| 1. |
- Atzendorf, Josefine, et al.
(författare)
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Do smoking, nutrition, alcohol use, and physical activity vary between regions in Germany?-results of a cross-sectional study
- 2020
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies on lifestyle risk factors mainly focused on age- or gender-specific differences. However, lifestyle risk factors also vary across regions. Aim of the present study was to examine the extent to which prevalence rates of SNAP (smoking, nutrition, alcohol consumption, physical activity) vary between East and West Germany or North and South Germany.Methods: Data came from the population-representative 2015 Epidemiological Survey of Substance Abuse (ESA) comprising 9204 subjects aged 18 to 64 years. To assess an east-west or south-north gradient, two binary logistic regression models were carried out for each SNAP factor.Results: The logistic regression models revealed statistically significant differences with higher rates of at-risk alcohol consumption and lower rates of unhealthy nutrition in East Germany compared to West Germany. Significant differences between North and South Germany were found for at-risk alcohol consumption with higher rates of at-risk alcohol consumption in South Germany. Daily smoking and low physical activity were equally distributed across regions.Conclusions: The implementation of measures reducing at-risk alcohol consumption in Germany should take the identified east-west and south-north gradient into account. Since the prevalence of unhealthy nutrition was generally high, prevention and intervention measures should focus on Germany as a whole instead of specific regions.
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| 2. |
- Atzendorf, Josefine, et al.
(författare)
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The Use of Alcohol, Tobacco, Illegal Drugs and Medicines : An Estimate of Consumption and Substance-Related Disorders in Germany
- 2019
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Ingår i: Deutsches Ärzteblatt International. - : Deutscher Arzte-Verlag GmbH. - 1866-0452. ; 116:35-36, s. 577-584
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prevalence estimates of the use of tobacco, alcohol, illegal drugs, and psychoactive medications and of substance-related disorders enable an assessment of the effects of substance use on health and society.Methods: The data used for this study were derived from the 2018 Epidemiological Survey of Substance Abuse (Epidemiologischer Suchtsurvey, ESA). The sample of the German adult population comprised 9267 persons aged 18 to 64 (response rate, 42%). Population estimates were obtained by extrapolation to a total resident population of 51 544 494 people.Results: In the 30 days prior to the survey, 71.6% of the respondents (corresponding to 36.9 million persons in the population) had consumed alcohol, and 28.0% (14.4 million) had consumed tobacco. 4.0% reported having used e-cigarettes, and 0.8% reported having used heat-not-burn products. Among illegal drugs, cannabis was the most commonly used, with a 12-month prevalence of 7.1% (3.7 million), followed by amphetamines (1.2%: 619 000). The prevalence of the use of analgesics without a prescription (31.4%) was markedly higher than that of the use of prescribed analgesics (17.5%, 26.0 million); however, analgesics were taken daily less commonly than other types of medication. 13.5% of the sample (7.0 million) had at least one dependence diagnosis (12-month prevalence).Conclusion: Substance use and the consumption of psychoactive medications are widespread in the German population. Substance-related disorders are a major burden to society, with legal substances causing greater burden than illegal substances.
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| 3. |
- Delle, Simone, et al.
(författare)
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Motives for not drinking alcohol : why adults in late middle age abstain
- 2022
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Ingår i: Addiction Research and Theory. - : Informa UK Limited. - 1606-6359 .- 1476-7392. ; 30:2, s. 126-133
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older individuals are not only more sensitive to the impact of alcohol but also face significant health risks from alcohol-drug interactions. To alter current drinking patterns, it is crucial to understand the motives for abstention of adults in late middle age.Objectives: We hypothesized that, for adults in late middle age, socio-demographic characteristics and health-related factors predict alcohol abstinence; and that current motives for abstention vary between subgroups of abstainers.Method: Data on adults aged 50-64 years (n = 2,308) came from the German Epidemiological Survey of Substance Abuse (ESA). Logistic regression was used to examine the association between different types of abstinence and socio-demographic and health-related variables.Results: Low income, low education and poor self-rated physical health predicted 12-month abstinence. Men with a chronic disease had a 9.5 % chance to be abstinent, whilst it was 17.7 % for women. Main motives for older lifetime abstainers were 'dislike of taste or smell', 'loss of control' and 'family constraints'. For 12-month abstainers, it was 'loss of control', 'health constraints' and 'dislike of taste or smell'.Conclusion: Poor health in middle-aged drinkers offers an opportunity to recommend reduction or cessation of alcohol use by explaining the negative health effects from alcohol. Future research investigating abstention needs to differentiate between lifetime and 12-month abstainers.
