Alcohol use during pregnancy and breastfeeding can have adverse consequences for child development, including fetal alcohol spectrum disorder (FASD). This study investigated the prevalence of alcohol use during pregnancy and breastfeeding and its associations with current substance use behaviors and beliefs about the safety of alcohol use in pregnancy. This cross-sectional study used pooled data from the 2018-2020 CAMH Monitor Survey, a population-based survey of adults in Ontario (N = 5957). Descriptive analyses and multivariable logistic regression were conducted to examine associations between maternal alcohol use and sociodemographic characteristics, substance use, and beliefs. Of parous women (n = 1512; mean age: 65 years), 14.7% reported drinking alcohol during their most recent pregnancy (30 years prior, on average) and 17.8% while breastfeeding. Alcohol use during pregnancy was associated with lifetime substance use, current tobacco and alcohol use, and misconceptions about alcohol use in pregnancy. Gender differences emerged in beliefs: while awareness of FASD was relatively high among both women (87.2%) and men (80.6%), men were more likely than women to hold inaccurate beliefs, including that small amounts or certain types of alcohol may be safe during pregnancy. Men and women who were current drinkers of alcohol were significantly more likely to endorse these misconceptions. Public health messaging and maternal alcohol use prevention strategies must address persistent misconceptions about alcohol use in pregnancy and engage not only women and expectant mothers, but also men, partners, and broader social networks. Interventions should integrate education, universal screening, and trauma-informed care.
Although NLRP3, sTREM2, and p-tau217 are important in Alzheimer's disease (AD), their relevance in alcohol-related brain damage (ARBD) is unclear. This study aimed to compare these biomarkers in patients with ARBD, non-alcoholic AD, and alcohol dependence without encephalopathy, and to examine their links to cognitive function. This cross-sectional study included 45 ARBD patients, 41 non-alcoholic AD patients, and 39 alcohol-dependent patients without encephalopathy. We measured peripheral serum levels of NLRP3, sTREM2, and p-tau217 by enzyme-linked immunosorbent assay and assessed cognitive function using the Montreal Cognitive Assessment and Mini-Mental State Examination. Statistical analyses were performed to evaluate group differences and associations with ARBD. ARBD patients exhibited higher levels of inflammatory markers and more severe anxiety and depression than other groups. Serum sTREM2 was significantly highest in the ARBD group compared to both non-alcoholic AD and alcohol-dependent groups (P < .05). NLRP3 was also elevated in ARBD patients compared to the alcohol-dependent group (P = .005). No significant group differences were found for p-tau217. After adjusting for confounders, sTREM2 was significantly associated with cognitive, alcohol use, and mood scores, whereas NLRP3 was associated only with alcohol use and cognitive scores. Both sTREM2 and NLRP3 were independent predictors of ARBD. ROC analysis demonstrated that sTREM2 had the highest diagnostic accuracy for ARBD (AUC = 0.814), significantly outperforming NLRP3 (AUC = 0.671) and p-tau217 (AUC = 0.590). Serum sTREM2 and NLRP3 are promising peripheral biomarkers for ARBD. sTREM2, in particular, shows a strong association with clinical severity and demonstrates robust diagnostic potential, supporting its utility in the diagnosis and pathophysiological understanding of ARBD.
Alcohol intake is linked to systemic inflammation with some studies suggesting a U-shaped relationship. However, little is known about associations between alcohol consumption and novel biomarkers like glycoprotein acetyls (GlycA) and galectin-3 (Gal-3), which may offer earlier, more stable, and more sensitive detection of inflammation. To examine relationships between alcohol use and levels of high-sensitivity C-reactive protein (hs-CRP), GlycA, and Gal-3 in a large, diverse, community-based sample. Cross-sectional data from a community-based cohort (N = 2159) were analyzed. Alcohol use was treated both as continuous (drinks per week, DPW) and as a five-level ordinal variable (alcohol use group: never, past, light, moderate, and heavy drinkers). Analyses of covariance (ANCOVAs) compared mean inflammation levels (GlycA, Gal-3, and hs-CRP) across alcohol use groups, adjusting for covariates related to alcohol and inflammation. Linear regressions examined associations between DPW and inflammation. ANCOVAs revealed a significant association between alcohol use groups and Gal-3 levels (P = .031). Post-hoc pairwise comparisons showed that past drinkers had higher Gal-3 levels than light (P = .004), moderate (P = .012), and never drinkers (P = .044). Regressions showed no significant relationships between DPW and any inflammation biomarkers. Gal-3, but not GlycA or hs-CRP, was elevated in past drinkers compared to light, moderate, and never drinkers. These findings may reflect inflammation related to unmeasured illness among past drinkers that prompted alcohol cessation, rather than a direct alcohol effect. Future studies with longitudinal designs and objective alcohol measures are warranted to clarify causality and reduce potential self-report bias.
