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CORK Bibliography: Alcohol-related Morbidity

83 citations. January 2010 to present

Prepared: June 2011

Alameida MD; Harrington C; LaPlante M; Kang TW. Factors associated with alcohol use and its consequences. Journal of Addictions Nursing 21(4): 194-206, 2010. (45 refs.)

The aim of this study was to examine the self-reported experiences of an adult population living in the community, as they relate to alcohol use and potential negative outcomes (emotional/physical problems, role function problems, drinking and driving, risk behaviors, and alcohol abuse/dependence). Analyses focused on 37,026 individuals that are weighted to the population of 212,686,651 drawn from a large representative cross-sectional survey of the US. population-the 2003 National Survey on Drug Use and health (NSDUH). Alcohol use of 1-9 drinks in the past month showed a significant increase in the odds ratios for most of the study outcomes compared to those who did not drink alcohol. As alcohol use increased, the odds ratios for all of the study outcomes linearly increased. Mental health symptoms and illicit drug use in the past year also significantly increased the odds ratios for all of the study outcomes. Hispanic and other race reflected an increased odds ratio for alcohol caused role function problems, when compared to Caucasians. Higher income and education levels increased the odds ratios for drinking and driving. Negative consequences occur at low levels of self-reported monthly alcohol use, when binge and heavy drinking are not present. An increase in alcohol consumption reflects a linear increase in the odds ratios for alcohol related problems. Nursing professionals need to be aware of the importance in educating clients about the risks associated with alcohol consumption.

Alhelail MA; Hoppe JA; Rhyee SH; Heard KJ. Clinical course of repeated supratherapeutic ingestion of acetaminophen. Clinical Toxicology 49(2): 108-112, 2011. (19 refs.)

Background. Repeated supratherapeutic ingestion (RSTI) of acetaminophen (APAP) is recognized as an important cause of APAP-related morbidity and mortality. This study describes the characteristics and clinical course of patients with RSTI, and identifies the risk factors for developing hepatotoxicity and death. Methods. This secondary analysis of a multicenter retrospective chart review studied patients treated with IV and/or oral N-acetylcysteine for acetaminophen poisoning. For this analysis, we included all subjects coded as RSTIs, defined as ingestions of greater than 4 g of APAP per 24 h over a period longer than 8 h. Data collected include demographics, coingestants, comorbidities, presenting laboratory data, and outcomes. The analysis includes descriptive statistics and associations of demographic and clinical factors with patient outcome. Results. Of the 503 patients enrolled, 119 (23.7%) were RSTI. The mean age was 39.6 years (SD +/- 15); 63.9% of the patients were females, 60.5% Caucasians, 27.7% alcoholics, 5% malnourished, 10.9% had viral hepatitis, and 3.4% had other liver diseases. Coingestants included ethanol, opioids, and antihistamines (17.6, 48.7, and 19.3%, respectively). Among this group, 44 patients developed hepatotoxicity, two received liver transplants, and four died (37.0, 1.7, and 3.4%, respectively). The risk for hepatotoxicity increased with a history of alcoholism, viral hepatitis, and other liver diseases. A history of alcoholism and an elevated presenting serum creatinine were associated with increased risk for death/transplant. The lowest presenting ALT levels in a subject who developed hepatotoxicity and who died were 252 and 426 IU/l, respectively. Conclusion. RSTI-induced hepatotoxicity and poor outcomes can be predicted at the patient's presentation. All patients with RSTI who developed hepatotoxicity presented with an abnormal ALT. A history of alcoholism and an elevated creatinine at presentation are markers of increased risk for hepatotoxicity and death.

Anderson KG; Brown SA. Middle school drinking: Who, where, and when. Journal of Child & Adolescent Substance Abuse 20(1): 48-62, 2011. (34 refs.)

The goal of this research was to describe the most common drinking situations for young adolescents (N=1171; 46.6% girls), as well as determine predictors of their drinking in the seventh and eighth grades. Middle school students most frequently drank at parties with three to four teens, in their home or at a friend's home, and reported alcohol-related problems including conflicts with friends or parents, memory loss, nausea, and doing things they would not normally do. Differences emerged in predicting higher levels of drinking on the basis of sex, race, grade, positive alcohol expectancies, impulsivity, and peer drinking. These findings suggest both specific and general factors are implicated in drinking for middle school students. Contextual factors, including drinking alone, in public places, and at or near school, are characteristic of the most problematic alcohol involvement in middle school and may have utility in prevention and early intervention.

[Anon]. Drinking ourselves into oblivion? (editorial). Lancet Oncology 11(2): 103-103, 2010. (0 refs.)

Two reports released in January, 2010, highlight the scale of alcohol use in the UK and the burden this presents to health-care providers. Consumption of alcohol in the UK has risen by almost 20% in the past three decades, with more than a quarter of the population drinking at hazardous levels-more than 21 units per week for men and 14 units per week for women. A joint statement from the National Health Service (NHS) and the Royal College of Physicians stated that the treatment of alcohol-related conditions cost the NHS in England almost �3 billion in 2006-07. This is double the estimated cost just 5 years earlier. These costs include not only the acute effects of intoxication, and the well documented links to many cancers, but also damge to many of the body's major organ systems that results from heavy chronic use. The second report, from parliament provides a stark summary of how successive governments have failed to react to this growing problem, deeming their responses to have "ranged from non-existent to ineffectual." It concludes that the government must pay more attention to the views of health experts than to those of the alcohol industry, which wields a great deal of power as a result of the revenue the government raises through taxes on alcohol. The committee also recommends stricter regulations on alcohol advertising.

Astudillo M; Kuntsche S; Graham K; Gmel G. The influence of drinking pattern, at individual and aggregate levels, on alcohol-related negative consequences. European Addiction Research 16(3): 115-123, 2010. (38 refs.)

Aim: To determine the extent drinking patterns (at the individual and country level) are associated with alcohol-related consequences over and above the total alcohol the person consumes. Methods: Hierarchical linear models were estimated based on general population surveys conducted in 18 countries participating in the GENACIS project. Results: In general, the positive association between drinking pattern scores and alcohol-related consequences was found at both the individual and country levels, independent of volume of drinking. In addition, a significant interaction effect indicated that the more detrimental the country's drinking pattern, the less steep the association between the volume of drinking and its consequences. Conclusion: Drinking patterns have an independent impact on consequences over and above the relationship between volume and consequences.

Barbosa C; Godfrey C; Parrott S. Methodological assessment of economic evaluations of alcohol treatment: What is missing ? Alcohol and Alcoholism 45(1): 53-63, 2010. (64 refs.)

Aim: The aim of this study is to review the methodology that has been adopted in previous economic evaluations of alcohol treatment and offer research recommendations with a view to enhancing the consistency and harmonization of economic evaluations in the alcohol field. Methods: Published full economic evaluations of alcohol treatment were retrieved using a systematic search. The studies were analysed in terms of the identification, measurement and valuation methods used to assess the society-level consequences and the methods used to carry out the analysis of individual-level consequences and costs of the intervention. A taxonomy of alcohol-related consequences was developed and used as a framework for the methodology extraction. Results: Twenty- seven studies were selected. Almost half of the studies did not include society-level consequences in their analysis. Some consequences of alcohol treatment at a societal level, such as the impact of treatment on health-related quality of life of family and friends of the drinker, have never been considered in the economic analysis. There was no agreement regarding the individual health consequences used in the evaluations. Measures capturing life years and morbidity have not been extensively used in the alcohol field. The level of reporting treatment costs on the reviewed studies is generally well detailed. Conclusion: The literature is still rather sparse in this area and further research is required to fulfil the gaps. If a common methodology is adopted in future economic evaluations of alcohol treatment, more stable cost-effectiveness estimates will be produced and informed decisions for resources allocation to alcohol treatments will be possible.

Bloomfield K; Wicki M; Gustafsson NK; Makela P; Room R. Changes in alcohol-related problems after alcohol policy changes in Denmark, Finland, and Sweden. Journal of Studies on Alcohol and Drugs 71(1): 32-40, 2010. (43 refs.)

Objective: European Union travelers' allowances for alcohol import to Denmark, Sweden, and Finland were abolished in 2004. In addition, excise taxes on alcohol were lowered in 2003 and 2005 in Denmark, and in 2004 in Finland. Using northern Sweden as a control site, this study examines whether levels of reported alcohol problems have changed in Denmark, Finland, and southern Sweden as a consequence of these policy changes. Method: Annual cross-sectional surveys were conducted in Denmark, Finland, and Sweden from 2003 to 2006. Five dependency items and seven extrinsic alcohol-related problems were examined. Changes were analyzed within each country/region with logistic regressions and tested for short- and long-term changes. Differential change was also tested between each country and the control site, northern Sweden. Results: Prevalence of alcohol problems decreased over the study period. Only in selected subgroups did problems increase. This mainly occurred in the samples for northern Sweden and Finland, and mostly among older age groups and men. In relation to the control site, however, no increases in problem prevalence were found. Conclusions: Our findings on a decline in reported alcohol problems largely agree with published reports on alcohol consumption over the same period in the study countries. They do not agree, however, with findings on changes in health and social statistics in Finland and Denmark, where some significant increases in alcohol-related harm have been found.

Burns L. Drinking and women's health: Time for action. (editorial). Addiction Research & Theory 18(2): 119-121, 2010. (10 refs.)

Burstyn I; Kapur N; Cherry NM. Substance use of pregnant women and early neonatal morbidity: Where to focus intervention? Canadian Journal of Public Health 101(2): 149-153, 2010. (31 refs.)

Background: Few studies, and none in Canada, have examined the relation between maternal smoking, alcohol consumption and drug dependence during pregnancy and early neonatal morbidity. Methods: We analyzed records of singleton live births in Alberta, Canada. Markers of neonatal morbidity were Apgar scores (<7 at 5 minutes postpartum) and resuscitation measures (2001-2005, N=191,686), and neonatal intensive care unit (NICU) admissions (2002-2005, N=154,924). Logistic regression was used to estimate odds ratios (ORs) for self-reported substance use and maternal health before conception, adjusting for maternal age, parity, year and fetal gender. Univariate ORs and population-attributable fractions were computed with and without correction for under-reporting of substance use. Results: Maternal smoking during pregnancy was the most prevalent risk factor, affecting 20% of mothers by self-report, with the figure being possibly twice as high once corrected for under-reporting. Smoking (ORs 1.2), alcohol consumption (ORs 1.2-1.5) and drug dependence (ORs 1.7-2) by the mother during pregnancy were associated with increased risk for each of the markers of early neonatal morbidity (p<0.05, after correcting for covariates). Eliminating the most common among these risk factors, maternal smoking, would prevent 10-15% of each of the three neonatal morbidity markers. Other recorded factors related to mother's pre-conception health, despite some strong associations, were responsible for only a small proportion of cases. Discussion: We conclude that in preventing early neonatal morbidity among singleton births in Alberta, control of maternal smoking, the most common of the potentially modifiable risk factors, remains an important goal.

Darke S; Torok M; Kaye S; Duflou J. Cardiovascular disease risk factors and symptoms among regular psychostimulant users. Drug and Alcohol Review 29(4): 371-377, 2010. (35 refs.)

Introduction and Aims. The aim of this study is to determine the prevalence of risk factors and possible symptoms of cardiovascular disease among regular psychostimulant users. Design and Methods. A total of 239 regular psychostimulant users were administered a structured interview on health and cardiovascular disease symptoms. Results. Thirty per cent had a family history of cardiovascular disease, 37% had sought treatment for possible symptoms of cardiovascular disease and 14% had been prescribed medications for symptoms of possible cardiovascular problems. The most commonly reported severe symptoms were: chronic shortness of breath (17%), chest pains (15%), palpitations (14%), chronic fatigue (13%) and dizziness/loss of consciousness (11%). Chest pains had been experienced on at least a weekly basis in the past 12 months by 13%. All symptoms occurred at significantly higher levels after the initiation of psychostimulant use. Higher levels of psychostimulant dependence were positively correlated with the number of frequently occurring symptoms (r = 0.23). Independent correlates of higher levels of frequently occurring symptoms were higher level of psychostimulant dependence, higher levels of alcohol dependence, a family history of cardiovascular disease and a diagnosis of cardiovascular disease. Discussion and Conclusions. While a great deal of clinical attention has been given to the sequelae of psychostimulant use, such as psychosis, the potential effects upon the cardiovascular systems of users are worthy of specific public health attention.

Deng LH; Xue P; Huang L; Yang XN; Wan MH; Xia Q. Binge drinking aggravates the outcomes of first-attack severe acute pancreatitis. Pancreas 39(2): 149-152, 2010. (34 refs.)

Objectives: To study the association of binge drinking and the outcomes of severe acute pancreatitis (SAP). Methods: This retrospective study included 347 patients with first-attack SAP from January 2001 to February 2004. On the basis of the history of binge drinking or not, the patients were divided into the alcohol (n = 77) and the control groups (n = 270). Clinical data of the 2 groups were compared. Results: Patient age and comorbidity were similar between the 2 groups. There were more men (64, 83.1%) than women (13, 16.9%; P < 0.05) in the alcohol and the control groups (111, 41.1%; P < 0.05). The 2 groups had significant differences in admission serum triglyceride levels (5.0 +/- 5.0 vs 3.0 +/- 3.5, P < 0.05), Balthazar computed tomographic score (6.3 +/- 5.4 vs 4.2 +/- 4.5, P < 0.05), and Acute Physiology and Chronic Heath Evaluation II score (19.1 +/- 5.1 vs 16.2 +/- 6.0, P < 0.05). Total mortality and the incidences of complications were higher in the alcohol group than in the control group (P < 0.05). Conclusions: Binge drinking might be a contributor to the aggravation of first-attack SAP.

du Toit MM; Smith M; Odendaal HJ. The role of prenatal alcohol exposure in abruptio placentae. South African Medical Journal 100(12): 832-835, 2010. (25 refs.)

