Archive

Archive for the ‘alcohol abuse’ Category

Social Host Liability for Underage Drinking Statutes

April 16, 2014 Comments off

Social Host Liability for Underage Drinking Statutes
Source: National Conference of State Legislatures

Enacted in 1984, the National Minimum Drinking Age Act set the minimum drinking age at 21. To comply with federal law, states prohibit persons under 21 years of age from purchasing or publicly possessing alcoholic beverages.

According to the 2012 National Survey on Drug Use and Health, about 9.3 million persons aged 12 to 20 (24.3 percent of this age group) reported drinking alcohol in the past month and an estimated 11.2 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year.

In an effort to combat underage drinking, state legislators have enacted laws that assign responsibility to adults who allow minors to drink alcohol at social gatherings. Thirty-one states allow social hosts to be civilly liable for injuries or damages caused by underage drinkers. Twenty-six states and the Virgin Islands have criminal penalties for adults who host or permit parties with underage drinking to occur in the adults’ homes or in premises under the adults’ control. These social host statutory provisions do not apply to licensed establishments such as restaurants, bars, and liquor stores, which are covered by dram shop laws.

About these ads

Gender Differences in Primary Substance of Abuse across Age Groups

April 16, 2014 Comments off

Gender Differences in Primary Substance of Abuse across Age Groups
Source: Substance Abuse and Mental Health Services Administration

+ In 2011, about 609,000 of the 1.84 million admissions to substance abuse treatment were female (33.1 percent), and 1.23 million were male (66.9 percent)
+ Compared with their male counterparts, a larger proportion of female admissions aged 12 to 17 reported alcohol as their primary substance of abuse (21.7 vs. 10.5 percent)
+ Marijuana as the primary substance of abuse was less common among female than male admissions aged 12 to 17 (60.8 vs. 80.7 percent) and 18 to 24 (22.1 vs. 33.4 percent)
+ Within the 65 or older age group, the proportion of female admissions reporting primary abuse of prescription pain relievers (e.g., oxycodone) was nearly 3 times that of their male counterparts (7.2 vs. 2.8 percent)

Daytime sleepiness: associations with alcohol use and sleep duration in americans

April 15, 2014 Comments off

Daytime sleepiness: associations with alcohol use and sleep duration in americans
Source: Sleep Disorders

The aim of the current analysis was to investigate the relationship of daytime sleepiness with alcohol consumption and sleep duration using a population sample of adult Americans. Data was analyzed from adult respondents of the National Health and Nutritional Examination Survey (NHANES) 2007-2008 (N = 2919) using self-reported variables for sleepiness, sleep duration, and alcohol consumption (quantity and frequency of alcohol use). A heavy drinking episode was defined as the consumption of ≥5 standard alcoholic beverages in a day. Logistic regression models adjusted for sociodemographic variables and insomnia covariates were used to evaluate the relationship between daytime sleepiness and an interaction of alcohol consumption variables with sleep duration. The results showed that daytime sleepiness was reported by 15.07% of the subjects. In univariate analyses adjusted for covariates, an increased probability of daytime sleepiness was predicted by decreased log drinks per day [OR = 0.74 (95% CI, 0.58–0.95)], a decreased log drinking frequency [0.90 (95% CI, 0.83–0.98)], and lower sleep duration [OR = 0.75 (95% CI, 0.67–0.84)]. An interaction between decreased sleep duration and an increased log heavy drinking frequency predicted increased daytime sleepiness (P = 0.004). Thus, the effect of sleep duration should be considered when evaluating the relationship between daytime sleepiness and heavy drinking.

Effect of Drinking on All-Cause Mortality in Women Compared with Men: A Meta-Analysis

April 11, 2014 Comments off

Effect of Drinking on All-Cause Mortality in Women Compared with Men: A Meta-Analysis
Source: Journal of Women’s Health

Background:
Alcoholic beverages are consumed by humans for a variety of dietary, recreational, and other reasons. It is uncertain whether the drinking effect on risk of all-cause mortality is different between women and men. We conducted a meta-analysis to evaluate the effect of drinking on the risk of all-cause mortality in women compared with men.

