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CORK Bibliography: Binge Drinking

130 citations. January 2007 to present

Prepared: December 2008

Aalto M; Seppa K. Primary health care physicians' definitions on when to advise a patient about weekly and binge drinking. Addictive Behaviors 32(7): 1321-1330, 2007. (28 refs.)

Objective: Little is known about the level of alcohol consumption at which physicians think that they should advise their patients to reduce drinking. This is especially true concerning the amounts consumed per one drinking occasion. The aim of the present study was to examine these issues and also characteristics of physicians possibly associated with their different opinions. Method: Cross-sectional self-administered questionnaire survey to all 3193 primary health care physicians in Finland. Response rate was 61.0%. Results: The physicians reported that on average 14.8 drinks (one drink = 12 g of absolute alcohol)/week for males and 10.6 drinks/week for females to be the threshold that would cause them to advise their patients. Corresponding figures for one drinking occasion were 6.6 and 4.9 drinks/week. In linear regression analyses physicians' AUDIT scores, use of brief intervention, experience as a physician and age explained the variance of all or some reported thresholds, but all the variables explained only about 10% of the phenomena. Conclusions: Compared to the official Finnish recommendations regarding the definition of heavy drinking, the physicians reported similar levels of drinking per occasion for deciding to advise their patients, but rather low levels concerning weekly drinking. This may lead to extra workload for physicians and thus hamper implementation of brief intervention. Physicians' characteristics seem to be a decidedly minor issue in implementing drinking limits in health care.

Akins S; Mosher C; Smith CL; Gauthier JF. The effect of acculturation on patterns of Hispanic substance use in Washington state. Journal of Drug Issues 38(1): 103-118, 2008. (38 refs.)

A growing body of research on Hispanic substance use in the United States has found acculturation to result in increased drug use. This study contributes to this research by analyzing the effect of acculturation on Hispanic substance use in Washington State, a state with a rural and dispersed Hispanic population. Findings reveal acculturation to have a strong positive effect on levels of illicit drug use, hard drug use, binge drinking and bender drinking among Hispanics.

Anderson JF. Screening and brief intervention for hazardous alcohol use within indigenous populations: Potential solution or impossible dream? Addiction Research & Theory 15(5): 439-448, 2007. (37 refs.)

Despite the increasing popularity of screening and brief intervention (SBI) for hazardous drinking within the wider population, there is a paucity of SBI research directed at Indigenous populations. In Canada, Aboriginal drinkers are less than half as likely to drink on a weekly/daily basis but more than twice as likely to binge drink compared to the general drinking population. As a result, there is a high rate of alcohol related deaths and hospitalisations compared to the non-Aboriginal population. Modification of these patterns and levels of hazardous drinking - especially binge drinking - among Aboriginal drinkers should markedly improve health outcomes. Although the efficacy of SBI has been demonstrated across a range of health care settings and sociocultural groups, there are potential systemic and cultural barriers to implementation of SBI for Aboriginal hazardous drinkers including the historic impact of alcohol on Aboriginal communities. Implementation of SBI must address these barriers and be sensitive to the historic relationship between Aboriginals and alcohol.

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.

Bagnardi V; Zatonski W; Scotti L; La Vecchia C; Corrao G. Does drinking pattern modify the effect of alcohol on the risk of coronary heart disease? Evidence from a meta-analysis. Journal of Epidemiology and Community Health 62(7): 615-619, 2008. (42 refs.)

Objective: To evaluate the strength of the evidence provided by epidemiological literature investigating drinking pattern as effect modifier of alcohol intake on the risk of coronary heart disease ( CHD). Design: Meta-analysis of observational studies. Data sources: Medline, citation tracking, from 1966 to 2006. Review methods: Original studies investigating the amount of alcohol intake, combined with the frequency of alcohol consumption and/or pattern of alcohol drinking affecting the risk of CHD were extracted. Among them, cohort and case-control studies reporting sufficient data to perform statistical analyses and using people who abstained from alcohol as the reference were included. Results: Six ( 4 cohort and 2 case-control) out of 118 studies reviewed met the inclusion criteria. Compared with those who abstained from alcohol, regular heavy drinkers and heavy irregular or binge drinkers showed significantly different pooled relative risks of 0.75 (95% confidence interval 0.64 to 0.89) and 1.10 (1.03 to 1.17) respectively. The dose-response relation between the amount of alcohol intake and CHD risk was significantly different in regular and irregular drinkers. A J-shaped curve, with nadir around 28 grams of alcohol per week, and last protective dose of 131 grams per week, was obtained including drinkers who consumed alcohol for 2 days a week or less. Conversely, in people who consumed alcohol for more than 2 days a week a significant protective effect was seen even when drinking high amounts of alcohol. Conclusion: This meta-analysis suggests that binge and heavy irregular drinking modify the favourable effect of alcohol intake on the CHD risk. However, this conclusion should be taken with caution because of the small number of studies considered.

Balsa AI; Homer JF; Fleming MF; French MT. Alcohol consumption and health among elders. Gerontologist 48(5): 622-636, 2008. (65 refs.)

Purpose: This article estimates the effects of alcohol consumption on self-reported overall health status, injuries, heart problems, emergency room use, and hospitalizations among persons older than the age of 65. Design and Methods: We analyzed data from the first wave of the National Epidemiologic Survey on Alcohol and Related Conditions, a notionally representative study. We used multivariate regression and instrumental variables methods to study the associations between alcohol consumption (current drinking, binge drinking, and average number of drinks consumed) and several indicators of health status and health care utilization. Results: Alcohol consumption by women was associated with better self-perceived health status, improved cardiovascular health, and lower rates of hospitalizations. We detected no significant negative or positive associations for older men. Implications: These findings suggest that light to moderate alcohol use by older women may have beneficial health effects. Experimental trials, however, are needed to more rigorously assess the potential benefits of alcohol use by elders due to the inherent biases of observational studies.

Banta JE; Przekop P; Haviland MG; Pereau M. Binge drinking among California adults: Results from the 2005 California Health Interview Survey. American Journal of Drug and Alcohol Abuse 34(6): 801-809, 2008. (25 refs.)

Objective: To calculate binge drinking rates among California adults and describe the characteristics of female and male binge drinkers. Method: Analyses of 2005 California Health Interview Survey (CHIS) data. Results: At least one binge drinking episode over a 30-day period was reported by 1.4 million California women (10.7% of all adult women) and 3.2 million California men (24.7%). For both women and men, factors associated with binge drinking included being 18-44 years of age, smoking, and having mid-range psychological distress scores. There were gender differences in binge drinking risk by race/ethnicity and health status. Method: Given the multi-stage sampling design and non-responses in the 2005 California Health Interview Survey-Specific techniques were employed to ensure that the 43,020 compteted result yeilded reasonable state wide estimates. Conclusion: Binge drinking is a serious public health concern that affects millions of adult Californians.

Bazargan-Hejazi S; Bazargan M; Gaines T; Jemanez M. Alcohol misuse and report of recent depressive symptoms among ED patients. American Journal of Emergency Medicine 26(5): 537-544, 2008. (46 refs.)

Objective: This study examined the magnitude of association between alcohol misuse and recent depressive symptoms. Methods: We conducted a cross-sectional study of 412 randomly selected patients at least 18 years old and seeking emergency department (ED) care. Results: Of the patients, 5 1.0% reported depressive symptoms. At-risk drinking was reported by 26.0%, and 28.2% scored positive on the Rapid Alcohol Problems Screen 4. Alcohol abuse and binge drinking were reported by 25.1% and 29%, respectively, of the patients. According to our results, at-risk drinking (odds ratio [OR] = 2.49, 95% confidence interval [CI] = 1.47-4.20, P <= .001), problem drinking (OR = 2.11, 95% CI = 1.27-3.5 1, P <= .004), drinking abuse (OR - 2.58, 95% CI = 1.51-4.40, P <.001), and binge drinking (OR = 1.89, 95% CI = 1.13-3.15, P <.001) were all related to the manifestation of depressive symptoms. Conclusions: The findings of this study yield information that could be used by ED health care practitioners and health educators to educate ED patients at risk for alcohol misuse and depression.

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.

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.

Caldwell TM; Rodgers B; Clark C; Jefferis BJMH; Stansfeld SA; Power C. Lifecourse socioeconomic predictors of midlife drinking patterns, problems and abstention: Findings from the 1958 British Birth Cohort Study. Drug and Alcohol Dependence 95(3): 269-278, 2008. (41 refs.)

Background: Research suggests that outcomes associated with drinking may differ depending upon patterns of consumption, drinking related symptoms and social problems. This paper investigated socioeconomic predictors (measuring multiple indices, period and consistency of disadvantage) of midlife drinking patterns. Methods: Socioeconomic information from the 1958 British Birth Cohort Study (n=9146) included: manual socioeconomic position and owner/buyer residential tenure (7, 11, 16, 33 and 42 y), and educational attainment (33 y). At 45 y, the overlap between drinking patterns was explored using the Alcohol Use Disorders Identification Test. Patterns included: 'Moderate-binge' (binge drinkers with low-problem scores, consuming within UK sensible drinking weekly guidelines); Low-Problem Heavy (LPH) drinkers (regardless of binge); 'Problem' (and heavy or binge) and 'Non-/occasional' (<= monthly) drinkers. These categories were compared to 'Low-risk' drinkers. Results: Socioeconomic disadvantage was consistently associated with moderate-binge, non-/occasional and problem but not LPH drinking, The highest risk was associated with multiple and persistent disadvantage across childhood and adulthood; this risk was partially accounted for education. Non-/occasional and moderate-binge drinking was predicted by disadvantage during childhood alone. The socioeconomic disadvantage of non-/occasional drinkers was not explained by past problem or heavy drinking. Conclusions: Socioeconomic disadvantage across the lifecourse was consistently linked to specific drinking patterns. Furthermore, associations linking socioeconomic disadvantage with drinking patterns will typically be underestimated if multiple and persistent disadvantage is not investigated. The role of persistent socioeconomic disadvantage in the poor health of non-drinkers and moderate-binge drinkers needs investigation. The findings support current initiatives targeting the reduction of social and individual costs associated with specific drinking patterns.

Carswell K; Chen Y; Nair RC; Shaw AK; Speechley KN; Barrera M et al. Smoking and binge drinking among Canadian survivors of childhood and adolescent cancers: A comparative, population-based study. Pediatric Blood & Cancer 51(2): 280-287, 2008. (50 refs.)

Background. Objectives of this study were to describe the prevalence of smoking and binge drinking among survivors of childhood and adolescent cancer compared to controls who had never had cancer, and to identify factors associated with these behaviors. Procedure. Data came from a national, multi-centre, population-based study of survivors of childhood and adolescent cancer (n=1,263) aged 16 to 37 years and an age and gender matched control group (n = 1,422). Logistic regression analyses were performed to determine the likelihood and predictors of current smoking and binge drinking. Results. Survivors were less likely to be current smokers (ORadj=0.65, 95% CI=0.54-0.77) and binge drinkers (ORadj=0.66, 95% CI = 0.55-0.78) than the controls. Still, a substantial proportion of survivors reported smoking (23%) and binge drinking (25%). Survivors' smoking and binge drinking did not vary substantially by the clinical factors assessed. Survivors who received therapy associated with cardiac and/or pulmonary toxicity were as likely to smoke as non-exposed survivors. For both the survivors and controls current smoking and binge drinking were associated with lower education and higher reported stress. Binge drinking was also associated with being male and life dissatisfaction in both groups. Conclusions. This study indicates a need to reduce smoking and binge drinking among survivors of childhood and adolescent cancer and to design interventions addressing the underlying reasons for adopting unhealthy behaviors despite their risk for late effects. We identified factors related to smoking and binge drinking among survivors: being male, lower educational attainment, life dissatisfaction and high stress, which should help inform intervention development.

Castro-Costa E; Ferri CP; Lima-Costa MF; Zaleski M; Pinsky I; Caetano R et al. Alcohol consumption in late-life: The first Brazilian National Alcohol Survey (BNAS). Addictive Behaviors 33(12): 1598-1601, 2008. (14 refs.)

To investigate the alcohol consumption in later life in Brazil and its association with sociodemographic characteristics. This study was a cross-sectional analysis of nationally representative survey data. A multistage cluster sampling procedure was used to select 3007 individuals of 14 years of age and older from the Brazilian household population. In this study we analyzed data from all 400 participants who were over 60 years old. Alcohol Abuse and Dependence Syndrome was established according to DSM-IV and Risky Drinking was defined in two ways: heavy drinkers (>7 drinks/week) and as binge drinkers (>3 drinks/one occasion). Twelve percent of participants reported heavy drinking behavior while 10.4% and 2.9% were binge drinkers and alcohol dependent respectively. In the adjusted logistic regression only gender was associated with heavy drinking behavior. Males, the youngest and the wealthiest were more likely to report binge drinking behaviors. In conclusion, alcohol related-problems are common but under-recognized among older adults. Health professionals should be aware that common definitions of alcohol abuse and dependence may not apply as readily to older people, who have had biological changes for alcohol tolerance and its effects on the Central Nervous System.

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.

Chermack ST; Murray RL; Walton MA; Booth BA; Wryobeck J; Blow FC. Partner aggression among men and women in substance use disorder treatment: Correlates of psychological and physical aggression and injury. Drug and Alcohol Dependence 98(1/2): 35-44, 2008. (67 refs.)