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| 4. |
- Kraus, Ludwig, et al.
(författare)
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'Are The Times A-Changin'? Trends in adolescent substance use in Europe
- 2018
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 113:7, s. 1317-1332
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Tidskriftsartikel (refereegranskat)abstract
- Aims To estimate temporal trends in adolescents' current cigarette, alcohol and cannabis use in Europe by gender and region, test for regional differences and evaluate regional convergence. Design and Setting Five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 28 countries between 1999 and 2015. Countries were grouped into five regions [northern (NE), southern (SE), western (WE), eastern Europe (EE) and the Balkans (BK)]. Participants A total of 223 814 male and 211 712 female 15-16-year-old students. Measurements Daily cigarette use, weekly alcohol use, monthly heavy episodic drinking (HED) and monthly cannabis use. Linear and quadratic trends were tested using multi-level mixed-effects logistic regression; regional differences were tested using pairwise Wald tests; mean absolute differences (MD) of predicted prevalence were used for evaluating conversion. Findings Daily cigarette use among boys in EE showed a declining curvilinear trend, whereas in all other regions a declining linear trend was found. With the exception of BK, trends of weekly drinking decreased curvilinear in both genders in all regions. Among girls, trends in WE, EE and BK differed from trends in NE and SE. Monthly HED showed increasing curvilinear trends in all regions except in NE (both genders), WE and EE (boys each). In both genders, the trend in EE differed from the trend in SE. Trends of cannabis use increased in both genders in SE and BK; differences were found between the curvilinear trends in EE and BK. MD by substance and gender were generally somewhat stable over time. Conclusions Despite regional differences in prevalence of substance use among European adolescents from 1999 to 2015, trends showed remarkable similarities, with strong decreasing trends in cigarette use and moderate decreasing trends in alcohol use. Trends of cannabis use only increased in southern Europe and the Balkans. Trends across all substance use indicators suggest no regional convergence.
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| 5. |
- Kraus, Ludwig, 1955-, et al.
(författare)
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Changes in the use of tobacco, alternative tobacco products, and tobacco alternatives in Germany
- 2022
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Ingår i: Deutsches Ärzteblatt International. - : Deutscher Arzte-Verlag GmbH. - 1866-0452. ; 119:31-32, s. 535-541
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Tidskriftsartikel (refereegranskat)abstract
- Background: Due to the increasing use of alternative tobacco products (waterpipes, heat-not-burn) and tobacco alternatives (e-cigarettes), we studied recent changes in the prevalence of conventional tobacco use and alternative products.Methods: Data come from ten waves of the Epidemiological Survey of Substance Abuse (ESA) from 1995 to 2021, with representative samples collected via paper-pencil questionnaires, telephone interviews, or online. We compared the prevalence of conventional tobacco use and alternative products by gender and age (18–24, 25–39, 40–59 years).Results: In all age groups, the use of conventional tobacco products decreased. The prevalence of the exclusive use of one of the three alternative products differed statistically significantly between age groups and in 2021 was higher for ages 18–24 (females: 11.1%, males: 12.4%) compared to ages 25–39 (females: 2.9%; males: 4.9%) and ages 40–59 (females: 1.4%; males: 2.0%). The use of alternative products was mainly due to the exclusive use of waterpipes among individuals aged 18 to 24 and 25 to 39 and the exclusive use of e-cigarettes among individuals aged 40 to 59.Conclusions: The higher prevalence of alternative product use among young adults implies a turning point that needs to be considered in prevention. Because of the addictive potential of these products, young adults can be expected to maintain their use into middle and older adulthood. There is a need to monitor the use of alternative products, identify the risks associated with them, and develop effective prevention and cessation interventions for adults.