Methods:
We selected cohort studies with measures of relative risk (RR) and 95% confidence interval (CI) for all-cause mortality for drinkers versus nondrinkers by sex. Sex-specific RR and 95% CI were used to estimate the female-to-male ratio of RR (RRR) and 95% CI. Pooled estimates of RRR across studies were obtained by the fixed-effects model or the random-effects model (if heterogeneity was detected). Second-order fractional polynomials and random effects meta-regression models were used for modeling the dose-risk relationship.

Results:
Twenty-four studies were considered eligible. A total of 2,424,964 participants (male: 1,473,899; female: 951,065) were enrolled and 123,878 deaths (male: 76,362; female: 47,516) were observed. Compared with nondrinkers, the pooled female-to-male RRR for drinkers was 1.07 (95% CI: 1.02, 1.12). Subgroup analyses showed that the increased risk among female drinkers appeared to be consistent. J-shaped dose–response relationship was confirmed between alcohol and all-cause mortality in men and women, respectively. Moreover, the female-to-male RRR of all-cause mortality were 1.52 (95% CI: 1.01, 2.29), 1.95 (95% CI: 1.08, 3.49), and 2.36 (95% CI: 1.15, 4.88), respectively, for those who consumed 75, 90, and 100 g/day of alcohol.

Conclusions:
Females had an increased risk for all-cause mortality conferred by drinking compared with males, especially in heavy drinkers. The present study suggested that female drinkers, particularly heavy drinkers, should moderate or completely reduce their level of consumption to have a health benefit.

Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings

April 8, 2014 Comments off

Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings
Source: Cyberpsychology, Behavior, and Social Networking

Job applicants and incumbents often use social media for personal communications allowing for direct observation of their social communications “unfiltered” for employer consumption. As such, these data offer a glimpse of employees in settings free from the impression management pressures present during evaluations conducted for applicant screening and research purposes. This study investigated whether job applicants’ (N=175) personality characteristics are reflected in the content of their social media postings. Participant self-reported social media content related to (a) photos and text-based references to alcohol and drug use and (b) criticisms of superiors and peers (so-called “badmouthing” behavior) were compared to traditional personality assessments. Results indicated that extraverted candidates were prone to postings related to alcohol and drugs. Those low in agreeableness were particularly likely to engage in online badmouthing behaviors. Evidence concerning the relationships between conscientiousness and the outcomes of interest was mixed.

Web-Based Alcohol Screening and Brief Intervention for University Students: A Randomized Trial

March 27, 2014 Comments off

Web-Based Alcohol Screening and Brief Intervention for University Students: A Randomized Trial
Source: Journal of the American Medical Association

Importance
Unhealthy alcohol use is a leading contributor to the global burden of disease, particularly among young people. Systematic reviews suggest efficacy of web-based alcohol screening and brief intervention and call for effectiveness trials in settings where it could be sustainably delivered.

Objective
To evaluate a national web-based alcohol screening and brief intervention program.

Design, Setting, and Participants
A multisite, double-blind, parallel-group, individually randomized trial was conducted at 7 New Zealand universities. In April and May of 2010, invitations containing hyperlinks to the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screening test were e-mailed to 14 991 students aged 17 to 24 years.

Interventions
Participants who screened positive (AUDIT-C score ≥4) were randomized to undergo screening alone or to 10 minutes of assessment and feedback (including comparisons with medical guidelines and peer norms) on alcohol expenditure, peak blood alcohol concentration, alcohol dependence, and access to help and information.

Main Outcomes and Measures
A fully automated 5-month follow-up assessment was conducted that measured 6 primary outcomes: consumption per typical occasion, drinking frequency, volume of alcohol consumed, an academic problems score, and whether participants exceeded medical guidelines for acute harm (binge drinking) and chronic harm (heavy drinking). A Bonferroni-corrected significance threshold of .0083 was used to account for the 6 comparisons and a sensitivity analysis was used to assess possible attrition bias.