This study examined intimate partner aggression in a sample of 489 participants enrolled in substance use disorder treatment, and expands on prior research by including measures of various forms of aggression, a mixed gender sample (76% men, 24% women), and measurement of several potential risk domains. Aggression measures included both participant-partner and partner-to-participant psychological aggression, physical aggression and injury. Analyses focused on the role of distal and proximal risk factors, including demographics, history of childhood physical and sexual abuse, and family history of problems with alcohol, drugs and depression, as well as recent substance use and symptoms of depression. Overall rates of participant-partner psychological aggression (77%), physical aggression (54%) and injuring partners (33%) were high, as were rates of partner-to-participant psychological aggression (73%), physical aggression (51%), and injury (33%). Several distal (family history variables, physical abuse) and proximal factors (binge drinking, several different drugs, depressive symptoms) were bivariately related to most of the aggression measures. However, according to multivariate analyses predicting aggression and injury measures, binge drinking and cocaine use were the drugs significantly associated with most measures, depression symptoms also were related to most aggression and injury measures, and a history of reported childhood physical abuse was related to all frequency of aggression and injury measures among those reporting such behaviors. Overall, the high rates of aggression among both men and women observed in this study further illustrate the need for interventions targeting substance use and aggression, and for further research regarding the inter-relationships among substance, aggression and depressive symptoms.

Chersich MF; Luchters SMF; Malonza IM; Mwarogo P; King'ola N; Temmerman M. Heavy episodic drinking among Kenyan female sex workers is associated with unsafe sex, sexual violence and sexually transmitted infections. International Journal of STD & AIDS 18(11): 764-769, 2007. (41 refs.)

This study examined patterns of alcohol use and its association with unsafe sex and related sequelae among female sex workers in Mombasa, Kenya. A community-based cross-sectional study was conducted using snowball sampling. Binge drinkers (>= 5 alcoholic drinks on >= 1 occasion in the previous month) were compared with non-binge drinkers. Of 719 participants, 22.4% were lifetime-alcohol abstainers, 44.7% non-binge and 33.0% binge drinkers. Compared with non-binge drinkers, binge drinkers were more likely to report unprotected sex (adjusted odds ratio (AOR) = 1.59, 95% confidence interval [CI] = 1.00-2.53; P = 0.047) and sexual violence (AOR = 1.85, 95% Cl = 1.27-2.71; P = 0.001) and to have either syphilis, Neisseria gonorrhoeae or Trichomonas vaginalis infection (AOR = 1.56, 95% Cl = 1.00-2.41; P = 0.048). HIV prevalence was higher among women having ever drunk (39.9%) than lifetime abstainers (23.2%; P < 0.001), but was not associated with drinking patterns. Interventions are needed to assist female sex workers adopt safer drinking patterns. Investigation is needed for the effectiveness of such interventions in reducing unprotected sex, sexual violence and sexually transmitted infections.

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.

Conrod PJ; Castellanos N; Mackie C. Personality-targeted interventions delay the growth of adolescent drinking and binge drinking. Journal of Child Psychology and Psychiatry 49(2): 181-190, 2008. (43 refs.)

Background: Personality factors are implicated in the vulnerability to adolescent alcohol misuse. This study examined whether providing personality-targeted interventions in early adolescence can delay drinking and binge drinking in high-risk youth. Methods: A randomised control trial was carried out with 368 adolescents recruited from years 9 and 10 (median age 14) with personality risk factors for substance misuse. Participants received either a personality-targeted intervention or no intervention. Outcome data were collected on alcohol use through self-reports at 6 and 12-month post intervention and analyses were conducted on the full intent to treat sample. Results: Multi-group analysis of a latent growth curve model showed a group difference in the growth of alcohol use between baseline and 6-months follow-up, with the control group showing a greater increase in drinking than the intervention group for this period. Interventions were particularly effective in preventing the growth of binge drinking in those students with a sensation seeking (SS) personality. SS drinkers in the intervention group were 45% and 50% less likely to binge drink at 6 (OR = .45) and 12 months (OR = .50) respectively, than SS drinkers in the control group, p = .001, phi = .49, Number Needed to Treat = 2.0. Conclusions: Considering the robust, inverse relationship between age of onset of alcohol use and later alcohol dependence, this intervention strategy may prove effective in preventing the onset of adult alcohol use disorders, by helping high-risk youth delay the growth of their drinking to a later developmental stage.

Cooper TV; DeBon M; Haddock CK; Esquivel DR; Klesges RC; Lando H; Talcott W. Demographics and risky lifestyle behaviors associated with willingness to risk sexually transmitted infection in air force recruits. American Journal of Health Promotion 22(3): 164-167, 2008. (9 refs.)

Purpose. To investigate sexually transmitted infection (STI) risk-taking behaviors relative to other lifestyle and risk-taking behaviors. Design. The study design is cross sectional. Setting. Lackland Air Force Base in San Antonio, Texas. Subjects. Participants (N = 32,144) were 100% of Air Force recruits beginning basic military training from, August 1995 to August 1996. Measures. Recruits completed a questionnaire that included rating the statement "Sex without condoms is sometimes worth the risk of possibly getting AIDS or sexually transmitted diseases." Risky behaviors. such as risk taking, rebelliousness, seat belt use, smoking, alcohol use and binge drinking, opinions of illicit drug use, and lifestyle behaviors, such as dietary intake and physical activity, were also assessed. Analysis. Univariate and multivariate logistic regression analyses examined the relationships between participant characteristics and willingness to risk STI. Results. Sixteen percent stated willingness to risk STI to have sex without a condom. Women and white/non-Hispanic participants were less likely to agree with the statement than men and minority, participants. Those who reported willingness toward risky, sexual behaviors were less likely to use seat bells, were more likely to binge drink, had more positive views of illicit drugs, and reported eating fewer fruits and vegetables. Conclusion. Results of this study suggest the importance of continued education on condom use and the possibility, that multiple risk behavior interventions include sexual risk components.

Corliss HL; Rosario M; Wypij D; Fisher LB; Austin SB. Sexual orientation disparities in longitudinal alcohol use patterns among adolescents findings from the Growing Up Today Study. Archives of Pediatrics & Adolescent Medicine 162(11): 1071-1078, 2008. (52 refs.)

Objective: To compare sexual orientation group differences in the longitudinal development of alcohol use behaviors during adolescence. Design: Community-based prospective cohort study. Setting: Self-reported questionnaires. Participants: A total of 13 450 Growing Up Today Study participants (79.7% of the original cohort) aged 9 to 14 years at baseline in 1996 were followed up for more than 7 years. Main Exposure: Self-reported sexual orientation classified as heterosexual, mostly heterosexual, bisexual, or gay/lesbian. Main Outcome Measures: Age at alcohol use initiation, any past-month drinking, number of alcoholic drinks usually consumed, and number of binge drinking episodes in the past year. Results: Compared with heterosexual participants, youth reporting any minority sexual orientation reported having initiated alcohol use at younger ages. Greater risk of alcohol use was consistently observed for mostly heterosexual males and females and for bisexual females, whereas gay and bisexual males and lesbians reported elevated levels of alcohol use on only some indicators. Gender was an important modifier of alcohol use risk; mostly heterosexual and bisexual females exhibited the highest relative risk. Younger age at alcohol use initiation among participants with minority sexual orientations significantly contributed to their elevated risk of binge drinking. Conclusions: Our findings suggest that disparities in alcohol use among youth with a minority sexual orientation emerge in early adolescence and persist into young adulthood. Health care providers should be aware that adolescents with a minority sexual orientation are at greater risk of alcohol use.

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. [Note: A correction/addendum is published in Addiction 102(12): 1224-1233.]

Delnevo CD; Gundersen DA; Hagman BT. Declining estimated prevalence of alcohol drinking and smoking among young adults nationally: Artifacts of sample undercoverage? American Journal of Epidemiology 167(1): 15-19, 2008. (19 refs.)

A growing concern in public health surveillance surveys that rely on random digit dialing for sampling is the exclusion of adults in cell-phone-only households. The purpose of this study was to examine whether recent increases in wireless substitution have affected estimates of tobacco and alcohol use in the Behavioral Risk Factor Surveillance System (BRFSS) in a subpopulation with notable cell-phone usage (i.e., young adults). BRFSS data from 2001-2005 were examined. Analyses were limited to participants aged 18-24 years, and the sample contained approximately 18,500 persons in each year. Prevalence estimates were generated with SUDAAN software for three health behaviors: cigarette smoking, binge drinking, and heavy alcohol consumption. In addition, the authors examined sample completeness for young adults relative to US Census estimates. Overall, prevalences of all three health behaviors among young adults were fairly stable between 2001 and 2003 but significantly decreased between 2003 and 2005. These trends are not replicated in national surveys that use area probability samples. The authors found a declining trend in the sample completeness ratio for young adults; it declined from 0.32 in 2001 to 0.15 in 2005. Given the high prevalence of wireless substitution among young adults and the declining sample completeness ratio, the authors suspect that the observed decreases in prevalence are artifacts of undercoverage.

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.

Doumas DM; Haustveit T. Reducing heavy drinking in intercollegiate athletes: Evaluation of a Web-based personalized feedback program. Sport Psychologist 22(2): 212-228, 2008. (50 refs.)

This study evaluated the efficacy of a Web-based personalized feedback program aimed at reducing drinking in freshman intercollegiate athletes. The program was offered through the Athletic Department freshman seminar at a NCAA Division I university. Seminar sections were randomly assigned to one of two conditions: Web-based personalized feedback (WPF) or Web-based education (WE). Assessment measures were completed at baseline, 6 weeks, and 3 months. Athletes were classified as high-risk or low-risk drinkers based on baseline reports of binge drinking. Results indicated for high-risk athletes, students in the WPF condition reported significantly greater reductions in drinking and changes in beliefs about peer drinking than those in the WE condition. In addition, reductions in drinking were related to reductions in peer drinking estimates for athletes in the WPF group. Findings provide initial support for the efficacy of Web-based personalized feedback for reducing the quantity and frequency of heavy drinking in freshman intercollegiate athletes.

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.

Eldridge A; Roberts M. Hen parties: Bonding or brawling? Drugs: Education, Prevention and Policy 15(3): 323-328, 2008. (24 refs.)

While the number of marriages taking place in Britain continues to decline, the hen party has become both an accepted marriage ritual and a source of controversy. In previous research we have found bar owners and town centre managers eager to discourage hen parties from their town centres and venues. Equally, in the popular press, the hen party is increasingly portrayed in comparable terms to the 'stag do'; a night of drunken excess and embarrassing misdemeanours. This paper examines the hen party in terms of the articulation of gender, alcohol and public space. Through a wide-ranging literature survey and pilot interviews, we ask if the hen party exaggerates existing behaviours and practices, or whether it represents an entirely new, albeit limited, example of how women are using public space at night. Against the backdrop of a historical anxiety about women and public space, and growing concern about women and binge drinking, we examine the hen party as both a site of transgression, empowerment and female bonding, and as a unique opportunity to explore women's shifting attitudes to late-night culture.

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.

Flowers NT; Naimi TS; Brewer RD; Elder RW; Shults RA; Jiles R. Patterns of alcohol consumption and alcohol-impaired driving in the United States. Alcoholism: Clinical and Experimental Research 32(4): 639-644, 2008. (46 refs.)

Background: Alcohol-related motor vehicle crashes kill approximately 17,000 Americans annually and were associated with more than $51 billion in total costs in 2000. Relatively little is known about the drinking patterns of alcohol-impaired drivers in the United States. Methods: 2006 Behavioral Risk Factor Surveillance System (BRFSS) was analyzed for alcohol consumption and self-reported AI driving among U.S. adults aged >= 18 years for all states. Alcohol consumption was divided into 4 categories: binge/heavy, binge/nonheavy, nonbinge/heavy, and nonbinge/nonheavy. Binge drinking was defined as >= 5 drinks for men or >= 4 drinks for women on one or more occasions in the past month, and heavy drinking was defined as average daily consumption of > 2 drinks/day (men) or > 1 drink/day (women). The prevalence of alcohol-impaired driving was examined by drinking pattern and by demographic characteristics. Logistic regression analysis was used to assess the association between drinking patterns and AI driving. Results: Five percent of drinkers were engaged in alcohol-impaired driving during the past 30 days. Overall, 84% of AI drivers were binge drinkers and 88% of alcohol-impaired driving episodes involved binge drinkers. By drinking category, binge/nonheavy drinkers accounted for the largest percentage of alcohol-impaired drivers (49.4%), while binge/heavy drinkers accounted for the most episodes of AI driving (51.3%). The adjusted odds of AI driving were 20.1 (95% CI: 16.7, 24.3) for binge/heavy, 8.2 (6.9, 9.7) for binge/nonheavy, and 3.9 (2.4, 6.3) for nonbinge/heavy drinkers, respectively. Conclusions: There is a strong association between binge drinking and alcohol-impaired driving. Most alcohol-impaired drivers and almost half of all alcohol-impaired driving episodes involve persons who are not heavy drinkers (based on average daily consumption). Implementing effective interventions to prevent binge drinking could substantially reduce alcohol-impaired driving.

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.

Frank E; Elon L; Naimi T; Brewer R. Alcohol consumption and alcohol counselling behaviour among US medical students: Cohort study. British Medical Journal 337(e-article a2155), 2008. (50 refs.)

Objective: To determine which factors affect alcohol counselling practices among medical students. Design: Cohort study. Setting Nationally representative medical schools ( n= 16) in the United States. Participants: Medical students who graduated in 2003. in the third year of training) ( n= 1630/ 1982), and their final ( fourth) year ( n= 1469/ 1901). Main outcome measures: Previously validated questions on alcohol consumption and counselling. Results: 78% ( 3777/4847) of medical students reported drinking in the past month, and a third (1668/ 4847) drank excessively; these proportions changed little over time. The proportion of those who believed alcohol counselling was highly relevant to care of patients was higher at entrance to wards (61%; 919/1516) than in final year students (46%; 606/1329). Although students intending to enter primary care were more likely to believe alcohol counselling was highly relevant, only 28% of final year students (391/1393) reported usually or always talking to their general medical patients about their alcohol consumption. Excessive drinkers were somewhat less likely than others to counsel patients or to think it relevant to do so. In multivariate models, extensive training in alcohol counselling doubled the frequency of reporting that alcohol counselling would be clinically relevant (odds ratio 2.3, 95% confidence interval 1.6 to 3.3) and of reporting doing counselling (2.2, 1.5 to 3.3). Conclusions: Excessive drinking and binge drinking among US medical students is common, though somewhat less prevalent than among comparably aged adults in the US general population. Few students usually discussed alcohol use with patients, but greater training and confidence about alcohol counselling predicted both practising and believing in the relevance of alcohol counselling. Medical schools should consider routinely training students to screen and counsel patients for alcohol misuse and consider discouraging excessive drinking.

