus non-monopoly states. Alcohol monopolies may prevent 45 impaired driving deaths annually. Conclusions: Continuing existing retail alcohol monopolies should help control underage drinking and associated harms.

Mukamal KJ; Kawachi I; Miller M; Rimm EB. Drinking frequency and quantity and risk of suicide among men. Social Psychiatry and Psychiatric Epidemiology 42(2): 153-160, 2007. (47 refs.)

Background Individuals who die from suicide commonly have consumed alcohol immediately beforehand, often in large quantities. However, prospective cohort data on regular alcohol use as a risk factor for suicide are lacking. Method As part of the Health Professionals Follow-up Study, 47,654 men free of cancer prospectively reported their drinking habits, including average use, drinking frequency, and typical maximal use on repeated occasions beginning in 1986. Participants were followed for death to 2002. Results A total of 136 men died from suicide during follow-up. Quantity of alcohol consumed per drinking day tended to be associated with a greater risk of suicide mortality, with an adjusted hazard ratio among men consuming 30.0 or more grams (more than two drinks) per drinking day of 2.42 (95% confidence interval, 0.75-7.80; P-trend 0.05). Average alcohol consumption, drinking frequency, and binge drinking were not independently associated with risk. The apparent relationship of quantity consumed per drinking day with risk was not substantially changed by adjustment for serious illness or other dietary factors and was most notable for suicide associated with firearm use. Conclusions Among men, risk of death from suicide tends to be associated primarily with quantity of alcohol consumed per drinking day, not with drinking frequency or overall alcohol consumption. This finding supports guidelines that limit consumption among men who choose to drink alcohol to two drinks or less per drinking day.

Naimi TS; Brewer RD; Miller JW; Okoro C; Mehrotra C. What do binge drinkers drink? Implications for alcohol control policy. American Journal of Preventive Medicine 33(3): 188-193, 2007. (36 refs.)

Background: Although binge drinking (drinking five or more drinks on an occasion) is an important public health problem, little is known about which beverage types are consumed by binge drinkers. This knowledge could guide prevention efforts because beer, wine, and liquor are taxed, marketed, and distributed differently. Methods: Data from 14,150 adult binge drinkers who responded to the Behavioral Risk Factor Surveillance System binge-drinking module in 2003 and 2004 were analyzed. Information pertained to the amount of alcohol consumed during a binge drinker's most recent binge episode, including beverage-specific consumption. Results: Overall, 74.4% of binge drinkers consumed beer exclusively or predominantly, and those who consumed at least some beer accounted for 80.5% of all binge alcohol consumption. By beverage type, beer accounted for 67.1%, liquor for 21.9%, and wine accounted for 10.9% of binge drinks consumed. Beer also accounted for most of the alcohol consumed by those at highest risk of causing or incurring alcohol-related harm, including people aged 18-20 years (67.0% of drinks were beer); those with three or more binge episodes per month (70.7%); those drinking eight or more drinks per binge episode (69.9%); those binging in public places (64.4%); and those who drove during or within 2 hours of binge drinking (67.1%). Conclusions: Beer accounted for two thirds of all alcohol consumed by binge drinkers and accounted for most alcohol consumed by those at greatest risk of causing or incurring alcohol-related harm. Lower excise taxes and relatively permissive sales and marketing practices for beer as compared with other beverage types may account for some of these findings. These findings suggest that equalizing alcohol control policies at more stringent levels would be an effective way to prevent excessive drinking.

Newes-Adeyi G; Chen CM; Williams GE; Faden VB. Trends in Underage Drinking in the United States, 1991-2003. Surveillance Report #74. Bethesda MD: National Institute on Alcohol Abuse and Alcoholism, 2005. (37 refs.)

