The link between early onset drinking and early onset alcohol-impaired driving in young males

Background: Young drivers represent a disproportionate number of the individuals involved in alcohol-impaired driving. Although there is a known association between drinking and alcohol-impaired driving in young drivers, the link between early onset drinking and early onset alcohol-impaired driving has not been explored. Objectives: The present study aimed to assess this link along with potentially confounding factors. Methods: The assessment used a proportional hazards model with data collected from the Buffalo Longitudinal Study of Young Men, a population-based sample of 625 males at aged 16–19. Results: Controlling for the effects of potentially relevant confounds, the early onset of drinking was the most influential factor in predicting the early onset of alcohol-impaired driving. Race and the early onset of other forms of delinquency also played a significant role in the early onset of alcohol-impaired driving. Conclusion: Preventing an early start of drinking among adolescents may be the most critical factor to address in preventing an early start of alcohol-impaired driving.     

Hypothalamic–pituitary–adrenal axis and smoking and drinking onset among adolescents: the longitudinal cohort TRacking Adolescents' Individual Lives Survey (TRAILS)

Aims   We examined within a prospective longitudinal study whether cortisol levels were associated with smoking or drinking behaviours, taking parental substance use into account.
Design   The influence of parental substance use on cortisol levels of their adolescent offspring at age 10–12 years was examined. Next, cortisol levels of adolescents who initiated smoking or drinking at the first data collection (age 10–12) were compared to non-users. Finally, we examined whether cortisol levels could predict new onset and frequency of smoking and drinking 2 years later.
Setting and participants   First and second assessment data of the TRacking Adolescents' Individual Lives Survey (TRAILS) were used, including 1768 Dutch adolescents aged 10–12 years, who were followed-up across a period of 2 years.
Measurements   Cortisol was measured in saliva samples at awakening, 30 minutes later, and at 8 p.m. at age 10–12. Self-reported substance use at age 10–12 and 13–14, and parental self-reported substance use were used.
Findings   Only maternal substance use was related to slightly lower adolescent cortisol levels at 8 p.m. Both maternal and paternal substance use were associated with adolescent smoking and drinking at age 13–14, although fathers' use only predicted the amount used and not the chance of ever use. Finally, higher cortisol levels were related moderately to current smoking and future frequency of smoking, but not to alcohol use.
Conclusions   In a general population, parental heavy substance use does not seem to affect cortisol levels consistently in their offspring. We found some evidence for higher, instead of lower, hypothalamic–pituitary–adrenal axis activity as a predictor of smoking in early adolescence.     

Alcohol expectancies and drinking in different age groups

Aims Because expectancies about the effects of alcohol change as drinking experience is accumulated, it is likely that the relationship of expectancy to drinking will differ with age. In this study, we examine the prediction of drinking behavior from positive and negative outcome expectancy at different ages. Design Data were collected as part of the National Alcohol Survey, using a multi‐stage area probability sample of the household population of the 48 contiguous United States. Participants US residents aged 12 and older (n = 2875). Measurements Survey questions included drinking habits (frequency, quantity, frequency of drunkenness, maximum quantity) and beliefs about the effects of alcohol (alcohol expectancies). Findings Structural equation models tested the relationship of positive and negative expectancy to drinking behavior in six age groups. Outcome expectancy accounted for a larger portion of the variance in drinking among younger respondents than among older respondents. However, suppression effects were common. When suppression effects were considered, positive expectancy predicted drinking better than negative expectancy only among respondents under 35, while negative expectancy was a better predictor of drinking status in most respondents over 35 years. Among drinkers, positive expectancy predominated over negative expectancy when suppression effects were considered. Conclusions These results suggest that negative expectancy predicts abstention, while positive expectancy predicts level of drinking among drinkers. In expectancy research, differences between drinkers and abstainers, age of participants and the presence of suppression effects should be taken into account.     