To understand the views and experiences of homeless adults who drink hazardously around alcohol use, alcohol harms and access to liver healthcare, and to quantify the prevalence of alcohol-related morbidity in this population. A sample of homeless adults (aged 18+) who drink hazardously (AUDIT score ≥8) were recruited to complete a health and alcohol use survey. From this sample, a smaller sample was purposively selected for semi-structured interview. Participants were recruited via liver outreach clinics held in five homeless hostels/day-centres in Southampton. Using a critical realist approach, qualitative data were analyzed using reflexive thematic analysis and descriptive statistics produced for survey responses. Around 56 survey participants were recruited, 84% of whom had probable alcohol dependence and 18% a diagnosis of advanced liver fibrosis/cirrhosis. Themes identified from 10 interviews described the ubiquity of alcohol misuse and harms in the life-histories of people experiencing homelessness (PEH), the differing levels of understanding and risk recognition of alcohol-related harms, and how PEH rationalize hazardous drinking, despite the risks. Normalization of alcohol misuse and harms underlies these themes and likely contributes to feelings of fatalism and powerlessness to prevent these harms. Normalization of alcohol-related harms may represent a barrier to timely engagement with healthcare and a mechanism driving greater likelihood of alcohol-related harms in PEH. Improving knowledge around alcohol-related harms and healthcare may help to counter the misperceptions of risk and fatalistic attitudes that normalization fosters. Such intervention may be particularly effective for PEH if targeted towards those accessing hostels and day-centres.
Exposure to alcohol advertisements and imagery is associated with alcohol initiation and use by adolescents and adults. The current study provides an update on the previously published article 'A content analysis of alcohol imagery in season 2 of The Kardashians' by exploring content in season 4 and estimating population exposure to this content. A content analysis of alcohol content in all 10 episodes of season 4 of The Kardashians was undertaken, and alcohol content was measured using 1-min interval coding. The presence of alcohol in the following four categories was noted: (i) actual use, (ii) implied use, (iii) other alcohol reference, and (iv) brand appearances, with particular attention paid to appearances of the Kardashian-owned brand of tequila, 818. Population exposure to content in season 2 and season 4 was estimated using population estimates and viewing figures. Alcohol content and branding continue to be shown in season 4, with a significant increase in any alcohol content, other alcohol content, alcohol branding, and 818 branding in season 4 compared to season 2. The two series resulted in a combined 347 million 818 tequila-branded gross impressions to the UK population. This content is not recognized by the UK regulator Ofcom as product placement, as there is no product placement deal in place. The current study posits that, despite this, 818 tequila is receiving widespread exposure through inclusion in the programme, suggesting that regulation on other forms of brand inclusion should exist.
Alcohol advertising is causally linked to early alcohol initiation and other harms. We characterized the content of social media alcohol advertising, and documented compliance with alcohol industry guidelines intended to prevent risks to minors and other populations vulnerable to alcohol harms. In January and February 2024, 816 ads were gathered from Instagram, YouTube, and their respective ad libraries (Meta and Alphabet). Ads were selected for 20 alcohol brands representing the 5 top-selling brands within each of 4 major alcohol product categories: beer, spirits, seltzers, and ready-to-drink cocktails. Multiple team members reviewed each ad and documented features, themes, compliance with industry guidelines, and responses to the ads using a standard protocol based on prior research. After removal of 148 exact duplicates, a sample of 309 ads were coded from the remaining 668 ads collected (46% of the sample). A total of 59% contained video. Common content included corporate branding (89%) and product display (68%). A total of 33% of ads, half of video ads (53%), and up to two-thirds (66%) of ads on one social media platform were non-compliant with industry guidelines. Ad views ranged from 13 to 37 million. Median user engagement (likes, shares, comments) was 79.5 per ad (range 0-168 240). User engagement was significantly higher for non-compliant ads vs. compliant ads (P = .007), although there was no difference in views (P = .263). Findings suggest a need for updating guidelines and stronger independent surveillance to monitor digital ad content to prevent messaging that may increase alcohol risks, especially for young people and other vulnerable populations.