This surveillance report from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), presents data on underage drinking for 1991-2003. This is the first of a series of reports to be published every two years on underage drinking and related attitudes and risk behaviors. Data for this series are compiled from three separate national surveys, the National Survey on Drug Use and Health (NSDUH), the Monitoring the Future (MTF) survey, and the Youth Risk Behavior Survey (YRBS). The following are highlights of trends from 1991 through 2003. Prevalence of use: There are differences across all three surveys data sources but all show an overall decline in the prevalence of alcohol consumption in the past 30 days between 1991 and 2003. In 2003, 29.3 percent of youth ages 12-20 reported consuming alcohol in the past 30 days. Throughout the decade, rates of underage drinking remained highest among non-Hispanic whites, followed by Hispanics and non-Hispanic blacks. Rates were also higher among youth not enrolled in school as compared with those enrolled in school. Drinking patterns: The mean age of onset for drinking alcohol has increased slightly from 13.8 years in 1991 to 14 years in 2003. In addition, over the decade there has been a decline in those who reported beginning to drink before age 12 or younger. Differences between males and females continue. Males report drinking more frequently and greater quantities. In 2003, youth ages 12 to 20 reported drinking on a mean of 5.8 days in the past 30 days. They consumed an average of 4.9 drinks on these days, corresponding to an average total of 35.4 drinks in the past 30 days (NSDUH). Overall rates of binge drinking have increased among 12 to 20 year olds between 1991 and 2003, from 15.2 to 18.9 percent. (Data from the secondary school based surveys (MTF and YRBS), however, show an overall decline in binge drinking rates during this time period.] These data also show an increase in binge drinking rates among girls, whereas the rates declined among boys. Although rates increased for both males and females in the NSDUH data, the increase is steeper for females than for males. Alcohol-related attitudes: There has been a gradual shift in attitudes towards underage drinking. Between 1991 and 2003 there has been a decline in the number of youth who strongly disapproving of others regularly consuming alcohol or binge drinking, as well as a decrease in those who consider regular or binge drinking a great risk. Alcohol-related risk behaviors: In respect to driving while under the influence, between 1991 and 2003, there was a decline in secondary school students. However, for those age 18-20, there was a substantial increase --from 14.9% to 19.1%. Data is presented in 96 figures and 8 tables.

Public Domain

Newman IM; Shell DF; Li TD; Innadda S. Buddhism and adolescent alcohol use in Thailand. Substance Use & Misuse 41(13): 1789-1800, 2006. (24 refs.)

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.

Norman P; Armitage CJ; Quigley C. The theory of planned behavior and binge drinking: Assessing the impact of binge drinker prototypes. Addictive Behaviors 32(9): 1753-1768, 2007. (56 refs.)

The present study assessed the value of including prototype perceptions within the theory of planned behavior (TPB) when predicting young people's binge drinking intentions and behavior. Undergraduate students (N=94) completed questionnaires assessing the main constructs of the TPB as well as measures of prototype evaluation and prototype similarity. Binge drinking behavior was assessed at one-week follow-up (N=79). The TPB explained 58% of the variance in binge drinking intentions and 22% of the variance in binge drinking at one-week follow-up. The prototype perception measures explained additional variance in both binge drinking intentions (Delta R-2 =.04) and behavior (Delta R-2 =.09), although only prototype similarity emerged as a significant predictor. In addition, a significant interaction was found between prototype similarity and subjective norm in relation to the prediction of binge drinking behavior, suggesting that the perception of supportive norms may enhance the impact of prototype perceptions on health-risk behavior. The implications of the findings for interventions to encourage more appropriate drinking behavior are outlined.

Office of Applied Studies. The NSDUH Report. Academic Performance and Substance Use among Students Aged 12-17: 2002, 2003, 2004. Issue 18. Rockville MD: Substance Abuse and Mental Health Services Administration, 2006. (5 refs.)

This short report examines the relationship between substance use patterns and academic performance among students age 12-17, based on data from the National Survey on Drug Use and Health. About 70% of students reported an A or B average in the most recent grading period. About 30% had a C average or less. The data shows that academic performance is related to substance use. Three groups were identified, those who didn't use alcohol in the previous month, those who did drink but hadn't engaged in binge drinking, and those who reporting binge drinkinging. The corresponging proportion of students in each group having an A or B average was 73% (non-drinkers), 67% drinkers, and 58% recent history of binge drinking. Similarly, academic performace and different frequencies of marijuana use were examined. Those who had used marijuana on 1-4 days in the prior month had a lower proportion of A or B grades, and the proportion was still lower within the group that used marijuana or 5 or more days.

Palma S; Pardo-Crespo R; Mariscal M; Perez-Iglesias R; Llorca J; Delgado-Rodriguez M. Weekday but not weekend alcohol consumption before pregnancy influences alcohol cessation during pregnancy. European Journal of Public Health 17(4): 394-399, 2007. (38 refs.)