Progression through early drinking milestones in an adolescent treatment sample

Aims Research using nationally representative and community samples demonstrates a robust association between early onset of drinking and increased likelihood of numerous adverse outcomes. However, little is known about the subsequent drinking that occurs early in the drinking career. The present study dissects the transition from any alcohol use to treatment entry by taking a fine‐grained approach to examining the attainment and progression of drinking events in a sample of adolescents in substance use treatment. Design/Setting Data were taken from the Drug Abuse Treatment Outcome Study for Adolescents (DATOS‐A), a multi‐site, community‐based study of adolescents entering treatment. Participants Respondents included 3331 youth aged 12–18 years (mean = 15.75) admitted to treatment in 1993–95 (74% male, 52% white, 24% African American, 20% Hispanic). Measurements Age of attainment was obtained for five drinking‐related milestones, including first drink of alcohol, first time drunk, first monthly drinking, first drank five or more drinks/day on a weekly basis and first drank five or more drinks/day on a daily basis. Findings Most milestones were attained at a very early age, and average progression through adjacent drinking events was relatively swift, Movement through early drinking milestones was accelerated in girls and white youth. Youth who reported their first drink at an early age (age 10 or younger) showed slower progression, suggesting the existence of distinct processes underlying early use and drinking transitions within an individual. Conclusions This study provides data relevant to understanding drinking progression/natural history in a large clinical sample, especially for differences by gender and ethnicity. The findings have implications for the identification of intermediate stages that might benefit from selected intervention programs.     

Age of onset of drinking and the use of alcohol in adulthood: a follow-up study from age 8-42 for females and males

Aim To investigate longitudinally for both genders the relation between the age of onset of drinking and several indicators of alcohol use. Design and setting In the Finnish Jyväskylä Longitudinal Study of Personality and Social Development, data have been collected by interviews, inventories, and questionnaires. Data on alcohol consumption was gathered at ages 14, 20, 27, 36 and 42 years; behavioural data at age 8. Participants A total of 155 women and 176 men; 90.4% of the original sample consisting of 12 complete school classes in 1968. Measurements The age of onset of drinking was determined based on participants’ responses that were closest to the actual age of onset of drinking. Four indicators of the adult use of alcohol were used: frequency of drinking, binge drinking, Cut‐down, Annoyed, Guilt, Eye‐opener (CAGE) and Malmö modified Michigan Alcoholism Screening Test (Mm‐MAST). Socio‐emotional behaviour at age 8 was assessed using teacher ratings and peer nominations. Findings Early onset of drinking was related to the four indicators of the use of alcohol in adulthood both in men and women. The level of adult alcohol use and alcohol problems was significantly higher in men. The risk for heavy drinking was highest in men and women if drinking was started at less than age 16 years. Socio‐emotional behaviour and school success at age 8 did not predict the age of onset of drinking. Conclusions Delaying the initiation of drinking from early adolescence to late adolescence is an important goal for prevention efforts. No clear risk group for early initiators of drinking could be identified on the basis of preceding behaviour among 8‐year‐olds.     

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.     

Exploring the emergence of alcohol use disorder symptoms in the two years after onset of drinking: findings from the National Surveys on Drug Use and Health

Aims This study investigates the occurrence of clinical features of alcohol dependence and socially maladaptive drinking during the first 24 months after the onset of alcohol use. Design Data for this study are from the nationally representative 2004–07 National Surveys on Drug Use and Health (NSDUH). Setting General population of the United States, aged 12 years and older. Participants New‐onset alcohol users (NOAUs) were drinkers who started to drink alcohol within 24 months of the NSDUH assessment and consumed alcohol during the last 12 months. Measurements The NSDUH assessed for clinical features of alcohol dependence and socially maladaptive drinking, consistent with the DSM‐IV. Findings NOAUs frequently experienced problems relating to self‐reported tolerance, spending a great deal of time recovering from the effects of alcohol and unsuccessful attempts at cutting down on drinking. The likelihood of experiencing the clinical features increased steadily in the first 9 months after use, but appeared to plateau or only gradually increase thereafter. Strong evidence emerged that the clinical features measured a single latent dimensional of ‘alcohol use disorder’ (AUD) in this sample. The majority of the clinical features were good indicators of the underlying AUD continuum in the 2 years after first drinking onset. Conclusions There may be a period of time during the second year of alcohol use, when level of alcohol use disorder fluctuates rather than increases. Public health and safety efforts designed to target problematic alcohol use in the earliest stages of alcohol involvement could be useful in preventing the escalation of alcohol problems in this group of drinkers.     