Results
Of 5135 students screened, 3422 scored 4 or greater and were randomized, and 83% were followed up. There was a significant effect on 1 of the 6 prespecified outcomes. Relative to control participants, those who received intervention consumed less alcohol per typical drinking occasion (median 4 drinks [interquartile range {IQR}, 2-8] vs 5 drinks [IQR 2-8]; rate ratio [RR], 0.93 [99.17% CI, 0.86-1.00]; P = .005) but not less often (RR, 0.95 [99.17% CI, 0.88-1.03]; P = .08) or less overall (RR, 0.95 [99.17% CI, 0.81-1.10]; P = .33). Academic problem scores were not lower (RR, 0.91 [99.17% CI, 0.76-1.08]; P = .14) and effects on the risks of binge drinking (odds ratio [OR], 0.84 [99.17% CI, 0.67-1.05]; P = .04) and heavy drinking (OR, 0.77 [99.17% CI, 0.56-1.05]; P = .03) were not significantly significant. In a sensitivity analysis accounting for attrition, the effect on alcohol per typical drinking occasion was no longer statistically significant.

Conclusions and Relevance
A national web-based alcohol screening and brief intervention program produced no significant reductions in the frequency or overall volume of drinking or academic problems. There remains a possibility of a small reduction in the amount of alcohol consumed per typical drinking occasion.

Alcohol-Attributable Deaths and Years of Potential Life Lost — 11 States, 2006–2010

March 24, 2014 Comments off

Alcohol-Attributable Deaths and Years of Potential Life Lost — 11 States, 2006–2010
Source: Morbidity and Mortality Weekly Report (CDC)

Excessive alcohol consumption, the fourth leading preventable cause of death in the United States (1), resulted in approximately 88,000 deaths and 2.5 million years of potential life lost (YPLL) annually during 2006–2010 and cost an estimated $223.5 billion in 2006 (2). To estimate state-specific average annual rates of alcohol-attributable deaths (AAD) and YPLL caused by excessive alcohol use, 11 states analyzed 2006–2010 data (the most recent data available) using the CDC Alcohol-Related Disease Impact (ARDI) application. The age-adjusted median AAD rate was 28.5 per 100,000 population (range = 50.9 per 100,000 in New Mexico to 22.4 per 100,000 in Utah). The median YPLL rate was 823 per 100,000 (range = 1,534 YPLL per 100,000 for New Mexico to 634 per 100,000 in Utah). The majority of AAD (median = 70%) and YPLL (median = 82%) were among working-age (20–64 years) adults. Routine monitoring of alcohol-attributable health outcomes, including deaths and YPLL, in states could support the planning and implementation of evidence-based prevention strategies recommended by the Community Preventive Services Task Force to reduce excessive drinking and related harms. Such strategies include increasing the price of alcohol, limiting alcohol outlet density, and holding alcohol retailers liable for harms related to the sale of alcoholic beverages to minors and intoxicated patrons (dram shop liability) (3).

Alcohol and mortality in Russia: prospective observational study of 151 000 adults

February 5, 2014 Comments off

Alcohol and mortality in Russia: prospective observational study of 151 000 adults
Source: The Lancet

Background
Russian adults have extraordinarily high rates of premature death. Retrospective enquiries to the families of about 50 000 deceased Russians had found excess vodka use among those dying from external causes (accident, suicide, violence) and eight particular disease groupings. We now seek prospective evidence of these associations.

Methods
In three Russian cities (Barnaul, Byisk, and Tomsk), we interviewed 200 000 adults during 1999—2008 (with 12 000 re-interviewed some years later) and followed them until 2010 for cause-specific mortality. In 151 000 with no previous disease and some follow-up at ages 35—74 years, Poisson regression (adjusted for age at risk, amount smoked, education, and city) was used to calculate the relative risks associating vodka consumption with mortality. We have combined these relative risks with age-specific death rates to get 20-year absolute risks.

Findings
Among 57 361 male smokers with no previous disease, the estimated 20-year risks of death at ages 35—54 years were 16% (95% CI 15—17) for those who reported consuming less than a bottle of vodka per week at baseline, 20% (18—22) for those consuming 1—2·9 bottles per week, and 35% (31—39) for those consuming three or more bottles per week; trend p<0·0001. The corresponding risks of death at ages 55—74 years were 50% (48—52) for those who reported consuming less than a bottle of vodka per week at baseline, 54% (51—57) for those consuming 1—2·9 bottles per week, and 64% (59—69) for those consuming three or more bottles per week; trend p<0·0001. In both age ranges most of the excess mortality in heavier drinkers was from external causes or the eight disease groupings strongly associated with alcohol in the retrospective enquiries. Self-reported drinking fluctuated; of the men who reported drinking three or more bottles of vodka per week who were reinterviewed a few years later, about half (185 of 321) then reported drinking less than one bottle per week. Such fluctuations must have substantially attenuated the apparent hazards of heavy drinking in this study, yet self-reported vodka use at baseline still strongly predicted risk. Among male non-smokers and among females, self-reported heavy drinking was uncommon, but seemed to involve similar absolute excess risks.