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| 6. |
- Kraus, Ludwig, et al.
(författare)
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Estimating the number of children in households with substance use disorders in Germany
- 2021
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : Springer Science and Business Media LLC. - 1753-2000. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Parental substance misuse is reported to endanger the health and psychological development of children and adolescents. The aim of the present study was to address conceptual and methodological problems in estimating the number of children affected by parental substance misuse (CaPSM) and offer a novel approach based on survey data.Methods Data came from the 2018 German Epidemiological Survey of Substance Abuse (ESA) among 18- to 64-year-olds (n = 9267) and from population statistics. DSM-IV diagnostic criteria were used to assess substance use disorder (SUD) related to tobacco, alcohol, cannabis, cocaine or amphetamine. Based on the number of household members, the number of children below age 18 years and the information on SUD status of the respondent living in this household, the number of children currently living in households with at least one member with SUD was estimated.Results In 2018, there were 13,597,428 children younger than 18 years living in Germany. Of these, 6.9-12.3% (935,522-1,673,103) were estimated to currently live in households where at least one adult had a tobacco use disorder, 5.1-9.2% (688,111-1,257,345) in households where at least one adult had an alcohol use disorder and 0.6-1.2% (87,817-158,401) in households where at least one adult had a disorder related to the use of illicit drugs. The total number of children currently living with SUD adults in their household was estimated at 11.2-20.2% (1,521,495-2,751,796).Conclusions Available estimates are difficult to interpret and to compare due to a lack of clear case definitions and methodological approaches with various biases and limitations. Future estimates need to provide precise case definitions and standard approaches.
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| 7. |
- Kraus, Ludwig, et al.
(författare)
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Estimation of the Number of People With Opioid Addiction in Germany
- 2019
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Ingår i: Deutsches Ärzteblatt International. - : Deutscher Arzte-Verlag GmbH. - 1866-0452. ; 116:9, s. 137-143
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Tidskriftsartikel (refereegranskat)abstract
- Background: Opioid addiction is one of the most common substance-related disorders worldwide, and morbidity and mortality due to opioid addiction place a heavy burden on society. Knowing the size of the population that is addicted to opioids is a prerequisite for the development and implementation of appropriate health-policy measures.Methods: Our estimate for Germany for 2016 is based on an enumeration of opioid-addicted persons who were entered in a registry of persons receiving substitution therapy, an enumeration of persons receiving outpatient and inpatient care for addiction without substitution therapy, an extrapolation to all addiction care facilities, and an estimation of the number of opioid-addicted persons who were not accounted for either in the substitution registry or in addiction care.Results: The overall estimate of the number of opioid-addicted persons in Germany in 2016 was 166 294 persons (lower and upper bounds: 164 794 and 167 794), including 123 988 men (122 968 to 125 007) and 42 307 women (41 826 to 42 787). The estimates for each German federal state per 1000 inhabitants ranged from 0.1 in Brandenburg to 3.0 in North Rhine-Westphalia and 5.5 in Bremen. The average value across Germany was 3.1 per 1000 inhabitants.Conclusion: Comparisons with earlier estimates suggest that the number of persons addicted to opioids in Germany has hardly changed over the past 20 years. Despite methodological limitations, this estimate can be considered highly valid. Nearly all persons who are addicted to opioids are in contact with the addiction care system.
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| 8. |
- Kraus, Ludwig, et al.