Background: Cantabria has the highest prevalence of alcohol consumption among women in Spain. Patterns of alcohol consumption before pregnancy were assessed as a determinant of alcohol cessation in pregnant women in Cantabria. Methods: Survey on a random sample of women delivering for the period 1998-2002 (n = 1510). Information was obtained from personal interview (data on alcohol consumption), clinical charts and prenatal care records. Relative risks (RR) and 95% confidence intervals (Cl) were estimated. Multivariable analyses were carried out using logistic regression. Results: Nearly half (49.5%) of the women drank regularly before pregnancy and 22.7% during pregnancy. Sociodemographic variables favouring alcohol cessation were: high education level and smoking cessation, whereas high social class, advanced maternal age and employment outside of home decreased the rate of alcohol cessation. Cessation decreased with the amount of alcohol consumed on weekdays (P < 0.001), but not with intake during weekends only. In women with alcohol use only during weekends, only the consumption of spirits increased the rate of alcohol cessation (adjusted RR = 1.40, 95% Cl: 1.13-1.60). Pre-pregnancy binge drinking (>= 4 drinks on one occasion) decreased alcohol cessation in pregnancy (adjusted RR = 0.66, 95% Cl: 0.40-0.97). Conclusions: Drinking patterns influenced the rate of alcohol cessation: the heavier the alcohol consumption on weekdays, the lower the rate of alcohol cessation.

Plant M; Plant M. Binge Britain: Alcohol and the national response. Oxford: Oxford University Press, 2006. (605 refs.)

This book discusses alcohol use in Britain. The use of "binge" in the title is a bit confusing, as the authors in their preface have some criticisms of the widespead and often contradictory ways in which the term is used, i.e. if a "binge" is synonymous with an occassion that may encompass a whole day versus severall hours, the likely related dangers and feeling states are quite different. The book is organized into seven chapters with an appended bibliography. The first chapter describes the use of alcohol over historical periods dating back to the Roman conquest, but focusing largely upon the periods from the Tudors and Stuarts. Chapter 2 considers the current drinking patterns and trends, with comparisons to other nations. Chapter 3 deals with problems related on alcohol use, considering both health consequences and social problems. Chapter 4 discusses alcohol policy. Chapter 5 examines some of the recent controversies around alcohol policy, including the changes in licensing allowing extended hours in bars, the media response, the response of police, and public opinion. Chapter 6 addresses "Lessons from the past." It looks to earlier periods in which licensing standards were eaased, as well as the experiences of other countries. Chapter 7 considers alternative and future policy initiatives, from restricting access of young people to alcohol, to tax policy, to drinking and driving, community action inititives, and ways of working with the beverage industry.

Rayburn BB; Rayburn WE; Meng C; Handmaker NS. Wine consumption by hazardous drinkers before and after pregnancy recognition. Journal of Reproductive Medicine 52(10): 871-873, 2007. (4 refs.)

OBJECTIVE: To investigate patterns of wine consumption among hazardous drinkers before and after pregnancy recognition. STUDY DESIGN: Using a standard alcohol survey, hazardous drinking was defined as either frequent or binge drinking with related consequences. Patients identified at our clinic during their first prenatal visit as being hazardous drinkers were interviewed during the prenatal and postpartum periods. The numbers of drinking days and drinks per drinking day were sought before and after pregnancy recognition. RESULTS: A total of 203 of 4,494 women met the criteria as hazardous drinkers before pregnancy recognition and completed the prenatal and postpartum interviews. Wine was consumed by approximately one fourth (49, 24.1 %) of these women, usually with other alcoholic beverages (45, 91.8%). Wine alone was not consumed heavily. Nearly half (46.9%) continued their wine consumption after pregnancy confirmation, although the numbers of drihking days and drinks per drinking day became significantly lower than before pregnancy awareness (p < 0.01). Thirty-five hazardous drinkers switched to wine after pregnancy recognition. CONCLUSION. Hazardous drinkers were inclined to drink wine with other alcoholic beverages yet tended to abstain or minimize consumption after pregnancy recognition.

Read JP; Merrill JE; Kahler CW; Strong DR. Predicting functional outcomes among college drinkers: Reliability and predictive validity of the Young Adult Alcohol Consequences Questionnaire. Addictive Behaviors 32(11): 2597-2610, 2007. (46 refs.)

Heavy drinking and associated consequences are widespread among U.S. college students. Recently, Read et al. (Read, J. P., Kahler, C. W., Strong, D., & Colder, C. R. (2006). Development and preliminary validation of the Young Adult Alcohol Consequences Questionnaire. Journal of Studies on Alcohol, 67, 169-178) developed the Young Adult Alcohol Consequences Questionnaire (YAACQ) to assess the broad range of consequences that may result from heavy drinking in the college milieu. In the present study, we sought to add to the psychometric validation of this measure by employing a prospective design to examine the test-retest reliability, concurrent validity, and predictive validity of the YAACQ. We also sought to examine the utility of the YAACQ administered early in the semester in the prediction of functional outcomes later in the semester, including the persistence of heavy drinking, and academic functioning. Ninety-two college students (48 females) completed a self-report assessment battery during the first weeks of the Fall semester, and approximately one week later. Additionally, 64 subjects (37 females) participated at an optional third time point at the end of the semester. Overall, the YAACQ demonstrated strong internal consistency, test-retest reliability, and concurrent and predictive validity. YAACQ scores also were predictive of both drinking frequency, and "binge" drinking frequency. YAACQ total scores at baseline were an early indicator of academic performance later in the semester, with greater number of total consequences experienced being negatively associated with end-of-semester grade point average. Specific YAACQ subscale scores (Impaired Control, Dependence Symptoms, Blackout Drinking) showed unique prediction of persistent drinking and academic outcomes.