Objective. To investigate the association between preconception and prenatal alcohol use and abruptio placentae. Methods. A case-control study of women with the clinical diagnosis of abruptio placentae, 65 cases and 66 controls, at Tygerberg Academic Hospital, Western Cape, South Africa. Women in whom a retroplacental blood clot, covering at least 15% of the placental surface, was found at delivery at 24 weeks' gestation or later were asked to complete a timeline follow-back questionnaire to determine their alcohol intake 12 and 3 months before and during pregnancy. The same questionnaire was administered to a control group of high-risk women who had no antepartum haemorrhage. Outcome. Women who drank alcohol 12 months before conception were more than 4 times more likely to develop abruptio placentae than the control group (odds ratio (OR) 4.49, p=0.00009). Women who drank alcohol 3 months prior to conception were 3 times more likely to develop abruptio placentae than the control group (OR 3.06, p=0.003). Drinking alcoholic beverages during pregnancy carried a more than 3 times greater risk of developing abruptio placentae (OR 3.52, p=0.0006). In the study group, women consumed a mean of 13.6, 12.0 and 11.2 standard drinks in a typical week at 12 and 3 months before and during pregnancy, respectively. The study group demonstrated a binge-drinking pattern, with two to four sessions per month. Conclusion. An association was found between preconception and prenatal consumption of alcohol and abruptio placentae.

Elder RW; Lawrence B; Ferguson A; Naimi TS; Brewer RD; Chattopadhyay SK et al. The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms. (review). American Journal of Preventive Medicine 38(2): 217-229, 2010. (110 refs.)

A systematic review of the literature to assess the effectiveness of alcohol tax policy Interventions for reducing excessive alcohol consumption and related harms was conducted for the Guide to Community Preventive Services (Community Guide) Seventy-two papers or technical reports, which were published prior to July 2005, met specified quality criteria, and included evaluation outcomes relevant to Public health (e.g, binge drinking, alcohol-related crash fatalities), were Included in the final review. Nearly all studies, including those with different Study designs, found that there was all inverse relationship between the tax or price of alcohol and indices of excessive drinking or alcohol-related health outcomes Among Studies restricted to underage populations, most found that increased taxes were also significantly associated with reduced consumption and alcohol-related harms. According to Community Guide rules of evidence, these results constitute strong evidence that raising alcohol excise taxes is all effective strategy for reducing excessive alcohol consumption and related harms. The impact of a potential tax increase is expected to be proportional to its magnitude and to be modified by such factors as disposable income and the demand elasticity for alcohol among various population groups.

El-Guindy NBD; Kovacs EJ; De Witte P; Spies C; Littleton JM; de Villiers WJS et al. Laboratory models available to study alcohol-induced organ damage and immune variations: Choosing the appropriate model. (review). Alcoholism: Clinical and Experimental Research 34(9): 1489-1511, 2010. (315 refs.)

The morbidity and mortality resulting from alcohol-related diseases globally impose a substantive cost to society. To minimize the financial burden on society and improve the quality of life for individuals suffering from the ill effects of alcohol abuse, substantial research in the alcohol field is focused on understanding the mechanisms by which alcohol-related diseases develop and progress. Since ethical concerns and inherent difficulties limit the amount of alcohol abuse research that can be performed in humans, most studies are performed in laboratory animals. This article summarizes the various laboratory models of alcohol abuse that are currently available and are used to study the mechanisms by which alcohol abuse induces organ damage and immune defects. The strengths and weaknesses of each of the models are discussed. Integrated into the review are the presentations that were made in the symposium "Methods of Ethanol Application in Alcohol Model-How Long is Long Enough" at the joint 2008 Research Society on Alcoholism (RSA) and International Society for Biomedical Research on Alcoholism (ISBRA) meeting, Washington, DC, emphasizing the importance not only of selecting the most appropriate laboratory alcohol model to address the specific goals of a project but also of ensuring that the findings can be extrapolated to alcohol-induced diseases in humans.

Fernandez-Serrano MJ; Perez-Garcia M; Rio-Valle JS; Verdejo-Garcia A. Neuropsychological consequences of alcohol and drug abuse on different components of executive functions. Journal of Psychopharmacology 24(9): 1317-1332, 2010. (122 refs.)

Several studies have shown alterations in different components of executive functioning in users of different drugs, including cannabis, cocaine and heroin. However, it is difficult to establish a specific association between the use of each of these drugs and executive alterations, since most drug abusers are polysubstance abusers, and alcohol is a ubiquitous confounding factor. Moreover, in order to study the association between consumption of different drugs and executive functioning, the patterns of quantity and duration of drugs used must be considered, given the association between these parameters and the executive functioning alteration degree. Based on the multicomponent approach to executive functions, the aims of the present study were: (i) to analyse the differential contribution of alcohol versus cocaine, heroin and cannabis use on executive functions performance; and (ii) to analyse the contribution made by the severity of the different drugs used (quantity and duration patterns) on these functions in a sample of polysubstance abusers that requested treatment for cannabis-, cocaine-or heroin-related problems. We administered measures of fluency, working memory, analogical reasoning, interference, cognitive flexibility, decision-making and self-regulation to two groups: 60 substance-dependent individuals (SDIs) and 30 healthy control individuals (HCIs). SDIs had significantly poorer performance than HCIs across all of the executive domains assessed. Results from hierarchical regression models showed the existence of common correlates of the use of alcohol, cannabis and cocaine on verbal fluency and decision-making; common correlates of quantity of cannabis and cocaine use on verbal working memory and analogical reasoning; common correlates of duration of cocaine and heroin use on shifting; and specific effects of duration of cocaine use on inhibition measures. These findings indicate that alcohol abuse is negatively associated with fluency and decision-making deficits, whereas the different drugs motivating treatment have both generalized and specific deleterious effects on different executive components.

Fielding JE; Rimer BK; Abraido-Lanza A; Calonge N; Clymer JM; Glanz K et al. Increasing alcoholic beverage taxes is recommended to reduce excessive alcohol consumption and related harms. (editorial). American Journal of Preventive Medicine 38(2): 230-232, 2010. (4 refs.)

Fleming MF; Balousek SL; Grossberg PM; Mundt MP; Brown D; Wiegel JR et al. Brief physician advice for heavy drinking college students: A randomized controlled trial in college health clinics. Journal of Studies on Alcohol and Drugs 71(1): 23-31, 2010. (36 refs.)

Objective: The aim of this study was to test the efficacy of brief physician advice in reducing alcohol use and related harm in college students. Method: The College Health Intervention Projects (CHIPs) is a randomized, controlled clinical trial with 12-month follow-up conducted in five college health clinics in Wisconsin; Washington state; and Vancouver, Canada. Of the 12,900 students screened for high-risk drinking, 484 men and 502 women met inclusion criteria and were randomized into a control (n = 493) or intervention (n = 493) group. Ninety-six percent of students participated in the follow-up procedures. The intervention consisted of two 15-minute counseling visits and two follow-up phone calls, and used motivational interviewing, contracting, diary cards, and take-home exercises. Results: No significant differences were found between groups at baseline on alcohol use, age, socioeconomic or smoking status, rates of depression, or measures of alcohol-related harm. At 12 months, the experimental subjects reduced their 28-day drinking totals by 27.2%, and the control group reduced their totals by 21%. A mixed effects repeated measures model found a statistical difference in favor of the brief-intervention group (beta = 4.7, SE = 2.0, p = .018) in 28-day drinking totals. The total Rutgers Alcohol Problem Index score was also significantly different during the 12-month follow-up period (beta = 0.8, SE = 0.4, p = .033). There was no difference on the other outcome measures of interest, such as frequency of excessive heavy drinking, health care utilization, injuries, drunk driving, depression, or tobacco use. Conclusions: The study supports resource allocation and implementation of alcohol screening and brief physician advice in primary care-based college health clinics.

Friesen MD; Woodward LJ; Horwood LJ; Fergusson DM. Childhood exposure to sexual abuse and partnership outcomes at age 30. Psychological Medicine 40(4): 679-688, 2010. (39 refs.)

Background. In this study, 30-year longitudinal data from the Christchurch Health and Development Study (CHDS) were used to examine the associations between childhood exposure to sexual abuse and intimate relationship outcomes at age 30. In addition, a broad range of early childhood and family confounding factors were tested, and the role of intervening factors from adolescence was explored. Method. The investigation analyzed data from a birth cohort of over 900 New Zealand adults studied to the age of 30. At ages 18 and 21 cohort members reported on any exposure to sexual abuse prior to age 16. This information, along with prospective data gathered in childhood and adolescence, was used to predict partnership outcomes at age 30. Results. After adjustment for early childhood and family factors, exposure to more severe forms of childhood sexual abuse (CSA) was associated with earlier and more frequent cohabitation, higher rates of perpetrated interpartner violence (IPV), and early parenthood, lower relationship satisfaction and investment. Several factors from adolescence partially or fully mediated these associations, notably a history of early consensual sexual intercourse, higher number of sexual partnerships, substance abuse problems, and self-esteem. After adjustment for intervening factors, exposure to CSA remained significantly associated with IPV. Conclusions. The findings support a causal chain process, whereby early childhood and family factors place some individuals at risk for CSA. The extent of CSA exposure is related to adolescent risk taking, which in turn leads to early and more frequent cohabitation, risk of IPV, and lower relationship satisfaction and investment.

Fritz K; Morojele N; Kalichman S. Alcohol: the forgotten drug in HIV/AIDS. (editorial). Lancet 376(9739): 398-400, 2010. (12 refs.)

Gaffo AL; Roseman JM; Jacobs DR; Lewis CE; Shikany JM; Mikuls TR et al. Serum urate and its relationship with alcoholic beverage intake in men and women: Findings from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. Annals of the Rheumatic Diseases 69(11): 1965-1970, 2010. (34 refs.)

Objective To investigate if beer, liquor (spirits), wine and total alcohol intakes have different associations with serum urate (SU) concentrations at different ages in a cohort of young men and women. Methods Data from 3123 participants at baseline and follow-up at 20 years were used, with balanced proportions of Caucasians and African Americans. The relationships of SU with categories of beer, liquor, wine and total alcohol intake referent to no intake were examined in sex-specific, cross-sectional analyses. Results Mean age (SD) at the beginning of follow-up was 25.1 (3.6) years. Compared with non-drinkers, significant associations between higher SU concentrations and greater beer intake were observed among men and women, with more pronounced and consistent associations for women. An association between greater liquor intake and higher SU concentrations was only seen for men at the year 20 evaluation. Wine intake was not associated with SU in either sex and total alcohol was associated with higher SU concentrations in both men and women. The magnitude of the associations between alcoholic beverages intake and SU was modest (<= 0.03 mg/dl/alcoholic beverage serving). Conclusion An association between higher SU concentrations and greater beer intake was consistent and pronounced among women, but also present in men. Despite the small magnitude of the increases in SU associated with alcohol intake, clinical implications in conditions such as cardiovascular disease and gout in young adults who are moderate and heavy drinkers cannot be ruled out.

Gass JD; Stein DJ; Williams DR; Seedat S. Intimate partner violence, health behaviours, and chronic physical illness among South African women. American Journal of Public Health 100(9): 582-585, 2010. (26 refs.)

Objectives. An association between intimate partner violence and adverse physical health outcomes and health-risk behaviours among women has been established, most scientific research having been conducted in the USA and other developed countries. There have been few studies in developing countries, including South Africa, which has one of the highest rates of intimate partner violence in the world. We therefore sought to study the association between physical intimate partner violence and physical health outcomes and behaviours among South African women. Methods. Using data from the cross-sectional, nationally representative South African Stress and Health Study, we assessed exposure to intimate partner violence, health-risk behaviours, health-seeking behaviours and chronic physical illness among a sample of 1 229 married and cohabiting women. Results. The prevalence of reported violence was 31%. This correlated with several health-risk behaviours (smoking, alcohol consumption, and use of non-medical sedatives, analgesics and cannabis) and health-seeking behaviours (recent visits to a medical doctor or healer). Intimate partner violence was not significantly associated with chronic physical illness, although rates of headache, heart attack and high blood pressure reached near-significance. Conclusions. Partner violence against women is a significant public health problem in South Africa, associated with health-risk behaviours and increased use of medical services. Public health programmes should incorporate interventions to mitigate the impact of violence on victims and reduce the risk of negative behavioural outcomes. Further investigation of the pathways between violence exposure and health Copyright 2010, South African Medical Association

Gaur DS; Talekar MS; Pathak VP. Alcohol intake and cigarette smoking: Impact of two major lifestyle factors on male fertility. Indian Journal of Pathology and Microbiology 53(1): 35-40, 2010. (24 refs.)

Context: Lifestyle factors, like alcohol intake and cigarette smoking, have been reported to affect male fertility. Aims: To find out the specific impact of alcohol and smoking on semen quality of male partners of couples seeking treatment for primary infertility. Materials and Methods: From the semen samples analyzed in our andrology laboratory, results of 100 alcoholics and 100 cigarette smoker males were studied following WHO guidelines and compared with 100 strict nonalcoholic and nonsmoker males for presence of asthenozoospermia, oligozoospermia and teratozoospermia. Statistical Analysis: Data was analyzed by F- test using Microsoft Office Excel 2003. Results: Only 12 alcoholics and six per cent smokers showed normozoospermia compared to 37 nonalcoholic nonsmoker males. Teratozoospermia, followed by oligozoospermia dominated alcoholics. Overall impact of asthenozoospermia and teratozoospermia, but not of oligozoospermia, was observed in smokers. Light smokers predominantly showed asthenozoospermia. Heavy alcoholics and smokers showed asthenozoospermia, teratozoospermia as well as oligozoospermia. Conclusions: Asthenozoospermia, the most common semen variable in our study, can be an early indicator of reduction in quality of semen. Alcohol abuse apparently targets sperm morphology and sperm production. Smoke-induced toxins primarily hamper sperm motility and seminal fluid quality. Progressive deterioration in semen quality is related to increasing quantity of alcohol intake and cigarettes smoked.

