| 1. |
- Rehm, Jürgen, et al.
(author)
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Prevalence of and potential influencing factors for alcohol dependence in Europe
- 2015
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In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 21:1, s. 6-18
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Journal article (peer-reviewed)abstract
- Alcohol use disorders (AUDs), and alcohol dependence (AD)in particular, are prevalent and associated with a large burdenof disability and mortality. The aim of this study wasto estimate prevalence of AD in the European Union (EU), Iceland, Norway, and Switzerland for the year 2010, and toinvestigate potential influencing factors. The 1-year prevalenceof AD in the EU was estimated at 3.4% among people18–64 years of age in Europe (women 1.7%, men 5.2%), resultingin close to 11 million affected people. Taking into accountall people of all ages, AD, abuse and harmful use resultedin an estimate of 23 million affected people. Prevalenceof AD varied widely between European countries, andwas significantly impacted by drinking cultures and socialnorms. Correlations with level of drinking and other drinking variables and with major known outcomes of heavy drinking,such as liver cirrhosis or injury, were moderate. Theseresults suggest a need to rethink the definition of AUDs.
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| 2. |
- Rehm, Jürgen, et al.
(author)
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The relationship between different dimensions of alcohol use and the burden of disease—an update
- 2017
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In: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 112:6, s. 968-1001
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Research review (peer-reviewed)abstract
- Background and aims Alcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs). Methods Systematic review of reviews and meta-analyses on alcohol consumption and health outcomes attributable to alcohol use. For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others. Results In total, 255 reviews and meta-analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD-10 three-digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in-depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently. Conclusions Research since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge.
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| 3. |
- Shield, Kevin D., et al.
(author)
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Life-time risk of mortality due to different levels of alcohol consumption in seven European countries : implications for low-risk drinking guidelines
- 2017
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In: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 112:9, s. 1535-1544
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Journal article (peer-reviewed)abstract
- Background and AimsLow-risk alcohol drinking guidelines require a scientific basis that extends beyond individual or group judgements of risk. Life-time mortality risks, judged against established thresholds for acceptable risk, may provide such a basis for guidelines. Therefore, the aim of this study was to estimate alcohol mortality risks for seven European countries based on different average daily alcohol consumption amounts.MethodsThe maximum acceptable voluntary premature mortality risk was determined to be one in 1000, with sensitivity analyses of one in 100. Life-time mortality risks for different alcohol consumption levels were estimated by combining disease-specific relative risk and mortality data for seven European countries with different drinking patterns (Estonia, Finland, Germany, Hungary, Ireland, Italy and Poland). Alcohol consumption data were obtained from the Global Information System on Alcohol and Health, relative risk data from meta-analyses and mortality information from the World Health Organization.ResultsThe variation in the life-time mortality risk at drinking levels relevant for setting guidelines was less than that observed at high drinking levels. In Europe, the percentage of adults consuming above a risk threshold of one in 1000 ranged from 20.6 to 32.9% for women and from 35.4 to 54.0% for men. Life-time risk of premature mortality under current guideline maximums ranged from 2.5 to 44.8 deaths per 1000 women in Finland and Estonia, respectively, and from 2.9 to 35.8 deaths per 1000 men in Finland and Estonia, respectively. If based upon an acceptable risk of one in 1000, guideline maximums for Europe should be 8–10 g/day for women and 15–20 g/day for men.ConclusionsIf low-risk alcohol guidelines were based on an acceptable risk of one in 1000 premature deaths, then maximums for Europe should be 8–10 g/day for women and 15–20 g/day for men, and some of the current European guidelines would require downward revision.
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| 4. |
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| 5. |
- Allamani, Allaman, et al.
(author)
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Contextual Determinants of Alcohol Consumption Changes and Preventive Alcohol Policies : A 12-Country European Study in Progress 2011
- 2011
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In: Substance Use & Misuse. - : Informa UK Limited. - 1082-6084 .- 1532-2491. ; 46:10, s. 1288-1303
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Journal article (peer-reviewed)abstract
- Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and 2008 are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes
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| 6. |
- Callinan, Sarah, et al.