Rostosky SS; Danner F; Riggle EDB. Is religiosity a protective factor against substance use in young adulthood? Only if you're straight! Journal of Adolescent Health 40(5): 440-447, 2007. (40 refs.)

Purpose: Previous research has documented that substance use peaks during young adulthood and that religiosity provides a protective effect against binge drinking, marijuana use, and cigarette smoking. The majority of these studies do not examine sexual identity as it relates to these factors. Drawing on social influence and developmental theories, we tested the hypothesis that religiosity would provide a protective effect for heterosexual but not sexual minority young adults. Method: Waves 1 and 3 of the National Longitudinal Study of Adolescent Health provided data for the study. Three young adult sexual identity groups were formed: sexual minorities who did not report same-sex attraction at Wave 1 (NA), sexual minorities who did report same-sex attraction at Wave 1 (SSA), and heterosexuals (HET) (sample n = 764). Results: Religiosity measured at baseline had no significant effect on past-year substance use, measured six years later in sexual minority young adults. For heterosexual young adults, each unit increase in religiosity reduced the odds of binge drinking by 9%, marijuana use by 20%, and cigarette smoking by 13%. Conclusions: Religiosity was not protective against substance use in sexual minority young adults, cautioning against over-generalizing previous findings about the protective effects of religiosity. Future studies that 1) consider the social context for sexual identity development, 2) model both risk and protective factors, and 3) use multidimensional measures of religiosity (and spirituality) and sexual identity are needed to build the necessary knowledge base for effective health promotion efforts among sexual minority youth and young adults.

Sonmez S; Apostolopoulos Y; Yu CH; Yang SY; Mattila A; Yu LC. Binge drinking and casual sex on spring break. Annals of Tourism Research 33(4): 895-917, 2006. (40 refs.)

College students' health-risk behaviors on spring break were examined via pre-and post-surveys. Over one-half reported getting drunk on the previous vacation and stated intentions to do so again. Personal normative beliefs and situational expectations emerged as strong predictors of intentions to binge and pacts of actual bingeing. Intentions for casual sex were predicted by attitudes, personal normative beliefs, situational expectations, and pacts, whereas engagement in casual sex was predicted by intentions for and prior experience with it. The majority of students reported rarely/never using condoms during spring break. They appear to participate in riskier behaviors in the spring break environment than at home.

Stahre M; Naimi T; Brewer R; Holt J. Measuring average alcohol consumption: The impact of including binge drinks in quantity-frequency calculations. Addiction 101(12): 1711-1718, 2006. (42 refs.)

Aims Average daily alcohol consumption is usually calculated based on self-reports of the quantity (number of drinks consumed per drinking-day) and frequency (number of drinking-days) of alcohol consumption within a given time period. However, this method may underestimate average daily alcohol consumption (and in turn, the prevalence of heavy drinking), because studies demonstrate that respondents do not typically include binge drinking occasions in estimates of their 'usual' or 'average' daily alcohol consumption. Design We used the Behavioral Risk Factor Surveillance System (BRFSS), an annual random-digit telephone survey of US adults aged 18 years or older, to estimate average daily alcohol consumption using standard quantity-frequency questions, and then recalculated this measure by including self-reports of binge drinking. The proportion of respondents who met a standard, sex-specific definition of heavy drinking based on average daily alcohol consumption was then assessed nationally and for each state. Findings Compared to standard quantity-frequency methods, including binge drinks in calculations of average daily alcohol consumption increased the relative prevalence of heavy drinking among all adults by 19% to 42% (depending on the method used to estimate the number of drinks per binge). Among binge drinkers, the overall prevalence of heavy drinking increased 53% relative to standard quantity-frequency methods. As a result, half of women binge drinkers and half of binge drinkers aged 55 or older met criteria for heavy drinking. Conclusions: Including binge drinks (especially the application of age- and sex-specific estimates of binge drinks) in the calculation of average daily alcohol consumption can improve the accuracy of prevalence estimates for heavy drinking among US adults, and should be considered to increase the usefulness of this measure for alcohol surveillance.