Interpretation
This large prospective study strongly reinforces other evidence that vodka is a major cause of the high risk of premature death in Russian adults.

Free registration required for full text.

Does legislation to prevent alcohol sales to drunk individuals work? Measuring the propensity for night-time sales to drunks in a UK city

January 24, 2014 Comments off

Does legislation to prevent alcohol sales to drunk individuals work? Measuring the propensity for night-time sales to drunks in a UK city
Source: Journal of Epidemiology & Community Health

Background
By measuring alcohol retailers’ propensity to illegally sell alcohol to young people who appear highly intoxicated, we examine whether UK legislation is effective at preventing health harms resulting from drunk individuals continuing to access alcohol.

Methods
73 randomly selected pubs, bars and nightclubs in a city in North West England were subjected to an alcohol purchase test by pseudo-drunk actors. Observers recorded venue characteristics to identify poorly managed and problematic (PMP) bars.

Results
83.6% of purchase attempts resulted in a sale of alcohol to a pseudo-intoxicated actor. Alcohol sales increased with the number of PMP markers bars had, yet even in those with no markers, 66.7% of purchase attempts resulted in a sale. Bar servers often recognised signs of drunkenness in actors, but still served them. In 18% of alcohol sales, servers attempted to up-sell by suggesting actors purchase double rather than single vodkas.

Conclusions
UK law preventing sales of alcohol to drunks is routinely broken in nightlife environments, yet prosecutions are rare. Nightlife drunkenness places enormous burdens on health and health services. Preventing alcohol sales to drunks should be a public health priority, while policy failures on issues, such as alcohol pricing, are revisited.

Vital Signs: Communication Between Health Professionals and Their Patients About Alcohol Use — 44 States and the District of Columbia, 2011

January 22, 2014 Comments off

Vital Signs: Communication Between Health Professionals and Their Patients About Alcohol Use — 44 States and the District of Columbia, 2011
Source: Morbidity and Mortality Weekly Report (CDC)

Introduction:
Excessive alcohol use accounted for an estimated 88,000 deaths in the United States each year during 2006–2010, and $224 billion in economic costs in 2006. Since 2004, the U.S. Preventive Services Task Force (USPSTF) has recommended alcohol misuse screening and behavioral counseling (also known as alcohol screening and brief intervention [ASBI]) for adults to address excessive alcohol use; however, little is known about the prevalence of its implementation. ASBI will also be covered by many health insurance plans because of the Affordable Care Act.

Methods:
CDC analyzed Behavioral Risk Factor Surveillance System (BRFSS) data from a question added to surveys in 44 states and the District of Columbia (DC) from August 1 to December 31, 2011, about patient-reported communication with a health professional about alcohol. Elements of ASBI are traditionally delivered via conversation. Weighted state-level prevalence estimates of this communication were generated for 166,753 U.S. adults aged ≥18 years by selected demographic characteristics and drinking behaviors.

Results:
The prevalence of ever discussing alcohol use with a health professional was 15.7% among U.S. adults overall, 17.4% among current drinkers, and 25.4% among binge drinkers. It was most prevalent among those aged 18–24 years (27.9%). However, only 13.4% of binge drinkers reported discussing alcohol use with a health professional in the past year, and only 34.9% of those who reported binge drinking ≥10 times in the past month had ever discussed alcohol with a health professional. State-level estimates of communication about alcohol ranged from 8.7% in Kansas to 25.5% in DC.

Conclusions:
Only one of six U.S. adults, including binge drinkers, reported ever discussing alcohol consumption with a health professional, despite public health efforts to increase ASBI implementation.

Implications for Public Health Practice:
Increased implementation of ASBI, including systems-level changes such as integration into electronic health records processes, might reduce excessive alcohol consumption and the harms related to it. Routine surveillance of ASBI by states and communities might support monitoring and increasing its implementation.

