15 December 2016 In Drinking & Eating Patterns

PURPOSE: We seek answers to three questions about adolescent risk of starting to drink alcoholic beverages: (1) in new United States (US) data, can we reproduce a recently discovered female excess risk? (2) has a female excess risk emerged in European countries? and (3) might the size of country-level female-male differences (FMD) be influenced by macro-level gender equality and development processes?

METHODS: Estimates are from US and European surveys of adolescents, 2010-2014. For US estimates, newly incident drinking refers to consuming the first full drink during the 12-month interval just prior to assessment. For all countries, lifetime cumulative incidence of drinking refers to any drinking before assessment of the sampled 15-16 years.

RESULTS: Cumulative meta-analysis summary estimates from the US show a highly reproducible female excess in newly incident drinking among 12-17 years (final estimated female-male difference in risk, FMD = 2.1%; 95% confidence interval = 1.5%, 2.7%). Several European countries show female excess risk, estimated as lifetime cumulative incidence of drinking onsets before age 17 years. At the country level, the observed magnitude of FMD in risk is positively associated with the Gender Development Index (especially facets related to education and life expectancy of females relative to males), and with residence in a higher income European country.

CONCLUSIONS: New FMD estimates support reproducibility of a female excess risk in the US. In Europe, evidence of a female excess is modest. Educational attainment, life expectancies, and income merit attention in future FMD research on suspected macro-level processes that influence drinking onsets.

15 December 2016 In Drinking & Eating Patterns

AIM: To systematically review evidence on the influence of specific marketing components (Price, Promotion, Product attributes and Place of sale/availability) on key drinking outcomes (initiation, continuation, frequency and intensity) in young people aged 9-17.

METHODS: MEDLINE, EMBASE, SCOPUS, PsychINFO, CINAHL and ProQuest were searched from inception to July 2015, supplemented with searches of Google Scholar, hand searches of key journals and backward and forward citation searches of reference lists of identified papers.

RESULTS: Forty-eight papers covering 35 unique studies met inclusion criteria. Authors tended to report that greater exposure to alcohol marketing impacted on drinking initiation, continuation, frequency and intensity during adolescence. Nevertheless, 23 (66%) studies reported null results or negative associations, often in combination with positive associations, resulting in mixed findings within and across studies. Heterogeneity in study design, content and outcomes prevented estimation of effect sizes or exploration of variation between countries or age subgroups. The strength of the evidence base differed according to type of marketing exposure and drinking outcome studied, with support for an association between alcohol promotion (mainly advertising) and drinking outcomes in adolescence, whilst only two studies examined the relationship between alcohol price and the drinking behaviour of those under the age of 18.

CONCLUSION: Despite the volume of work, evidence is inconclusive in all four areas of marketing but strongest for promotional activity. Future research with standardized measures is needed to build on this work and better inform interventions and policy responses.

21 September 2016 In General Health

Although excessive alcohol use and alcohol misuse contribute to a broad range of health problems, recent research indicates that moderate alcohol consumption may in fact be beneficial. The present study builds on previous research to investigate the associations between alcohol use and self-rated health status among young adults. Using data collected in 2008 from the National Longitudinal Survey of Adolescent to Adult Health (Add Health), we use ordered probit models to determine whether the protective effects of moderate alcohol use are present after controlling for demographic, lifestyle, family background, and health-related characteristics. Our findings generally support earlier research with older samples, but some key gender differences are present. For women (n = 8275), moderate drinkers have better self-rated health status relative to former drinkers, infrequent drinkers, and light drinkers. Among men (n = 7207), the effects are mixed and less often significant. Differences in results between men and women point to the need for further gender-specific research and studies with other measures of health.

21 September 2016 In Drinking & Eating Patterns

AIMS: Unlike adults, abstaining has increased and regular use of alcohol has decreased among 12-16-year-olds over the past two decades. The paper studies whether these developments will be continued as the adolescent cohorts come of age.

METHODS: The Adolescent Health and Lifestyle Survey is a nationally representative monitoring system of the health habits of 12-, 14-, 16-, and 18-year-old Finns, conducted biannually between 1981 and 2013. The prevalence of alcohol use and drunkenness were measured for each 5-year cohort born in 1967-1995. Age-by-cohort trajectories and hierarchical age-period-cohort (APC) modeling were used to assess effects of age, period, and birth cohort.

RESULTS: Cohorts differentiate for underage drinking, but not at the age of 18. The younger cohorts postpone their drinking debut compared with older cohorts and thus age profiles are steeper than before. The most recent cohorts born in the 1990s, and the oldest cohorts born in 1967-71, have the highest prevalence in abstinence but drinking has been more prevalent for cohorts born in 1973-1989. APC modeling confirms significant cohort effects, but no significant decrease in drinking or drunkenness at the age of 18 years. Some of the changes can also be attributed to period effects.

CONCLUSIONS: Despite the decrease in underage drinking in Finland, 18-year-olds continue to drink similarly from cohort to another postponing the onset of drinking has a preventive effect on alcohol-related harms, but a reduction in drinking among adult cohorts is not evident in the future.

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