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.

Garcia V. Meeting a binational research challenge: Substance abuse among transnational Mexican farmworkers in the United States. Journal of Rural Health 23(Supplement S): 61-67, 2007. (20 refs.)

To help in understanding the manner in which community, individual, and other factors in the United States and Mexico contribute to drug use among transnational migrants, this paper introduces a binational social ecology model of substance abuse in this population. E We draw on our 2 NIH-funded ethnographic studies-1 on problem drinking and the other on drug abuse-among transnational Mexican workers in the mushroom industry of southeastern Pennsylvania. Our model demonstrates that major reasons for substance abuse among transnational migrants include nontraditional living arrangements in labor camps and overcrowded apartments, the absence of kin and community deterrents to drug use; social isolation, the presence of drug use and binge drinking subcultures, the availability of drugs, family history of drugs, previous drug use or witnessing of drug use in Mexico, and drug use norms and drug availability in Mexico. It suggests the need for US and Mexican researchers to collaborate in binational teams and address factors on both sides of the border: Our binational social ecology model, together with our research recommendations, will assist alcohol and drug researchers to discover how community and individual factors in both the United States and abroad fit and interact beyond mere association and provide a more comprehensive research approach to substance abuse research among transnational migrants.

Garretsen HFL; Rodenburg G; De Goor LAMV; van den Eijnden RJJM. Alcohol consumption in The Netherlands in the last decade: Sharp decreases in binge drinking, especially among youngsters. Alcohol and Alcoholism 43(4): 477-480, 2008. (11 refs.)

Aim: The aim of this study was to examine the development of alcohol consumption and 'binge drinking' in The Netherlands over the period 1997-2005. Methods: Data from three national population surveys commissioned by the Dutch Ministry of Health were compared. Results: Decreases in binge drinking have appeared, especially for youngsters, which are not explained by changes in the composition of the population according to religious orientation, and for which no other explanation can be given at present. Conclusion: Trends in binge drinking in The Netherlands can vary over relatively short spaces of time.

Gerend MA; Cullen M. Effects of message framing and temporal context on college student drinking behavior. Journal of Experimental Social Psychiatry 44(4): 1167-1173, 2008. (35 refs.)

This study evaluated the interactive effects of message framing and temporal context on college student alcohol use. Participants (n = 228) were randomly assigned to read an alcohol prevention message that varied by message frame (gains vs. losses) and temporal context (short- vs. long-term consequences). Participants returned to the lab one month later to report their drinking behavior over the past month. As predicted, students exposed to the gain-framed message reported lower alcohol use (drank less frequently, drank fewer alcoholic beverages per drinking occasion, and engaged in less binge drinking) as compared to students exposed to the loss-framed message, but only if they read about short-term consequences of alcohol use. Message frame had no effect when participants were exposed to long-term consequences. This investigation extends previous research by demonstrating the effectiveness of message framing for reducing health-damaging behaviors and by identifying temporal context as a moderator of framing effects.

Giang KB; Allebeck P; Spak F; Van Minh H; Dzung TV. Alcohol use and alcohol consumption-related problems in rural Vietnam: An epidemiological survey using AUDIT. Substance Use & Misuse 43(3/4): 481-495, 2008. (33 refs.)

This study aimed to assess alcohol use and alcohol consumption-related problems in different sociodemographic groups in a rural district in Vietnam. Interviews were completed between March 2004 and July 2004. The Alcohol Use Disorder Identification Test (AUDIT) was applied to interview 3423 people, who were randomly selected in a rural district (1695 men and 1728 women). People who had an AUDIT score greater than 7 (in men) or greater than 5 (in women) were identified as having alcohol consumption-related problems. Prevalences and adjusted odds ratios of alcohol use and alcohol consumption-related problems were estimated for different subgroups of the population. Weekly and daily "binge drinking" among men were 5.7 and 3.6%, while binge drinking in women was virtually nonexistent. The prevalence of alcohol consumption-related problems was 25.5% among men and 0.7% among women. The differences between sociodemographic groups were not strong, but women who were separated, divorced, or widowed as well as those with higher education had significantly higher rates of alcohol consumption-related problems than married women and those with lower education. This study indicates an urgent need for alcohol intervention programs focused on men. However, further monitoring of alcohol use and problems among women is important to follow-up changes in consumption pattern. The study's limitations are discussed.

Gmel G; Givel JC; Yersin B; Daeppen JB. Injury and repeated injury: What is the link with acute consumption, binge drinking and chronic heavy alcohol use? Swiss Medical Weekly 137(45-46): 642-648, 2007. (43 refs.)

Objectivcs: First, to test whether current injury is more closely related to acute intake than to usual consumption patterns, and second, to test whether repeated injury is more closely related to general consumption patterns than to acute intake. Methods: Screening of alcohol consumption of 7,872 patients enrolling between january 1, 2003 and June 30, 2004 in an emergency department (ED) in Lausanne, Switzerland. General consumption patterns were measured as usual volume (in drinks per week) and binge drinking (5+ drinks for men; 4+ drinks for women) at least once monthly. Acute intake was measured through number of drinks in the 24-hour period prior to attending the ED. Separate logistic regression models of current injury and repeated injury on alcohol consumption patterns were estimated. Results: Acute intake and binge drinking dominated the association with current injury, while general consumption patterns were predictive of repeated alcohol-related injury. Conclusions: Acute intake is associated with current injury in a dose-response relationship and with binge drinking. Because acute intake can be found among moderate volume drinkers as well as among chronic heavy drinkers, for current injury usual volume adds little predictive value over the effects of acute intake. Repeated injuries occur more often among chronic heavy drinkers, and thus general consumption patterns are more closely associated with injury "recidivism" than with acute intake. A screening question assessing prior injury may be a useful tool in the ED for distinguishing between chronic heavy drinkers and usually moderate drinkers with heavy drinking episodes, and thus prove helpful when creating preventive efforts tailored to different types of drinker.

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.

Good GE; Schopp LH; Thomson D; Hathaway SL; Mazurek MO; Sanford-Martens TC. Men with serious injuries: Relations among masculinity, age, and alcohol use. Rehabilitation Psychology 53(1): 39-45, 2008. (51 refs.)

Objective: To increase understanding of masculine role attitudes and conflicts associated with alcohol use among men with serious injuries. Participants and Measures: Fifty-two Midwestern adult men with spinal cord injury or traumatic brain injury completed masculine role attitudes and conflicts and alcohol consumption instruments. Age and blood alcohol content at injury were obtained from records. Results: Younger men reported greater pursuit of status, drive for dominance, and risk taking but less self-reliance and overall masculine role conflict. Earlier age of injury was associated with greater pursuit of status and drive for dominance but less self-reliance, restrictive emotionality, and overall masculine role conflict. Endorsement of dominance correlated positively with number of alcoholic drinks per drinking episode (r(s) = .43) and binge drinking (r(s) = .47). Masculine role conflict associated with success, power, and competition correlated with number of drinks per drinking episode (r(s) = .46). Implications: Greater awareness and sensitivity to masculinity-related attitudes and conflicts may (a) reduce psychological barriers to accepting assistance, (b) promote active engagement in rehabilitation activities, (c) avoid counterproductive ambivalence and resistance, and (d) improve the therapeutic working alliance associated with favorable outcomes among men with serious injuries.

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.

Guise JMF; Gill JS. 'Binge drinking? It's good, it's harmless fun': A discourse analysis of accounts of female undergraduate drinking in Scotland. Health Education Research 22(6): 895-906, 2007. (40 refs.)

Binge drinking in young people, particularly females and students, is a source of some concern to those engaged in health education. The concept is usually defined in terms of quantities of alcohol consumed within a relatively short space of time. Research suggests that reasons for drinking are varied, and are likely to be influenced by culture and context. This study aimed to explore issues important to female undergraduate students in Scotland. Semi-structured interviews were carried out with 19 participants who were asked to describe what they understand by the term 'binge drinking', why they drink and what might trigger excessive consumption. Discourse analysis was used to explore the possible 'functions' of what was said, as well as the content. Participants showed sensitivity to how others might interpret their responses. They described binge drinking in terms of its behavioural effects rather than quantities consumed. Crucially, they positioned themselves outside the categories of 'serious' or 'anti-social' drinkers. These findings have important implications for our understanding of factors influencing drinking behaviour in this group of people, which in turn impacts on the potential design of health-enhancing interventions. The study also demonstrates the usefulness of a discourse analytic approach to accounts of drinking behaviour.

Hahm HC; Wong FY; Huang ZJ; Ozonoff A; Lee J. Substance use among Asian Americans and Pacific Islanders sexual minority adolescents: Findings from the National Longitudinal Study of Adolescent Health. Journal of Adolescent Health 42(3): 275-283, 2008. (39 refs.)

Purpose: We assessed the prevalence, incidence, and correlates of substance use among Asian American individuals transitioning from adolescence to young adulthood. Methods: Data were obtained from the National Longitudinal Study of Adolescent Health, Wave 11 (1996) and Wave 111 (2001). Information on substance use was abstracted from a nationally representative sample of 1108 Asian Americans and Pacific Islanders (AAPIs) from both Waves. Weighted prevalence, incidence, and patterns of smoking, binge drinking, marijuana use, and other drug use were analyzed by sexual orientation and gender. Multiple logistic regression analyses were conducted to investigate the unique contribution of being a sexual minority in relation to four types of substance use by gender. Results: A link between sexual orientation and substance use behaviors among AAPIs did not emerge until young adulthood. Significant increases in the incidence and prevalence of all four types of substance use (tobacco, binge drinking, marijuana, and other drugs) were found among sexual minority AAPIs. Specifically being an AAPI sexual minority young woman, compared with being a heterosexual young woman, a heterosexual young man, or a sexual minority young man, was significantly associated with substance use after controlling for demographic characteristics, problem behaviors, and substance use during adolescence. Also the highest prevalence of substance use was found among AAPI sexual minority women. Conclusions: These findings add greater urgency to addressing the role of sexual orientation in designing substance abuse programs.

Hanewinkel R; Tanski SE; Sargent JD. Exposure to alcohol use in motion pictures and teen drinking in Germany. International Journal of Epidemiology 36(5): 1068-1077, 2007. (41 refs.)

Background: To assess whether movie alcohol exposure is associated with alcohol use during early adolescence. Methods: We conducted a survey of adolescents (N = 5581) from 27 schools in Germany. Each was asked if he/she had seen a list of 50 movie titles, randomly selected from a sample of 398 US box office hits released there. Screen alcohol use was timed for each movie, summed for movies each adolescent had seen, and adjusted to reflect exposure to all 398 movies. We assessed the association between this exposure and any alcohol use without parental knowledge (WPK) and binge drinking (>=5 drinks). Results Alcohol use was depicted in 88% of the 398 movies. Median exposure to movie alcohol use was 3.44h (interquartile range 1.51-6.23h). Overall 36.6% of subjects used alcohol WPK and 18.1 reported binge drinking. Movie alcohol exposure was directly associated with alcohol use WPK and binge drinking, after controlling for multiple covariates including sociodemographics, personality characteristics and social influences. Compared with quartile one, the adjusted odds of alcohol use WPK were 1.47 [95% confidence interval (CI) 1.19-1.82], 2.12 (1.75-2.57) and 2.95 (2.35-3.70) for quartiles 2, 3 and 4, respectively; similarly, adjusted odds of binge drinking were 1.42 (0.93-2.28), 1.84 (1.27-2.67) and 2.59 (1.70-3.95). Conclusion This study demonstrates an association between exposure to alcohol use in US movies and alcohol use without parental knowledge in Germany, and is the first study to link movie exposure with binge drinking. Given international distribution of US movies, depicted behaviours may influence adolescents outside the country of origin.

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.

Harrell ZAT; Karim NM. Is gender relevant only for problem alcohol behaviors? An examination of correlates of alcohol use among college students. Addictive Behaviors 33(2): 359-365, 2008. (12 refs.)

This study examined correlates of alcohol use: substance-use coping, drinking to "feel high," and depressive symptoms as related to drinking behaviors in males and females. A sample of 266 female and 140 male college students from a private and public college were surveyed. Males reported more frequent alcohol use, alcohol-related problems, binge drinking, substance-use coping, and drinking to "feel high." There were no gender differences in self-reported depressive symptoms. Alcohol-use frequency and binge drinking were both accounted for by substance-use coping and drinking to "feel high" among males and females. However, alcohol-related problems were accounted for by males' frequency of alcohol use and drinking to "feel high," whereas females' problems were accounted for by frequency of alcohol use and depressive symptoms. Findings indicate that motivation for drinking is a more robust correlate of alcohol-related problems among males, while depressive symptomatology is a more relevant correlate of alcohol-related problems among females.

Harrison ELR; Mckee SA. Young adult non-daily smokers: Patterns of alcohol and cigarette use. Addictive Behaviors 33(5): 668-674, 2008. (34 refs.)

Binge drinking and non-daily cigarette smoking are behaviors that are both problematic and prevalent in young adults. Although the relationship between drinking and daily smoking has been well categorized, the intersection between drinking and smoking in non-daily smokers has not been heavily researched. Past 30-day and within-episode patterns of alcohol and cigarette use were collected in young adult non-daily smokers (N=40). Results demonstrated that 79% of smoking occurred on drinking days. Alcohol use was significantly greater on smoking days with the result that drinking to risky binge levels was more likely to occur on a smoking day. Smoking typically occurred after a certain level of alcohol pre-load (2.87 drinks). Together these results confirm that young adult non-daily smokers often concurrently use alcohol and cigarettes. Research is needed to identify possible mechanisms underlying the association between binge drinking and cigarette use in this vulnerable population.