Timberlake DS; Hopfer CJ; Rhee SH; Friedman NP; Haberstick BC; Lessem JM et al. College attendance and its effect on drinking behaviors in a longitudinal study of adolescents. Alcoholism: Clinical and Experimental Research 31(6): 1020-1030, 2007. (37 refs.)

Background: While college attendance has been shown to be associated with increased drinking behaviors, there are no studies to our knowledge that have examined whether college attendance moderates genetic influences for drinking. We first tested for changes in alcohol consumption in adolescents who did and did not subsequently attend college, and then tested for variation of the genetic and environmental determinants of drinking in these 2 groups. Methods: Participants eligible for this study were selected from 2 samples from the National Longitudinal Study of Adolescent Health (Add Health), a national probability sample (n=7,083) and a sample of sibling pairs (n=855 pairs). Participants were assessed for measures of drinking behaviors as adolescents (wave I) and reinterviewed at 1 (wave II) and 6 years (wave III) following the initial survey. Changes in binge drinking and average quantity of alcohol consumed in the past year were estimated among 4 groups (2-year college students, 4-year college students, college withdrawers, noncollege participants) in sequential cohorts which spanned the ages of 13 to 24 across the 3 Add Health waves. Gene by environment interactions were then tested at wave III using biometrical models in the genetically informative pairs. Results: Participants who did not attend college reported more binge drinking and consumed greater quantities of alcohol as adolescents than participants who subsequently attended college. However, the college students not only surpassed their noncollege peers in alcohol use as young adults, but also exhibited a greater genetic influence on quantity of alcohol consumed per drinking episode. Conclusions: Exposure to a college environment acts as an environmental moderator, supporting the hypothesis that the magnitude of genetic influence on certain aspects of alcohol consumption is greater in environments where drinking behaviors are more likely to be promoted.

Tsai J; Floyd RL; Green PP; Boyle CA. Patterns and average volume of alcohol use among women of childbearing age. Maternal and Child Health Journal 11(5): 437-445, 2007. (53 refs.)

Objectives: Maternal alcohol use is a leading preventable cause of neurobehavioral and developmental abnormalities in children. This study examines the patterns and average volume of alcohol use among U.S. women of childbearing age in order to identify subgroups of high-risk women for selective intervention. Methods: A sample of 188,290 women aged 18-44 years participated in the Centers for Disease Controls and Prevention (CDC)'s Behavioral Risk Factor Surveillance System (BRFSS) survey during the period of 2001-2003. Reported alcohol use patterns and average volume were examined for pregnant and nonpregnant women. Efforts were made to evaluate and characterize women who practiced various levels of binge drinking. Results: The results showed that approximately 2% of pregnant women and 13% of nonpregnant women in the United States engaged in binge drinking during the period of 2001-2003. Among the estimated average of 6.7 million women of childbearing age overall who engaged in binge drinking during the period, approximately 28.5% women also reported consuming an average of 5 drinks or more on typical drinking days, or about 21.4% women consumed at least 45 drinks on average in a month. Larger proportions of binge drinkers with high usual quantity of consumption were found among women of younger ages (18-24 years) or current smokers. Conclusions: Future prevention efforts should include strategies that combine health messages and encourage women of childbearing age, with particular emphasis on women 18-24 years, to avoid alcohol and tobacco use, and take multivitamins and folic acid daily for better pregnancy outcomes. Other efforts must also include broad-based implementation of screening and brief intervention for alcohol misuse in primary and women's health care settings.

Tsai J; Floyd RL; Bertrand J. Tracking binge drinking among US childbearing-age women. Preventive Medicine 44(4): 298-302, 2007. (20 refs.)

Objective. The purpose of this analysis was to track the estimated prevalence of binge drinking for the years 2001-2003 among U.S. women of childbearing age in order to inform ongoing efforts to prevent alcohol-exposed pregnancies. Method. A total of 58,431, 64,18 1, and 65,678 women aged 18-44 for the years 2001, 2002, and 2003, respectively, participated in the Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) survey. The estimated binge drinking prevalence for each survey year and changes in these estimates for the entire survey period were calculated for these women. Results. The estimated binge drinking prevalence among childbearing-age women 18-44 years for the years 2001, 2002, and 2003 was 11.9%, 12.4%, and 13.0%, respectively. The estimated number of childbearing-age women who engaged in binge drinking rose from 6.2 million in 2001 to 7.1 million in 2003, an increase of 0.9 million. Conclusion. The results of this analysis provide support for enhancing efforts among healthcare providers to identify and intervene with childbearing-age women who engage in alcohol use that can increase their risks for various health problems, including an alcohol-exposed pregnancy.