Gerdes S; Zahl VA; Weichenthal M; Mrowietz U. Smoking and alcohol intake in severely affected patients with psoriasis in Germany. Dermatology 220(1): 38-43, 2010. (21 refs.)

Background: Smoking and alcohol may contribute as triggering factors for psoriasis and are substantial for managing severely affected psoriasis patients. Objectives: To evaluate the general state of smoking and alcohol intake in a group of hospitalized, severely affected patients with psoriasis in comparison with the general population of Germany. Methods: A retrospective, multicentre study analysing data from 1,203 patients with severe psoriasis was performed. Results: 43.3% of all patients were found to be active smokers (males: 46.6%; females: 39.2%) with a higher likelihood as the control group (odds ratio, OR, 2.08, 95% confidence interval, CI, 1.81-2.39; p < 0.0001). 14.9% of all patients were found to be excessive drinkers (female patients: 5.5%; male patients: 22.3%), more likely than the control group (OR 3.10, 95% CI 2.53-3.80; p < 0.0001); males had an OR of 2.86 (95% CI 2.29-3.56; p < 0.0001) and females an OR of 5.12 (95% CI 3.12-8.39; p < 0.0001). Conclusion: Smoking and alcohol intake are independently associated with severe forms of psoriasis. Disease severity is correlated with smoking in both genders as well as with alcohol intake in female patients.

Giesbrecht N; Cukier S; Steeves D. Collateral damage from alcohol: Implications of 'second-hand effects of drinking' for populations and health priorities. (editorial). Addiction 105(8): 1323-1325, 2010. (19 refs.)

Gmel G; Kuntsche E; Wicki M; Labhart F. Measuring alcohol-related consequences in school surveys: Alcohol-attributable consequences or consequences with students' alcohol attribution. American Journal of Epidemiology 171(1): 93-104, 2010. (53 refs.)

In alcohol epidemiology surveys, there is a tradition of measuring alcohol-related consequences using respondents' attribution of alcohol as the cause. The authors aimed to compare the prevalence and frequency of self-attributed consequences to consequences without self-attribution using alcohol-attributable fractions (AAF). In 2007, a total of 7,174 Swiss school students aged 13-16 years reported the numbers of 6 alcohol-related adverse consequences (e.g., fights, injuries) they had incurred in the past 12 months. Consequences were measured with and without attribution of alcohol as the cause. The alcohol-use measures were frequency and volume of drinking in the past 12 months and number of risky single-occasion (>= 5 drinks) drinking episodes in the past 30 days. Attributable fractions were derived from logistic (>= 1 incident) and Poisson (number of incidents) regression analyses. Although relative risk estimates were higher when alcohol-attributed consequences were compared with nonattributed consequences, the use of AAFs resulted in more alcohol-related consequences (10,422 self-attributed consequences vs. 24,520 nonattributed consequences determined by means of AAFs). The likelihood of underreporting was higher among drinkers with intermediate frequencies than among either rare drinkers or frequent drinkers. Therefore, the extent of alcohol-related adverse consequences among adolescents may be underestimated when using self-attributed consequences, because of differential attribution processes, especially among infrequent drinkers.

Goldman RD. Drug-induced gynecomastia in children and adolescents. Canadian Family Physician 56(4): 344-345, 2010. (11 refs.)

QUESTION I frequently see adolescent boys in my practice with transient gynecomastia. My management includes reassuring the boys and their families; however, I also understand that specific medication, alcohol, and drugs can cause gynecomastia. How common is this phenomenon, and what medications can induce gynecomastia? ANSWER While gynecomastia is a physiologic phenomenon in most newborns and adolescents, it is important to consider pathologic conditions and medications that can cause breast enlargement. Antibiotics, antiulcer drugs, growth hormones, and chemotherapy have been reported to induce gynecomastia. Adolescents who use anabolic steroids, or who abuse alcohol, marijuana, heroin, or amphetamines, should be alerted to the fact that gynecomastia might develop. Treatment of drug-induced gynecomastia includes discontinuation of the offending drug. Very rarely is surgical intervention required.

Gustafsson NK. Changes in alcohol availability, price and alcohol-related problems and the collectivity of drinking cultures: What happened in southern and northern Sweden? Alcohol and Alcoholism 45(5): 456-467, 2010. (54 refs.)

Aims: The aims of this study were to study whether alcohol-related self-reported problems follow the same pattern of changes in alcohol consumption in southern Sweden, assumed to be affected by a decrease in Danish spirits tax and by an increase in Swedish travellers' import quotas, and to study whether the results obtained for southern and northern Sweden follow the predictions of Skog's theory of collectivity of drinking cultures. Methods: Analysis was carried out on a sample from the Swedish general population from southern and northern Sweden separately. Two indices such as impaired self-control/dependent behaviour and extrinsic problems for alcohol-related problems were computed and analysed in terms of sex, age, income and alcohol consumption level. Results: Although there were no huge changes in the number of persons reporting alcohol-related problems, the general trend in data for various subpopulations was a decrease in the southern site and an increase in the northern site. In the northern site, the increase in alcohol consumption among men also showed an increase in alcohol-related problems. However, various population subgroups changed in different directions and did not move in concert over the population distribution. Conclusions: Analysis confirmed that alcohol-related problems, according to the two indices used, followed a similar pattern to alcohol consumption, but less divergent. A version of Skog's theory applied on alcohol-related problems could not confirm that alcohol-related problems did not change collectively within the population.

Hansel B; Thomas F; Pannier B; Bean K; Kontush A; Chapman MJ et al. Relationship between alcohol intake, health and social status and cardiovascular risk factors in the urban Paris-Ile-De-France Cohort: is the cardioprotective action of alcohol a myth? European Journal of Clinical Nutrition 64(6): 561-568, 2010. (39 refs.)

Background/Objectives: Observational studies document the inverse relationship between cardiovascular disease (CVD) and moderate alcohol intake. However, the causal role for alcohol in cardioprotection remains uncertain as such protection may be caused by confounders and misclassification. The aim of our study was to evaluate potential confounders, which may contribute to putative cardioprotection by alcohol. Subjects/Methods: We evaluated clinical and biological characteristics, including cardiovascular (CV) risk factors and health status, of 149 773 subjects undergoing examination at our Center for CVD Prevention (The Urban Paris-Ile-de-France Cohort). The subjects were divided into four groups according to alcohol consumption: never, low (<= 10 g/day), moderate (10-30 g/day) and high (>30 g/day); former drinkers were analyzed as a separate group. Results: After adjustment for age, moderate male drinkers were more likely to display clinical and biological characteristics associated with lower CV risk, including low body mass index, heart rate, pulse pressure, fasting triglycerides, fasting glucose, stress and depression scores together with superior subjective health status, respiratory function, social status and physical activity. Moderate female drinkers equally displayed low waist circumference, blood pressure and fasting triglycerides and low-density lipoprotein-cholesterol. Alcohol intake was strongly associated with plasma high-density lipoprotein-cholesterol in both sexes. Multivariate analysis confirmed that moderate and low drinkers displayed better health status than did never drinkers. Importantly, few factors were causally related to alcohol intake. Conclusions: Moderate alcohol drinkers display a more favorable clinical and biological profile, consistent with lower CV risk as compared with nondrinkers and heavy drinkers. Therefore, moderate alcohol consumption may represent a marker of higher social level, superior health status and lower CV risk.

Happell B; Platania-Phung C; Gruenert S. Rates of alcohol usage among Vietnamese Australian communities: A literature review. (review). Journal of Substance Use 15(4): 246-256, 2010. (33 refs.)

Census data indicates a steady increase in the number of Vietnamese people migrating to Australia. Despite this there is a paucity of research examining alcohol usage within this community. A review of the literature was undertaken to examine the prevalence of alcohol use, related harms, and health service use. Vietnamese Australians were found to consume alcohol at a rate lower than that of Australians in general. However, the relevant research may not be generalizable, alcohol usage and associated harms may be under-reported, and prevalence rates contradicted the breadth and frequency of harms reported. These issues are discussed.

Haren MT; Li M; Petkov J; McDermott RA. Alcohol, metabolic risk and elevated serum gamma-glutamyl transferase (GGT) in Indigenous Australians. BMC Public Health 10: 454, 2010. (43 refs.)

Background: The interaction between overweight/obesity and alcohol intake on liver enzyme concentrations have been demonstrated. No studies have yet examined the interaction between metabolic syndrome or multiple metabolic risk factors and alcohol intake on liver enzymes. The aim of this study was to examine if alcohol consumption modifies the effect of metabolic risk on elevated serum GGT in Indigenous Australians. Methods: Data were from N = 2609 Indigenous Australians who participated in a health screening program in rural far north Queensland in 1999-2000 (44.5% response rate). The individual and interactive effects of metabolic risk and alcohol drinking on elevated serum GGT concentrations (>= 50 U/L) were analyzed using logistic regression. Results: Overall, 26% of the population had GGT >= 50 U/L. Elevated GGT was associated with alcohol drinking (moderate drinking: OR 2.3 [95% CI 1.6 - 3.2]; risky drinking: OR 6.0 [4.4 - 8.2]), and with abdominal obesity (OR 3.7 [2.5 - 5.6]), adverse metabolic risk cluster profile (OR 3.4 [2.6 - 4.3]) and metabolic syndrome (OR 2.7 [2.1 - 3.5]) after adjustment for age, sex, ethnicity, smoking, physical activity and BMI. The associations of obesity and metabolic syndrome with elevated GGT were similar across alcohol drinking strata, but the association of an adverse metabolic risk cluster profile with elevated GGT was larger in risky drinkers (OR 4.9 [3.7 - 6.7]) than in moderate drinkers (OR 2.8 [1.6 - 4.9]) and abstainers (OR 1.6 [0.9 - 2.8]). Conclusions: In this Indigenous population, an adverse metabolic profile conferred three times the risk of elevated GGT in risky drinkers compared with abstainers, independent of sex and ethnicity. Community interventions need to target both determinants of the population's metabolic status and alcohol consumption to reduce the risk of elevated GGT.

Hayes J; Koo J. Psoriasis: Depression, anxiety, smoking, and drinking habits. Dermatologic Therapy 23(2): 174-180, 2010. (64 refs.)

Psoriasis is a chronic disease that can negatively impact many aspects of quality of life. Patients with psoriasis may suffer from pain and discomfort from the disease as well as psychological and social difficulties including stigmatization, embarrassment, and social inhibition. Anxiety, depression, smoking, and alcohol abuse have been found to have a higher prevalence among psoriasis patients than healthy controls. These comorbidities have also been found to have a directly negative impact on psoriasis. Awareness of the relationship between psoriasis, psychiatric disorders, and substance abuse is important for dermatologists, as these comorbidities can lead to poor compliance and treatment outcomes.

Huckle T; You RQ; Casswell S. Socio-economic status predicts drinking patterns but not alcohol-related consequences independently. Addiction 105(7): 1192-1202, 2010. (44 refs.)

Aim: To identify independent relationships between socio-economic status and drinking patterns and related consequences and to identify socio-economic groups at risk for heavier consumption. Design and setting: Three comparable national telephone surveys were utilized: 1995, 2000 and 2004. The respondents were aged 18-65 years. Contextual information includes that a number of liberalized alcohol policy changes occurred over the time of the surveys. Results; Educationational qualification, income and occupation were associated independently with alcohol consumption. There were indications that the different dimensions of drinking (quantity and frequency) had different relationships with socio-economic status (SES). For example, lower SES groups drank heavier quantities while higher SES groups drank more frequently. SES, however, did not play a major role predicting drinking consequences once drinking patterns were controlled for, although there were some exceptions. It was the lower-to-average SES groups that were at greater risk for drinking heavier quantities compared to other SES groups in the population (as they had sustained increases in the quantities they consumed over time where other SES groups did not). Conclusion: Socio-economic status was related independently to drinking patterns and there were indications that SES interacted differently with the different dimensions of drinking (quantity and frequency). For the most part, socio-economic status was not related independently to the experience of alcohol-related consequences once drinking patterns were accounted for. It was the lower-to-average SES groups that were at greater risk for drinking heavier quantities compared to other SES groups in the population.

Jaworski F; Dubertret C; Ades J; Gorwood P. Presence of co-morbid substance use disorder in bipolar patients worsens their social functioning to the level observed in patients with schizophrenia. Psychiatry Research 185(1-2): 129-134, 2011. (50 refs.)

Bipolar disorder has been considered to have a better prognosis than schizophrenia at the very beginning of its definition. However, psychosocial functioning may vary not only because of the characteristics of the disorder, but also of co-morbid conditions, especially regarding substance use disorder (SUD). The purpose of this study was to compare the social adjustment level of patients with bipolar disorder with that observed in patients with schizophrenia, taking into account substance use disorder (SUD). Forty subjects with schizophrenia and 40 subjects with bipolar disorder, in the stable phase of the disorder, were matched for age, gender and presence of SUD (DSM-IV criteria). The social adjustment scale was completed with socio-demographic and clinical characteristics of illness. The global adaptation score of bipolar patients with SUD was poorer than bipolar patients without SUD, but was not observed as being significantly different from that of patients with schizophrenia, with or without associated SUD. Suicide attempts, poor compliance, longer hospitalisation, shorter remissions and criminal activity were also more frequently observed in the group of patients with bipolar disorder and SUD. Presence of substance use disorder seems to have a greater weight than the main diagnostic (schizophrenia versus bipolar disorder) to predict worse social adjustment and poorer outcome.

Jin LH; Chang SJ; Koh SB; Kim KS; Lee TY; Ryu SY et al. Association between alcohol consumption and bone strength in Korean adults: the Korean Genomic Rural Cohort Study. Metabolism: Clinical and Experimental 60(3): 351-358, 2011. (46 refs.)