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.

Helasoja V; Lahelma E; Prattala R; Petkeviciene J; Pudule I; Tekkel M. The sociodemographic patterning of drinking and binge drinking in Estonia, Latvia, Lithuania and Finland, 1994-2002. BMC Public Health 7: e-article 241, 2007. (40 refs.)

Background: Despite the relatively low recorded alcohol consumption level, the Baltic countries (Estonia, Latvia and Lithuania) and neighbouring Finland suffer from similar harmful consequences related to the use of alcoholic beverages, including socio-economic inequalities in alcohol related mortality. Comparative evidence is needed to understand harmful drinking patterns and to implement preventive alcohol policies also in the Baltic countries. This study compared heavy and binge drinking by sex, age, education, urbanisation and marital status in the Baltic countries and Finland. Methods: The data were nationally representative postal surveys conducted in Estonia (n = 6271), Latvia (n = 6106), Lithuania (n = 7966) and Finland (n = 15764) during 1994-2002. The criterion for heavy drinking was at least 15 portions weekly among men, and at least five among women, and for binge drinking at least six portions per one occasion. Results: Heavy drinking was more common among younger participants in all countries, and in Latvia among the less-educated. Among Finnish men, and among women from all countries except Latvia, the better-educated were more often heavy drinkers. In Latvia and Finland, urban men, and in all countries, urban women, were more often heavy drinkers. Heavy drinking was more common among non-married Lithuanian and Finnish men, and Finnish women. Binge drinking was more common among less-educated Estonian and Latvian men, and among younger and less-educated women in all countries. Conclusion: Our results support the continued power of traditional drinking habits in the North Eastern part of Europe. In the future the target groups for prevention of excessive drinking should also include young and less-educated women in all four countries studied.

Herring R; Berridge V; Thom B. Binge drinking today: Learning lessons from the past. Drugs: Education, Prevention and Policy 15(5): 475-486, 2008. (39 refs.)

Binge drinking is a matter of current social, media and political concern. Within the current debates binge drinking is sometimes portrayed as a recent phenomenon, but in fact it has a history and concern about binge drinking is not new. This paper sets the phenomenon in its historical context by examining how the nature and definition of binge drinking has changed over time. Aims: The overall aim is to draw lessons for policy through the interaction of social science and historical perspectives. Methods: A literature review was conducted and a workshop brought together researchers, policy makers and practitioners to consider current perceptions of binge drinking, current responses and possible future approaches. Findings: From this study it is evident that that the meaning ascribed to the term 'binge drinking' has changed over time but further research is required to establish quite how and why this shift came about. Parallels can be drawn between the current concerns about 'binge drinking' and those about the 'gin craze' of the eighteenth century: they are both focused on public drunkenness, urban locations and women's drinking and the media has played a pivotal role in shaping the response to the 'crisis'.

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.

Huang JH; DeJong W; Schneider SK; Towvim LG. Measuring college student drinking: Illustrating the feasibility of a composite drinking scale. Substance Abuse 27(1/2): 33-45, 2007

This study explored the feasibility of a Composite Drinking Scale (CDS) designed to capture fully the phenomenon of problem drinking among college students while allowing easy public understanding. A survey conducted at 32 four-year U.S. colleges included four consumption measures: 30-day frequency; average number of drinks per week; number of drinks usually consumed when partying; and greatest number of drinks in one sitting in the past two weeks. Responses were normalized and added to create a continuous distribution, which was then subdivided into quartiles (CDS/Q1-Q4). The CDS is an easily understood scoring system, but compared to the simplistic "binge drinking" measure, it captures a broader range of relative risks and more clearly establishes the quadratic relationship between consumption and alcohol-related problems. Development of the CDS will require further exploring the best set of questions to include, establishing U.S. norms for the general population, and then transforming those scores to a simple measurement yardstick whose meaning can be easily communicated to the public.

Hutton HE; McCaul ME; Santora PB; Erbelding EJ. The relationship between recent alcohol use and sexual behaviors: Gender differences among sexually transmitted disease clinic patients. Alcoholism: Clinical and Experimental Research 32(11): 2008-2015, 2008. (44 refs.)

Background: Binge drinking is associated with risky sexual behaviors and sexually transmitted diseases (STDs). Few studies have investigated this by gender or in an STD clinic. This cross-sectional study examined the association between binge drinking and risky sexual behaviors/STDs among patients attending an urban STD clinic. Method: A total of 671 STD clinic patients were tested for STDs, and queried about recent alcohol/drug use and risky sexual behaviors using audio computer-assisted-self-interview. The association between binge drinking and sexual behaviors/STDs was analyzed using logistic regression adjusting for age, employment, and drug use. Results: Binge drinking was reported by 30% of women and 42% of men. Gender differences were found in rates of receptive anal sex which increased linearly with increased alcohol use among women but did not differ among men. Within gender analyses showed that women binge drinkers engaged in anal sex at more than twice the rate of women who drank alcohol without binges (33.3% vs. 15.9%; p < 0.05) and 3 times the rate of women who abstained from alcohol (11.1%; p < 0.05). Having multiple sex partners was more than twice as common among women binge drinkers than women abstainers (40.5% vs. 16.8%; p < 0.05). Gonorrhea was nearly 5 times higher among women binge drinkers compared to women abstainers (10.6% vs. 2.2%; p < 0.05). The association between binge drinking and sexual behaviors/gonorrhea remained after controlling for drug use. Among men, rates of risky sexual behaviors/STDs were high, but did not differ by alcohol use. Conclusion: Rates of binge drinking among STD clinic patients were high. Among women, binge drinking was uniquely associated with risky sexual behaviors and an STD diagnosis. Our findings support the need to routinely screen for binge drinking as part of clinical care in STD clinics. Women binge drinkers, in particular, may benefit from interventions that jointly address binge drinking and risky sexual behaviors. Developing gender-specific interventions could improve overall health outcomes in this population.

Ilomaki J; Korhonen MJ; Enlund H; Hartzema AG; Kauhanen J. Risk drinking behavior among psychotropic drug users in an aging Finnish population: The FinDrink study. Alcohol 42(4): 261-267, 2008. (53 refs.)

Psychotropic drug use and alcohol consumption is increasing among aging Finns. Alcohol use is not recommended with benzodiazepines and some other psychotropic medicines. Concomitant use may lead to accidents and other serious consequences. The aim of this study was to analyze the drinking behavior of psychotropic drug users in an aging Finnish population. This study is part of the ongoing epidemiologic FinDrink study. Self-reported data on alcohol consumption and psychotropic drug use were collected from the Kuopio Ischaemic Heart Disease Risk Factor Study examinations conducted in 1998-2001. Overall, 854 men and 920 women participated in the study. A total of 204 (11.5%) individuals used psychotropic drugs regularly (14.2% of women and 8.5% of men; P <.001). Three quarters of the study population had used alcohol weekly during the preceding year (68.9% of women and 87.5% of men; P <.001). Men who use anxiolytics and sedatives were more likely to drink alcohol at least twice a week (odds ratio=2.42; 95% confidence interval= 1.30-4.51), to be binge drinkers (odds ratio=1.86; 95% confidence interval= 1.01-3.43) and to be heavy alcohol consumers (odds ratio=2.22; 95% confidence interval= 1.13-4.39) than men not using psychotropics. In women, alcohol consumption and drinking patterns were same between the groups. Our results indicate the potential for alcohol-related health risks among aging Finnish men and women using psychotropic drugs..

Isralowitz RE; Reznik A. Former Soviet Union immigrant and native-born adolescents in Israel: Substance use and related problem behavior. Journal of Ethnicity in Substance Abuse 6(1): 131-138, 2007

Studies on immigration and adolescence show that youth experience a variety of emotional and cognitive adjustments as well as conflicts related to acculturation and the realities of life in their new country. Such conditions place many of them at increased risk for psychosocial problems including personal stress, interpersonal conflicts, mental illness, school failure, delinquency, substance use, and other risk-taking behavior. This prospective study compares the patterns of substance use and problem behaviors among 365 at-risk adolescents born in Israel and those who immigrated to that country from the Former Soviet Union. Findings show that Former Soviet Union youth tend to have higher levels of last 30-day alcohol and ecstasy use and binge drinking. Multiple regression shows binge drinking behavior related to trading property to obtain drugs; deterioration of school achievement; selling drugs; and time spent when being absent from school and hanging around during the day. Country of origin was not found related to this behavior. Further research is needed to study substance use and related problem behavior among immigrant youth controlling for the impact of acculturation and other factors.

Isralowitz RE; Reznik A. Former Soviet Union immigrant and native-born adolescents in Israel: Substance use and related problem behavior. Journal of Ethnicity in Substance Abuse 6(1): 131-138, 2007

Jamison J; Myers LB. Peer-group and price influence students drinking along with planned behaviour. Alcohol and Alcoholism 43(4): 492-497, 2008. (42 refs.)

Aims: To examine the theory of planned behaviour (TPB), as a framework for explaining binge drinking among young adults. Methods: One hundred and seventy-eight students in a cross-sectional design study completed self-report questionnaires examining attitudes to drinking, intention to drink and drinking behaviour in university. Binge drinking was defined for females (and males) as consuming 'four (males-five) or more pints of beer/glasses of wine/measures of spirits' in a single session. Results: Drinking alcohol was common; 39.6% of males and 35.9% of females reported binge drinking. The TPB explained 7% of the variance in intention to drink. Overall, 43% of the variance in intention, 83% of the variance in total weekly consumption and 44% of the variance in binge drinking was explained. The frequency of drinking and the drinking behaviour of friends significantly predicted intention to drink and binge drinking, respectively. Binge drinkers were influenced by peers and social-situational factors. Pressure to drink was greater for males; undergraduates were influenced by the size of the drinking group, 'special offer' prices, and the availability of alcohol. Conclusions: The TPB appeared to be a weak predictor of student drinking but this may be a result of how constructs were measured. With friends' drinking behaviour emerging as a significant predictor of alcohol consumption, interventions seeking to reduce excessive drinking should target the role of peers and the university environment in which drinking occurs.

Jansen H; Lahaut V; Garretsen H; van de Mheen D. Measuring the year consumption of alcohol: The development of a questionnaire. Substance Use & Misuse 43(7): 880-894, 2008. (37 refs.)

Most general alcohol consumption population surveys are meant to represent the year consumption, although they actually ask only for habitual drinking and/or frequencies and quantities of binge drinking in the past months. These surveys typically cover about half of the alcohol sales figures. In order to enhance sales coverage and to reduce seasonal bias, we developed a year consumption questionnaire on the basis of daily and weekly drinking adding 13 categories of less-than-weekly drinking occasions over the year. As a first test we offered the new questionnaire together with a traditional typical week questionnaire, in different modes to various groups adding up to a purposive high diversity sample of 101 drinking persons (56 women, 44 men, 16-69 years old, mean age 34 years). After correction for overlaps between weekly habits and less-than-weekly occasions, the new questionnaire produces considerably higher reports of annual consumption, compared with the typical-week-based estimates of year consumption. Limitations of the study are discussed.

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.

Kerr-Correa F; Tucci AM; Hegedus AM; Trinca LA; de Oliveira JB; Floripes TMF et al. Drinking patterns between men and women in two distinct Brazilian communities. Revista Brasileira de Psiquiatria 30(3): 235-242, 2008. (44 refs.)

Objective: A survey was conducted to compare gender differences in patterns of drinking in two stratified, urban and representative samples from two communities (B and RJr). Method: The Genacis (Gender Alcohol, and Culture: an International Study) questionnaire was used. Results: There were several significant differences in the demographics and patterns of alcohol use between these two samples. One had an older, more Catholic, educated, Caucasian population, with more women in the labor force. Data from B community showed that women and men had similar patterns of drinking. RJr had much higher use of alcohol among men, and almost 22% of those under 49 years old were binge drinkers. Discussion: Access, smoking, income and having a heavy drinker partner were important risk factors for women's drinking, Conclusions: This study shows that when women's roles become more similar to men's, so do their drinking patterns.

Keyes KM; Grant BF; Hasin DS. Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population. Drug and Alcohol Dependence 93(1/2): 21-29, 2008. (72 refs.)

Background: Descriptively, male-female differences in alcohol consumption and alcohol use disorders appear to have decreased in birth cohorts reaching adulthood since the 1970s compared to earlier birth cohorts. However, such birth cohort effects on gender differences have never been statistically tested in nationally representative data. The aim of this study was to test the hypothesis that gender differences in alcohol consumption, abuse, and dependence are decreasing over time. Methods: Face-to-face survey conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions among those aged <90 (N=42,693). Birth cohort was divided into four categories: 1913-1932, 1933-1949, 1950-1967, 1968-1984. Outcomes included lifetime largest drinks, frequent binge drinking, DSM-IV defined alcohol abuse, and alcohol dependence, measured with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-IV). Findings: Birth cohort and gender interacted significantly in predicting lifetime largest drinks (F=27.6, [d.f.=3], p<0.0001), frequent binge drinking (F=40.0, [d.f. = 3], p < 0.0001), alcohol abuse (F= 62.0, [d.f. = 3], p < 0.0001) and alcohol dependence (F = 15.3, [d.f. = 3], p < 0.0001). Cohort-specific ORs indicated monotonic decreases in the gender ratio in more recent birth cohorts for all outcomes. Conclusion: These results suggest that gender differences in the prevalence of all four outcomes are decreasing in younger age cohorts. While these changes are consistent with a cohort effect, the possibility of age and period effects cannot be ruled out but suggest important avenues for more specific hypothesis testing. Further, women in younger cohorts may be in need of new targeted prevention and intervention efforts.