Turner JC. Is the binge-drinking glass half full or half empty? (letter). Pediatrics 119(5): 1035-1035, 2007. (2 refs.)

The authors asert that short of enforcement of the minimum drinking age, little has been done over the years to reduce underage drinking. They also suggest a number of interventions that should be implemented to reduce underage drinking. At the same time they ignore some of the positive trends and exploring the factors that have contributed to a reductions in binge drinking by adolescents. In the meantime it is suggested that "physicians caring for teens should be aware that a substantial minority of them (25%-28%) have likely engaged in alcohol misuse in the preceding month. Screening, counseling, and appropriate referral are vital interventions that can be conducted in the office setting and will likely reduce future high-risk alcohol use among these patients. Perhaps as important, for alcohol users and nonusers alike, clinicians should strongly reinforce that the majority of American teens (71%-75%) chose not to use alcohol (or to use it minimally). Adolescents generally respond to pressure to engage in normative behavior."

Tuunanen M; Aalto M; Seppa K. Binge drinking and its detection among middle-aged men using AUDIT, AUDIT-C and AUDIT-3. Drug and Alcohol Review 26(3): 295-299, 2007. (17 refs.)

Binge (heavy episodic) drinking is common, but there is little knowledge on how this drinking pattern could be detected. This study compares three structured questionnaires among binge drinking middle-aged men. All 45-year-old men in the city of Tampere, Finland, were asked to fill in the Alcohol Use Disorders Identification Test (AUDIT). Based on the interview on their drinking the men were divided into non-binging moderate drinkers (n = 352), binging moderate drinkers (n = 130), non-binging heavy drinkers (n = 10) and binging heavy drinkers (n = 63). The complete AUDIT, AUDIT-C (first three AUDIT questions inquiring quantity-frequency) and AUDIT-3 (the third binging-frequency question of AUDIT) in detecting binge drinking were compared. The complete AUDIT was effective in detecting binge drinkers by a cut-off score of >= 8 or >= 7. The optimal cut-off score for AUDIT-C was >= 6 and that for AUDIT-3 >= 2. The area under the curve (AUC) among all risky drinkers (binging moderate and binging heavy and non-binging heavy drinkers) for AUDIT was 0.824 (95% CI 0.789-0.859), for AUDIT-C 0.829 (95% CI 0.795-0.864) and for AUDIT-3 0.779 (0.739-0.818). The complete AUDIT and its short versions are applicable in populations where binging is the dominant drinking pattern, but the cut-off scores should be tailored to individual cultures.

Valencia-Martin JL; Galan I; Rodriguez-Artalejo F. Binge drinking in Madrid, Spain. Alcoholism: Clinical and Experimental Research 31(10): 1723-1730, 2007. (49 refs.)

In Mediterranean countries, the information on the prevalence of binge drinking and associated socio-demographic variables is very scarce. Moreover, there are no reported data on the amount of alcohol ingested and the type of beverage consumed during drinking episodes. This study describes the prevalence and characteristics of binge drinking in the adult population of Madrid, Spain. Data were taken from a telephone survey conducted during the period 2000 to 2005 on 12,037 persons, representative of the population aged 18 to 64 years in the Madrid Region. Binge drinking was defined as the intake of >= 80 g of alcohol in men or >= 60 g in women, during any drinking session in the preceding 30 days. In this analysis, the threshold between moderate and heavy average weekly alcohol consumption was set at 40 g/d for men and 24 g/d for women. Prevalence of binge drinking was 14.4% (95% confidence interval, CI: 13.5 to 15.3%) in men and 6.5% (95% CI: 5.8 to 7.1%) in women. Prevalence was higher among persons: in the youngest age group (30.8% among men and 18.2% among women aged 18 to 24 years); having the highest educational level (14.5% in male and 9.2% in female university graduates); and with a heavy average consumption of alcohol (55.3% in men and 50.0% in women). However, 3 of 4 binge drinkers of both sexes showed a moderate average consumption. Among binge-drinkers, average monthly episodes of binge drinking were 3.2 in men and 2.6 in women, with 5.4 and 2 episodes/person/year, respectively. During each episode, a mean of 119 g of alcohol was ingested by men and 83 g by women, with spirits accounting for 72% of total alcohol intake. Prevalence of binge drinking is high in Madrid, particularly among younger men with higher education, and heavy average alcohol consumption. Binge drinking is characterized by frequent episodes, where large amounts of alcohol are ingested, mainly from spirits.

Viner RM; Taylor B. Adult outcomes of binge drinking in adolescence: findings from a UK national birth cohort. Journal of Epidemiology and Community Health 61(10): article 902, 2007. (37 refs.)

