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Sökning: L773:1360 0443 OR L773:0965 2140 > Kraus Ludwig

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1.
  • Ludwig, Monika, et al. (författare)
  • Gambling experiences, problems, research and policy : gambling in Germany
  • 2013
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 108:9, s. 1554-1561
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims The objective of this paper is to present an overview of gambling in Germany, including historical development, legislative and economic changes as well as treatment options and their effectiveness. Methods The available scientific literature and research reports on gambling in Germany were reviewed to obtain relevant information on history, commercialization, legislation, treatment and research agenda. Results Gambling in Germany is characterized by compromises between protective and economic efforts. At present, gambling is illegal in Germany, and provision is subject to the state monopoly. Mere gaming machines (specific slot machines) are not classified as gambling activity, permitting commercial providers. In recent years, implementing regulations for state gambling and gaming machines have been changed. Concerning the treatment of pathological gambling, various options exist; treatment costs have been covered by health and pension insurance since 2001. Information on the effectiveness of treatment in Germany is limited. Similarly, the number of peer-reviewed publications on gambling is small. Conclusions German gambling legislation was subject to major changes in the past years. Based on the available body of research (longitudinal), studies on risk and protective factors and the aetiology of pathological gambling are needed. The effectiveness of pathological gambling treatment in Germany and the impact of gambling regulations on gambling behaviour also need to be investigated.
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2.
  • Kilian, Carolin, et al. (författare)
  • A new perspective on European drinking cultures : a model-based approach to determine variations in drinking practices among 19 European countries
  • 2021
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 116:8, s. 2016-2025
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims In recent decades, alcohol drinking in the European Union has been characterized by increasing homogenization of levels of drinking coupled with an overall decrease. This study examined whether we can still distinguish distinct practices of drinking by addressing two research questions: (1) are drinking practices still characterized by the choice of a certain alcoholic beverage; and (2) how do drinking practices vary across countries?Design Cross-sectional study: latent-class analyses of drinking variables and fractional response regression analyses of individual characteristics for individual-level class endorsement probabilities, respectively.Setting Nineteen European countries and one autonomous community.Participants A total of 27 170 past-year drinkers aged 18-65 years in 2015.Measurements Data were collected through the Standardized European Alcohol Survey included frequency of past-year drinking, pure alcohol intake per drink day, occurrence of monthly risky single-occasion drinking and preferred beverage, together with socio-demographic data.Findings Three latent classes were identified: (1) light to moderate drinking without risky single-occasion drinking [prevalence: 68.0%, 95% confidence interval (CI) = 66.7-69.3], (2) infrequent heavy drinking (prevalence: 12.6%, 95% CI = 11.5-13.7) and (3) regular drinking with at least monthly risky single-occasion drinking (prevalence: 19.4%, 95% CI = 18.1-20.9). Drinking classes differed considerably in beverage preference, with women reporting a generally higher share of wine and men of beer drinking. Light to moderate drinking without risky single-occasion drinking was the predominant drinking practice in all locations except for Lithuania, where infrequent heavy drinking (class 2) was equally popular. Socio-demographic factors and individual alcohol harm experiences (rapid alcohol on-line screen) explained up to 20.5% of the variability in class endorsement.Conclusions Beverage preference appears to remain a decisive indicator for distinguishing Europeans' drinking practices. In most European countries, multiple drinking practices appear to be present.
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3.
  • Kraus, Ludwig, et al. (författare)
  • 'Are The Times A-Changin'? Trends in adolescent substance use in Europe
  • 2018
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 113:7, s. 1317-1332
  • 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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4.
  • Kraus, Ludwig, et al. (författare)
  • Changes in mortality due to major alcohol-related diseases in four Nordic countries, France and Germany between 1980 and 2009 : a comparative age-period-cohort analysis
  • 2015
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 110:9, s. 1443-1452
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: To investigate age, period and cohort effects on time trends of alcohol-related mortality in countries with different drinking habits and alcohol policies.Design and setting: Age-period-cohort (APC) analyses on alcohol-related mortality were conducted in Denmark, Finland, Norway, Sweden, France and Germany.Participants: Cases included alcohol-related deaths in the age range 20-84 years between 1980 and 2009.Measurements: Mortality data were taken from national causes of death registries and covered the ICD codes alcoholic psychosis, alcohol use disorders, alcoholic liver disease and toxic effect of alcohol.Findings: In all countries changes across age, period and cohort were found to be significant for both genders [effect value with confidence interval (CI) shown in Supporting information, Table S1]. Period effects pointed to an increase in alcohol-related mortality in Denmark, Finland and Germany and a slightly decreasing trend in Sweden, while in Norway an inverse U-shaped curve and in France a U-shaped curve was found. Compared with the cohorts born before 1960, the risk of alcohol-related mortality declined substantially in cohorts born in the 1960s and later. Pairwise between-country comparisons revealed more statistically significant differences for period (P<0.001 for all 15 comparisons by gender) than for age [P<0.001 in seven (men) and four (women) of 15 comparisons] or cohort [P<0.01 in two (men) and three (women) of 15 comparisons].Conclusions: Strong period effects suggest that temporal changes in alcohol-related mortality in Denmark, Finland, Norway, Sweden, France and Germany between 1980 and 2009 were related to secular differences affecting the whole population and that these effects differed across countries.