Previous studies have reported an inconsistent relationship between alcohol consumption and bone health. A growing body of research has shown that chronic alcoholism leads to osteopenia and increased incidence of skeletal fractures, but some studies have concluded that alcohol consumption may be associated with higher bone mineral density in elderly populations. However, most studies showing a significant relationship between alcohol consumption and bone status have been in Western countries; and subjects have usually been postmenopausal women. The purpose of the present study was to investigate the association of alcohol consumption with bone strength in Korean adults. Data were from the Korean Genomic Rural Cohort Study, which is an ongoing population-based study of adults aged 40 to 70 years from 5 regions. A total of 7713 participants (3368 men, 4345 women) were surveyed about their annual consumption of alcohol such as soju, beer, makkolli, wine, and whisky. Bone strength was measured by stiffness index using the calcaneal quantitative ultrasound method. Overall, the annual age-specific decrease rate in the stiffness index of women was 2.7 times higher than that of men (0.463% for women, 0.169% for men). After adjustment for eligible covariates, the association between alcohol consumption and risk of reduced bone strength showed a J-shaped curve for both men and women. Compared with nondrinkers, the relative risk of reduced bone strength was 0.52 (95% confidence interval, 0.33-0.83) in men who drank 4 to 5 cups of soju for an amount of 29.626 to 49.375 g of alcohol per day and 0.61 (95% confidence interval, 0.38-0.86) in men who drank 6 to 7 cups of soju for an amount of 49.376 to 69.125 g of alcohol per day. We found no significant relationship between alcohol consumption and bone strength in any other group of men. For women, results suggested that the risk of reduced bone strength was lower in the moderate-consumption group; but no significant relationship was found between alcohol consumption at any level and bone strength. Among Korean adults, alcohol consumption has a J-shaped relationship with risk of reduced bone strength.

Justice A; Sullivan L; Fiellin D; Veterans Aging Cohort Study Projec. HIV/AIDS, comorbidity, and alcohol can we make a difference? Alcohol Research & Health 33(3): 258-266, 2010. (97 refs.)

Alcohol use is common among people infected with HIV and plays an important role in their health outcomes. Because alcohol use complicates HIV infection and contributes to comorbid diseases, it is important for researchers and practitioners to understand these interactions and to integrate alcohol treatment with medical management of long-term HIV infection and associated comorbidity. The Veterans Aging Cohort Study (VACS) is a large, multisite study of the effects of alcohol use on HIV outcomes in the broader context of aging. A multilevel strategy intervention trial is needed to address the many modifiable implications of alcohol consumption among those receiving treatment for HIV.

Kalapatapu RK; Paris P; Neugroschl JA. Alcohol use disorders in geriatrics. (review). International Journal of Psychiatry in Medicine 40(3): 321-337, 2010. (68 refs.)

Alcohol use disorders cause significant morbidity and mortality in the geriatric population This review article begins with a hypothetical case for illustration, asking what the primary care physician could do for a geriatric patient with alcohol abuse over a course of four office visits. Various aspects of alcohol use disorders in the geriatric population are reviewed such as range of alcohol use, epidemiology medical/psychiatric impact, detection, comprehensive treatment planning, modalities of psychotherapy, medication management, and resources for clinicians/patients.

Kalichman SC. Social and structural HIV prevention in alcohol-serving establishments: Review of international interventions across populations. Alcohol Research & Health 33(3): 184-194, 2010. (48 refs.)

Alcohol use is associated with risks for sexually transmitted infections (STIs), including HIV/AIDS. People meet new sex partners at bars and other places where alcohol is served, and drinking venues facilitate STI transmission through sexual relationships within closely knit sexual networks. This paper reviews HIV prevention interventions conducted in bars, taverns, and informal drinking venues. Interventions designed to reduce HIV risk by altering the social interactions within drinking environments have demonstrated mixed results. Specifically, venue-based social influence models have reduced community-level risk in U.S. gay bars, but these effects have not generalized to gay bars elsewhere or to other populations. Few interventions have sought to alter the structural and physical environments of drinking places for HIV prevention. Uncontrolled program evaluations have reported promising approaches to bar-based structural interventions with gay men and female sex workers. Finally, a small number of studies have examined multilevel approaches that simultaneously intervene at both social and structural levels with encouraging results. Multilevel interventions that take environmental factors into account are needed to guide future HIV prevention efforts delivered within alcohol-serving.

Katano S; Nakamura Y; Nakamura A; Murakami Y; Tanaka T; Nakagawa H et al. Relationship among physical activity, smoking, drinking and clustering of the metabolic syndrome diagnostic components. Journal of Atherosclerosis and Thrombosis 17(6): 644-650, 2010. (38 refs.)

Aim: To examine the relation between lifestyle and the number of metabolic syndrome (MetS) diagnostic components in a general population, and to find a means of preventing the development of MetS components. Methods: We examined baseline data from 3,365 participants (2,714 men and 651 women) aged 19 to 69 years who underwent a physical examination, lifestyle survey, and blood chemical examination. The physical activity of each participant was classified according to the International Physical Activity Questionnaire (IPAQ). We defined four components for MetS in this study as follows: 1) high BP: systolic BP >= 130 mmHg or diastolic BP >= 85 mmHg, or the use of antihypertensive drugs; 2) dyslipidemia: high-density lipoprotein-cholesterol concentration <40 mg/dL, triglycerides concentration >= 150 mg/dL, or on medication for dyslipidemia; 3) Impaired glucose tolerance: fasting blood sugar level >= 110 mg/d, or if less than 8 hours after meals >= 140 mg/dL), or on medication for diabetes mellitus; 4) obesity: body mass index >= 25 kg/m(2). Results: Those who had 0 to 4 MetS diagnostic components accounted for 1,726, 949, 484, 190, and 16 participants, respectively, in the Poisson distribution. Poisson regression analysis revealed that independent factors contributing to the number of MetS diagnostic components were being male (regression coefficient b = 0.600, p<0.01), age (b = 0.027, p<0.01), IPAQ class (b = -0.272, p = 0.03), and alcohol consumption (b = 0.020, p = 0.01). The contribution of current smoking was not statistically significant (b = -0.067, p = 0.76). Conclusion: Moderate physical activity was inversely associated with the number of MetS diagnostic components, whereas smoking was not associated.

Kerr WC; Ye Y. Relationship of life-course drinking patterns to diabetes, heart problems, and hypertension among those 40 and older in the 2005 US National Alcohol Survey. Journal of Studies on Alcohol and Drugs 71(4): 515-525, 2010. (49 refs.)

Objective: The goal of this study was to estimate relationships between life-course drinking patterns and the risks of self-reported diabetes, heart problems, and hypertension. Method: Respondents to the 2005 National Alcohol Survey, age 40 and older, reported ever having a doctor or health professional diagnose each of the health-problem outcomes. Retrospective earlier-life drinking patterns were characterized by lifetime abstention and the frequency of 5+ drinking days (i.e., days on which five or more drinks were consumed) in the respondent's teens, 20s, and 30s. Past-year drinking patterns were measured through intake volume and 5+ days. Potential confounders in the domains of demographics, socioeconomic resources, and other health-risk variables that is, depression, distress, sense of coherence, body mass index, tobacco use, marijuana use, childhood abuse, and family history of alcohol problems were controlled through propensity-score matching. Results: After matching, lifetime abstainers were found to be at increased risk of diabetes compared with both lifetime and current moderate drinkers. Exdrinkers were found to be at increased risk of diabetes, heart problems, and hypertension. Higher volume drinkers without monthly 5+ days were found to be at reduced risk of diabetes relative to moderate-volume current drinkers. Heavy-occasion drinkers were found to be at increased risk of hypertension. Conclusions: Regular lower quantity alcohol intake may be protective against adult onset of diabetes, but no evidence of protection from heart problems or hypertension was found. Both life course defined and past year defined drinking groups exhibit substantial clustering of confounding risk variables, indicating the need for modeling strategies like propensity-score matching. Increased risks among exdrinkers suggest a substantial "sick-quitter" effect.

Kim W; Kim I; Nochajski TH. Risk and protective factors of alcohol use disorders among Filipino Americans: Location of residence matters. American Journal of Drug and Alcohol Abuse 36(4): 214-219, 2010. (33 refs.)

Background: Despite the growing number of Asian Americans (AA) in the United States, research on alcohol abuse in this population is sparse. Although AA have few alcohol use disorders (AUD) as an aggregate group, within-group variations in AUD need to be explored among specific ethnic groups in this population. Objectives: This study compared correlates of 12-month prevalence of AUD between Filipino Americans who currently drink alcohol and live in San Francisco (SF) or Honolulu. Methods: Data from the 1998-1999 Filipino American Community Epidemiological Survey (N = 537) were used to test two hypotheses: 1) current drinkers in SF and Honolulu will differ in the characteristics and prevalence of AUD and 2) current drinkers in SF and Honolulu do not share the same protective and risk factors of AUD. Results: Current drinkers from the two regions substantially differed in age, years of education, age at first drink, religiosity, ethnic identity, psychological distress, the nativity status, as well as the prevalence of AUD. Logistic regression models revealed that AUD risk factors were different for SF current drinkers (higher psychological distress, U. S.-born, and lower religiosity) compared to Honolulu drinkers (more years of education and lower emotional support). Conclusion: Filipino American drinkers living in SF and Honolulu have different risk and protective factors for AUD. Health professionals need to be aware of this difference when screening for factors associated with AUD among Filipino Americans. Scientific Significance: The current study revealed the importance of socioenvironmental context (location of residence) in predicting AUD among an Asian ethnic group.

Klatsky AL. Alcohol and cardiovascular mortality: Common sense and scientific truth. Journal of the American College of Cardiology 55(13): 1336-1338, 2010. (15 refs.)

Anstie, a prominent public health activist, promulgated Anstie's Rule of a "sensible limit" of 45 ml of ethyl alcohol/dray or approximately 3 standard-sized drinks. The use of "sensible" rather than "safe" acknowledges that no amount of alcohol is safe for everyone. The author reviews the growing scientific evidence, as well as the findings of a national trial confirming a U-shaped relationship between alcohol intake and CV mortality. As expected, most of the apparent benefit in light-moderate drinkers is due to lower risk of CAD death. However, it is noted that absolute proof that persons at CAD risk obtain benefits form light-moderate drinking will not appear soon. In the 21st century a universal sensible limit would not accommodate serious public health issues such as the increased risk of female breast cancer risk associated with even moderate drinking or the consequences of the mixture of youthful drinking with the motor vehicle. The risks of moderate drinking differ by sex, age, personal history, and family history. As is often the case in medical practice, advice about lifestyle must be based on something less than certainty. There is no substitute for balanced judgment by a knowledgeable, objective health professional. What is required is a synthesis of common sense and the best available scientific facts.

LaBrie JW; Hummer JF; Neighbors C; Larimer ME. Whose opinion matters? The relationship between injunctive norms and alcohol consequences in college students. Addictive Behaviors 35(4): 343-349, 2010. (56 refs.)

Harm reduction approaches may benefit from research extending the exploration of predictors of alcohol use per se to those components most directly related to alcohol-related harm. This investigation evaluated the relationship between perceived injunctive norms of alcohol use (level of approval of drinking behaviors in specific situations) and the experience of alcohol-related consequences as a function Of typical Student reference groups at increasing levels of similarity to the respondent: based on race, gender, Greek Status, and combinations of these dimensions, as well as parents, close friends. and the Students' own attitudes. Participants were 3753 students (61% female) from two campuses who completed an online survey. Preliminary analyses determined that there were no differences in the relationship between perceived injunctive norms and consequences across the eight student groups of varying specificity, thus all eight levels were combined into one variable of perceived student injunctive norms. However, the relationship between this variable and consequences was weaker than the perceived attitudes of more proximal referents (parents, close friends, as well as their own personal attitudes). Subsequent analyses predicting consequences while controlling for demographic variables and drinking level, revealed that perceived injunctive norms for students, parents, and close friends as well as personal attitudes each significantly predicted consequences. Results suggest an important role for perceived injunctive norms in the experiencing of consequences over and above the amount of consumption and point to types of injunctive norms feedback that might form effective interventions (i.e., incorporating close friend and parent feedback as well as general student feedback).

LaBrie JW; Kenney SR; Lac A. The use of protective behavioral strategies is related to reduced risk in heavy drinking college students with poorer mental and physical health. Journal of Drug Education 40(4): 361-378, 2010. (57 refs.)

The present study examined the moderating role of health status (physical, mental, and social health) and the relationships between protective behavioral strategies utilized to reduce high-risk drinking (e. g., avoiding drinking games, setting consumption limits, or having a designated driver) and alcohol use and negative consequences in a sample of heavy drinking college students (N = 1,820). In this high risk sample, multiple regression analyses showed that stronger social health was related to increased drinking, while poorer physical, mental, and social health were related to increased alcohol negative consequences. Further, moderation effects revealed that increasing the use of protective behaviors was associated with significantly less drinking in those with stronger social health, as well as significantly lower numbers of negative consequences among participants with poorer physical and mental health. Implications for college counselors and medical personnel are discussed.

Latino-Martel P; Chan DSM; Druesne-Pecollo N; Barrandon E; Hercberg S; Norat T. Maternal alcohol consumption during pregnancy and risk of childhood leukemia: Systematic review and meta-analysis. (review). Cancer Epidemiology, Biomarkers & Prevention 19(5): 1238-1260, 2010. (59 refs.)