Hazardous alcohol consumption represents a substantial health risk for older adults (aged 55 and above). Although healthcare professionals play a key role in addressing alcohol consumption, findings are mixed regarding older adults' attitudes toward alcohol-related conversations with different professionals. This study examined older adults' attitudes towards alcohol-related conversations with GPs, practice nurses, district nurses and volunteers, and explored associations with socio-demographic characteristics and alcohol consumption. A cross-sectional web-based survey (N = 424) was conducted among older adults in the Netherlands, recruited via a national association. Alcohol consumption was assessed using the AUDIT-C and participants were classified as abstainers, low-risk or high-risk drinkers. Attitudes were assessed using six statements. Multivariable logistic regression examined associations between socio-demographic characteristics, alcohol consumption and attitudes. Support for routinely asking about alcohol consumption was highest for GPs (60.4%, 95% CI 55.7-65.1), followed by practice nurses (55.0%, 95% CI 50.2-59.7), district nurses (46.7%, 95% CI 41.9-51.5) and volunteers (17.5%, 95% CI 13.8-21.1). Older adults aged 75 and above were more likely to view alcohol consumption as a personal matter and less likely to discuss with GPs (OR 0.66, 95% CI 0.43-1.00) or district nurses (OR 0.60, 95% CI 0.38-0.94) than those younger than 75. High-risk drinkers were less supportive of district nurses routinely addressing alcohol consumption (OR 0.54, 95% CI 0.29-0.99) than abstainers and low-risk drinkers. Attitudes towards alcohol-related conversations differ across professionals, with GPs viewed most favourably and volunteers least. This highlights the need to avoid treating professionals as interchangeable when addressing alcohol consumption.
The direction and temporality of the association between alcohol use and pain remain understudied among non-manual workers. This study investigated bidirectional associations between alcohol consumption and pain among current and retired non-manual workers, with exploratory subgroup analyses by retirement transition status, retirement age, and socioeconomic position (SEP). Survey data from Phases 7, 9, and 12 (2002-15) of the Whitehall II cohort study were analyzed (n = 5928, baseline mean age 60.7 years, 71% men). Alcohol consumption was assessed through self-reported intake converted to pure alcohol units. Pain severity was derived from musculoskeletal pain-site number and RAND-36 bodily pain measures, categorized as none, mild, or moderate/severe. Random-intercept cross-lagged panel models without equality constraints estimated within-person associations, with subgroup analyses by retirement transition and SEP. At baseline, 23.1% reported above-moderate pain severity and 30.0% exceeded recommended limits (>14 units/week). During 14-year follow-up, 47.3% remained retired, 10.1% were employed, and 40.1% transitioned from employment to retirement. Elevated alcohol consumption was associated with increased pain severity among all participants (βP7 → P9 = 0.07, 95% confidence interval [CI]: 0.02-0.12; βP9 → P12 = 0.04, 95% CI: 0.00-0.08), with stronger effect among midlife retirees (βP9→P12 = 0.15, 95% CI: 0.04-0.25) and low-SEP participants (βP9→P12 = 0.22, 95% CI: 0.04-0.51). Pain was associated with alcohol consumption at earlier intervals, but associations attenuated subsequently. Elevated alcohol consumption might be associated with increased pain severity among non-manual workers, particularly midlife retirees and low-SEP individuals. Pain-to-alcohol associations were observed but were inconsistent across intervals.