(author)
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Age-based differences in quantity and frequency of consumption when screening for harmful alcohol use
- 2022
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In: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 117:9, s. 2431-2437
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Journal article (peer-reviewed)abstract
- Background and aims: Survey questions on usual quantity and frequency of alcohol consumption are regularly used in screening tools to identify drinkers requiring intervention. The aim of this study was to measure age-based differences in quantity and frequency of alcohol consumption on the Alcohol Use Disorders Identification Test (AUDIT) and how this relates to the prediction of harmful or dependent drinking.Design: Cross-sectional survey.Setting: Australia.Participants: Data were taken from 17 399 respondents who reported any alcohol consumption in the last year and were aged 18 and over from the 2016 National Drug Strategy Household Survey, a broadly representative cross-sectional survey on substance use.Measurement: Respondents were asked about their frequency of consumption, usual quantity per occasion and the other items of the AUDIT.Findings: In older drinkers, quantity per occasion [β = 0.53, 95% confidence interval (CI) = 0.43, 0.64 in 43–47-year-olds as an example] was a stronger predictor of dependence than frequency per occasion (β = 0.24, 95% CI = 0.17, 0.31). In younger drinkers the reverse was true, with frequency a stronger predictor (β = 0.54, 95% CI = 0.39, 0.69 in 23–27-year-olds) than quantity (β = 0.26, 95% CI = 0.18, 0.34 in 23–27-year-olds). Frequency of consumption was not a significant predictor of dependence in respondents aged 73 years and over (β = −0.03, 95% CI = −0.08, 0.02). Similar patterns were found when predicting harmful drinking. Despite this, as frequency of consumption increased steadily with age, the question on frequency was responsible for at least 65% of AUDIT scores in drinkers aged 53 years and over.Conclusions: In younger drinkers, frequent drinking is more strongly linked to dependence and harmful drinking subscale scores on the Alcohol Use Disorders Identification Test (AUDIT) than quantity per occasion, yet quantity per occasion has a stronger influence on the overall AUDIT score in this group. In older drinkers, frequency of consumption is not always a significant predictor of the AUDIT dependence subscale and is a weak predictor of the harmful drinking subscale.
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| 7. |
- Frick, Ulrich, et al.
(author)
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Average volume of alcohol consumption, drinking patterns and related burden of mortality in young people in established market economies in Europe
- 2001
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In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 7:3, s. 148-151
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To determine the burden of mortality in young people (age 15-29) in established market economies in Europe in 1999, which is attributable to alcohol consumption. Two dimensions of alcohol consumption were considered: average volume of consumption, and patterns of drinking.METHODS:Mortality data were obtained from the WHO EIP data bank, average volume data from the WHO global databank on alcohol, pattern of drinking data from a questionnaire sent out to experts, from the published literature and from the WHO global databank. Methods are explained and discussed in detail in two other contributions to this volume.RESULTS:More than 8,000 deaths of people aged 15-29 in Europe in 1999 were attributable to alcohol. Young males show a higher proportion of alcohol-attributable deaths (12.8%) than females (8.3%). Both average volume and patterns of drinking contribute to alcohol-related death.CONCLUSIONS:Alcohol-related deaths constitute a considerable burden in young people in Europe.
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| 8. |
- Gmel, Gerhard, et al.
(author)
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Dimensions of alcohol-related social and health consequences in survey research
- 2000
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In: Journal of Substance Abuse. - 0899-3289 .- 1873-6491. ; 12:1-2, s. 113-138
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Journal article (peer-reviewed)abstract
- Dimensions of alcohol-related social and health consequences are approached from two different perspectives. First, classical approaches with factor analytic techniques are used to empirically determine the dimensionality of item batteries intended to measure harm. Second, a closer look is taken at theoretically underlying dimensions of social and health consequences and their association with alcohol consumption. Using as empirical material data from the US national survey of males aged 21–59 (N3) conducted in 1969, the following specific questions are discussed: (1) What are the underlying dimensions of alcohol-related social and health consequences? (2) How should the relation between alcohol consumption and consequences best be assessed (in terms of epidemiological traditions or social constructivist traditions)? (3) How can we best incorporate the time perspective into modeling the relationship between alcohol consumption and consequences? A first attempt is made to develop practical guidelines for future research on handling these problems.
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| 9. |
- Karlsson, Patrik, 1977-, et al.
(author)
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How well do DSM-5 criteria measure alcohol use disorder in the general population of older Swedish adolescents? An item response theory analysis
- 2024
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In: Addictive Behaviours. - 0306-4603 .- 1873-6327. ; 154
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Journal article (peer-reviewed)abstract
- BackgroundThis study assesses the psychometric properties of DSM-5 criteria of AUD in older Swedish adolescents using item response theory models, focusing specifically on the precision of the scale at the cut-offs for mild, moderate, and severe AUD.MethodsData from the second wave of Futura01 was used. Futura01 is a nationally representative cohort study of Swedish people born 2001 and data for the second wave was collected when participants were 17/18 years old. This study included only participants who had consumed alcohol during the past 12 months (n = 2648). AUD was measured with 11 binary items. A 2-parameter logistic item response theory model (2PL) estimated the items’ difficulty and discrimination parameters.Results31.8% of the participants met criteria for AUD. Among these, 75.6% had mild AUD, 18.3% had moderate, and 6.1% had severe AUD. A unidimensional AUD model had a good fit and 2PL models showed that the scale measured AUD over all three cut-offs for AUD severity. Although discrimination parameters ranged from moderate (1.24) to very high (2.38), the more commonly endorsed items discriminated less well than the more difficult items, as also reflected in less precision of the estimates at lower levels of AUD severity. The diagnostic uncertainty was pronounced at the cut-off for mild AUD.ConclusionDSM-5 criteria measure AUD with better precision at higher levels of AUD severity than at lower levels. As most older adolescents who fulfil an AUD diagnosis are in the mild category, notable uncertainties are involved when an AUD diagnosis is set in this group.
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