Kim JH; Lee S; Chow J; Lau J; Tsang A; Choi J et al. Prevalence and the factors associated with binge drinking, alcohol abuse, and alcohol dependence: A population-based study of Chinese adults in Hong Kong. Alcohol and Alcoholism 43(3): 360-370, 2008. (56 refs.)

Aims: To examine the patterns of drinking, the relationship between binge drinking, alcohol abuse, and dependence, and the sociodemographic factors associated with problem drinking among Hong Kong Chinese. Method: An anonymous, random telephone survey was conducted on 9860 Hong Kong Chinese adults from April to June, 2006. Results: The age-adjusted prevalence amongst men for binge drinking was 14.4% with 5.3% of males being alcohol abusers and 2.3% dependent on alcohol. The corresponding figures for women were all lower at 3.6%, 1.4%, and 0.7%, respectively. Younger age groups showed the highest prevalence of these drinking problems. Among male binge drinkers, 18.7% were also alcohol abusers and 12.3% were alcohol dependent. Among female binge drinkers, 16% reported alcohol abuse and 9.9% reported dependence. Male binge drinkers were less likely to be older, less likely to be students but more likely to be employed in the service industry. Female binge drinkers were less likely to be over 60 years of age or married but more likely to be smokers. In both genders, smoking was significantly associated with the likelihood of binge drinking (OR = 3.6-12.3), alcohol abuse (OR = 3.0-12.1), and dependence (OR = 5.2-20.6). Conclusions: Although binge drinking has been well tolerated in Chinese culture, it is strongly associated with alcohol abuse and dependence in both genders in Hong Kong. Our findings suggest that prevalence of problematic alcohol consumption warrants greater promotion of alcohol harms awareness. Higher rates of heavy drinking in younger-aged individuals may reflect changing lifestyle behaviors and herald higher future levels of alcohol-related health and social problems.

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.

Kypri K; Bell ML; Hay GC; Baxter J. Alcohol outlet density and university student drinking: A national study. Addiction 103(7): 1131-1138, 2008. (36 refs.)

Aims: To examine the geographic density of alcohol outlets and associations with drinking levels and related problems among university students. Design: Cross-sectional survey study using geospatial data, with campus-level and individual-level analyses. Participants A total of 2550 students (mean age 20.2, 60% women) at six university campuses in New Zealand (63% response). Measurements Counts of alcohol outlets within 3 km of each campus were tested for their non-parametric correlation with aggregated campus drinking levels and related problems. Generalized estimating equations were used to model the relation between outlet counts within 1 km and 3 km of student residences and individual drinking levels/problems, with control for gender, age, ethnicity and high school binge drinking frequency, and adjustment for campus-level clustering. Findings Correlations for campus-level data were 0.77 (P = 0.07) for drinking and personal problems, and 0.31 (P = 0.54) for second-hand effects. There were consistent significant associations of both on- and off-licence outlet densities with all outcomes in student-level adjusted models. Effects were largest for 1 km densities and off-licence outlets. Conclusions: There are positive associations between alcohol outlet density and individual drinking and related problems. Associations remain after controlling for demographic variables and pre-university drinking, i.e. the associations are unlikely to be due to self-selection effects. Increasing alcohol outlet density, and particularly off-licences, may increase alcohol-related harm among university students.

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.

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.

Lim WY; Fong CW; Chan JML; Heng D; Bhalla V; Chew SK. Trends in alcohol consumption in Singapore 1992-2004. Alcohol and Alcoholism 42(4): 354-361, 2007. (30 refs.)

Aims: To present trends in alcohol consumption between 1992 and 2004 in Singapore. Methods: Alcohol consumption data were derived from national health surveys conducted in 1992, 1998 and 2004. Age-adjusted prevalence of frequent (drinking 1-4 days a week), regular (drinking more than 4 days a week) and binge (having five or more drinks during a drinking session at least once in the month) drinking by gender and age group for the three surveys were compared. Multivariate analyses for binge drinking in 2004 were performed using logistic regression models. Results: Prevalence of frequent, regular and binge drinking increased between 1992 and 2004. Prevalence increase in binge drinking was highest (from 5.1 to 10.0%), followed by frequent drinking (from 4.5 to 7.5%) and regular drinking (from 2.9 to 3.1%). Uptake in binge drinking increased in both genders and across all age groups but was most evident among adults aged 18-29. Frequent drinking increase was observed for both genders but was most pronounced among women aged 18-29. The level of regular drinking declined in men but increased in women, especially those aged 18-29 and 30-49. Being younger, male, separated, divorced or widowed, a current smoker, or having a monthly household income of S$6000 and above were attributes positively associated with binge drinking. Conclusions: Alcohol consumption, especially binge drinking, has increased among Singaporeans between 1992 and 2004. There is gender convergence in alcohol consumption.

Lysova AV; Hines DA. Binge drinking and violence against intimate partners in Russia. Aggressive Behavior 34(4): 416-427, 2008. (50 refs.)

This study is the first to provide information on the association between intimate partner violence (IPV) and binge drinking among Russian university students. Using data from 500 (58% female) university students from the four Russian sites of the International Dating Violence Study, we found gender differences in rates of IPV perpetration and in the association between binge drinking and IPV. Specifically, more females than males perpetrated IPV, and the associations between binge drinking and IPV were stronger for the female students than for the male students. In addition, antisocial traits and behavior (ATSB) were significantly related to both binge drinking and IPV perpetration for males and females. For males, the relatively weak associations between binge drinking and IPV perpetration disappeared once ASTB was accounted for. For females, the relationship decreased but remained significant when ATSB was statistically controlled. Path analyses confirmed that this pattern of relationships would be consistent with ATSB serving as a partial mediator between binge drinking and IPV perpetration. However, other alternative mediation and moderation models for the relationships between binge drinking, IPV perpetration, and ATSB could not be ruled out with this one-wave correlational study.

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.

Marczinski CA; Harrison ELR; Fillmore MT. Effects of alcohol on simulated driving and perceived driving impairment in binge drinkers. Alcoholism: Clinical and Experimental Research 32(7): 1329-1337, 2008. (57 refs.)

Background: Binge drinking (heavy episodic alcohol use) is associated with high rates of impaired driving and myriad alcohol-related accidents. However, the underlying reasons for the heightened accident risk in this demographic group are not known. This research examined acute alcohol effects on simulated driving performance and subjective ratings of intoxication and driving ability in binge and nonbinge drinkers. Methods: Young social drinking college students (24 binge drinkers and 16 nonbinge drinkers) participated in this study. Participants attended a session during which they received a moderate dose of alcohol (0.65 g/kg) and a session during which they received a placebo. A simulated driving task measured participants' driving performance in response to each dose. Subjective responses to each dose were also assessed, including ratings of sedation, stimulation, and driving ability. Results: The acute dose of alcohol impaired multiple aspects of driving performance in both binge and nonbinge drinkers. Under alcohol, all participants had greater difficulty in maintaining their lane position, maintaining the appropriate speed and made multiple driving errors compared to placebo performance. By contrast, compared with nonbinge drinkers, binge drinkers reported feeling less sedated by the alcohol and reported having a greater ability to drive following the acute dose of alcohol. Conclusion: Reduced subjective intoxication and perceived driving impairment in binge drinkers may account for the greater accident risk in this demographic group. Binge drinkers may lack the internal sedation cue that helps them accurately assess that they are not able to effectively drive a vehicle after drinking.

Marks NF; Jun H; Song J. Death of parents and adult psychological and physical well-being - A prospective US national study. Journal of Family Issues 28(12): 1611-1638, 2007. (78 refs.)

Guided by a life course perspective, attachment theory, and gender theory, this study aims to examine the impact of death of a father, a mother, or both parents, as well as continuously living with one or both parents dead (in contrast to having two parents alive) on multiple dimensions of psychological well-being (depressive symptoms, happiness, self-esteem, mastery, and psychological wellness), alcohol abuse (binge drinking), and physical health (self-assessed health). Analyses of longitudinal data from 8,865 adults in the National Survey of Families and Households 1987-1993 reveal that a father's death leads to more negative effects for sons than daughters and a mother's death leads to more negative effects for daughters than sons. Problematic effects of parent loss are reflected more in men's physical health reports than women's. This study's results suggest that family researchers and practitioners working with aging families should not underestimate the impact of filial bereavement on adult well-being.

Maxwell JC. Are we becoming more alike? Comparison of substance use in Australia and the United States as seen in the 1995, 1998, 2001 and 2004 national household surveys. Drug and Alcohol Review 27(5): 473-481, 2008. (33 refs.)

Introduction. This paper reports the results of the 1995, 1998, 2001 and 2004 Australian and US household surveys, with emphasis on changes since 2001. Design and Methods. The US survey data were recalculated to match age groups in the Australian data. Statistically significant changes are reported. Differences in prevalence of use by gender within age group were tested for significance. Results. The past-year use of 'any illicit drug', cannabis, cocaine, tranquillisers and injecting drugs decreased between 2001 and 2004 in Australia, but remained stable for all these drugs except ecstasy between 2002 and 2004 in the United States. The use of hallucinogens decreased in both countries. Alcohol and use of many illicit drugs by teenage girls in both countries increased to rates similar to or higher than boys, and teens in both countries reported binge and heavy drinking in the past month. Australians in their 20s had the highest rates of use, but in the United States, past-year use of many drugs was highest among teenagers. Discussion. More treatment services are needed, particularly for people dependent upon non-opiate drugs. The changes in acceptability of use of different drugs and their perceived availability are related to changes in prevalence rates. Even with the similarities in levels of use, there are differences in patterns of use and preferences for certain drugs in each country, and geographic proximity to drug sources is a factor.

McAlaney J; McMahon J. Diagnosing and dealing with the 'new British disease'. Psychologist 20(12): 738-741, 2007. (21 refs.)

Former Prime Minister Tony Blair is reported as having said that binge drinking was at risk of becoming the 'new British disease.' Figures are cited from a 2003 General Household Survey reported that 35% or males and 28% of females, between the age of 16 and 24 binge drink at least once per week. The authors note while there are those who question whether people are being overly alarmist, that the evidence does suggest an increase in binge drinking. This commentary examines the construct of binge drinking and the lack of consensus as to an appropriate definition. Indeed the Journal of Studies on Alcohol and Drugs will not use the phrase, and suggests the alternative of "heavy episodic drinking." The article also examines some of the interventions introduced in the UK to reduce binge drinking. The authors review educational campaigns, efforts to change tax policy, There is also discussion of social norms approach used in the US. The authors conclude with a call to achieve a consensus on the meaning of the term, adoption of evidence-based interventions at the level of media campaigns so as not to inadvertently suggest a greater normative frequency than is the case.

McCauley JL; Calhoun KS. Faulty perceptions? The impact of binge drinking history on college women's perceived rape resistance efficacy. Addictive Behaviors 33(12): 1540-1545, 2008. (34 refs.)

College women who binge drink are at greater risk than their peers for experiencing an alcohol-involved rape. Evidence suggests that these women commonly underestimate their risk for assault. This study examines college women's perceptions of their rape resistance efficacy in two acquaintance rape scenarios (one involving the woman's alcohol consumption and one not) as a function of their binge drinking and alcohol-involved rape history. Alcohol-involved rape was inversely associated only with efficacy in situations involving alcohol. Binge drinking was differentially predictive of efficacy in the two scenarios, with regular binge drinkers being significantly more likely to have high perceived efficacy in rape scenarios in which they were drinking and significantly less likely than their peers to have high perceived efficacy in rape scenarios in which they weren't drinking. Findings have direct implications for both college drinking and rape risk reduction interventions, highlighting the need to address women's minimization of alcohol's impact on their rape resistance ability.

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.

Midford R; Midford S; Farringdon F. School leaver (Graduate) celebrations in Margaret River, Western Australia: A community approach to management. Substance Use & Misuse 42(12-13): 1915-1932, 2007. (10 refs.)

In recent years, an increasing number of young Western Australians have chosen the tourist town of Margaret River, about 300 kilometers south of the Perth, as the place to celebrate completing school. Typically, the celebrations involve intense socializing and considerable binge drinking. In 2001, the community developed a comprehensive management strategy to minimize the impact of the celebrations, while still facilitating an enjoyable experience for the leavers (recent graduates). This incorporated community members providing supervised activities for the leavers. Evaluation of the intervention employed a mixed methodology, comprising surveys of school leavers, interviews with community stakeholders, and participant observation. The findings indicated that the leavers generally got what they wanted from the experience and the community felt it had maintained control. Providing activities built a relationship between the leavers and the community and seemed important in minimizing problems for both groups. An added bonus was the community developed greater confidence and capacity.

Morch LS; Johansen D; Thygesen LC; Tjonneland A; Lokkegaard E; Stahlberg C et al. Alcohol drinking, consumption patterns and breast cancer among Danish nurses: A cohort study. European Journal of Public Health 17(6): 624-629, 2007. (26 refs.)

Background: The aim of this study was to analyse the impact of alcohol intake and drinking pattern on the risk of breast cancer. Methods: A total of 17647 nurses were followed from 1993 until the end of 2001. At baseline participants completed a questionnaire on alcohol intake and other lifestyle-related factors. Data were analysed using Coxs proportional hazard model. Results: During follow-up 457 women were diagnosed with breast cancer. The relative risk of breast cancer was 2.30 [Confidence interval (Cl): 1.56-3.39] for alcohol intake of 22-27 drinks per week, compared to 1-3 drinks per week. Among alcohol consumers, weekly alcohol intake increased the risk of breast cancer with 2% for each additional drink consumed. Weekend consumption increased the risk with 4% for each additional drink consumed friday through sunday. Binge drinking of 4-5 drinks the latest weekday increased risk with 55%, compared with consumption of one drink. A possible threshold in risk estimates was found for consumption above 27 drinks per week. Conclusions: For alcohol consumption above the intake most frequently reported, the risk of breast cancer is increased. The risk is minor for moderate levels but increases for each additional drink consumed during the week. Weekend consumption and binge drinking imply an additional increase in breast cancer risk.

