26 March 2015 In Social and Cultural Aspects

BACKGROUND: Different drinkers may experience specific risks depending on where they consume alcohol. This longitudinal study examined drinking patterns, and demographic and psychosocial characteristics associated with youth drinking in different contexts.

METHODS: We used survey data from 665 past-year alcohol-using youths (ages 13 to 16 at Wave 1) in 50 midsized California cities. Measures of drinking behaviors and drinking in 7 contexts were obtained at 3 annual time points. Other characteristics included gender, age, race, parental education, weekly disposable income, general deviance, and past-year cigarette smoking.

RESULTS: Results of multilevel regression analyses show that more frequent past-year alcohol use was associated with an increased likelihood of drinking at parties and at someone else's home. Greater continued volumes of alcohol (i.e., heavier drinking) was associated with increased likelihood of drinking at parking lots or street corners. Deviance was positively associated with drinking in most contexts, and past-year cigarette smoking was positively associated with drinking at beaches or parks and someone else's home. Age and deviance were positively associated with drinking in a greater number of contexts. The likelihood of youth drinking at parties and someone else's home increased over time, whereas the likelihood of drinking at parking lots/street corners decreased. Also, deviant youths progress to drinking in their own home, beaches or parks, and restaurants/bars/nightclubs more rapidly.

CONCLUSIONS: The contexts in which youths consume alcohol change over time. These changes vary by individual characteristics. The redistribution of drinking contexts over the early life course may contribute to specific risks associated with different drinking contexts.

05 March 2015 In Drinking & Eating Patterns

BACKGROUND AND PURPOSE: Although alcohol-stroke association is well known, the age-varying effect of alcohol drinking at midlife on subsequent stroke risk across older adulthood has not been examined. The effect of genetic/early-life factors is also unknown. We used cohort and twin analyses of data with 43 years of follow-up for stroke incidence to help address these gaps.

METHODS: All 11 644 members of the population-based Swedish Twin Registry born 1886 to 1925 with alcohol data aged 2 drinks/d) had greater risk of stroke (hazard ratio, 1.34; P=0.02) and the effect for nondrinkers approached significance (hazard ratio, 1.11; P=0.08). Age increased stroke risk for nondrinkers (P=0.012) and decreased it for heavy drinkers (P=0.040). Midlife heavy drinkers were at high risk from baseline until the age of 75 years when hypertension and diabetes mellitus grew to being the more relevant risk factors. In analyses of monozygotic twin-pairs, heavy drinking shortened time to stroke by 5 years (P=0.04).

CONCLUSIONS: Stroke-risk associated with heavy drinking (>2 drinks/d) in midlife seems to predominate over well-known risk factors, hypertension and diabetes, until the age of approximately 75 years and may shorten time to stroke by 5 years above and beyond covariates and genetic/early-life factors. Alcohol consumption should be considered an age-varying risk factor for stroke.

23 January 2015 In Drinking & Eating Patterns

OBJECTIVE: The purpose of this study was to examine the relations between drinking (mean quantity and heavy drinking patterns) and alcohol use disorders (AUDs) in the U.S. general population.

METHOD: Data from three telephone National Alcohol Surveys (in 2000, 2005, and 2010) were pooled, with separate analyses for men and women restricted to current drinkers (ns = 5,922 men, 6,270 women). Predictors were 12-month volume (mean drinks per day), rates of heavy drinking (5+/4+ drinks in a day for men/women), and very heavy drinking (8+, 12+, and 24+ drinks in a day). Outcomes were negative alcohol-related consequences constituting abuse (1+ of 4 DSM-IV-based domains assessed by 13 items) and alcohol dependence (symptoms in 3+ of 7 DSM-IV-based domains), together taken to indicate an AUD. Segmentation analyses were used to model risks of problem outcomes from drinking patterns separately by gender.

RESULTS: In the general population, men and women who consumed </=1 drink/day on average with no heavy drinking days did not incur substantial risks of an AUD (<10%). Men who drank from 1 to 2 drinks/day on average but never 5+ incurred a 16% risk of reporting an AUD (3.5% alcohol dependence). At higher volumes, men and women who indicated higher rates of drinking larger amounts per day and/or involving 8+ and 12+ drinks/day (and even 24+ drinks/day for men) showed much higher risks of experiencing AUDs.

CONCLUSIONS: The findings provide quantitative guidance for primary care practitioners who wish to make population-based recommendations to patients who might benefit by reducing both overall intake and amounts per occasion in an effort to lower their risks of developing AUDs.

23 January 2015 In Cancer

OBJECTIVES: Results from studies examining the association between alcohol consumption and the risk of Barrett's esophagus have been inconsistent. We assessed the risk of Barrett's esophagus associated with total and beverage-specific alcohol consumption by pooling individual participant data from five case-control studies participating in the international Barrett's and Esophageal Adenocarcinoma Consortium.

METHODS: For analysis, there were 1,282 population-based controls, 1,418 controls with gastroesophageal reflux disease (GERD), and 1,169 patients with Barrett's esophagus (cases). We estimated study-specific odds ratios (ORs) and 95% confidence intervals (95% CI) using multivariable logistic regression models adjusted for age, sex, body mass index (BMI), education, smoking status, and GERD symptoms. Summary risk estimates were obtained by random-effects models. We also examined potential effect modification by sex, BMI, GERD symptoms, and cigarette smoking.

RESULTS: For comparisons with population-based controls, although there was a borderline statistically significant inverse association between any alcohol consumption and the risk of Barrett's esophagus (any vs. none, summary OR=0.77, 95% CI=0.60-1.00), risk did not decrease in a dose-response manner (Ptrend=0.72). Among alcohol types, wine was associated with a moderately reduced risk of Barrett's esophagus (any vs. none, OR=0.71, 95% CI=0.52-0.98); however, there was no consistent dose-response relationship (Ptrend=0.21). We found no association with alcohol consumption when cases were compared with GERD controls. Similar associations were observed across all strata of BMI, GERD symptoms, and cigarette smoking.

CONCLUSIONS: Consistent with findings for esophageal adenocarcinoma, we found no evidence that alcohol consumption increases the risk of Barrett's esophagus.

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