We aim to investigate alcohol consumption patterns before and after the pandemic onset and utilize liver fibrosis measurements to identify at-risk drinking patterns. We selected 10 259 participants in the National Health and Nutrition Examination Survey across two cohorts: January 2017-March 2020 (pre-pandemic) and August 2021-August 2023 (during-pandemic). We employed the alcohol use questionnaire to identify drinking patterns, including heavy drinking and binge drinking frequencies. Vibration-controlled transient elastography was used to define stage 1 and significant liver fibrosis by liver stiffness measurement >7 to 9 and > 9 kPa, respectively. We first compared the prevalence and frequencies of binge drinking and single day heavy drinking between the two cohorts. We then calculated the odds of liver fibrosis among during-pandemic participants with various alcohol use patterns, compared to pre-pandemic participants with the same use patterns. We found a higher prevalence of at-risk alcohol use in the during-pandemic cohort, including single-day heavy drinking and binge drinking at least once a month. Notably, the distributions of the frequency of single day heavy drinking and binge drinking were skewed towards a higher frequency of at-risk alcohol use in the during-pandemic group. Furthermore, the odds of significant liver fibrosis were higher among during-pandemic non-heavy/binge drinkers and heavy/binge drinkers, compared to their pre-pandemic counterparts. The data showed increases in heavy drinking and binge drinking in the during-pandemic cohort, which calls for urgent public health interventions to mitigate future adverse health impacts.
Stress is an inevitable part of life that can have positive or negative effects depending on one's beliefs about stress (stress mindset). Having a more stress-is-enhancing mindset may lead to better physical and psychological health outcomes, but its associations with alcohol-related outcomes have not been examined. This study assessed whether stress mindset was associated with problematic alcohol use and human flourishing, and whether these associations were mediated by perceived stress and loneliness. The analytic sample included 202 adults [mean age = 42.0 years old, 51.5% male, 46.0% White, and 41.6% with a history of alcohol use disorder] who completed self-reported measures of stress mindset, perceived stress, loneliness, problematic alcohol use, and human flourishing. Correlational and path analyses were conducted. Higher stress mindset scores (viewing stress as more enhancing) were correlated with lower perceived stress, lower loneliness, lower problematic alcohol use, and higher human flourishing. Perceived stress was a significant mediator of the associations between stress mindset and both outcomes, such that higher stress mindset scores were indirectly associated with lower problematic alcohol use and higher human flourishing via lower perceived stress. Loneliness mediated the association between stress mindset and human flourishing, such that higher stress mindset scores were associated with higher human flourishing via lower loneliness. The promotion of a stress-is-enhancing mindset is relevant to alcohol intervention as it may help individuals view stress in more adaptive ways and activate social support that has the potential to reduce problematic alcohol use and foster human flourishing.
Alcohol consumption is a well-established risk factor for health problems such as cancer; yet, public health campaigns have shown mixed results in their effectiveness to reduce alcohol use. Drawing on the health belief model, this study examines adolescents' self-reported alcohol consumption and explores drivers and barriers to abstaining from or reducing their alcohol consumption, with the ultimate goal of reducing alcohol-attributable cancers. A large-scale, cross-sectional and cross-national online survey was conducted in 2024 among N = 4054 adolescents between 12 and 18 years, chiefly recruited through schools, in eight European countries (Belgium, Cyprus, Greece, Italy, Romania, Slovenia, Spain, and Switzerland). Results indicate that 47.5% of adolescents reported never consuming alcohol. Alcohol use increased with age and country differences were observed, while we found no differences in gender. Among the 52.5% participants who reported drinking alcohol, the average intention to reduce consumption was moderate. Adolescents who drank more frequently were less inclined to reduce their alcohol use. Intention to reduce drinking decreased with age. Perceived benefits of alcohol reduction followed by self-efficacy were the strongest predictors of this intention. The study's results provide valuable insights into adolescent alcohol consumption across Europe, leading to the formulation of concrete guidelines for future prevention campaigns regarding target groups (e.g. age, country), messaging, and framing. Specifically, future alcohol prevention campaigns could emphasize long-term health benefits and aim to increase adolescents' perceptions of self-efficacy to refrain from initiating or to reduce alcohol consumption. Among adolescents (12–18 years) from eight European countries, 47.5% reported never drinking alcohol. Age was the strongest predictor of alcohol use. Among adolescents that did drink alcohol, the intention to reduce was moderate, mainly influenced by perceived benefits and self-efficacy.