The relationship between drinking games and intentions to continue drinking,intentions to drive after drinking,and adverse consequences: Results of a field study

Background: Drinking games have become a nearly universal aspect of excessive drinking on university campuses with 50–62% of college students reporting playing drinking games in the past month. Participation in drinking games has been correlated with numerous negative consequences and increased consumption of alcohol. Objectives: The present study addresses the influence of drinking games on three drinking-related outcomes: problems experienced the night of the drinking event, the intent to keep drinking, and the intent to drive after drinking. Methods: The data collected for the present study were part of a study testing environmental influences of drinking behaviors of young adults. A total of 226 randomly selected parties (representing 1725 partygoers) were selected for study inclusion. Three multilevel logistic regression models tested the relationship between drinking games and the three drinking-related outcomes. Results: Participants who reported playing drinking games were 1.58 times more likely to report continued drinking intentions than participants who did not play drinking games. If drinking games were observed at a party, participants were 2.38 times more likely to plan to drive while intoxicated. Additionally, participants who reported playing drinking games were 1.59 times more likely to report experiencing a drinking-related problem than participants who did not play drinking games. Conclusion: Drinking games have consequences beyond increasing the level of intoxication; they contribute to problematic behavior at individual and environmental levels. Preventing drinking games is warranted.     

Binge drinking: Burden of liver disease and beyond

The consumption of alcoholic beverages is harmful to human health. In recent years, consumption patterns of alcoholic beverages have changed in our society, and binge drinking has generalized. It is considered to be a socio-sanitary problem with few known consequences in terms of individual and third-party social impacts (in the form of violence or traffic accidents) and its organic impact (affects the liver and other organs and systems, such as the nervous and cardiovascular systems) and represents an important financial burden due to its increasing economic impact. This review provides a global approach to binge drinking and emphasizes its epidemiological character, the effect of this type of consumption and the possible management of a problem with an increasing tendency in our society.     

Social anxiety and drinking game participation among university students: the moderating role of drinking to cope

Background: Few studies have examined the relationship of social anxiety with drinking game participation. Drinking games represent a popular form of drinking in university settings. Due to their structure, games may appeal to socially anxious drinkers, particularly among those seeking to fit in or cope with the social setting. Objectives: To examine the relationship of social anxiety with frequency of drinking game participation among a university undergraduate sample and to investigate if drinking motives moderate this association. Method: A total of 227 undergraduate students aged 18–24 years (73% female) who had consumed alcohol in the prior year were included in the current investigation. Hierarchical regression examined the influences of social anxiety and drinking motives on frequency of drinking game participation, as well the interactions of social anxiety with drinking for coping motives and conformity motives. Results: Social anxiety failed to emerge as a significant predictor of frequency of drinking game participation. However, drinking to cope moderated the relationship of social anxiety with frequency of drinking game participation. Socially anxious students who drank to cope were more likely to participate in drinking games on occasions when they consumed alcohol than those who did not endorse this drinking motive. Conclusion: Results demonstrated the influence of drinking to cope in the relationship of social anxiety with frequency of drinking game participation. Future work should examine the relationship with other indicators of drinking game activity. Intervention efforts addressing social anxiety and drinking should consider motives for drinking, as well as drinking patterns.     

Bringing alcohol on campus to raise money: impact on student drinking and drinking problems

AIMS: Universities are striving to raise funds, often attracting spectators by selling alcohol at campus events. This study evaluates the effect of a policy change on student drinking at a large western university that had historically banned alcohol on campus but transitioned to permitting the sale of alcohol in some of its facilities. METHODS: Surveys of student drinking and perceptions of other students' drinking were conducted before, during and after the policy change at the transition university (TU) and compared to similar data from a control university (CU). Surveys of student drinking at on-campus and off-campus venues and observations of alcohol service practices were also conducted. RESULTS: The policy change at the TU was introduced cautiously, and sales to underage drinkers were relatively well controlled. Despite this, student drinking rose initially, then declined after 1 year. Perceptions of the amount of drinking by other students increased slightly, but there was no overall measurable increase in student drinking during the first 3 years of the new policy. CONCLUSIONS: The conservative TU policy-to sell alcohol only at select events and to control sales to minors-may have limited the impact of on-campus alcohol sales on student consumption. Although the study results did not find a stable increase in student drinking, they do not necessarily support the liberalization of campus alcohol policy, because the transition is still 'in progress' and the final outcome has not been evaluated.