08 April 2015 In Social and Cultural Aspects

OBJECTIVES: This study investigated the unique associations between electronic media communication (EMC) with friends and adolescent substance use (tobacco, alcohol, and cannabis), over and beyond the associations of face-to-face (FTF) interactions with friends and the average level of classroom substance use.

METHODS: Drawn from the cross-national 2009/2010 Health Behaviour in School-aged Children (HBSC) study in The Netherlands, 5,642 Dutch adolescents (M age = 14.29) reported on their substance use, EMC, and FTF interactions. Two-level multilevel analyses (participants nested within classrooms) were run.

RESULTS: Electronic media communication was positively associated with adolescent substance use, though significantly more strongly with alcohol (beta = 0.15, SE beta = 0.02) than with tobacco (beta = 0.05, SE beta = 0.02, t (5,180) = 3.33, p < 0.001) or cannabis use (beta = 0.06, SE beta = 0.02, t (5,160) = 2.79, p < 0.01). Further, EMC strengthened several positive associations of FTF interactions and average classroom substance use with adolescent substance use.

CONCLUSIONS: Electronic media communication was uniquely associated with substance use, predominantly with alcohol use. Thus, adolescents' EMC and other online behaviors should not be left unnoticed in substance use research and prevention programs.

08 April 2015 In Drinking & Eating Patterns

BACKGROUND: Preventive interventions for adolescents are an important priority within school systems. Several interventions have been developed, but the effectiveness of such interventions varies considerably between studies. The purpose of this study was to assess the effectiveness of universal school-based prevention programs on alcohol use among adolescents by using meta-analytic techniques.

METHOD: A systematic literature search in the databases, PubMed (Medline), PsycINFO (Ovid), EMBASE (Ovid) and WEB of Science (ISI) was conducted to search for empirical articles published in the period January 1990 to August 2014.

RESULTS: In total, 28 randomized controlled studies with 39,289 participants at baseline were included. Of these 28 articles, 12 studies (N = 16279) reported continuous outcomes (frequency of alcohol use and quantity of alcohol use), and 16 studies (N = 23010) reported categorical data (proportion of students who drank alcohol). The results of the random effects analyses showed that the overall effect size among studies reporting continuous outcomes was small and demonstrated a favorable effect from the preventive interventions (Hedges' g = 0.22, p < .01). The effect size among studies reporting categorical outcomes was not significant (OR = 0.94, p = .25). The level of heterogeneity between studies was found to be significant in most analyses. Moderator analyses conducted to explore the heterogeneity showed neither significant difference between the different school levels (junior high schools and high schools), nor between the varied program intensities (low, medium and high intensity programs). The meta-regression analyses examining continuous moderators showed no significant effects for age or gender.

CONCLUSIONS: The findings from this meta-analysis showed that, overall, the effects of school-based preventive alcohol interventions on adolescent alcohol use were small but positive among studies reporting the continuous measures, whereas no effect was found among studies reporting the categorical outcomes. Possible population health outcomes, with recommendations for policy and practice, are discussed further in this paper.

05 March 2015 In Drinking & Eating Patterns

BACKGROUND: Ex-drinkers suffer from worse health than drinkers; however, whether a worsening of health is associated with a change in drinking status from early adulthood has not been previously investigated. We assess whether a worsening of health is associated with a cessation in consumption or reduction to special occasion drinking from early adulthood to middle age.

METHODS: Multinomial logistic regression assessing whether a change in self-reported limiting longstanding illness (LLI) was associated with ceasing alcohol consumption, or a reduction to special occasion drinking compared with being a persistent drinker from age 23 in separate models at ages 33, 42, and 50. All models adjusted for sex, poor psychosocial health, education, marital status, and children in the household. Sample included participants from Great Britain followed longitudinally in the National Child Development Study from ages 23 to 33 (N = 5,529), 42 (N = 4,787), and 50 (N = 4,476).

RESULTS: Developing an LLI from the previous wave was associated with ceasing alcohol consumption at ages 33 (odds ratio [ORs] = 2.71, 95% confidence interval [CI] = 1.16-4.93), 42 (OR = 2.44, 95%CI = 1.24-4.81), and 50 (OR = 3.33, 95%CI = 1.56-7.12) and a reduction to special occasion drinking at ages 42 (OR = 2.04, 95%CI = 1.40-2.99) and 50 (OR = 2.04, 95%CI = 1.18-3.53). Having a persistent LLI across 2 waves increased the odds of ceasing consumption at ages 42 (OR = 3.22, 95%CI = 1.06-9.77) and 50 (OR = 4.03, 95%CI = 1.72-9.44) and reducing consumption to special occasion drinking at ages 33 (OR = 3.27, 95%CI = 1.34-8.01) and 42 (OR = 2.25, 95%CI = 1.23-4.50). Persistent drinkers at older ages had the best overall health suffering less from previous poor health compared with those who reduced or ceased consumption at an earlier time point.

CONCLUSIONS: Developing an LLI was associated with a cessation in alcohol consumption and a reduction in consumption to special occasion drinking from early adulthood. Persistent drinkers who drank at least till 50 were the healthiest overall. Health selection is likely to influence nondrinking across the life course.

23 January 2015 In Drinking & Eating Patterns

The study identifies changes in selected ("unplanned") socio-demographic and economic factors as well as in (planned) political measures that are most strongly correlated with changes in alcohol consumption and alcohol consumption-related harm between 1961 and 2006 in Austria. During the period of investigation consumption increased until the early 1970s, dropped during the next decade and have leveled off since. Increasing urbanization, female employment and average age of mothers at their child births are associated with the best time series model for the interpretation of consumption changes. The results regarding alcohol control policies and their impact on consumption were paradoxical. Study limitations were noted pointing up the necessity to improve indicators and concepts.

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