Aims: The aim of the study was to determine outcomes in adult life of binge drinking in adolescence in a national birth cohort. Design and setting: Longitudinal birth cohort: 1970 British Birth Cohort Study surveys at 16 years (1986) and 30 years (2000). Participants: A total of 11 622 subjects participated at age 16 years and 11 261 subjects participated at age 30 years. Measurements: At the age of 16 years, data on binge drinking (defined as two or more episodes of drinking four or more drinks in a row in the previous 2 weeks) and frequency of habitual drinking in the previous year were collected. Thirty-year outcomes recorded were alcohol dependence/ abuse (CAGE questionnaire), regular weekly alcohol consumption (number of units), illicit drug use, psychological morbidity (Malaise Inventory) and educational, vocational and social history. Findings: 17.7% of participants reported binge drinking in the previous 2 weeks at the age of 16 years. Adolescent binge drinking predicted an increased risk of adult alcohol dependence (OR 1.6, 95% CI 1.3 to 2.0), excessive regular consumption (OR 1.7, 95% CI 1.4 to 2.1), illicit drug use (OR 1.4, 95% CI 1.1 to 1.8), psychiatric morbidity (OR 1.4, 95% CI 1.1 to 1.9), homelessness (OR 1.6, 95% CI 1.1 to 2.4), convictions (1.9, 95% CI 1.4 to 2.5), school exclusion (OR 3.9, 95% CI 1.9 to 8.2), lack of qualifications (OR 1.3, 95% CI 1.1 to 1.6), accidents (OR 1.4, 95% CI 1.1 to 1.6) and lower adult social class, after adjustment for adolescent socioeconomic status and adolescent baseline status of the outcome under study. These findings were largely unchanged in models including both adolescent binge drinking and habitual frequent drinking as main effects. Conclusions: Adolescent binge drinking is a risk behaviour associated with significant later adversity and social exclusion. These associations appear to be distinct from those associated with habitual frequent alcohol use. Binge drinking may contribute to the development of health and social inequalities during the transition from adolescence to adulthood.

Wallace JM; Yamaguchi R; Bachman JG; O'Malley PM; Schulenberg JE; Johnston LD. Religiosity and adolescent substance use: The role of individual and contextual influences. Social Problems 54(2): 308-327, 2007. (28 refs.)

For more than three decades scholars have debated about if, when, and under what circumstances religiosity deters delinquency. The present study uses multilevel modeling data analytic techniques (i.e., hierarchical linear model [HLM]) and large nationally representative samples of American public high schools (N = 227) and high school seniors ( N = 16,595) to examine various unresolved issues in the ongoing debate, with a specific focus on the relationships between individual- and contextual-level (i.e., school) religiosity and adolescent's use of tobacco, alcohol, and marijuana. The results indicate first, that the higher adolescents' level of religiosity, the less likely they are to be current tobacco users, to engage in binge drinking, or to have used marijuana in the past year; second, that as the level of religiosity in a school increases, adolescents' frequency of cigarette use, binge drinking, and marijuana use decreases; third, that the religiosity of the school influences students' substance use, over and above their individual religiosity, but that this relationship exists only for marijuana; and fourth, that the strength of the relationship between individual- level religiosity and individual-level substance use varies depending upon the religiosity of the context, such that adolescents who are highly religious and in highly religious contexts are less likely to engage in binge drinking or marijuana use than those who are equally religious but in less religious contexts. Future research should seek to understand the mechanisms through which individual- and contextual-level religiosity influences young people's use of substances and other delinquent behaviors.

Wild, TC; Cunningham, JA; Roberts, AB. Controlled study of brief personalized assessment-feed back for drinkers interested in self-help. Addiction 102(2): 241-250, 2007. (61 refs.)

Aims: Brief alcohol interventions typically have been directed to heavy-drinking patients seeking primary health care and college students. This study examined the efficacy of mailing brief personalized assessment-feedback to interested drinkers recruited from the general public. We hypothesized that problem drinkers would benefit more from the intervention than individuals who were not problem drinkers. Design: A two-arm, double-blinded, community-based randomized controlled trial with 6-month follow-up. Setting and participants A screening interview was administered to a stratified random sample of 10 014 Canadians 18 years of age and older (5621 women and 4393 men; M age = 43.3 years, SD = 15.99; response rate = 65.4%). Intervention: Current drinkers interested in receiving alcohol self-help materials (n = 172 7) were assigned randomly to receive brief personalized assessment-feedback on male and female population drinking norms by mail, or to a delayed-treatment control group, and were contacted 6 months later (76% retention rate). Measurements Problem drinking status at baseline [using sex-specific Alcohol Use Disorders Identification Test (AUDIT) cut scores], and frequency and quantity of alcohol use at follow-up. Findings: Analysis of covariance identified the hypothesized interaction of baseline problem drinking status and treatment condition (P < 0.01). Among problem drinkers identified at baseline the intervention caused a 10.1% reduction in per-occasion binge drinking compared to controls, whereas there was no difference in binge drinking across conditions for nonproblem drinkers. Conclusions: The continuum of care for alcohol problems can be broadened by providing brief interventions to interested drinkers in the general population.

