The importance of drinking frequency in evaluating individuals' drinking patterns: implications for the development of national drinking guidelines

Aims   This paper examines the relationship between frequency of drinking, usual daily consumption and frequency of binge drinking, taking into consideration possible age and gender differences.
Participants and design   Subjects were 10 466 current drinkers (5743 women and 4723 men) aged between 18 and 76 years, who participated in the GENACIS Canada (GENder Alcohol and Culture: an International Study) study.
Setting   Canada.
Measurements   The independent variable was the annual drinking frequency. The dependent variables were the usual daily quantity consumed, annual, monthly and weekly frequency of binge drinking (five drinks or more on one occasion).
Findings   Logistic regressions show (i) that those who drink less than once a week are less likely than weekly drinkers to take more than two drinks when they do drink; (ii) that the usual daily quantity consumed by weekly drinkers is not related to their frequency of drinking; but that (iii) the risk and frequency of binge drinking increase with the frequency of drinking.
Conclusions   Given that risk and frequency of binge drinking among Canadians increases with their frequency of drinking, any public recommendation to drink moderately should be made with great caution.     

Alcohol drinking pattern and non-fatal myocardial infarction in women

AIMS: Evidence continues to emerge indicating the pattern of alcohol consumption has important implications for cardiovascular disease (CVD) risk, although the majority of studies have focused on men. The aim of the study is to examine the association between alcohol volume and various drinking patterns and non-fatal myocardial infarction (MI) in women aged 35-69 years. DESIGN AND SETTING: Population-based case-control study, 1996-2001. PARTICIPANTS: Incident MI cases (n = 320) recruited from Western NY hospitals, controls (n = 1565) identified from motor vehicle rolls and Health Care Financing Administration (HCFA) files. MEASUREMENTS: Incident MI, volume and drinking patterns for the 12-24 months prior to interview (controls) or MI (cases) were assessed in detail. FINDINGS: Of cases and controls, 13% were life-time abstainers; current drinkers averaged 2.3 +/- 2.2 drinks/drinking day. Compared to life-time abstainers, current drinkers tended to have a reduced likelihood of MI [odds ratio (OR), 0.67; 95% confidence interval (CI), 0.43-1.03]. Volume, drinks/drinking day and frequency were associated inversely with MI risk (P trends < 0.001). Wine drinkers (OR, 0.56; 95% CI, 0.33-0.96) and consumers of mixed beverage types (OR, 0.56, 0.31-1.01) had lower odds of MI compared to abstainers. Among current drinkers, for volume and most patterns, similar but somewhat weaker associations were noted than when abstainers were the reference. In contrast, frequency of intoxication at least once/month or more was associated with a strong increased risk compared to abstention (OR, 2.90; 95% CI 1.01-8.29) or in current drinkers, never drinking to this extent (OR, 6.22; 95% CI 2.07-18.69). CONCLUSION: In this population of light to moderate drinkers, alcohol consumption in general was associated with decreased MI risk in women; however, episodic intoxication was related to a substantial increase in risk.     

Alcohol drinking pattern and subjective health in a population-based study

AIMS: Some patterns of alcohol consumption (e.g. binge drinking, drinking outside of meals) have been associated with detrimental effects on health outcomes. Subjective health provides a global assessment of health status and is a strong predictor of total mortality; however, little is known about its relationship with alcohol drinking pattern. The association between several drinking patterns (i.e. drinking intensity and frequency, frequency of intoxication, drinking outside of meals, and beverage type) and subjective health was examined in a random sample of 3586 women and men. DESIGN: A population-based cross-sectional study. METHODS: Subjective health was assessed using the physical and mental health component summaries of the Short Form-36 health survey questionnaire. Alcohol consumption refers to the 30 days before the interview. Analysis of covariance compared gender-specific mean scores across alcohol drinking patterns. FINDINGS: Overall, non-current drinkers reported poorer physical and mental health than life-time abstainers and current drinkers, while no consistent differences were found between life-time abstainers and current drinkers. In female current drinkers, daily drinking, beer and mixed beverage consumption were associated with better mental health. In male current drinkers, moderate alcohol consumption (2-2.9 drinks per day), wine and mixed beverage consumption were associated with better physical health. Intoxication and liquor consumption were associated with poorer mental health in women and poorer physical health in men. No consistent associations were found for drinking outside meals. CONCLUSIONS: Aspects of drinking pattern may affect subjective health differentially in women and men. Overall, intoxication and liquor drinking are associated with poorer self-perceived health status than regular, moderate consumption of other alcoholic beverages.     

A dose–response perspective on college drinking and related problems

Aims In order to examine the degree to which heavy drinking contributes to risks for problems among college drinkers this paper develops and tests a dose–response model of alcohol use that relates frequencies of drinking specific quantities of alcohol to the incidence of drinking problems. Methods A mathematical model was developed that enabled estimation of dose–response relationships between drinking quantities and drinking problems using self‐report data from 8698 college drinkers across 14 campuses in California, USA. The model assumes that drinking risks are a direct monotone function of the amount consumed per day and additive across drinking days. Drinking problems accumulate across drinking occasions and are the basis for cumulative reports of drinking problems reported by college drinkers. Results Statistical analyses using the model showed that drinking problems were related to every drinking level, but increased fivefold at three drinks and more gradually thereafter. Problems were associated most strongly with occasions on which three drinks were consumed, and more than half of all reported problems were related to occasions on which four or fewer drinks were consumed. There were some important differences in dose–responsiveness between men and women and between different groups of ‘light’, ‘moderate’ and ‘heavier’ drinkers. Conclusion Many problems among college students are associated with drinking relatively small amounts of alcohol (two to four drinks). Programs to reduce college drinking problems should emphasize risks associated with low drinking levels.