Status report on alcohol and health in 35 European countries 2013

October 15, 2013 Comments off

Status report on alcohol and health in 35 European countries 2013
Source: World Health Organization

People in the WHO European Region consume the most alcohol per head in the world. In the European Union (EU), alcohol accounts for about 120 000 premature deaths per year: 1 in 7 in men and 1 in 13 in women. Most countries in the Region have adopted policies, strategies and plans to reduce alcohol-related harm. In 2012, the WHO Regional Office for Europe collected information on alcohol consumption and related harm, and countries policy responses to contribute to the Global Information System for Alcohol and Health; this report presented a selection of the results for 35 countries – EU Member States and candidate countries, Norway and Switzerland – individually and in groups distinguished by their drinking patterns and traditions.

The WHO Regional Office for Europe is grateful to the Ministry of Social Affairs and Health, Finland, for financial support in the production of this report. This report has received funding from the European Union (EU) in the frame of the EU’s Health Programme 2008-2013.

Drinking games as a venue for sexual competition

October 10, 2013 Comments off

Drinking games as a venue for sexual competition
Source: Evolutionary Psychology

Based on sexual selection theory, we hypothesized that sex differences in mating effort and social competitiveness—and subsequent sex differences in sexual and competitive motivations for participating in drinking games—are responsible for the well-documented sex differences in college students’ drinking game behaviors. Participants in a cross-sectional study were 351 women and 336 men aged 17 to 26. In a mediation model, we tested sex differences in mating effort, social competitiveness, sexual and competitive motivations for participating in drinking games, drinking game behaviors, and alcohol-related problems. Men participated in drinking games more frequently, consumed more alcohol while participating in drinking games, and experienced more problems associated with drinking. These sex differences appeared to be partially mediated by mating effort, social competitiveness, and sexual and competitive motivations for participating in drinking games. Drinking games are a major venue in which college students engage in heavy episodic drinking, which is a risk factor for college students’ behavioral and health problems. Thus, the functional perspective we used to analyze them here may help to inform public health and university interventions and enable better identification of at-risk students.

Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings

October 10, 2013 Comments off

Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings
Source: Cyberpsychology, Behavior, and Social Networking

Job applicants and incumbents often use social media for personal communications allowing for direct observation of their social communications “unfiltered” for employer consumption. As such, these data offer a glimpse of employees in settings free from the impression management pressures present during evaluations conducted for applicant screening and research purposes. This study investigated whether job applicants’ (N=175) personality characteristics are reflected in the content of their social media postings. Participant self-reported social media content related to (a) photos and text-based references to alcohol and drug use and (b) criticisms of superiors and peers (so-called “badmouthing” behavior) were compared to traditional personality assessments. Results indicated that extraverted candidates were prone to postings related to alcohol and drugs. Those low in agreeableness were particularly likely to engage in online badmouthing behaviors. Evidence concerning the relationships between conscientiousness and the outcomes of interest was mixed.

Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings and Detailed Tables

September 16, 2013 Comments off

Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings and Detailed Tables
Source: Substance Abuse and Mental Health Services Administration

This report and the detailed tables present a first look at results from the 2012 National Survey on Drug Use and Health (NSDUH), an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years old or older. Both the report and detailed tables present national estimates of rates of use, numbers of users, and other measures related to illicit drugs, alcohol, and tobacco products, with a focus on trends between 2011 and 2012 and from 2002 to 2012, as well as differences across population subgroups in 2012. NSDUH national estimates related to mental health and NSDUH State-level estimates related to both substance use and mental health will be published in separate releases in the fall of 2013.

Reaching Zero: Actions to Eliminate Alcohol-Impaired Driving

September 12, 2013 Comments off

Reaching Zero: Actions to Eliminate Alcohol-Impaired Driving (PDF)
Source: National Transportation Safety Board

This safety report represents the culmination of a year-long National Transportation Safety Board (NTSB) effort focused on the problem of substance-impaired driving. The report addresses the necessity of providing all the following elements to achieve meaningful reductions in alcohol-impaired driving crashes: stronger laws, improved enforcement strategies, innovative adjudication programs, and accelerated development of new in-vehicle alcohol detection technologies. Moreover, the report recognizes the need for states to identify specific and measurable goals for reducing impaired driving fatal ities and injuries, and to evaluate the effectiveness of implemented countermeasures on an ongoing basis.