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.

Nelson MC; Lust K; Story M; Ehlinger E. Credit card debt, stress and key health risk behaviors among college students. American Journal of Health Promotion 22(6): 400-407, 2008. (34 refs.)

Purpose. To examine cross-sectional associations between credit card debt, stress, and health risk behaviors among college students, focusing particularly on weight-related behaviors. Design. Random-sample, mailed survey. Subjects/Setting. Undergraduate and graduate students (n = 3206) attending a large public university. Measures. Self-reported health indicators (e.g., weight, height, physical activity, diet, weight control, stress, credit card debt). Results. More than 23 % of students reported credit card debt >= $1000. Using Poisson regression to predict relative risks (RR) of health behaviors, debt of at least $1000 was associated with nearly every risk indicator tested, including overweight/obesity, insufficient physical activity, excess television viewing, infrequent breakfast consumption, fast food consumption, unhealthy weight control, body dissatisfaction, binge drinking, substance use, and violence. For example, adjusted RR [ARR] ranged from 1. 09 (95 % Confidence interval [CI]: 1.02-1.17) for insufficient vigorous activity to 2.17 (CI:. 0.68-2.82) for using drugs other than marijuana in the past 30 days. Poor stress management was also a robust indicator of health risk. Conclusion. University student lifestyles may be characterized by a variety of coexisting risk factors. These findings indicate that both debt and stress were associated with wide-ranging adverse health indicators. Intervention strategies targeting at-risk student populations need to be tailored to work within the context of the many challenges of college life, which may serve as barriers to healthy lifestyles. Increased health promotion efforts targeting stress, financial management, and weight-related health behaviors may be needed to enhance wellness among young adults.

Newes-Adeyi G; Chen CM; Williams GD; Faden VB. Surveillance Report #81. Trends in Underage Drinking in the United States, 1991-2005. Bethesda MD: National Institute on Alcohol Abuse and Alcoholism, 2007. (43 refs.)

This surveillance report, the second of a series of reports to be published every two years, presents data on underage drinking for 1991-2005. Data for the series are compiled from three separate nationally representative 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 2005. In terms of prevalence of use, all three survey data sources show an overall decline in the prevalence of alcohol consumption reported in the past 30 days between 1991 and 2005. In 2005 28.3% of youth ages 12-20 reported consuming alcohol in the past 30 days. Rates of underage drinking remained highest among non-Hispanic whites, followed by Hispanics and non-Hispanic blacks. In terms of drinking patterns the mean age of initiation of drinking alcohol increased slightly from 13.8 years in 1991 to 14.2 years in 2005 (NSDUH). Over the course of the decade, males have maintained higher average frequency, quantity, and volume of consumption in the past 30 days than females. In respect to alcohol-related attitudes, there has been a gradual shift in attitudes towards underage drinking, with a decrease between 1991 and 2005 in the percentage of youth strongly disapproving of others regularly consuming alcohol or binge drinking, and a decrease in the percentage of those who consider regular or binge drinking a great risk. Alcohol-related risk behaviors have not changed markedly.

Public Domain

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, Substance Abuse and Mental Health Administration. Results from the 2006 National Survey on Drug Use and Health: National Findings. NSDUH Series H-32. Rockville MD: Substance Abuse and Mental Health Services Administration, 2007. (254 refs.)

This report presents the first information from the 2006 National Survey on Drug Use and Health (NSDUH), an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years old or older. In respect to illicit drug use, major findings were (1) that in 2006, an estimated 20.4 million Americans aged 12 or older had used an illicit drug in the prior month. (2) Marijuana was the most commonly used illicit drug, and the rate of use essentially the same as in 2005. (3) 2.8 percent of those aged 12 or older who used prescription drugs nonmedically in the past month. The majority are pain relievers. (4) Among youths aged 12 to 17, current illicit drug use declined significantly between 2002 and 2006 for illicit drugs in general (from 11.6 to 9.8 percent) and for several specific drugs, including marijuana, hallucinogens, LSD, Ecstasy, prescription-type drugs used nonmedically, pain relievers, tranquilizers. In terms of alcohol use, slightly more than half of Americans aged 12 or older (50.9 percent had a drink in the preceeding month. Heavy drinking, defined as binge drinking on at least 5 days in the past 30 days, was reported by 6.9 percent of the population aged 12 or older. Among young adults aged 18 to 25, the rate of binge drinking was 42.2 percent, and the rate of heavy drinking was 15.6 percent. Underage (persons aged 12 to 20) past month and binge drinking rates have remained essentially unchanged since 2002. In respect to tobacco use 29.6 percent of the population were current cigarette smokers; 13.7 million (5.6 percent) smoked cigars; 8.2 million (3.3 percent) used smokeless tobacco; and 2.3 million (0.9 percent) smoked tobacco in pipes. The rate of past month cigarette use among 12 to 17 year olds declined from 13.0 percent in 2002 to 10.4 percent in 2006. However, past month smokeless tobacco use was higher in 2006 (2.4 percent) than in 2002 (2.0 percent). The report also provides information on the initiation of substance use, prevention-related measures , and rates of substance dependence, abuse, and also information on those who entered treatment.

Public Domain

Office of Applied Studies, Substance Abuse and Mental Health Services Administration. The NSDUH Report. Gender Differences in Alcohol Use and Alcohol Dependence or Abuse - 2004 and 2005. (August 2, 2007). Rockville MD: Substance Abuse and Mental Health Services Administration, 2007. (6 refs.)

Based on combined data from SAMHSA's 2004-2005 National Surveys on Drug Use & Health, the rate of past year alcohol dependence or abuse among persons aged 12 or older varied by level of alcohol use: 44.7% of past month heavy drinkers, 18.5% binge drinkers, 3.8% past month non-binge drinkers, and 1.3% of those who did not drink alcohol in the past month met the criteria for alcohol dependence or abuse in the past year. Males had higher rates than females for all measures of drinking in the past month: any alcohol use (57.5% vs. 45%), binge drinking (30.8% vs. 15.1%), and heavy alcohol use (10.5% vs. 3.3%). Also, males were twice as likely as females to have met the criteria for alcohol dependence or abuse in the past year (10.5% vs. 5.1%).

Public Domain

Office of Applied Studies, Substance Abuse and Mental Health Services Administration. The NSDUH Report: Impact of Hurricanes Katrina and Rita on Substance Use and Mental Health. (January 31, 2008). Rockville MD: Substance Abuse and Mental Health Services Administration, 2008. (8 refs.)

Data are presented on substance use and mental health problems before and after Hurricanes Katrina and Rita among adults aged 18 or older who lived in the Gulf State Disaster Area and for adults living in the rest of the United States. Estimates of substance use and mental health problems before Hurricanes Katrina and Rita were based on SAMHSA's National Survey on Drug Use and Health (NSDUH) from July 2004 through June 2005. Estimates for the post hurricane period were based on NSDUH data from January 2006 through December 2006. Based on SAMHSA's National Survey on Drug Use and Health, the impact of Hurricanes Katrina and Rita on substance use and mental health was primarily found among persons who were displaced from their homes. Substance Use: Adult Gulf State Disaster Area residents who were displaced from their homes for 2 weeks or longer had significantly higher rates of past month use of illicit drugs, marijuana, and cigarettes than those who were not displaced. Adult Gulf State Disaster Area residents who were displaced from their homes for less than 2 weeks had significantly higher rates of past month binge alcohol use than those who were not displaced. Mental Health Problems: Adult Gulf State Disaster Area residents who were displaced from their homes for 2 weeks or longer had significantly higher rates of serious psychological distress, major depressive episode, and unmet need for mental health treatment or counseling in 2006 than those who were not displaced.

Public Domain

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.

Pascarella ET; Goodman KM; Seifert TA; Tagliapietra-Nicoli G; Park S; Whitt EJ. College student binge drinking and academic achievement: A longitudinal replication and extension. Journal of College Student Development 48(6): 715-727, 2007. (30 refs.)

This study sought to determine if previous findings suggesting a negative, net influence of excessive alcohol consumption on student academic performance in college were replicable. The answer was "yes." Among the notable findings was that (1) as early as the second semester, freshman year, it is possible to see the impact of high levels of alcohol consumption. (2) The impact of alcohol consumption cannot be attributed simply to less time spent studying. (3) There is no campus group, in terms of gender, racial or ethnic group, or dofferent types of academic preparation, that places stuents at particular risk, or, on the other hand, provides protection. Among students who report binge drinking five or more times in a five week period, their grade point average is lowered -.53 of a standard deviation for first-year students and -.35 of a standard deviation for seniors.

Pfaff JJ; Almeida OP; Witte TK; Waesche MC; Joiner TE. Relationship between quantity and frequency of alcohol use and indices of suicidal behavior in an elderly Australian sample. Suicide and Life-Threatening Behavior 37(6): 616-626, 2007. (41 refs.)

Relatively little research has been conducted on the relationship between alcohol misuse and suicidal behavior among the elderly. The current study's aim was to examine whether quantity and frequency of alcohol use and the interaction between these variables are related to current suicidal ideation, previous suicidal ideation/intent, and past suicide attempts in a community sample of 1,010 Australian adults over age 60. Results partially supported our hypotheses. The interaction between quantity and frequency of alcohol use was significant, suggesting that those who use alcohol less frequently but in greater quantities (i.e., binge drinking) are more likely to have a history of suicide attempts.

Pitkanen T; Kokko K; Lyyra AL; Pulkkinen L. A developmental approach to alcohol drinking behaviour in adulthood: a follow-up study from age 8 to age 42. Addiction 103(Supplement 1): 48-68, 2008. (80 refs.)

Aims: To study the links of family background, child and adolescent social behaviour, and (mal)adaptation with heavy drinking by age 20 and with the frequency of drinking, binge drinking, Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire scores and problems due to drinking at ages 27 and 42 years. Design In the Finnish Jyvaskyla Longitudinal Study of Personality and Social Development, data have been collected by interviews, inventories and questionnaires. Behavioural data were gathered at ages 8 and 14; data on alcohol consumption were gathered at ages 14, 20, 27, 36 and 42. Participants: A total of 184 males and 163 females; 94% of the original sample of the 8-year-olds. Findings Family adversities, externalizing problem behaviours, low school success, truancy and substance use in adolescence were associated in early middle age with problems due to drinking in both genders, and to binge drinking and CAGE scores in females. The antecedents varied, however, across the indicators of drinking and gender. The frequency of drinking was least predictable by the studied antecedents. Childhood and adolescent antecedents and drinking up to age 20 explained 43% of males' and 31% of females' problem drinking at age 42; 31% and 19%, respectively, at age 27. Conclusions: The early warning signs of drinking problems should be taken seriously in the preventive work for alcohol abuse. Problem drinking in early middle age is preceded by maladjustment to school, early age of onset of drinking and heavy drinking in adolescence even more significantly than problem drinking in early adulthood.

Polizzotto MN; Saw MM; Tjhung I; ChuA' EH; Stockwell TR. Fluid skills: Drinking games and alcohol consumption among Australian university students. Drug and Alcohol Review 26(5): 469-475, 2007. (30 refs.)

The objective of this study was to assess participation in drinking games among Australian university students; to determine the range of games played, their context and participant motivations; and to analyse the impact of games on alcohol consumption and its adverse consequences. We used a cross-sectional survey incorporating structured interviews and a self-administered questionnaire with students between 18 and 25 years of age at the University of Western Australia. This was a qualitative assessment of drinking game typology and contexts and participant motivation. Quantitative outcomes were rate and ftequency of participation in drinking games; amount and rate of alcohol consumption during games; incidence of adverse outcomes following participation. Twenty-seven interview responses and 256 questionnaire responses were analysed for qualitative and quantitative outcomes, respectively. The qualitative analysis enabled categorisation of drinking games by skill and competitive nature, with varying influence on hazardous drinking. Common reported motivations for play included boredom, social pressure and social unease. The associated heavy drinking and possible hazards were well recognised but did not affect the decision to play. In the quantitative arm, most drinkers (74%) reported having participated in a drinking game. Game players reported playing an average of four drinking games in the previous 6 months. An average of six standard drinks was consumed during the most recent game. Pressure to participate from others was reported by 60% of game participants, while 50% reported that they had placed pressure on others to participate. Half (51%) reported an adverse outcome following participation. Loss of consciousness due to drinking was experienced or witnessed by 89% of game players, of whom 63% reported that the person was put to bed, while 54% reported that the person was watched. Participation in drinking games was common, and plays an important social role in this group. Drinking games were associated commonly with binge drinking and adverse outcomes. Future harm minimisation strategies targeting this group should address the particular risks of these games.

Popova S; Rehm J; Patra J; Zatonski W. Comparing alcohol consumption in central and eastern Europe to other European countries. Alcohol and Alcoholism 42(5): 465-473, 2007. (46 refs.)

Aims: To give an overview of the volume of alcohol consumption, beverage preference, and patterns of drinking among adults (people 15 years and older) in central and eastern Europe (Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, and Slovenia) and to compare it to southern and western Europe, Russia and Ukraine. Methods: Secondary data analysis. Consumption and preferred beverage type data for the year 2002 were taken from the WHO Global Status Report on Alcohol and the WHO Global Alcohol Database. Results: Average consumption in central and eastern Europe is high with a relatively large proportion of unrecorded consumption ranging from one litre in Czech Republic and Estonia to 10.5l in Ukraine. The proportion of heavy alcohol consumption (more than 40g of pure alcohol per day) among men was the lowest in Bulgaria (25.8%) and the highest in Czech Republic (59.4%). Among women, the lowest proportion of heavy alcohol consumption was registered in Estonia (4.0%) and the highest in Hungary (16.0%). Patterns of drinking are detrimental with a high proportion of binge drinking, especially in the group of countries traditionally drinking vodka. In most countries, beer is now the most prevalent alcoholic beverage. Conclusion: Other studies suggest that the population drinking levels found in central and eastern Europe are linked with higher levels of detrimental health outcomes. Known effective and cost-effective programs to reduce levels of risky drinking should, therefore, be implemented, which may, in turn, lead to a reduction of alcohol-attributable burden of disease.