Wosje KS; Kalkwarf HJ. Bone density in relation to alcohol intake among men and women in the United States. Osteoporosis International 18(3): 391-400, 2007. (44 refs.)

Summary: Studies of postmenopausal women have shown a positive association between BMD and alcohol intake. We found that BMD was higher in men, and possibly postmenopausal women, who drank alcohol compared with those who abstained. Drinking alcohol, but not binge drinking, may benefit bone health of men and postmenopausal women. Introduction Osteoporotic fractures account for over 2.5 million physician visits annually for persons ages >= 45 years in the United States. Studies of postmenopausal women show a positive association between bone mineral density (BMD) and alcohol intake, but for men and premenopausal women, the bone-alcohol relationship remains unclear. We examined the association between total hip (TH) and femoral neck (FN) BMD and alcohol intake of men and pre- and postmenopausal women. Methods We conducted multiple regression analyses using data from 13,512 persons ages >= 20 years from the Third National Health and Nutrition Examination Survey, 1988-1994. Alcohol intake and binge drinking were measured by questionnaire and hip BMD by dual energy X-ray absorptiometry (DXA). Results: Accounting for covariates, TH BMD was higher in men (n = 6,868) who had 5-29 (+2.1%, p < 0.01) and > 29 drinking occasions/month (+1.7%, p < 0.05) than men who abstained. BMD of premenopausal women (n = 4,136) who drank alcohol did not differ from those who abstained. FN BMD was 3.8% higher in postmenopausal women (n = 2,043) who had > 29 drinking occasions/month than those who abstained (p = 0.06). Binge drinking was not associated with BMD of men or women. Conclusions Drinking alcohol, but not binge drinking, appears to be beneficial to bone health of men and possibly postmenopausal women.

Yang SM; Lynch JW; Raghunathan TE; Kauhanen J; Salonen JT; Kaplan GA. Socioeconomic and psychosocial exposures across the life course and binge drinking in adulthood: Population-based study. American Journal of Epidemiology 165(2): 184-193, 2007. (51 refs.)

Despite recognition of the health risks of binge drinking, its life-course precursors have not been widely examined. Data from the Kuopio Ischemic Heart Disease Risk Factor Study (1984-1989) were used to investigate the association between socioeconomic and psychosocial exposures across the life course and binge drinking in a population-based sample of 2,316 middle-aged men. Binge drinking was defined as drinking at least four bottles of beer, one bottle of wine, one bottle of strong wine, or six servings of spirits on a single occasion. A composite indicator of childhood socioeconomic position was based on parental education, occupation, and number of rooms and divided into tertiles. Low childhood socioeconomic position increased the odds of binge drinking (odds ratio = 1.70, 95% confidence interval: 1.26, 2.31) when other early life exposures were adjusted. Additional adjustment of adult socioeconomic and psychosocial factors attenuated the odds of bingeing associated with low childhood socioeconomic position (odds ratio = 1.29, 95% confidence interval: 0.93, 1.79). Adult socioeconomic conditions, marital status, hostility, and organizational membership were independently associated with bingeing. This study shows that both early and later life characteristics including socioeconomic conditions and adult psychosocial factors contribute to adult binge drinking in this population, but the effects of adult characteristics are stronger.

Zucker AN; Landry LJ. Embodied discrimination: The relation of sexism and distress to women's drinking and smoking behaviors. Sex Roles 56(3/4): 193-203, 2007. (86 refs.)

Discrimination has been conceptualized as a stressor that may be more negative than generic stress because it is tied to valued and unchangeable social identities. As with other stressful events, the experience of sexism has been related to poorer mental health and some physical health outcomes. This study of 179 female college students (79% of whom were White) showed that the relation between perceived sexism and binge drinking and smoking was mediated by psychological distress. In addition, there was a direct relation between sexism and smoking for weight control. Given the large toll that tobacco and excessive alcohol use exact on the U.S. population, we suggest that policy makers aim to reduce discrimination as one method to improve overall health.