(författare)
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Has beverage composition of alcohol consumption in Sweden changed over time? An age-period-cohort analysis
- 2022
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 41:1, s. 153-166
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. In recent years, beverage composition of total alcohol consumption has changed substantially in Sweden. As beverage choice is strongly associated with drinking practices, our paper aims to analyse trends in beverage composition of alcohol consumption by age, period and cohort. Methods. Age-period-cohort (APC) analysis was conducted using monthly data from the Swedish Alcohol Monitoring Survey (2003-2018). The sample consisted of n = 260 633 respondents aged 16-80 years. APC analysis was conducted on drinkers only (n = 193 954; 96 211 males, 97 743 females). Beverage composition was defined as the beverage-specific proportion of total intake in litre ethanol. Fractional multinomial logit regression was applied to estimate the independent effects of age, period and cohort on trends in beverage composition. Results. Regression models revealed statistically significant effects of age on all beverages except for medium-strength beer and spirits in males. Controlling for age and cohort, decreasing trends were found over time for medium-strength beer and spirits. The proportion of regular beer increased statistically significantly in males and the proportion of wine in females, whereas the trends for the opposite sex remained stable in each case. Predictions for cohorts showed statistically significant decreasing trends for medium-strength beer in males, lower proportions for regular beer and higher proportions for spirits in the youngest cohorts. Discussion and Conclusions. The increasing proportion of wine drinking, which is associated with less risky drinking practices, may decrease alcohol-related morbidity and mortality. Increasing proportions of spirits in the youngest cohorts raises concerns of a possible revival in spirits consumption among the youngest.
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| 9. |
- Kraus, Ludwig, et al.
(författare)
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Quantifying harms to others due to alcohol consumption in Germany : a register-based study
- 2019
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Ingår i: BMC Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: The consumption of alcohol increases the risk of drinkers harming others. The extent of alcohol's morbidity and mortality harms to others in Germany in 2014 was estimated for (1) fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorders (FASD) among newborns, (2) road traffic fatalities, and (3) interpersonal violence-related deaths. Methods: The incidences of FAS and FASD were estimated by means of a meta-analytical approach, combining data on alcohol use during pregnancy and the risk relationship between alcohol consumption during pregnancy and FAS/FASD. In order to estimate alcohol-attributable road traffic fatalities and interpersonal violence due to the drinking of others, an attributable fraction methodology was applied to cause-of-death statistics for road traffic and interpersonal violence-related deaths. Results: For 2014, the incidences of FAS and FASD were estimated at 41 children per 10,000 live births (95% CI 24; 63) and 177 children per 10,000 live births (95% CI 135; 320), or 2930 (95% CI 1720; 4500) and 12,650 (95% CI 9650; 23,310) children, respectively. Furthermore, alcohol was estimated to be responsible for 1214 (95% CI 1141; 1287) third-party road traffic fatalities and 55 (95% CI 46; 64) deaths from interpersonal violence, representing 45.1% of all third-party road traffic fatalities and 14.9% of all interpersonal violence deaths. Conclusion: These study's estimates indicate there is a substantial degree of health harm to third parties caused by alcohol in Germany. While more research on harms to others caused by alcohol is needed to provide comprehensive estimates, the results indicate a need for effective prevention.
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| 10. |
- Loy, Johanna K., et al.
(författare)
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Changes in Alcoholic Beverage Choice and Risky Drinking among Adolescents in Europe 1999-2019
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:20
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores trends in beverage preference in adolescents, identifies related regional differences, and examines cluster differences in key drinking measures. Data were obtained from the European School Survey Project on Alcohol and Other Drugs (ESPAD), covering 24 European countries between 1999 and 2019. Trends in the distribution of alcoholic beverages on the participants’ most recent drinking occasion were analysed by sex and country using fractional multinomial logit regression. Clusters of countries based on trends and predicted beverage proportions were compared regarding the prevalence of drinkers, mean alcohol volume and prevalence of heavy drinking. Four distinct clusters each among girls and boys emerged. Among girls, there was not one type of beverage that was preferred across clusters, but the proportion of cider/alcopops strongly increased over time in most clusters. Among boys, the proportion of beer decreased, but was dominant across time in all clusters. Only northern European countries formed a geographically defined region with the highest prevalence of heavy drinking and average alcohol volume in both genders. Adolescent beverage preferences are associated with mean alcohol volume and heavy drinking at a country-level. Future approaches to drinking cultures need to take subpopulations such as adolescents into account.
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