Background: Leukemia is the most frequently occurring cancer in children. Although its etiology is largely unknown, leukemia is believed to result from an interaction between genetic and environmental factors. Among different potential risk factors, the possible role of maternal alcohol consumption during pregnancy has been questioned. Methods: To assess the association between maternal alcohol consumption during pregnancy and childhood leukemia, a systematic review and meta-analysis of published studies was done. Results: Twenty-one case-control studies were included in categorical and dose-response meta-analyses. No cohort study was identified. Analyses were conducted by type of leukemia, children's age at diagnosis, and type of alcoholic beverage and trimester of pregnancy at alcohol use. Alcohol intake during pregnancy (yes versus no) was statistically significantly associated with childhood acute myeloid leukemia (AML) [odds ratio (OR), 1.56; 95% confidence interval (CI), 1.13-2.15] but not with acute lymphoblastic leukemia (OR, 1.10; 95% CI, 0.93-1.29). Heterogeneity between studies was observed. The OR of AML for an increase of a drink per week was 1.24 (95% CI, 0.94-1.64). The association of alcohol intake during pregnancy with AML was observed for cancers diagnosed at age 0 to 4 years (OR, 2.68; 95% CI, 1.85-3.89) in five studies without heterogeneity (I-2 <= 0.1%). Conclusions: The results of case-control studies indicate that maternal alcohol consumption during pregnancy is associated with a significantly increased risk of AML in young children. Impact: Avoidance of maternal alcohol drinking during pregnancy might contribute to a decrease in the risk of childhood AML.

Lee CM; Patrick ME; Neighbors C; Lewis MA; Tollison SJ; Larimer ME. Exploring the role of positive and negative consequences in understanding perceptions and evaluations of individual drinking events. Addictive Behaviors 35(8): 764-770, 2010. (49 refs.)

While research has established that drinking more alcohol is associated with experiencing more positive and negative alcohol-related consequences, less is known about how college students evaluate their drinking experiences. Evaluations of drinking events may vary with factors such as how much one drinks, which consequences one experiences, and the context (i.e., where and with whom) one drinks on a given occasion. This research used daily data (Level 2: N = 166 students, 61% female; Level 1: N = 848 person drinking days) to explore the relationship between quantity of alcohol consumed and experience of specific domains of positive and negative consequences and to examine how the experience of specific consequences related to overall evaluation of the drinking experience. Drinking on a given day was positively associated with experiencing more negative (social and personal) and more positive (image, fun/social, and relaxation) consequences. With respect to the formation of overall impressions, negative (social and personal) consequences were associated with less favorable evaluations whereas positive (image, fun/social, and relaxation) consequences were associated with more favorable evaluations of the drinking experience. Indirect effects analyses suggested that consequences (negative personal, negative social, positive fun/social, and positive relaxation) significantly mediated the relationship between drinking and overall evaluation at the daily level. These results underscore the importance of considering both positive and negative consequences in understanding students' choices to drink and how they evaluate their experiences.

Maldonado-Molina MM; Reingle JM; Tobler AL; Komro KA. Effects of beverage-specific alcohol consumption on drinking behaviors among urban youth. Journal of Drug Education 40(3): 265-280, 2010. (32 refs.)

Alcoholic beverage consumption among high school students has shifted from beer to liquor. The current longitudinal study examined the effects of beverage-specific alcohol use on drinking behaviors among urban youth. Data included 731 adolescents who participated in Project Northland Chicago and reported consuming alcohol in 7th grade. Logistic regression tested the effects of beverage-specific use on consequences (e. g., alcohol use in the past month, week, heavy drinking, and ever drunkenness). Compared to wine users, adolescents who reported drinking hard liquor during their last drinking occasion had increased odds of alcohol use during the past month (OR = 1.44; 95% CI = 1.01-2.05), past week (OR = 3.37; 95% CI = 1.39-8.18), and ever drunkenness (OR = 1.56; 95% CI = 1.07-2.29). Use of hard liquor was associated with increased risk of alcohol-related consequences. Early selection of certain alcoholic beverages (e. g., hard liquor) may result in negative health outcomes and problematic alcohol use over time.

Midanik LT; Greenfield TK. Reports of alcohol-related problems and alcohol dependence for demographic subgroups using interactive voice response versus telephone surveys: The 2005 US National Alcohol Survey. Drug and Alcohol Review 29(4): 392-398, 2010. (38 refs.)

Introduction and Aims. Interactive voice response (IVR), a computer-based interviewing technique, can be used within a computer-assisted telephone interview (CATI) survey to increase privacy and the accuracy of reports of sensitive attitudes and behaviours. Previous research using the 2005 National Alcohol Survey indicated no overall significant differences between IVR and CATI responses to alcohol-related problems and alcohol dependence. To determine if this result holds for demographic subgroups that could respond differently to modes of data collection, this study compares the prevalence rates of lifetime and last-year alcohol-related problems by gender, ethnicity, age and income subgroups obtained by IVR versus continuous CATI interviewing. Design and Methods. As part of the 2005 National Alcohol Survey, subsamples of English-speaking respondents were randomly assigned to an IVR group that received an embedded IVR module on alcohol-related problems (n = 450 lifetime drinkers) and a control group that were asked identical alcohol-related problem items using continuous CATI (n = 432 lifetime drinkers). Results. Overall, there were few significant associations. Among lifetime drinkers, higher rates of legal problems were found for white and higher income respondents in the IVR group. For last-year drinkers, a higher percentage of indicators of alcohol dependence was found for Hispanic respondents and women respondents in the CATI group. Discussion and Conclusion. Data on alcohol problems collected by CATI provide largely comparable results to those from an embedded IVR module. Thus, incorporation of IVR technology in a CATI interview does not appear strongly indicated even for several key subgroups.

Moore SC. Substitution and complementarity in the face of alcohol-specific policy interventions. Alcohol and Alcoholism 45(5): 403-408, 2010. (62 refs.)

Aim: Policy responses to the growing burden of alcohol-related disease fail to consider the interrelated nature of substance misuse and the potential for complex interactions in response to alcohol-specific interventions. This paper considers possible aggregate level responses to the alcohol policy and whether alcohol policy can be expected to reduce overall harm. Methods: A review and discussion of the relevant literature was conducted. Results: Evidence indicates that those at greatest risk consume stronger alcoholic beverages more frequently, that they are likely to complement their consumption with a range of intoxicants and that they are more likely to substitute alcohol with other substances. Conclusions: Policies aimed at reducing alcohol consumption can be successful. However, evidence suggests a significant minority of consumers are likely to substitute or complement consumption with a range of intoxicants suggesting that policy is unlikely to reduce all-cause mortality and morbidity. Further research into the nature of substitution and complementarity is required.

Moos RH; Brennan PL; Schutte KK; Moos BS. Spouses of older adults with late-life drinking problems: Health, family, and social functioning. Journal of Studies on Alcohol and Drugs 71(4): 506-514, 2010. (57 refs.)

Objective: This study focuses on the health, family, and social functioning of spouses of late-life remitted and continuing problem drinkers, and on predictors of spouses' alcohol-related functioning and depressive symptoms. Method: Three groups of spouses were compared at baseline and a 10-year follow-up: (a) spouses (n = 73) of older adults who had no drinking problems at baseline or followup, (b) spouses (n = 25) of older adults who had drinking problems at baseline but not follow-up, and (c) spouses (n = 69) of older adults who had drinking problems at both baseline and follow-up. At each contact point, spouses completed an inventory that assessed their alcohol-related, health, family, and social functioning. Results: At baseline, compared with spouses of problem-free individuals, spouses of older adults whose drinking problems later remitted reported more alcohol consumption, poorer health, more depressive symptoms, and less involvement in domestic tasks and social and religious activities. At the 10-year follow-up, spouses of remitted problem drinkers were comparable to spouses of problem-free individuals, but spouses of continuing problem drinkers consumed more alcohol, incurred more alcohol-related consequences, and had friends who approved more of drinking. Overall, spouses whose friends approved more of drinking and whose partners consumed more alcohol and had drinking problems were likely to consume more alcohol and to have drinking problems themselves. Conclusions: Spouses of older adults whose late-life drinking problems remit can attain normal functioning; however, spouses of older adults with continuing late-life drinking problems experience some ongoing deficits.

Morgan CJA; Muetzelfeldt L; Muetzelfeldt M; Nutt DJ; Curran HV. Harms associated with psychoactive substances: Findings of the UK National Drug Survey. Journal of Psychopharmacology 24(2): 147-153, 2010. (6 refs.)

Nutt and colleagues' 'rational' scale to assess the harms of commonly used drugs was based on ratings by a panel of experts. This survey aimed to assess drug users' views of the harms of drugs using the same scale. As users' drug choices are not solely based on harms, we additionally assessed perceived benefits. The survey was hosted at http: www.nationaldrugsurvey.org. UK residents reported their experience of 20 commonly used substances; those with direct experience of a substance rated its physical, dependence-related and social harms as well as benefits. A total of 1501 users completed the survey. There was no correlation between the classification of the 20 drugs under the Misuse of Drugs Act and ranking of harms by users. Despite being unclassified substances, alcohol, solvents and tobacco were rated within the top ten most harmful drugs. There was a remarkably high correlation (r = 0.896) overall between rankings by users' and by experts. Ecstasy, cannabis and LSD were ranked highest by users on both acute and chronic benefits. These findings imply that users are relatively well informed about the harms associated with the drugs they use. They also suggest that the current UK legal classification system is not acting to inform users of the harms of psychoactive substances.

Mukamal KJ; Chen CM; Rao SR; Breslow RA. Alcohol consumption and cardiovascular mortality among US Adults, 1987 to 2002. Journal of the American College of Cardiology 55(13): 1328-1335, 2010. (53 refs.)

Objectives: The aim of this study was to determine the association of alcohol consumption and cardiovascular mortality in the U. S. population. Background:Alcohol consumption has been associated with a lower risk of cardiovascular disease in cohort studies, but this association has not been prospectively examined in large, detailed, representative samples of the U. S. population. Methods: We analyzed 9 iterations of the National Health Interview Survey, an annual survey of a nationally representative sample of U. S. adults between 1987 and 2000. Exposures of interest included usual volume, frequency, and quantity of alcohol consumption and binge drinking. Mortality was ascertained through linkage to the National Death Index through 2002. Relative risks were derived from random-effects meta-analyses of weighted, multivariable-adjusted hazard ratios for cardiovascular mortality from individual survey administrations. Results: Light and moderate volumes of alcohol consumption were inversely associated with cardiovascular mortality. Compared with lifetime abstainers, summary relative risks were 0.95 (95% confidence interval [CI]: 0.88 to 1.02) among lifetime infrequent drinkers, 1.02 (95% CI: 0.94 to 1.11) among former drinkers, 0.69 (95% CI: 0.59 to 0.82) among light drinkers, 0.62 (95% CI: 0.50 to 0.77) among moderate drinkers, and 0.95 (95% CI: 0.82 to 1.10) among heavy drinkers. The magnitude of lower risk was similar in subgroups of sex, age, or baseline health status. There was no simple relation of drinking pattern with risk, but risk was consistently higher among those who consumed >= 3 compared with 2 drinks/drinking day. Conclusions: In 9 nationally representative samples of U. S. adults, light and moderate alcohol consumption were inversely associated with CVD mortality, even when compared with lifetime abstainers, but consumption above recommended limits was not.

Nelson MR; Alkhateeb AN; Ryan P; Willson K; Gartlan JG; Reid CM. Physical activity, alcohol and tobacco use and associated cardiovascular morbidity and mortality in the Second Australian National Blood Pressure study cohort. Age and Ageing 39(1): 112-116, 2010. (32 refs.)

Physical inactivity and smoking are modifiable risk factors for cardiovascular disease. High alcohol consumption and a sedentary lifestyle contribute to the risk of hypertension in the elderly and thus mortality from its associated disease outcomes. This study seeks to ascertain the prevalence rate at baseline and the changes over time of alcohol intake, cigarette smoking and physical activity among 6,083 Australian hypertensive elderly who participated in the Second Australian National Blood Pressure study. The risk of cardiovascular events or death from any cause as a result of these lifestyle factors was also assessed. It was found that adverse lifestyle factors (especially physical inactivity) are prevalent in the hypertensive elderly, and there is a significant increase in relative risk of CVD or death from any cause in these patients who continued to smoke or were physically inactive.

Nondahl DM; Cruickshanks KJ; Wiley TL; Klein BEK; Klein R; Chappell R et al. The ten-year incidence of tinnitus among older adults. International Journal of Audiology 49(8): 580-585, 2010. (21 refs.)

As part of a population-based study in Beaver Dam, Wisconsin, we estimated the 10-year cumulative incidence of tinnitus and its risk factors. Participants (n = 2922, aged 48-92 years) not reporting tinnitus at baseline (1993-1995) were followed for up to ten years. In addition to audiometric testing and anthropometric measures, data on tinnitus, health, and other history were obtained via questionnaire. Potential risk factors were assessed with discrete-time proportional hazards models. The 10-year cumulative incidence of tinnitus was 12.7%. The risk of developing tinnitus was significantly associated with: history of arthritis (hazard ratio (HR) = 1.37), history of head injury (HR = 1.76), history of ever smoking (HR = 1.40), and among women, hearing loss (HR = 2.59). Alcohol consumption (HR = 0.63 for >= 141 grams/week vs. < 15 grams/week), age (among women, HR = 0.90 for each five-year increase in age), and among men, obesity (HR = 0.55), were associated with decreased risk. The risk of developing tinnitus was high for older adults, and associated with modifiable health and behavioral factors.

Osby U; Liljenberg J; Kockum I; Gunnar A; Terenius L. Genes and alcohol. European Psychiatry 25(5, special issue): 281-283, 2010. (18 refs.)

The negative effects of excessive alcohol use include dependence, psychiatric co-morbidity and increased risk for suicide. A dominating risk factor is heritage. A large number of studies have addressed the genetic basis, either "candidate genes" in the brain reward system, or searched for unknown genes in family studies by linkage analysis. It is clear that no single gene polymorphism is of use in preventive medicine. A consistent finding, however, is that polymorphism in the alcohol dehydrogenase cluster and other metabolic pathways are of some relevance on a population basis, suggesting a link between alcohol toxicity in general and dependence. An emerging concern is potential gender differences as women, who are generally more sensitive, acquire male drinking habits.