Prais HAC; de Loyola AI; Firmo JOA; Lima-Costa MF; Uchoa E. A population-based study on binge drinking among elderly Brazillan men: evidence from the Belo Horizonte and Bambui health surveys. Revista Brasileira de Psiguiatria 30(2): 118-123, 2008. (26 refs.)

Objectives: To assess the prevalence and factors associated with binge drinking in two populations of older adults (>= 60 years). Method: A random sample of 685 subjects in the metropolitan area of Belo Horizonte (4.4 million inhabitants) and 643 subjects (92.7% from total residents) in Bambui City (15, 000 inhabitants), both in Southeast Brazil, participated in the study. The dependent variable was binge drinking (>= 5 drinks on a single occasion in the last 30 days), and independent variables included sociodemographic characteristics, social network, health conditions and use of health services. Results: The prevalence of binge drinking was higher in the metropolitan area of Belo Horizonte (27.0%) than in Bambui (13.7%).In the multivariate analysis, worse self-rated health was the only variable associated with binge drinking in both populations (Prevalence ratios [PR] 0.62; 95%CI 0.45-0.85 and 0.57; (0.40-0.83), respectively). On the other hand, two important differences were found: 1) in the metropolitan area of Belo Horizonte, binge drinking was associated with higher school level [8 + years] (PR = 1.55; 95%CI 1.07-2.26) and functional disability (PR = 0.12); 95 %CI (0.02-0.83) 2) in Bambui, binge drinking was associated with being divorced or separated (PR = 2.49; 95%CI 1.55-3.99). Conclusions: Among older adults, differences of prevalence and factors associated with binge drinking can be found in a same country, probably due to sociocultural influences.

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.

Razvodovsky YE. All-cause mortality and fatal alcohol poisoning in Belarus, 1970-2005. Drug and Alcohol Review 27(5): 562-565, 2008. (16 refs.)

Introduction and Aims. Although alcohol appears to be an important contributor to the burden of disease in the countries of eastern Europe, little systematic research has been undertaken on its impact on mortality in the former Soviet republic of Belarus. There may be a number of factors underlying the particularly negative effect of alcohol on mortality in Belarus, including the pattern of drinking and use of surrogates. A solid body of research and empirical evidence suggests that hazardous patterns of alcohol consumption (binge drinking) lead to quicker and deeper intoxication, increasing the propensity for alcohol-related mortality. Design and Method. To estimate the aggregate level effect of binge drinking on the all-cause mortality rate, trends in the all-cause mortality and fatal alcohol poisoning rates (as a proxy for binge drinking) in Belarus from 1970 to 2005 were analysed employing AutoRegressive Integrated Moving Average (ARIMA) time-series analysis in order to assess a bivariate relationship between the two time-series. Results. The results of time-series analysis suggest a close relationship between all-cause mortality and fatal alcohol poisoning rates at the population level. Conclusions. This study supports the hypothesis that alcohol and all-cause mortality are connected closely in countries where the drinking culture is characterised by heavy drinking episodes and adds to the growing body of evidence that a substantial proportion of total mortality in Belarus is due to acute effects of binge drinking.

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.

Rose AK; Grunsell L. The subjective, rather than the disinhibiting, effects of alcohol are related to binge drinking. Alcoholism: Clinical and Experimental Research 32(6): 1096-1104, 2008. (59 refs.)

Background: Evidence suggests that alcohol-related problems are associated with impulsivity and disinhibited behavior. Less certain is whether disinhibited behavior is due to an impulsive disposition or alcohol's ability to disinhibit some people more than others. There are a range of disinhibited behaviors associated with alcohol, including excessive alcohol consumption, bingeing. The study tested whether nondependent alcohol bingers showed more disinhibition after placebo and/or alcohol relative to nonbingers and whether this was related to enhanced motivation to drink following a priming dose of alcohol. Methods: Twenty participants (10 bingers) attended the laboratory twice. Baseline measures included impulsivity, alcohol-related cognitions, alcohol urge, and mood. Participants were preloaded with alcohol (male: 0.6 g/kg, female: 0.5 g/kg) and placebo (counterbalanced). After a 20-minute rest, participants completed 2 impulsivity tasks (Two Choice & Time Estimation) separated by second urge and mood ratings. Results: Bingers did not show greater impulsivity characteristics but were more concerned about their drinking (p = 0.02) and ability to control drinking (p = 0.04). A priming effect was found: alcohol urge increased after alcohol but not placebo (p = 0.006). Bingers reported greater tolerance to the sedative (p = 0.05) and lightheaded (p = 0.04) effects of alcohol, relative to nonbingers. Binge status was not associated with impulsivity task performance, while preload type (alcohol/placebo) supported only marginal associations. Conclusions: Risk of binge drinking in nondependent individuals is not strongly affected by impulsive personality characteristics or alcohol's ability to induce behavioral disinhibition. However, alcohol did lead to a priming effect and bingers were more tolerant to the sedative and lightheaded effects of alcohol relative to placebo. Risk of binge drinking is associated with the subjective effects of a priming dose of alcohol.

Rosta J. Hazardous alcohol use among hospital doctors in Germany. Alcohol and Alcoholism 43(2): 198-203, 2008. (58 refs.)

Aims. To describe alcohol use, and the prevalence and predictors of hazardous drinking, among hospital doctors. Methods. Data were collected by anonymous mail survey in 2006, from a representative national sample of 1917 (58% response rate) hospital doctors in Germany. Alcohol use was measured using the AUDIT-C, scores of 5 or more for males and females indicating hazardous drinking. Results. There were 9.5% abstainers, 70.7% moderate drinkers, and 19.8% hazardous drinkers. The majority of doctors (90.5%) used alcohol mainly at a sensible level, e.g., 24 times a month (32%) or 23 times a week (29%), and 12 glasses on one occasion (83%). Binge drinking was common (53%), but for most occurred less than once in a month (39%). When hazardous drinking was controlled for certain confounders, being male (OR 4.7; 95% CI 3.46.5) and having a surgical specialty (OR 1.4; 1.11.8) were significantly correlated to hazardous drinking. Age had no influence on this model. By contrast, the age group 40 years and younger (OR 2.1; 1.43.0) was a significant predictor of abstinence. Conclusions. There is a higher rate of abstainers and a lower rate of binge drinkers among hospital doctors in Germany than in the general population. However, some hospital doctors drink hazardously, the risk being greater among males and among surgeons, which should be paid due attention in the interest of their health and their function as doctors.

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.

Ryb GE; Dischinger PC; Smith GS; Soderstrom CA. School suspensions, injury-prone behaviors, and injury history. Journal of Trauma, Injury, Infection and Critical Care 65(5): 1106-1113, 2008. (59 refs.)

Purpose: To investigate the association of history of school suspension (HSS) to risky behaviors and injury history. Methods: Adult patients admitted to a Level I trauma center (n = 774) were assessed for demographics, socioeconomic status, educational history, risky behaviors (infrequent seat belt use, drinking and driving, binge drinking, and speeding for a thrill), substance abuse disorders, and prior injury history. Student's t test and chi(2) statistics were used to compare subjects with and without a HSS in relation to risky behaviors and injury history (alpha = 0.05). Logistic regression models were constructed with each risky behavior and injury history as the outcome adjusting for demographics, socioeconomic status, and substance abuse disorders. Results: Patients with HSS (n = 260) were significantly younger, more likely to be male, not married, low income, Black, unemployed, smokers, and alcohol and drug dependent than patients without such history (n = 514). They had higher rates of binge drinking (66% vs. 33%), infrequent seat belt use (50% vs. 26%), drinking and driving (24% vs. 12%), and driving fast for a thrill (21% vs. 8%). Similarly. they had more frequent previous history of vehicular injuries (44% vs. 31 %) and assaults (36 % vs. 16 %). Multivariate models revealed school suspension to be associated with infrequent seat belt use (Odds ratio [OR] = 2.02 [1.44-2.83]), binge drinking (OR = 1.95 [1.25-3.04]), speeding for a thrill (OR = 1.83 [1.15-2.92]), prior vehicular injuries (OR = 1.46 [1.06-2.02]), and assaults (OR = 1.67 [1.13-2.47]). Conclusion: HSS is associated with risky behaviors, and history of prior vehicular crashes and assaults.

Spijkerman R; van den Eijnden RJJM; Huiberts A. Socioeconomic differences in alcohol-specific parenting practices and adolescents' drinking patterns. European Addiction Research 14(1): 26-37, 2008. (46 refs.)

The aim of this study was to investigate to what extent alcohol-specific parenting practices relate to adolescents' alcohol use, binge drinking, and alcohol-related problems, and whether these associations are moderated by socioeconomic status (SES), i.e. parents' education level and family income. The present data were collected within the framework of a representative study on alcohol use among Dutch students. The present findings are based on data from respondents who had been drinking in the past year (81.5%), and of whom one of the parents had filled out a short questionnaire including SES characteristics (52%). The sample consisted of 1,344 adolescents. Adolescents were approached in a school setting; parents received a short questionnaire at the home address. The results show that applying strict rules about alcohol use and having qualitative good conversations about drinking alcohol seem to prevent adolescents from heavy drinking patterns, whereas parental alcohol use seems to promote adolescents' drinking. A positive association was found between frequency of alcohol communication and availability of alcohol at home on the one hand and adolescents' drinking on the other. Some moderating effects of SES were found.

Standerwick K; Davies C; Tucker L; Sheron N. Binge drinking, sexual behaviour and sexually transmitted infection in the UK. International Journal of STD & AIDS 18(12): 810-813, 2007. (24 refs.)

Associations between sexual risk and alcohol consumption may be self-evident but have eluded detailed examination in the UK. A cohort of 520 genitourinary (GU) medicine clinic attenders in the south of England were given a detailed questionnaire and compared with a matched cohort from the General Household Survey (GHS). Clinic attenders binged heavily -a median of 13 units on a usual night and 26 on a 'heavy' night, compared with six units in the GHS cohort. In all, 86% of clinic attenders exceeded the UK government 'binge drinking' level of six units, and 32% of subjects thought that alcohol played a role in their clinic attendance. A total of 77% had been drinking before sex with a new partner; of these, 65% were usually or occasionally very drunk. Binge drinking was increased in the 29% diagnosed with a bacterial sexually transmitted infection (P < 0.003). Of the women, 19% reported an unwanted pregnancy, with 28% drinking beforehand.

Stephens DN; Duka T. Cognitive and emotional consequences of binge drinking: Role of amygdala and prefrontal cortex. Philosophical Transactions of the Royal Society of London. Series B. Biological Sciences 363(1507): 3169-3179, 2008. (88 refs.)

Binge drinking is an increasingly recognized problem within the UK. We have studied the relationship of binge drinking to cognitive and emotional functioning in young adults, and have found evidence for increased impulsivity, impairments in spatial working memory and impaired emotional learning. Since in human studies it is difficult to understand whether such behavioural changes predate or are a consequence of binge drinking, we have also studied parallel behaviours in a rodent model, in which rats are exposed to intermittent episodes of alcohol consumption and withdrawal. In this model, and in parallel with our findings in human binge drinkers, and alcoholic patients who have undergone multiple episodes of detoxification, we have found evidence for impairments in aversive conditioning as well as increased impulsivity. These behavioural changes are accompanied by facilitated excitatory neurotransmission and reduced plasticity (long-term potentiation (LTP)) in amygdala and hippocampus. The impaired LTP is accompanied by both impaired associative learning and inappropriate generalization of previously learned associations to irrelevant stimuli. We propose that repeated episodes of withdrawal from alcohol induce aberrant neuronal plasticity that results in altered cognitive and emotional competences.

Stokkeland K; Hilm G; Spak F; Franck J; Hultcrantz R. Different drinking patterns for women and men with alcohol dependence with and without alcoholic cirrhosis. Alcohol and Alcoholism 43(1): 39-45, 2008. (27 refs.)

Aim: The aim of our study was to investigate if there were differences in drinking patterns in patients with alcohol dependence (AD), with or without cirrhosis. Methods: We examined three groups in regard to differences in drinking patterns. We collected information from 50 patients with alcoholic cirrhosis (AC), 50 patients with AD, and 40 patients with non-alcoholic cirrhosis (NAC). We used the structured interview Lifetime Drinking History (LDH) to measure the alcohol consumed. Information regarding the total lifetime alcohol intake (LAI), drinking days (DD), drinks per drinking day (DDD), their beverage preferences, and their binge consumption was collected during interviews. Results: Women drank less than men. Women with AC reported 9,198 drinks as binge drinking compared to 25,890 drinks for women with AD without liver cirrhosis (P < 0.05), Women with AC reported 14,009 drinks of alcohol consumed during their lifetime compared to 45,658 drinks consumed by men with AC (P < 0.0001). Women with AD had drunk 5.8 DDD, and men had 8.5 DDD (P < 0.05). Both women and men with AC had significantly fewer DDD compared to men and women with AD without cirrhosis, 4.4 drinks for women (P = 0.046) and 6.2 for men (P = 0.048) with AC. Conclusions: Patients with AC seem to be predisposed to the hepatotoxic effects of alcohol- and the affected women seem to be even more sensitized. Binge drinking, rather than continuous drinking, does not seem to be especially associated with the development of cirrhosis. That women had drunk less alcohol during binge drinking further emphasizes this.