Specifically, in the report, the NTSB makes safety recommendations in the following safety issue areas: reducing the per se blood alcohol concentration limit for all drivers; conducting high – visibility enforcement of impaired driving laws and incorporating passive alcohol sensing technology into enforcement efforts; expanding the use of in-vehicle devices to prevent operation by an impaired driver; using driving while intoxicated (DWI) courts and other programs to reduce recidivism by repeat DWI offenders; and establishing measurable goals for reducing impaired driving and tracking progress toward those goals.

Nearly 18 percent of pregnant women drink alcohol in early stages of pregnancy

September 9, 2013 Comments off

Nearly 18 percent of pregnant women drink alcohol in early stages of pregnancy
Source: Substance Abuse and Mental Health Services Administration

Approximately 18 percent of women in their first trimester of pregnancy used alcohol within the past month according to a new report by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report showed that 6.6 percent of women in their first trimester of pregnancy engaged in binge drinking (i.e., drinking five or more drinks on the same occasion at least once in the past 30 days).

Women who drink alcohol while pregnant increase their infants’ risk of developing a Fetal Alcohol Spectrum Disorder (FASD), a group of conditions that can cause physical, behavioral and learning problems – some of which may have lifelong repercussions. Although there is no safe amount of alcohol for pregnant women to drink, they can lower the risk for their infants when they stop drinking alcohol immediately after finding out they are pregnant.

The report indicates that the level of alcohol use dropped sharply among pregnant woman in their second and third trimesters. The rate of past month alcohol use (i.e., at least one drink in the past 30 days) for women in the second trimester of pregnancy fell to 4.2 percent and among women in the third trimester dipped to 3.7 percent. By comparison, 55.5 percent of non-pregnant women aged 15 to 44 consumed alcohol in the past month.

Alcohol Intake Between Menarche and First Pregnancy: A Prospective Study of Breast Cancer Risk

August 29, 2013 Comments off

Alcohol Intake Between Menarche and First Pregnancy: A Prospective Study of Breast Cancer Risk
Source: Journal of the National Cancer Institute

Background
Adult alcohol consumption during the previous year is related to breast cancer risk. Breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. No study has characterized the contribution of alcohol consumption during this interval to risks of proliferative benign breast disease (BBD) and breast cancer.

Methods
We used data from 91005 parous women in the Nurses’ Health Study II who had no cancer history, completed questions on early alcohol consumption in 1989, and were followed through June 30, 2009, to analyze breast cancer risk. A subset of 60093 women who had no history of BBD or cancer in 1991 and were followed through June 30, 2001, were included in the analysis of proliferative BBD. Relative risks (RRs) were estimated using Cox proportional hazard regression.

Results
We identified 1609 breast cancer cases and 970 proliferative BBD cases confirmed by central histology review. Alcohol consumption between menarche and first pregnancy, adjusted for drinking after first pregnancy, was associated with risks of breast cancer (RR = 1.11 per 10g/day intake; 95% confidence interval [CI] = 1.00 to 1.23) and proliferative BBD (RR = 1.16 per 10g/day intake; 95% CI = 1.02 to 1.32). Drinking after first pregnancy had a similar risk for breast cancer (RR = 1.09 per 10g/day intake; 95% CI = 0.96 to 1.23) but not for BBD. The association between drinking before first pregnancy and breast neoplasia appeared to be stronger with longer menarche to first pregnancy intervals.

Conclusions
Alcohol consumption before first pregnancy was consistently associated with increased risks of proliferative BBD and breast cancer.

Alcohol is considered by the International Agency for Research on Cancer to be causally related to invasive breast cancer (hereafter called “breast cancer”) (1), with a 7% to 10% increase in risk for each 10g alcohol consumed daily by adult women (2–4). One mechanism may be alcohol-induced increases in circulating estrogens and subsequently epithelial cell proliferation (3). However, the risk attributable to alcohol intake during adolescence and early adulthood remains inconclusive (2,5–12).