Palfai TP; Ralston TE; Wright LL. Understanding university student drinking in the context of life goal pursuits: The mediational role of enhancement motives. Personality and Individual Differences 50(2): 169-174, 2011. (35 refs.)

Previous research has shown that university students who experience lower levels of meaning in the pursuit of typical life goals use more alcohol and experience more alcohol-related problems. The main objective of the present study was to extend this work by identifying motivational mechanisms that underlie the association between goal meaning and alcohol involvement. Ninety-three introductory psychology students participated in a university health behaviors study for course credit. Students completed a goal assessment in which they generated and rated goals that characterized their lives on dimensions of meaning and efficacy and then completed a series of assessments about alcohol use. Controlling for gender, partial correlations showed that higher meaning ratings for life goals were associated with less alcohol use and fewer alcohol-related consequences. Multiple mediational analyses among drinkers showed that the association between goal meaning ratings and alcohol involvement was mediated by enhancement but not coping motives. Findings support motivational models that have suggested that those who experience less engagement in their daily life tasks may experience greater positive incentive value from drinking. Results: point to the potential value of alcohol intervention approaches that include efforts to help students engage in sources of non-substance related reinforcement in their daily lives.

Patra J; Taylor B; Irving H; Roerecke M; Baliunas D; Mohapatra S et al. Alcohol consumption and the risk of morbidity and mortality for different stroke types: A systematic review and meta-analysis. BMC Public Health 10: article 258, 2010. (69 refs.)

Background: Observational studies have suggested a complex relationship between alcohol consumption and stroke, dependent on sex, type of stroke and outcome (morbidity vs. mortality). We undertook a systematic review and a meta-analysis of studies assessing the association between levels of average alcohol consumption and relative risks of ischemic and hemorrhagic strokes separately by sex and outcome. This meta-analysis is the first to explicitly separate morbidity and mortality of alcohol-attributable stroke and thus has implications for public health and prevention. Methods: Using Medical Subject Headings (alcohol drinking, ethanol, cerebrovascular accident, cerebrovascular disorders, and intracranial embolism and thrombosis and the key word stroke), a literature search of MEDLINE, EMBASE, CINAHL, CABS, WHOlist, SIGLE, ETOH, and Web of Science databases between 1980 to June 2009 was performed followed by manual searches of bibliographies of key retrieved articles. From twenty-six observational studies (cohort or case-control) with ischemic or hemorrhagic strokes the relative risk or odds ratios or hazard ratios of stroke associated with alcohol consumption were reported; alcohol consumption was quantified; and life time abstention (manually estimated where data for current abstainers were given) was used as the reference group. Two reviewers independently extracted the information on study design, participant characteristics, level of alcohol consumption, stroke outcome, control for potential confounding factors, risk estimates and key criteria of study quality using a standardized protocol. Results: The dose-response relationship for hemorrhagic stroke had monotonically increasing risk for increasing consumption, whereas ischemic stroke showed a curvilinear relationship, with a protective effect of alcohol for low to moderate consumption, and increased risk for higher exposure. For more than 3 drinks on average/day, in general women had higher risks than men, and the risks for mortality were higher compared to the risks for morbidity. Conclusions: These results indicate that heavy alcohol consumption increases the relative risk of any stroke while light or moderate alcohol consumption may be protective against ischemic stroke. Preventive measures that should be initiated are discussed.

Peele S. Alcohol as evil: Temperance and policy. Addiction Research & Theory 18(4): 374-382, 2010. (28 refs.)

Beverage alcohol has developed indelibly different footprints in different cultures. Research shows, indeed, that how a culture views and appreciates alcohol impacts people's very likelihood of being addicted to it. In this context, the US and other Protestant English-speaking nations, and particularly Nordic ones, are characterized by intense binge drinking - amidst overall low consumption - leading to both social and health problems (including higher levels of alcohol-related mortality). At the same time, these are the very nations that propose alcohol control policies worldwide, which they support with advanced epidemiologic research. Ironically, this same research has shown how peculiar Temperance cultures' drinking patterns are, particularly in contrast with those in Southern Europe. Yet superior-drinking cultures are ignored - even belittled - in formulating governmental alcohol policies. This paradox is explored and laid at the feet of ingrained anti-alcohol feelings that pervade Temperance cultures. One resulting subplot is the effort by leading Temperance journals and researchers to discourage alcohol producers and sellers from having any role in policy, and to punish and to ban researchers and social scientists in any way associated with producers and sellers.

Perala J; Kuoppasalmi K; Pirkola S; Harkanen T; Saarni S; Tuulio-Henriksson A et al. Alcohol-induced psychotic disorder and delirium in the general population. British Journal of Psychiatry 197(3): 200-206, 2010. (37 refs.)

Background: Epidemiologic data on alcohol-induced psychotic disorder and delirium (alcohol-induced psychotic syndrome, AIPS) are scarce. Aims: To investigate the epidemiology of AIPS, the risk factors for developing AIPS among people with alcohol dependence, and mortality associated with alcohol dependence with or without AIPS, in a sample drawn from the general population of Finland. Method: A general population sample of 8028 persons were interviewed with the Composite International Diagnostic Interview and screened for psychotic disorders using multiple sources. Best-estimate diagnoses of psychotic disorders were made using the Structured Clinical Interview for DSM-IV Axis I Disorders and case notes. Data on hospital treatments and deaths were collected from national registers. Results: The lifetime prevalence was 0.5% for AIPS and was highest (1.8%) among men of working age. Younger age at onset of alcohol dependence, low socioeconomic status, father's mental health or alcohol problems and multiple hospital treatments were associated with increased risk of AIPS. Participants with a history of AIPS had considerable medical comorbidity, and 37% of them died during the 8-year follow-up. Conclusions: Alcohol-induced psychotic disorder is a severe mental disorder with poor outcome.

Peterson J. A qualitative comparison of parent and adolescent views regarding substance use. Journal of School Nursing 26(1): 53-64, 2010. (45 refs.)

Substance use is a major cause of adolescent morbidity and mortality. By age 14, 70% of adolescents have consumed alcohol and half of 12th graders report having used marijuana. The purpose of this study was to increase the understanding of parent and adolescent perceptions regarding adolescent use of alcohol, tobacco, and other drugs (ATOD) to enhance the development of effective prevention programs. Six adolescent focus groups and one parent focus group participated. Results were derived following elicitation of adolescents' and parents' beliefs regarding adolescent ATOD use and current prevention programs. Findings indicate that current prevention programs are ineffective; ATOD use is normalized by schools, community, and family; positive adult role models deter use; and programs should involve youth, parents, schools, and community. Focus group discussions can strengthen the development of tailored ATOD prevention programs. School nurses can foster collaboration between families, schools, and communities to reduce adolescent substance use.

Petrie DJ; Doran CM; Shakeshaft AP; Sanson-Fisher R. The relationship between risky alcohol consumption, crime and traffic accidents in Australian rural communities. Addictive Behaviors 35(4): 359-362, 2010. (20 refs.)

Aim: To estimate the alcohol-attributable crime and traffic accidents for rural communities in Australia, controlling for potential bias. Method: For 20 rural communities in New South Wales. Australia, crime and traffic accident data was obtained from police records along with risky alcohol use estimated from a postal questionnaire. The relationship between community levels of risky drinking and crime and traffic accidents that occur in alcohol-related times is analysed controlling for the underlying level of crime by using the rate of incidents that occur in non-alcohol-related times. Findings: For the 20 rural communities, it was estimated that risky alcohol use is likely to have attributed to between 1.4 and 7.7 common assaults per 1000 Population and between 0.6 and 1.8 serious traffic injuries or fatalities per 1000 population, every year. Conclusions: Rural communities in Australia are experiencing a sizeable amount of potentially avoidable harm due to risky alcohol use. Reducing the population levels of those drinking at risk of acute harm or improving the settings in which drinking takes place may have benefits for these communities, especially in terms of crime and traffic accidents.

Pham DB; Clough AR; Nguyen HV; Kim GB; Buettner PG. Alcohol consumption and alcohol-related problems among Vietnamese medical students. Drug and Alcohol Review 29(2): 219-226, 2010. (32 refs.)

Introduction and Aims. This study examined prevalence and predictors of alcohol consumption and alcohol problems in a sample of medical students in Vietnam. Design and Methods. A cross-sectional survey using a multi-stage cluster sampling approach was conducted in 2007 in two universities in Vietnam. The students (n = 619, 100% response rate) completed questionnaires based on the Alcohol Use Disorder Identification Test. A score of >= 8 defined presence of alcohol problems. Data analyses adjusted for the cluster sampling approach. Results. Overall 65.5% of students had drunk alcohol during the previous year while alcohol problems were detected in 12.5%. Male students, students who reported that their family members drank and students who reported that their flat mates were drinking were more likely to be current drinkers. Male students were 14.3 times more likely to have an Alcohol Use Disorder Identification Test score of >= 8 compared with female students (P = 0.005). Discussion and Conclusions. Intervention programs focusing on male students and their social environment are warranted. As Vietnamese society rapidly modernises prevention programs for female students may also be needed.

Plant M; Miller P; Plant M; Gmel G; Kuntsche S; Bergmark K et al. The social consequences of binge drinking among 24-to 32-year-olds in six European countries. Substance Use & Misuse 45(4): 528-542, 2010. (31 refs.)

Data were available from general population surveys carried out in six countries in the years 2000 to 2005 under the auspices of Gender, Alcohol and Culture: An International Study (GENACIS). A total of 2089 adults aged 24-32 in the Czech Republic, Denmark, the Isle of Man, Spain, Sweden, and the United Kingdom (UK) responded to questions about their drinking habits and social consequences directly resulting from their drinking. Survey methods varied from quota sampling with face-to-face interviewing in Spain and the UK to telephone surveys in Denmark and Sweden. Response rates varied from 50% to 72%. "Binge drinking" defined as a usual amount of more than 8 UK "units" for men and more than 6 units for women was more likely than moderate drinking to lead to social consequences, fights, or being asked to cut down on drinking. There were highly significant differences between the countries both in the percentages of "heavy" drinkers and in the adverse consequences of binge drinking. In Spain, the UK, and the Czech Republic binge drinking was more likely to lead to adverse consequences than was binge drinking in the other three countries. Male gender, low educational level, high drinking frequency, and single marital status were also significantly associated with adverse social consequences from drinking, but none of these variables explained the country differences. The presence of children had little effect.

Quinn PD; Fromme K. Predictors and outcomes of variability in subjective alcohol intoxication among college students: An event-level analysis across 4 years. Alcoholism: Clinical and Experimental Research 35(3): 484-495, 2011. (45 refs.)

Background: Individual differences in subjective alcohol intoxication, as measured by laboratory-based alcohol challenge, have been identified as a phenotypic risk factor for alcohol use disorders. Further, recent evidence indicates that subjective alcohol response is also associated with event-level physiological consequences among college students, including blackouts and hangovers. Methods: The current investigation tested predictors of and outcomes associated with subjective intoxication in the natural drinking environment. In a preliminary laboratory alcohol-challenge study (n = 53), we developed a brief measure of subjective alcohol intoxication for use in event-level research. Participating students in the principal study (n = 1,867; 63% women; 54% Caucasian) completed 30 days of Web-based self-monitoring in each of the 4 college years. Results: In the principal study, generalized estimating equation analyses revealed that both lighter drinking and a family history of alcohol problems predicted greater subjective intoxication after accounting for estimated blood alcohol concentration (eBAC). Moreover, greater subjective intoxication during a given drinking episode was associated with negative alcohol-related consequences, illicit drug use, and unsafe sex, and at higher eBACs, was associated with aggression, sex, and property crime. Students who on average experienced greater subjective intoxication were also more likely to experience negative consequences and engage in illicit drug use, sex, unsafe sex, and aggression. Conclusions: These findings suggest that both within-person variability and between-person individual differences in subjective intoxication may be risk factors for adverse drinking outcomes at the event level. Intervention efforts aimed at reducing problems associated with collegiate drinking may benefit from consideration both of who experiences greater subjective intoxication and of the situations in which they are more likely to do so.

Reed E; Prado G; Matsumoto A; Amaro H. Alcohol and drug use and related consequences among gay, lesbian and bisexual college students: Role of experiencing violence, feeling safe on campus, and perceived stress. Addictive Behaviors 35(2): 168-171, 2010. (25 refs.)

Objective: To examine differences between gay, lesbian, and bisexual (GLB) and non-GLB university students in alcohol and other drug use (AOD) and related consequences as well as the relevance of violence, perceived safety, and stress to any such differences in AOD use and related concerns. Methods: A random representative sample of university students (n = 988) were recruited via email for an online survey. Linear regression models assessed associations between identifying as GLB and AOD use and related consequences. Results: Regression models (adjusted for gender) indicated that, in comparison to heterosexual students. GLB students were more likely to report recent illicit drug use (AOR=2.0; 95% Cl: 1.1-3.9), more frequent negative AOD consequences (beta=5.5, SE=1.4, p<0.0001), and having seriously thought about/attempted suicide due to AOD use in the past year (AOR = 6.6; 95% Cl: 3.0-14.3). Study findings also suggested that violence, safety, and stress variables partially contribute to AOD use and related concerns among GLB students. Conclusions: Findings highlight the need for future efforts to investigate and address mechanisms, including aspects of campus life, which contribute to AOD related risks among GLB students.

Rosenbloom MJ; Sullivan EV; Pfefferbaum A. Focus on the brain: HIV infection and alcoholism comorbidity effects on brain structure and function. Alcohol Research & Health 33(3): 247-257, 2010. (53 refs.)