Early onset alcohol use, mental health problems, familial alcohol use, and adverse childhood experiences (ACEs) increase the likelihood of persistent alcohol-use disorders later in life. This study aimed to determine the relative influence of such risk factors when predicting adolescent alcohol treatment outcomes, an area overlooked in prior research. Retrospective cross-sectional analysis using the National Drug Treatment Monitoring System, incorporating data from all publicly funded community alcohol services in England. The study included adolescents (aged 11-17) whose alcohol treatment took place between 1 April 2018 and 31 March 2023 (n = 2621). Logistic regression models tested for associations between predictors and key outcomes, including treatment non-completion and being non-abstinent at treatment completion. Predictors included demographics, treatment information, alcohol use, ACEs, care status, psychological, and socioeconomic factors. Significant predictors of not completing treatment: increased age; increased monthly drinking days; year of exit 2020-2021; Not in Education, Employment or Training (NEET) status and being placed on a child protection plan. NEET adolescents had double the incomplete treatment rate compared to the general cohort. Significant predictors of non-abstinent completion: increased age, monthly drinking days, units per drinking day, mental health treatment need, early onset use, affected by others' substance use, and illicit substance use. Adolescents with higher alcohol or illicit substance use at treatment start, NEET status and/or child protection plan (care status indicating prior ACE exposure) have worse alcohol treatment outcomes. These groups are highlighted for tailored interventions which consider psychological and environmental challenges adolescents may be experiencing.
Previous studies have demonstrated that the endocannabinoid system plays a significant role in the development of alcohol use disorder (AUD), and CB1 receptor antagonists/inverse agonists show promise as a novel AUD pharmacotherapy. However, these compounds failed in clinical trials due to the severe psychiatric side effects. Non-psychoactive phytocannabinoids may have a better safety profile and could be used as an alternative approach to treat AUD. The aim of this study was to test the potential of three phytocannabinoids in reducing alcohol consumption: CB1 receptor partial agonist cannabinol (CBN), neutral antagonist tetrahydrocannabivarin (THCV) and negative allosteric modulator cannabidiol (CBD). Male Wistar rats were subjected to a long-term voluntary alcohol drinking procedure that lasted for several months. Thereafter, rats were given three once daily administrations of CBN, THCV, or CBD. Their side-effect profile was examined by recording changes in water consumption, body weight and locomotor activity. Ultrasonic vocalisations were recorded in alcohol-naïve group-housed rats to monitor if treatment induced discomfort, distress, or other changes in emotional states. Our data demonstrated that all phytocannabinoids reduced voluntary alcohol consumption; however, the compounds differed in their effectiveness and side-effect profile. Treatment with CBN and THCV reduced alcohol intake and alcohol preference and had a mild sedative effect. CBD had a minor effect on alcohol consumption, did not affect alcohol preference, reduced the locomotor activity and lowered the positive emotional states of rats. None of the compounds caused discomfort or distress. We conclude that CBN and THCV may have potential in treating AUD.
Alcohol consumption has been identified as a significant risk factor for health and mortality. However, it remains unclear how many years are lived by individuals with various drinking groups and how many of these years are disability-free. The study aims to examine the association between alcohol consumption and total life expectancy (TLE) and disability-free life expectancy (DFLE). Incidence-based multistate life tables (MSLTs) were used to estimate TLE and DFLE by gender and alcohol consumption for individuals aged 50 years and over from the Health and Retirement Study (HRS, 1998-2018). Our results indicate a statistically significant association between alcohol consumption and TLE and DFLE, and gender differences are observed. The quantity of drinks consumed per occasion is more influential than the frequency of drinking days regarding health and mortality. Binge drinking is associated with reduced TLE and DFLE, especially for women. The study provides additional evidence for consideration in gender-differentiated guidelines. Policies discouraging binge drinking and promoting responsible consumption are crucial. The observed gender differences necessitate tailored approaches and interventions addressing the challenges faced by women regarding alcohol consumption.