Younger age at menarche and older age at first full-term pregnancy (hereafter called “pregnancy”) are associated with increased risk for breast cancer (13–15). Breast tissue undergoes rapid cellular proliferation between these reproductive events, and risk accumulates most rapidly until the terminal differentiation that accompanies first pregnancy. First pregnancy has both a short-term adverse effect on risk and a long-term reduction in subsequent risk accumulation (16). The longer the interval between menarche and first pregnancy the greater is a woman’s breast cancer risk (14,15,17). Therefore, menarche to first pregnancy represents a window of time when breast tissue is particularly vulnerable to carcinogenic stimuli (18). Alcohol consumption in late adolescence and early adulthood is associated with increased risk of proliferative benign breast disease (BBD), a known risk marker for breast cancer (19,20).

We therefore hypothesized that alcohol consumed before first pregnancy is associated with risks of both proliferative BBD and breast cancer, independent of drinking after first pregnancy. Such an association may be stronger when the menarche to first pregnancy interval is longer.

State Costs of Excessive Alcohol Consumption, 2006

August 14, 2013 Comments off

State Costs of Excessive Alcohol Consumption, 2006 (PDF)
Source: American Journal of Preventive Medicine

Background:
Excessive alcohol consumption is responsible for an average of 80,000 deaths in the U.S. each year and cost $223.5 billion ($1.90/drink) in 2006. Comparable state estimates of this cost are needed to help inform prevention strategies.

Purpose:
The goal of the study was to estimate the economic cost of excessive drinking by state for 2006.

Methods:
From December 2011 to November 2012, an expert panel developed methods to allocate component costs from the 2006 national estimate to states for (1) total; (2) government; (3) binge drinking; and (4) underage drinking costs. Differences in average state wages were used to adjust productivity losses.

Results:
In 2006, the median state cost of excessive drinking was $2.9 billion (range: $31.9 billion [California] to $419.6 million [North Dakota]); the median cost per drink, $1.91 (range: $2.74 [Utah] to $0.88 [New Hampshire]); and the median per capita cost, $703 (range: $1662 [District of Columbia] to $578 [Utah]). A median of 42% of state costs were paid by government (range: 45.0% [Utah] to 37.0% [Mississippi]). Binge drinking was responsible for a median of 76.6% of state costs (range: 83.1% [Louisiana] to 71.6% [Massachusetts]); underage drinking, a median of 11.2% of state costs (range: 20.0% [Wyoming] to 5.5% [District of Columbia]).

Conclusions:
Excessive drinking cost states a median of $2.9 billion in 2006. Most of the costs were due to binge drinking and about $2 of every $5 were paid by government. The Guide to Community Preventive Services has recommended several evidence-based strategies — including increasing alcohol excise taxes, limiting alcohol outlet density, and commercial host liability — that can help reduce excessive alcohol use and the associated economic costs.

Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse

August 8, 2013 Comments off

Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse
Source: U.S. Preventive Services Task

The USPSTF recommends that clinicians screen adults aged 18 years or older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening and behavioral counseling interventions in primary care settings to reduce alcohol misuse in adolescents.

Fewer States Holding Alcohol Retailers Responsible for Harms from Illegal Service

July 30, 2013 Comments off

Fewer States Holding Alcohol Retailers Responsible for Harms from Illegal Service
Source: Johns Hopkins Bloomberg School of Public Health

Fewer states are holding alcohol retailers liable for harms caused by customers who were served illegally, according to a new report from researchers at Alcohol Policy Consultations and the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health. Published online by the American Journal of Preventive Medicine, the legal research study documents the gradual erosion of commercial host liability (also referred to as dram shop liability) from 1989 to 2011.

Commercial host liability holds alcohol retailers liable for alcohol-attributable harms resulting from illegal alcohol sales to patrons who are intoxicated or underage at the time of service. It applies to both on-premise (bars, restaurants and clubs) and off-premise locations. The Community Preventive Services Task Force recently determined that commercial host liability was effective in reducing a range of harms from alcohol in states that have it, including a median six percent drop in alcohol-related motor vehicle crash deaths.

The report found that in recent years many states enacted legislation to protect retailers from commercial host liability by increasing the evidentiary requirements, limiting the amount of liability awards and/or protecting certain retailers from liability. For example, between 1989 and 2011, the number of states that recognized liability for serving intoxicated adults without restrictions declined from 25 to 21, and states with one of these major restrictions increased from 11 to 16. Maps illustrating the erosion of these laws can be accessed at the CAMY website at http://www.camy.org/action/commercial-host-liability/.

Follow

Get every new post delivered to your Inbox.

Join 773 other followers