Both HIV infection and alcohol abuse have negative effects on the brain, with some unique to each condition and others shared by both conditions. Investigators have used magnetic resonance imaging to study the size and integrity of various brain structures in participants with alcoholism, HIV infection, or both conditions and in healthy control subjects. In these studies, alcoholics exhibited enlarged cerebrospinal fluid-filled spaces (i.e., ventricles) as well as tissue shrinkage in various brain regions (e.g., the corpus callosum and frontal cortex), whereas study participants with asymptomatic HIV infection showed few abnormalities. Those with both HIV infection and alcoholism also had these volume abnormalities, particularly if they had experienced an AIDS-defining event. Diffusion tensor imaging, which measures the integrity of white matter fibers, has identified abnormalities of constituents of these fibers in both diseases. Again, people with HIV infection plus alcoholism show the greatest abnormalities, particularly those with a history of an AIDS-defining event. Magnetic resonance spectroscopy, which assesses the levels of brain metabolites and selective neurotransmitters, has revealed different patterns of deficits in biochemical markers of brain integrity in individuals singly affected and a compounding of effects in individuals with both HIV infection and alcoholism. Finally, neuropsychological studies have revealed impairment in selective functions involving working memory, visuospatial abilities, and movement speed that are especially likely to occur in people with comorbid HIV infection and alcoholism. Thus, alcoholism is a major risk factor for development of neuropathology and its functional sequelae in HIV-infected people.

Sabia JJ. Wastin' away in Margaritaville? New evidence on the academic effects of teenage binge drinking. Contemporary Economic Policy 28(1): 1-22, 2010. (37 refs.)

Using data from the National Longitudinal Study of Adolescent Health, this study examines the relationship between teenage binge drinking and three measures of academic performance: grade point average, out-of-school suspensions, and unexcused absences from school. While ordinary least square estimates show that binge drinking is associated with diminished academic performance, individual fixed-effects estimates suggest that much of this relationship can be explained by unmeasured heterogeneity. After controlling for individual fixed effects and for changes in drug use, psychological well-being, and time preference, binge drinking has a much smaller and often statistically insignificant effect on school performance.

Sabia S; Gueguen A; Berr C; Berkman L; Ankri J; Goldberg M et al. High alcohol consumption in middle-aged adults is associated with poorer cognitive performance only in the low socio-economic group. Results from the GAZEL cohort study. Addiction 106(1): 93-101, 2011. (41 refs.)

Aims: To examine the association of alcohol consumption over 10 years with cognitive performance in different socio-economic groups. Design: Prospective cohort study, the French GAZEL study. Setting: France. Participants: Employees of France's national electricity and gas company. Measurements: Alcohol intake was assessed annually, beginning in 1992, using questions on frequency and quantity of alcoholic beverages consumed in a week; used to define mean consumption and trajectory of alcohol intake over 10 years. Cognitive performance among participants aged >= 55 years (n = 4073) was assessed in 2002-04 using the Digit Symbol Substitution Test (DSST), a measure of psychomotor speed, attention and reasoning. Occupational position at age 35 and education were used as the markers of socio-economic position. Findings: All analyses were stratified by socio-economic position. In the low occupational group, participants consuming a mean of more than 21 drinks per week had 2.1 points lower (95% CI: -3.9, -0.3) DSST score compared to those consuming four to 14 drinks per week. In participants with primary school education, the corresponding difference was 3.6 points (95% CI: -7.1, -0.0). No association between alcohol consumption and cognitive performance was observed in the intermediate and high socio-economic groups, defined using either occupation or education. Analysis of trajectories of alcohol consumption showed that in the low socio-economic groups large increase or decrease in alcohol consumption was associated with lower cognitive scores compared to stable consumption. Conclusions: Our results suggest that high alcohol consumption is associated with poorer cognitive performance only in the low socio-economic group, due possibly to greater cognitive reserve in the higher socio-economic groups.

Schonbrun YC; Strong DR; Anderson BJ; Caviness CM; Brown RA; Stein MD. Alcoholics Anonymous and hazardously drinking women returning to the community after incarceration: Predictors of attendance and outcome. Alcoholism: Clinical and Experimental Research 35(3): 532-539, 2011. (50 refs.)

Background: The number of women incarcerated within the United States has risen dramatically in recent decades, and high rates of alcohol problems are evident among this population. Although little is known about the patterns of help utilization and efficacy for alcohol problems, preliminary evidence suggests that Alcoholics Anonymous (AA) is a widely available resource for this population. Methods: Data were collected as part of a study evaluating the effect of a brief intervention to reduce alcohol use among hazardously drinking (i.e., score of 8 or above on the Alcohol Use Disorders Identification Test or 4 or more drinks at a time on at least 3 days in prior 3 months) incarcerated women. The current study characterized demographic, clinical, and previous AA attendance variables associated with AA attendance in the 6 months following incarceration. Associations between frequency of AA attendance and drinking outcomes following incarceration were also evaluated. Results: Among the 224 participants who provided data about AA attendance, 54% reported some AA attendance during the follow-up assessment period. AA attendance in the year prior to study entry (OR = 4.02; 95% CI: 3.32 to 4.71) and greater baseline consequences of alcohol use (OR = 2.09; 95% CI: 1.73 to 2.44) were associated with increased odds of higher frequency of AA attendance following incarceration. Weekly or greater AA attendance was associated with reductions in negative drinking consequences (B = -0.45; p < 0.01) and frequency of drinking days (B = -0.28; p < 0.01) following incarceration. Conclusions: Findings from this study suggest that AA is frequently utilized by hazardously drinking women following incarceration. Alcohol outcomes may be enhanced by AA attendance at a weekly or greater frequency is associated with better alcohol outcomes relative to lower levels of AA attendance. Evaluation of clinical guidelines for prescribing AA attendance for incarcerated women remains a task for future research.

Schweinsburg AD; Schweinsburg BC; Nagel BJ; Eyler LT; Tapert SF. Neural correlates of verbal learning in adolescent alcohol and marijuana users. Addiction 106(3): 564-573, 2011. (64 refs.)

Aims: Alcohol and marijuana are the most widely used intoxicants among adolescents, yet their potential unique and interactive influences on the developing brain are not well established. Brain regions subserving learning and memory undergo continued maturation during adolescence, and may be particularly susceptible to substance-related neurotoxic damage. In this study, we characterize brain response during verbal learning among adolescent users of alcohol and marijuana. Design: Participants performed a verbal paired associates encoding task during functional magnetic resonance imaging (fMRI) scanning. Setting: Adolescent subjects were recruited from local public schools and imaged at a university-based fMRI center. Participants: Participants were 74 16-18-year-olds, divided into four groups: (i) 22 controls with limited alcohol and marijuana experience, (ii) 16 binge drinkers, (iii) eight marijuana users and (iv) 28 binge drinking marijuana users. Measurements: Diagnostic interview ensured that all teens were free from neurological or psychiatric disorders; urine toxicology and breathalyzer verified abstinence for 22-28 days before scanning; a verbal paired associates task was administered during fMRI. Findings: Groups demonstrated no differences in performance on the verbal encoding task, yet exhibited different brain response patterns. A main effect of drinking pointed to decreased inferior frontal but increased dorsal frontal and parietal fMRI response among binge drinkers (corrected P < 0.05). There was no main effect of marijuana use. Binge drinking x marijuana interactions were found in bilateral frontal regions (corrected P < 0.05), where users of either alcohol or marijuana showed greater response than non-users, but users of both substances resembled non-users. Conclusions: Adolescent substance users demonstrated altered fMRI response relative to non-using controls, yet binge drinking appeared to be associated with more differences in activation than marijuana use. Alcohol and marijuana may have interactive effects that alter these differences, particularly in prefrontal brain regions.

Shuper PA; Neuman M; Kanteres F; Baliunas D; Joharchi N; Rehm J. Causal considerations on alcohol and HIV/AIDS: A systematic review. Alcohol and Alcoholism 45(2): 159-166, 2010. (92 refs.)

Methods: A review based on meta-analyses and reviews was conducted according to standard epidemiological criteria to distinguish causality from association, examining (i) the potential impact of alcohol on the incidence of HIV and (ii) alcohol's impact on worsening the disease course. Results: In terms of incidence of HIV, although we found a consistent and strong association with consumption, there was not enough evidence for a causal connection. In particular, it is not clear whether personality traits such as sensation seeking or sexual compulsivity and psychiatric disorders such as antisocial personality disorder impact both alcohol consumption and risky sex, subsequently creating an association between both behaviors. In terms of worsening the disease course of HIV/AIDS, we found enough evidence for a causal impact of alcohol. Alcohol affects the immune system, thus contributing to a worsened course of HIV/AIDS. In addition, alcohol negatively impacts on behaviors that include support seeking and medication adherence. Conclusions: A randomized controlled clinical trial targeted toward at-risk HIV-negative individuals who live in areas with high HIV prevalence is suggested to test the effects of proven effective alcohol interventions on HIV incidence.

Smith MA; Berger JB. Women's ways of drinking: College women, high-risk alcohol use, and negative consequences. Journal of College Student Development 51(1): 35-49, 2010. (50 refs.)

The purpose of this study was to explore college women's high-risk alcohol use and related consequences. This study employed a qualitative approach to understand and provide visibility for a gender-related perspective on college women alcohol experiences and related outcomes, Data were collected from interviews with 10 undergraduate females at a large research university in the northeastern United States. The results of the data analysis generated four major themes, which include a conceptual model, the relational ritual reinforcement (R-3), for understanding the recurring high-risk alcohol use and related negative consequences among some university women.

Sorocco KH; Monnot M; Vincent AS; Ross ED; Lovallo WR. Deficits in affective prosody comprehension: Family history of alcoholism versus alcohol exposure. Alcohol and Alcoholism 45(1): 25-29, 2010. (32 refs.)

Background: Abstinent alcoholics have deficits in comprehending the affective intonation in speech. Prior work suggests that these deficits are due to alcohol exposure rather than preexisting risk factors for alcoholism. The present paper examines whether family history of alcoholism is a contributor to affective prosody deficits in alcoholics. Methods: Fifty-eight healthy, nonabusing young adults with and without a family history of alcoholism or other substance abuse (29 FH+ and 29 FH-) were compared on affective prosody comprehension using the Aprosodia Battery. A secondary analysis was done comparing affective prosody comprehension in FH+ and FH- detoxified alcoholics from an earlier study (17 FH+ and 14 FH-). Results: Performance on the Aprosodia Battery was not related to FH status in either the healthy, nonabusing sample or in the detoxified alcoholic group. Conclusions: The present study lends support to previous research suggesting that deficits in affective prosody comprehension observed in detoxified alcoholics are associated with a history of heavy drinking rather than with a family history of alcoholism.

Sullivan EV; Harris A; Pfefferbaum A. Alcohol's effects on brain and behavior. Alcohol Research & Health 33(1-2): 127-143, 2010. (136 refs.)

Over the past 40 years, rigorous examination of brain function, structure, and attending factors through multidisciplinary research has helped identify the substrates of alcohol-related damage in the brain. One main area of this research has focused on the neuropsychological sequelae of alcoholism, which has resulted in the description of a pattern of sparing and impairment that provided an essential understanding of the functional deficits as well as of spared capabilities that could be useful in recovery. These studies have elucidated the component processes of memory, problem solving, and cognitive control, as well as visuospatial, and motor processes and their interactions with cognitive control processes. Another large area of research has focused on observable brain pathology, using increasingly sophisticated imaging technologies-progressing from pneumoencephalography to computed tomography, magnetic resonance imaging (MRI), diffusion tensor imaging, and functional MRI-that have enabled ever more detailed insight into brain structure and function. These advancements also have allowed analysis of the course of brain structural changes through periods of drinking, abstinence, and relapse.

Tai SY; Wu IC; Wu DC; Su HJ; Huang JL; Tsai HJ et al. Cigarette smoking and alcohol drinking and esophageal cancer risk in Taiwanese women. World Journal of Gastroenterology 16(12): 1518-1521, 2010. (27 refs.)

AIM: To investigate the etiology of esophageal cancer among Taiwanese women. METHODS: This is a multi-center, hospital-based, case-control study. Case patients consisted of women who were newly diagnosed and pathology-proven to have esophageal squamous cell carcinoma (ESCC) from three large medical centers (one from Northern and two from Southern Taiwan, respectively) between August 2000 and December 2008. Each ESCC patient was matched with 4 healthy women based on age (within 3 years) and hospital of origin, from the Department of Preventive Medicine in each hospital. A total of 51 case patients and 204 controls, all women, were studied. RESULTS: Frequencies of smokers and drinkers among ESCC patients were 19.6% and 21.6%, respectively, which were significantly higher than smokers (4.4%) and drinkers (4.4%) among controls (OR = 4.07, 95% CI: 1.36-12.16, P = 0.01; OR = 3.55, 95% CI: 1.03-12.27, P = 0.04). Women who drank an amount of alcohol more than 158 g per week had a 20.58-fold greater risk (95% CI: 1.72-245.62, P = 0.02) of ESCC than those who never drank alcohol after adjusting for other covariates, although the sample size was small. CONCLUSION: Cigarette smoking and alcohol drinking, especially heavy drinking, are the major risks for developing ESCC in Taiwanese women.

Talamini R; Polesel J; Gallus S; Dal Maso L; Zucchetto A; Negri E et al. Tobacco smoking, alcohol consumption and pancreatic cancer risk: A case-control study in Italy. European Journal of Cancer 46(2): 370-376, 2010. (31 refs.)