Szmigin I; Griffin C; Mistral W; Bengry-Howell A; Weale L; Hackley C. Re-framing 'binge drinking' as calculated hedonism: Empirical evidence from the UK. International Journal of Drug Policy 19(5, special issue): 359-366, 2008. (45 refs.)

Background: Recent debates on 'binge drinking' in the UK have represented the activities of young drinkers in urban areas as a particular Source of concern, as constituting a threat to law and order, a drain on public health and welfare services and as a source of risk to their own future health and well being. The discourse of moral panic around young people's 'binge drinking' has pervaded popular media, public policy and academic research, often differentiating the excesses of 'binge drinking' from 'normal' patterns of alcohol consumption, although in practice definitions of 'binge drinking' vary considerably. However, recent research in this area has drawn on the notion of 'calculated hedonism' to refer to a way of 'managing' alcohol consumption that might be viewed as excessive. Methods: The paper presents a critical analysis of contemporary discourses around 'binge drinking' in the British context, highlighting contradictory messages about responsibility and self control in relation to the recent liberalisation of licensing laws and the extensive marketing of alcohol to young people. The paper analyses marketing communications which present drinking as a crucial element in 'having fun', and as an important aspect Of Young people's social lives. The empirical study involves analysis of focus group discussions and individual interviews with young people aged 18-25 in three areas of Britain: a major city in the West Midlands, a seaside town in the South-West of England and a small market town also in the South-West. Results: The initial findings present the varied forms and meanings that socialising and drinking took in these Young people's social lives. In particular the results illustrate the ways in which drinking is constituted and managed as a potential source of pleasure. Conclusion: The paper concludes that the term 'calculated hedonism' better describes the behaviour of the young people in this study and in particular the way they manage their pleasure around alcohol, than the emotive term 'binge drinking'.

Tewksbury R; Higgins GE; Mustaine EE. Binge drinking among college athletes and non-athletes. Deviant Behavior 29(3): 275-293, 2008. (39 refs.)

Concerns about incidence, forms, and consequences of alcohol use among college students lack examinations of the lifestyles and predictors of college student athletes. This article, using a sample of student-athletes and non-athletes from four Southern universities, identifies the lifestyle predictors for each population, identifying patterns and sets of predictors of binge drinking behavior. Findings indicate that for both samples, binge drinking behavior is explained by sex, drinking in bars, number of male friends who drink, and cigarette smoking. Student-athletes' binge drinking is explained further by residing on campus. Non-athlete binge drinking is related to race and amount of study time per week. Implications for these findings are also discussed.

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.

Tin ST; Ameratunga S; Robinson E; Crengle S; Schaaf D; Watson P. Drink driving and the patterns and context of drinking among New Zealand adolescents. Acta Paediatrica 97(10): 1433-1437, 2008. (30 refs.)

Aim: To examine the association between drink driving and the patterns and locations of usual drinking among New Zealand adolescents. Methods: This is a secondary analysis of data from a nationally representative youth health survey, the sampling frame for which was all New Zealand secondary schools with more than 50 students enrolled in years 9 to 13 (ages 12 to 18 years) in 2001. The analysis was restricted to the 3408 survey respondents aged 15 years or older who were current drinkers and drivers. Results: In total, 17.3% of participants reported drink driving in the previous month. Drink driving was significantly associated with frequent (at least weekly) alcohol use, binge drinking and usually drinking away from home, that is in cars, outdoors, at bars or nightclubs, at parties, at school and at work. Students' perception that parents and schools care about them, parental monitoring, and high academic achievement was associated with a reduced risk of drink driving while having friends who drink alcohol increased this risk. These associations were similar among boys and girls. Conclusion: The findings support calls to address how and where young people drink, and indicate the potential gains to be made with family- and school-based interventions.

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."

Tutenges S; Hesse M. Patterns of binge drinking at an international nightlife resort. Alcohol and Alcoholism 43(5): 595-599, 2008. (17 refs.)

Aims: The aim of this study was to compare the patterns of substance use in young Danes while holidaying in the Bulgarian holiday resort of Sunny Beach (SB) to their patterns of substance use in Denmark. Methods: Data were collected from visitors to SB in 2007 (n = 1011). Information on alcohol and drug use was surveyed using a short questionnaire. Findings: Most individuals surveyed were regular drinkers in Denmark, and the use of most illicit drugs was rare. Patterns of substance use in SB revealed heavy drinking was common, both in adolescents and young adults. Conclusions: International nightlife resorts provide a context for excess in drug use and alcohol use. Alcohol poses a potentially severe threat to the short- and long-term health of young tourists, but little attention has been paid to form interventions targeting binge drinking in nightlife resorts.

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.

Underwood B; Hackshaw A; Fox K. Smoking, alcohol and drug use among vocational dental practitioners in 2000 and 2005. British Dental Journal 203(12): 701-705, 2007. (22 refs.)

Objective To estimate the prevalence of tobacco smoking, alcohol and drug use among UK vocational dental practitioners (VDPs) in 2005, and compare these with prevalence in 2000. Design Cross-sectional survey using an anonymous self-report questionnaire. Subjects and methods All 767 VDPs who started practice in the summer of 2004 were sent a questionnaire in order to obtain data on the frequency and amount of tobacco, alcohol, cannabis and other illicit drugs used before and during vocational training (VT). The same survey had been conducted on VDPs five years earlier. The analysis was based on 502 subjects who responded and completed the questionnaire in 2005 and 534 subjects in 2000. Results Regular tobacco use (10+ cigarettes per day) was reported by 5.4% of males and 4.0% of females in 2005. This is lower than reported in 2000 (9%) and a statistically significant reduction in males. Eighty-two percent of males and 81% of females reported alcohol use; a statistically significant reduction from 2000 (89% males and 88% females). Reported 'binge drinking' remained high with 44% of males and 39% of females drinking at least half the recommended weekly units of alcohol in one session, similar to those levels seen in 2000. Thirty-eight percent of males and 26% of females reported cannabis use during their VT, similar to levels seen in 2000. Reported use of illicit drugs other than cannabis was less than in 2000. Reported illicit drug use was associated with alcohol drinking, and particularly with tobacco use. Conclusion This study has found the level of alcohol, tobacco and illicit drug use (excluding cannabis) among VDPs decreasing since 2000, but levels of binge drinking and cannabis use remaining similar.

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.

Valencia-Martin JL; Galan I; Rodriguez-Artalejo F. The joint association of average volume of alcohol and binge drinking with hazardous driving behaviour and traffic crashes. Addiction 103(5): 749-757, 2008. (62 refs.)

Background Previous studies on alcohol-related road safety have not assessed the joint impact of average volume of alcohol and binge drinking. Aim To examine the joint and separate association of average volume of alcohol and binge drinking with hazardous driving behaviour and traffic crashes. Methods Data were drawn from telephone interviews conducted in the period 2000-2005, with 12 037 individuals representative of the population aged 18-64 years in the Madrid region, Spain. The threshold between average moderate and heavy volumes was 40 g of alcohol/day in men and 24 g/day in women. Binge drinking was defined as intake of >= 80 g of alcohol in men and >= 60 g in women, during any drinking occasion in the preceding 30 days. Individuals were classified into the following categories: (i) non-drinkers; (ii) moderate drinkers with no binge drinking (MDNB); (iii) moderate drinkers with binge drinking (MDB); (iv) heavy drinkers with no binge drinking (HDNB); and (v) heavy drinkers with binge drinking (HDB). Analyses were performed using logistic regression, with adjustment for sex, age and educational level. Findings: Frequency of inadequate seat-belt use increased progressively across categories of alcohol consumption, with odds ratio (OR) 1 in non-drinkers, 1.19 [95% confidence interval (CI) 1.06-1.33] in MDNB, 1.69 (1.41-2.03) in MDB, 1.68 (1.24-2.29) in HDNB and 2.41 (1.83-3.18) in HDB (P for trend < 0.001). Compared with MDNB, alcohol-impaired driving was also more frequent in MDB (OR 7.43; 95% CI: 5.52-10.00), HDNB (OR 7.31; 95% CI: 4.37-12.25) and in HDB (OR 15.50; 95% CI: 10.62-22.61). Lastly, compared with non-drinkers, frequency of traffic crashes increased progressively across categories of alcohol consumption (P for trend = 0.028), although it only reached statistical significance in HDB (OR 2.01; 95% CI: 1.00-4.09). Conclusions: Self-reported average volume of alcohol and binge drinking are both associated with self-reported hazardous driving behaviour and traffic crashes. The strength of the association is greater when average heavy consumption and binge drinking occur jointly.

Vassallo S; Smart D; Sanson A; Cockfield S; Harris A; McIntyre A et al. Risky driving among young Australian drivers. II: Co-occurrence with other problem behaviours. Accident Analysis and Prevention 40(1): 376-386, 2008. (40 refs.)

This study examined the co-occurrence of risky driving with a range of externalising and internalising problems among 1055 young Australian drivers participating in an ongoing, 23-year longitudinal study. This issue was examined by: (1) investigating the co-occurrence of risky driving and other problem outcomes at 19-20 years; (2) exploring the rate of single and multiple problems among high, moderate and low young risky drivers and (3) investigating connections between risky driving in early adulthood and adolescent problem behaviours. Concurrent and longitudinal associations between risky driving and both substance use (alcohol, cigarette and marijuana use, binge drinking) and antisocial behaviour were found. However, risky driving generally appeared unrelated to internalising problems (depression, anxiety) and early sexual activity. Overall, young risky drivers varied considerably in the number and types of problem behaviours exhibited, although the great majority (70%) had displayed at least one other type of problem behaviour.

Vickery CD; Sherer M; Nick TG; Nakase-Richardson R; Corrigan JD; Hammond F et al. Relationships among premorbid alcohol use, acute intoxication, and early functional status after traumatic brain injury. Archives of Physical Medicine and Rehabilitation 89(1): 48-55, 2008. (41 refs.)

Objective: To investigate the relationships among intoxication at time of injury, preinjury history of problem drinking, and early functional status in patient's with traumatic brain injury (TBI). Design: Prospective cohort study. Setting: Acute inpatient TBI rehabilitation. Participants: Participants were 1748 persons with TBI. Interventions: Not applicable. Main Outcome Measures: Blood alcohol levels (BALs) were obtained at admission to the emergency department, and a history of problem drinking was obtained through interview. Study outcomes, Disability Rating Scale (DRS), and FIM instrument scores were gathered at admission to inpatient rehabilitation. Results: Multivariate regression analysis revealed that BAL and a history of binge drinking were predictive of DRS, but not FIM, scores. A higher BAL was associated with poorer functional status on the DRS. Paradoxically, a history of binge drinking was associated with more intact functional status on the DRS. Conclusions: The relationships among intoxication at time of injury, history of problem drinking, and early outcome after TBI were modest. Injury severity had a more significant association with TBI functional status.

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.

Waszkiewicz N; Szajda SD; Jankowska A; Kepka A; Dobryniewski J; Szulc A et al. The effect of the binge drinking session on the activity of salivary, serum and urinary beta-hexosaminidase: Preliminary data. Alcohol and Alcoholism 43(4): 446-450, 2008. (32 refs.)

Our report is the first to show that an acute ingestion (6 h) of a relatively large, yet tolerable dose of alcohol (120-160 g), significantly increases activity of total serum beta-hexosaminidase (total beta-HEX), beta-HEX A and beta-HEX B isoenzymes, as well as salivary total beta-HEX and urinary beta-HEX A, in eight infrequent binge drinkers. An increase in the activity of serum and urinary total HEX is mainly due to its secretory isoenzyme beta-HEX A.

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.

Witbrodt J; Kaskutas LA; Diehl S; Armstrong MA; Escobar GJ; Taillac C; Osejo V. Using drink size to talk about drinking during pregnancy: Early start plus. Journal of Addictions Nursing 18(4): 199-206, 2007. (57 refs.)

Heavy drinking during pregnancy can cause birth defects and other alcohol-related effects. Because costs associated with fetal complications are high, health care organizations are invested in finding ways to intervene with pregnant drinkers. We describe a computerized intervention tested at prenatal clinics that uses drink size as a way of creating dialogue about pregnancy drinking. The intervention helps pregnant women screened as at-risk for alcohol use recognize how much they actually drink, using calibrated glassware and beverage containers along with computer graphics designed to define true volume for specific alcoholic beverage types. The intervention promotes abstinence; however, if that is not an obtainable goal, women are taught ways to cut down as much as possible during the rest of their pregnancy. Clinician feedback has been very positive, and the few women who continued to drink did not drink frequently or engage in binge drinking. Further, their average daily volume was < 1 drink per day.

Wong CF; Kipke MD; Weiss G. Risk factors for alcohol use, frequent use, and binge drinking among young men who have sex with men. Addictive Behaviors 33(8): 1012-1020, 2008. (42 refs.)

We examined the prevalence and patterns of alcohol use within a large, ethnically diverse sample of young men who have sex with men (YMSM) and identified psychosocial correlates of these alcohol-use patterns. A sample of 526 YMSM (ages 18-24 years) was recruited in Los Angeles, CA using a venue-based, stratified probability sampling design. Based on criteria used by previous research with young adults, participants were assigned to one of four alcohol-use/non-use groups according to frequency and number of drinks per sitting in the last 30 days. Findings revealed a high prevalence of alcohol use (91%) within the sample, with 21% reporting binge drinking: of binge drinkers, 40% reported frequent binge drinking. Multinomial logistic regression analyses revealed that race/ethnicity, gay bar attendance, depression, sensation seeking, peer risk behaviors, and age of alcohol initiation significantly differentiated between non-/light users from frequent and binge drinkers. Results also indicated unique psychosocial profiles among frequent/binge drinkers. The heterogeneity of predictors associated with different patterns of alcohol use highlights the need to consider unique risk profiles and alcohol-use trajectories according to exposure to different risk and protective factors.

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.