This study aimed to identify (i) the number of alcohol care teams (ACTs) in England, (ii) the characteristics of patients supported by ACTs, and (iii) the service structure and care components offered by ACTs. All acute hospitals (i.e. those providing short-term high-dependency medical care) in England were approached to complete a survey of alcohol care provision. Surveys were completed through researcher-guided interviews by staff familiar with the hospital's alcohol provision. It featured questions on service structure, patient characteristics, service functions, and policies. Data collection took place between May and October 2023. Of 170 hospitals approached, 122 completed a survey and 80 reported having an ACT. Most ACT patients were male (mean 64.1%; 95% confidence interval (CI) 61.8-66.4), white (mean 79.2%; 95% CI 75.1-83.4), aged 45-54 (mean 27.8%; 95% CI 25.0-30.5), and experiencing severe alcohol dependence (mean 66.2%; 95% CI 36.8-95.7). Most services had a clinical lead but only 58% funded this role. Fifty-nine percent of services operated 7 days per week. Most services reported identification and brief advice, though it was rarely systematized. Nearly all supported medically assisted alcohol withdrawal, though a quarter of patients did not complete medically assisted alcohol withdrawal before discharge. ACT numbers increased significantly between 2019 and 2024. They offer a clinical service to highly vulnerable and complex patients. There is significant variation in ACT operational models, training, and leadership which will impact the effectiveness of identification strategies and management of patients with comorbid alcohol use disorder within acute medical settings.
This study sought to understand the subjective individual and collective benefits of alcohol use for transgender and gender diverse (TGD) people in the UK. A cross-sectional survey, co-produced with a TGD community advisory group, was open for responses from 1 February until 31 March 2022. Respondents were UK-based TGD adults who reported current or historical alcohol use. Those included in this sub-sample (n = 295) provided a valid response to one of two open-ended questions (OQ) concerning the subjective benefits of alcohol to TGD individuals (OQ1) and the perceived role of alcohol in UK TGD communities (OQ2). Data from these questions were collated (n = 455 responses) and coded using thematic analysis. An overarching theme was identified, 'belonging', under which two themes were developed to answer each question. For individuals, alcohol enhanced intimacy and relieved pain, and was described to have a role in bringing the TGD community together and facilitating gender exploration and affirmation. TGD people experience a range of benefits from using alcohol, attributable to its anxiolytic and analgesic properties. Many respondents felt alcohol had a specific role in their communities, associated with the relative safety of alcohol-serving venues for TGD people.
Explore the combined effects of alcohol use and metabolic syndrome (MetS) on liver injury in Asian Americans. We conducted a cross-sectional analysis of self-reported Asian Americans aged ≥21 years from the NIH All of Us database. MetS was defined using Adult Treatment Panel III criteria and operationalized as a binary diagnosis and severity score. Alcohol use was assessed using the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) questionnaire. Participants were categorized into four groups based on hazardous drinking status and MetS presence. Primary outcomes include liver injury (alanine aminotransferase >33 U/l for men, >25 U/l for women). Multivariable logistic regression models adjusted for age, sex, smoking, and socioeconomic status were used. Among 799 participants, 132 (16.5%) had MetS only, 190 (23.8%) had hazardous drinking only, and 41 (5.1%) had both exposures. Overall, 25.8% met criteria for liver injury, with prevalence differing across groups (P < .05): 32.6% of MetS only, 22.1% of hazardous drinking only, and greater than 35% in the combined-exposure group. Elevated triglycerides, waist circumference, MetS severity, MetS binary, and low high-density lipoprotein independently increased odds of liver injury. Significant interactions were observed between hazardous drinking and MetS severity [odds ratio (OR) 1.40; confidence interval (CI) 1.04-1.88], triglycerides (OR 3.62; CI 1.72-7.66), and blood pressure (OR: 2.09; CI 1.02-4.28). Metabolic dysfunction, particularly hypertriglyceridemia, synergistically interacts with hazardous alcohol use to increase liver injury risk in Asian Americans, underscoring the need for combined metabolic and alcohol reduction strategies.