In Italy, pancreatic cancer accounts for approximately 5% of cancer-related deaths. Tobacco smoking is the major established risk factor for this cancer, whereas the role of alcohol consumption is open to debate. Between 1991 and 2008, we conducted a hospital-based case-control study on pancreatic cancer in northern Italy Cases were 326 patients (median age 63 years) with incident pancreatic cancer admitted to major general hospitals. Controls were 652 patients (median age 63 years) with acute non-neoplastic conditions admitted to the same hospital network of cases. Multiple logistic regression was used to estimate the odds ratios (OR) and the corresponding 95% confidence intervals (CI). Pancreatic cancer was associated to current smoking (OR = 1.68; 95% Cl: 1.13-2.48), and the risk rose with increasing number of cigarettes/day (OR = 2.04; 95% CI: 1.14-3.66 for >= 20 cigarettes/day). No association emerged for former smokers (OR = 0.98; 95% CI: 0.66-1.45). Alcohol consumption was associated to increased pancreatic cancer risk, but ORs were significant only among heavy drinkers (ORs: 2.03 and 3.42 for 21-34 and >= 35 drinks/week, respectively). Pancreatic cancer risk was 4.3-fold higher in heavy smokers (>= 20 cigarettes/day) and heavy drinkers (>= 21 drinks/week) in comparison with never smokers who drunk <7 drinks/week, which is compatible with an additive effect of these exposures. In conclusion, we found that tobacco smoking and alcohol drinking are two independent risk factors for pancreatic cancer which may be responsible for approximately one third of these cancers in our population.

Thombs DL; O'Mara RJ; Hou W; Wagenaar AC; Dong HJ; Merves ML et al. 5-HTTLPR genotype and associations with intoxication and intention to drive: Results from a field study of bar patrons. Addiction Biology 16(1): 133-141, 2011. (27 refs.)

The serotonin transporter promoter polymorphism (5-HTTLPR) has been linked to a number of human behavioral traits and disorders. The variants of 5-HTTLPR are commonly reported in three forms, L/L, S/L and S/S, with the latter most often associated with emotional distress and/or behavioral dysfunction. Missing from the research literature are investigations that assess event-level associations between 5-HTTLPR genotype and specific incidents of risk behavior in natural drinking settings. This study reports associations between 5-HTTLPR, alcohol intoxication and intention to drive among young adult patrons exiting on-premise drinking establishments (i.e. bars) at night. Self-report measures, breath alcohol concentration (BrAC) readings and saliva samples for DNA analysis were collected from 477 bar patrons. Analyses were performed on 225 patrons likely to be near their peak intoxication level for the night. Results from a linear regression revealed that the 5-HTTLPR genotype was associated with exiting patron BrAC, after adjusting for random and fixed effects of other variables. An interaction effect involving 5-HTTLPR and bar-sponsored drink specials also had an independent association with BrAC, suggesting that selection of price-discounted alcoholic beverages increased intoxication in patrons with an L allele. In addition, results from logistic regression indicated that patrons with the S/S genotype were three times more likely to intend to drive a motor vehicle (after drinking on the night of study participation) compared with those with the L/L genotype. The 5-HTTLPR genotype may play an important role in the etiology of problems associated with on-premise drinking establishments.

Thyssen JP; Linneberg A; Menne T; Nielsen NH; Johansen JD. The effect of tobacco smoking and alcohol consumption on the prevalence of self-reported hand eczema: a cross-sectional population-based study. British Journal of Dermatology 162(3): 619-626, 2010. (37 refs.)

Background: Hand eczema is a prevalent disorder that leads to high health care costs as well as a decreased quality of life. Important risk factors include atopic dermatitis, contact allergy and wet work whereas the role of null mutations in the filaggrin gene complex remains to be clarified. It has been debated whether lifestyle factors such as tobacco smoking and alcohol consumption are associated with hand eczema. Objectives: The current study aimed to investigate whether self-reported hand eczema was associated with smoking and alcohol consumption in the general population. Methods: Between June 2006 and May 2008, a cross-sectional study was performed in the general population in Copenhagen, the capital of Denmark. A random sample of 7931 subjects aged 18-69 years old was invited to participate in a general health examination including a questionnaire; 3471 (44%) participated. Data were analysed with logistic regression analyses and associations were expressed as odds ratios (ORs) with 95% confidence intervals (CI). Results: The prevalence of hand eczema was higher among previous smokers (OR = 1.13; CI = 0.90-1.40), current light smokers (OR = 1.51; CI = 1.142-2.02) and current heavy smokers (OR = 1.38; CI = 0.99-1.92) compared with never-smokers. Conclusions: Tobacco smoking was positively associated with hand eczema among adults from the general population in Denmark. Apparently, current light smokers (< 15 g daily) had a higher prevalence of hand eczema than current heavy smokers (> 15 g daily) but this needs to be reconfirmed. Alcohol consumption was not associated with hand eczema.

Vangipuram SD; Lyman WD. Ethanol alters cell fate of fetal human brain-derived stem and progenitor cells. Alcoholism: Clinical and Experimental Research 34(9): 1574-1583, 2010. (61 refs.)

Background: Prenatal ethanol (ETOH) exposure can lead to fetal alcohol spectrum disorder (FASD). We previously showed that ETOH alters cell adhesion molecule gene expression and increases neurosphere size in fetal brain-derived neural stem cells (NSC). Here, our aim was to determine the effect of ETOH on the cell fate of NSC, premature glial-committed precursor cells (GCP), and premature neuron-committed progenitor cells (NCP). Methods: NSC, GCP, and NCP were isolated from normal second-trimester fetal human brains (n = 3) by positive selection using magnetic microbeads labeled with antibodies to CD133 (NSC), A2B5 (GCP), or PSA-NCAM (NCP). As a result of the small percentage in each brain, NSC were cultured in mitogenic media for 72 hours to produce neurospheres. The neurospheres from NSC and primary isolates of GCP and NCP were used for all experiments. Equal numbers of the 3 cell types were treated either with mitogenic media or with differentiating media, each containing 0 or 100 mM ETOH, for 120 hours. Expression of Map2a, GFAP, and O4 was determined by immunoflourescence microscopy and western blot analysis. Fluorescence intensities were quantified using Metamorph software by Molecular Devices, and the bands of western blots were quantified using densitometry. Results: ETOH in mitogenic media promoted formation of neurospheres by NSC, GCP, and NCP. Under control conditions, GCP attached and differentiated, NSC and NCP formed neurospheres that were significantly smaller in size than those in ETOH. Under differentiating conditions, Map2a expression increased significantly in NSC and GCP and reduced significantly in NCP, and GFAP expression reduced significantly in GCP and NCP, and Gal-C expression reduced significantly in all 3 cell types in the presence of ETOH compared to controls. Conclusions: This study shows that ETOH alters the cell fate of neuronal stem and progenitor cells. These alterations could contribute to the mechanism for the abnormal brain development in FASD.

Wagenaar AC; Tobler AL; Komro KA. Effects of alcohol tax and price policies on morbidity and mortality: A systematic review. American Journal of Public Health 100(11): 2270-2278, 2010. (70 refs.)

Objectives. We systematically reviewed the effects of alcohol taxes and prices on alcohol-related morbidity and mortality to assess their public health impact. Methods. We searched 12 databases, along with articles' reference lists, for studies providing estimates of the relationship between alcohol taxes and prices and measures of risky behavior or morbidity and mortality, then coded for effect sizes and numerous population and study characteristics. We combined independent estimates in random-effects models to obtain aggregate effect estimates. Results. We identified 50 articles, containing 340 estimates. Meta-estimates were r=-0.347 for alcohol-related disease and injury outcomes, -0.022 for violence, -0.048 for suicide, -0.112 for traffic crash outcomes, -0.055 for sexually transmitted diseases, -0.022 for other drug use, and -0.014 for crime and other misbehavior measures. All except suicide were statistically significant. Conclusions. Public policies affecting the price of alcoholic beverages have significant effects on alcohol-related disease and injury rates. Our results suggest that doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%.

Wakabayashi I. Cross-sectional relationship between alcohol consumption and prevalence of metabolic syndrome in Japanese men and women. Journal of Atherosclerosis and Thrombosis 17(7): 695-704, 2010. (41 refs.)

Aim: The aim of this study was to clarify the relationship between alcohol intake and metabolic syndrome in Japanese men and women. Methods: Japanese female subjects (n = 11,187) were divided into non-, light (<22 g ethanol/day) and heavy (>= 22 ethanol/day) drinkers, and Japanese male subjects (n = 19,398) were divided into non-, light (<22 g ethanol/day), heavy (>= 22 and <44 g ethanol/day) and very heavy (>= 44 g ethanol/day) drinkers. The mean level of each variable and the prevalence of each risk factor and metabolic syndrome were compared among the groups. Results: In men and women, blood pressure and HDL cholesterol tended to be higher, and hemoglobin A1c tended to be lower with increased alcohol intake. Waist circumference showed U-and V-shaped relationships, and log-converted triglyceride showed J- and V-shaped relationships with alcohol intake in men and women, respectively. The prevalence of metabolic syndrome was lowest in light drinkers in men and women and was significantly higher in very heavy drinkers than in nondrinkers in men. In men, the odds ratio vs. non-drinkers for metabolic syndrome was significantly low in light drinkers, while the odds ratio was significantly high in very heavy drinkers. In women, a significantly low odds ratio vs. non-drinkers for metabolic syndrome was obtained in light drinkers. Conclusion: Light drinking is associated with a lower risk of metabolic syndrome in Japanese men and women, while very heavy drinking is thought to increase the risk of metabolic syndrome in Japanese men.

Wilson DR. Health consequences of childhood sexual abuse. Perspectives in Psychiatric Care 46(1): 56-64, 2010. (54 refs.)

PURPOSE: This article provides a summary for advocacy, court testimony, assessment, treatment, prevention, and further research studies in the field of childhood sexual abuse. FINDINGS: A literature review identifies the psychiatric, social, and disease disorders to which this population is predisposed. Adult survivors experience more depression, obesity, autoimmune disorders (irritable bowel syndrome, asthma, fibromyalgia), eating disorders, and addictions. PRACTICE IMPLICATIONS: A holistic perspective allows understanding of health consequences for survivors. A model through which to consider these phenomena is presented. CONCLUSIONS: The long-term consequences of childhood sexual abuse must be assessed and addressed by healthcare professionals.

Wirtz PH; Redwine LS; Hong SZ; Rutledge T; Dimsdale JE; Greenberg BH et al. Increases in B-Type natriuretic peptide after acute mental stress in heart failure patients are associated with alcohol consumption. Journal of Studies on Alcohol and Drugs 71(5): 786-794, 2010. (51 refs.)

Objective: The aim of this study was to investigate in heart failure (HF) patients whether acute mental stress induces increases in the HF-severity biomarker B-type natriuretic peptide (BNP) and if alcohol consumption is associated with such stress-induced increases. Method: Twenty-one male HF patients and 19 male non-HF controls (M = 56 years, SEM = 2) underwent a 15-minute acute mental stress test combining public speaking and mental arithmetic. Plasma levels of BNP were determined immediately before as well as 2 hours after the stress test. Alcohol consumption was assessed by self-reported number of drinks per month and history of use. Results: HF patients had higher BNP levels before and after stress, F(1, 38) = 23.42, p < .001, and showed greater stress-induced increases in BNP levels, F(1, 38) = 4.52, p = .04, compared with controls. HF status (beta = .32, p = .015, Delta R-2 = .10) and higher alcohol consumption (beta = .61, p < .001, Delta R-2 = .37) were independently associated with higher BNP stress increases. Moreover, higher alcohol consumption moderated the greater BNP stress increases in HF patients but not in controls (beta = .49, p < .001, Delta R-2 = .20), although alcohol consumption did not differ between groups. Conclusions: For individuals with HF, particularly those who drink moderate to more substantial amounts of alcohol, exposure to acute psychological stress leads to increases in circulating levels of BNP, a biomarker which is associated with increased morbidity and mortality in HF.

Xie XA; Ma YT; Yang YN; Li XM; Liu F; Huang D et al. Alcohol consumption and ankle-to-brachial index: Results from the cardiovascular risk survey. PLoS ONE 5(11): e-article 15181, 2010. (43 refs.)

Background and Methodology: A low ankle-to-brachial index (ABI) is a strong correlate of cardiovascular disease and subsequent mortality. The relationship between ABI and alcohol consumption remains unclear. Data are from the Cardiovascular Risk Survey (CRS), a multiple-ethnic, community-based, cross-sectional study of 14 618 Chinese people (5 757 Hans, 4 767 Uygurs, and 4 094 Kazakhs) aged 35 years and over at baseline from Oct. 2007 to March 2010. The relationship between alcohol intake and ABI was determined by use of analysis of covariance and multivariable regressions. Principal Findings: In men, alcohol consumption was significantly associated with ABI (P<0.001). After adjusted for the confounding factors, such as age, sex, ethnicity, body mass index, smoking, work stress, diabetes, and fasting blood glucose, the difference remained significant (P<0.001); either the unadjusted or multivariate-adjusted odds ratio (OR) for peripheral artery disease (PAD) was significantly higher in men who consumed >60.0 g/d [OR = 3.857, (95% CI: 2.555-5.824); OR = 2.797, (95% CI: 1.106-3.129); OR = 2.878, (95% CI: 1.215-4.018); respectively] and was significantly lower in men who consumed 20.1-40.0 g/d [OR = 0.330, (95% CI: 0.181-0.599); OR = 0.484, (95% CI: 0.065-0.894); OR = 0.478, (95% CI: 0.243-1.534); respectively] and 40.1-60.0 g/d [OR = 0.306, (95% CI: 0.096-0.969); OR = 0.267, (95% CI: 0.087-0.886); OR = 0.203, (95% CI: 0.113-0.754); respectively] compared with never drinking, respectively (all P<0.01). Neither in unadjusted nor in multivariate-adjusted model was the association between ABI and alcohol consumption significant (all P>0.05) in women. Similarly, PAD was not correlated with alcohol intake in women (all P>0.05). Conclusions/Significance: Our results indicated that in Chinese men, alcohol consumption was associated with peripheral artery disease, and consumption of less than 60 g/d had an inverse association with peripheral atherosclerosis whereas consumption of 60 g/d or more had a positive association.