This study examines socioeconomic inequalities in alcohol-related emergency room (ER) visits in Catalonia, combining individual and area-level socioeconomic factors and comparing the results with the ones for all ER visits. This population-based study retrospectively analyzed all 7 043 795 individuals aged 12 and older who received public healthcare in Catalonia in 2022 using sociodemographic, ER visits, and medical diagnoses data. Individuals were classified by individual-based and area-based socioeconomic levels (ISL and ASL, respectively). Binomial models assessed associations between ISL and ER visits, stratifying results by sex, age, and ASL. Alternative models were performed including interactions between both socioeconomic levels. In 2022, 22.2% of individuals visited ERs, of which 0.45% accounted for alcohol-related ER visits. Socioeconomic disparities were evident: individuals in the lowest ISL had an alcohol-related ER visit prevalence six times higher than the highest ISL. This pattern persisted across ASL, with more pronounced effects in wealthier regions. Age and sex influenced trends, with middle-aged males from low ISL groups showing the highest prevalence ratios. Interaction analysis revealed that the combined effect of low individual socioeconomic status and living in disadvantaged areas was smaller than would be expected if the effects were multiplicative. Significant socioeconomic disparities in ER visits exist in Catalonia, with lower socioeconomic groups, especially at the individual level, experiencing higher rates of alcohol-related ER visits. These findings underscore the need to address socioeconomic inequalities in healthcare access, particularly concerning alcohol-related health outcomes, highlighting the need to further research ISL and ASL interactions.
To estimate the extent to which maternal adverse childhood experiences (ACEs) predict offspring age at initiation of regular alcohol use, directly and indirectly via offspring ACEs. This was a retrospective cohort study using data collected from a nationally representative sample of mothers enrolled in the National Longitudinal Survey of Youth 1979 and their offspring who were enrolled in a separate cohort. Maternal and offspring ACEs were retrospectively self-reported. Age of initiation of regular alcohol use was collected via offspring report. We fit causal mediation models to determine associations between maternal ACEs and offspring age at initiation of regular alcohol use, including unmediated and mediated effects. Models were adjusted for generation-specific confounders. Offspring who reported living with a problem drinker or alcoholic were removed from the sample in a sensitivity analysis. Among 4277 offspring born to 2326 mothers, the majority were born to mothers who reported no ACEs (58.7%), who had at least a high school education (76.6%), and were married (62.4%). For every one-unit increase in maternal ACEs, offspring engaged in regular alcohol use 0.17 years earlier, of which approximately 28.9% of the total effect [β = -0.17 (95% CI: -0.25, -0.08)] is mediated by offspring ACEs. Findings were confirmed in sensitivity analyses. Maternal ACEs were associated with earlier offspring regular alcohol use in a dose-dependent manner, independent of offspring ACEs, and other known intergenerational determinants of alcohol use. Maternal ACE screening and early service provision may provide a novel opportunity to delay alcohol use.
Black men may be especially prone to drinking-to-cope or drinking to alleviate negative affect in early adulthood due to a unique confluence of factors that impact drinking patterns in emerging and early adulthood. The current study examined these associations using a prospective longitudinal design among Black men in rural Georgia. We hypothesized that across time, increases in depression would be associated with decreases in state hope and perceived life chances. Similarly, we anticipated increases in depression and decreases in state hope and perceived life chances would be associated with a greater frequency of alcohol consumption and binge drinking episodes. Black men (N = 504) in rural communities were assessed at four timepoints across emerging adulthood. We examined between and within subject effects across time between harmful alcohol consumption and depression, state hope, and perceived life chances, using regression latent curve models with structured residuals (LCM-SR) and random intercept cross-lagged panel modeling (RI-CLPM). Generally, depressive symptoms, hope, and perceived life chances were not prospectively associated with frequency of alcohol consumption or binge drinking episodes. Binge drinking episodes were associated with increase in subsequent depressive symptoms, but symptoms were not associated with increases in binge drinking. These findings suggest that despite seeing increased depressive symptoms, decreased hope, and decreased life chances over time, these mood-related factors were not associated with drinking behaviors among this sample of rural Black men. Future research should explore alternative mechanisms that may drive consumption patterns in this marginalized population.