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5.
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6.
  • Kraus, Ludwig, 1955-, et al. (författare)
  • Does the decline in Swedish adolescent drinking persist into early adulthood?
  • 2024
  • Ingår i: Addiction. - 0965-2140 .- 1360-0443. ; 119:2, s. 259-267
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: Sweden has experienced a substantial decrease in adolescent drinking over the past decades. Whether the reduction persists into early adulthood remains unclear. Using survey data, the present study aimed to determine whether reductions in indicators of alcohol use observed among adolescents remain in early adulthood and whether changes in alcohol intake are consistent among light/moderate and heavy drinkers.Design: Data from the Swedish monthly Alcohol Monitoring Survey (2001–20) were used to construct five 5-year birth cohorts (1978–82, 1983–87, 1988–92, 1993–97 and 1998–2002).Setting: Sweden.Participants: A total of n = 52 847 respondents (48% females) aged 16 and 30 years were included in this study.Measurements: For both males and females, temporal changes in the prevalence of any drinking, the prevalence of heavy episodic drinking (HED) and total alcohol intake in the past 30 days in centilitres were analysed.Findings: The prevalence of any drinking in more recent cohorts remained low until young people came into their early (females) and mid- (males) 20s. Male cohorts differed in the prevalence of HED across age, with the later cohorts showing lower odds than earlier cohorts (odds ratios between 0.54 and 0.66). Among females, no systematic differences between cohorts across age could be observed. Later male birth cohorts in light/moderate drinkers had lower alcohol intake than earlier cohorts (correlation coefficients between −0.09 and −0.54). No statistically significant cohort effects were found for male heavy drinkers. Although differences in alcohol intake among females diminished as age increased, the cohorts did not differ systematically in their level of alcohol intake.Conclusions: In Sweden, the reduced uptake of drinking in adolescents appears to fade as people move into adulthood. Observed reductions in alcohol intake among light and moderate drinkers appear to persist into adulthood. More recent male cohorts show a lower prevalence rate of heavy episodic drinking.
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7.
  • Molinaro, Sabrina, et al. (författare)
  • Prevalence of youth gambling and potential influence of substance use and other risk factors throughout 33 European countries : first results from the 2015 ESPAD study
  • 2018
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 113:10, s. 1862-1873
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aimsAlthough generally prohibited by national regulations, underage gambling has become popular in Europe, with relevant cross‐country prevalence variability. This study aimed to estimate the prevalence of underage gambling in Europe stratified by type of game and on‐/off‐line mode and to examine the association with individual and family characteristics and substance use.DesignOur study used data from the 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross‐sectional study, a survey using self‐administered anonymous questionnaires.SettingThirty‐three European countries.ParticipantsSixteen‐year‐old‐year‐old students (n = 93 875; F = 50.8%).MeasurementsThe primary outcome measure was prevalence of past‐year gambling activity. Key predictors comprised individual behaviours, substance use and parenting (regulation, monitoring and caring).FindingsA total of 22.6% of 16‐year‐old students in Europe gambled in the past year: 16.2% on‐line, 18.5% off‐line. High prevalence variability was observed throughout countries both for mode and types of game. With the exception of cannabis, substance use shows a higher association with gambling, particularly binge drinking [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.39–1.53), life‐time use of inhalants (OR = 1.57, 95% CI = 1.47–1.68) and other substances (OR = 1.78, 95% CI = 1.65–1.92)]. Among life habits, the following showed a positive association: truancy at school (OR = 1.26, 95% CI = 1.18–1.35), going out at night (OR = 1.32, 95% CI = 1.26–1.38), participating in sports (OR = 1.30, 95% CI = 1.24–1.37). A negative association was found with reading books for leisure (OR = 0.82%, 95% CI = 0.79–0.86), parents’ monitoring of Saturday night activities (OR = 0.81, 95% CI = 0.77–0.86) and restrictions on money provided by parents as a gift (OR = 0.89, 95% CI = 0.84–0.94).ConclusionsUnderage gambling in Europe appears to be associated positively with alcohol, tobacco and other substance use (but not cannabis), as well as with other individual behaviours such as truancy, going out at night and active participation in sports, and is associated negatively with reading for pleasure, parental monitoring of evening activities and parental restriction of money.
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8.
  • Olderbak, Sally, et al. (författare)
  • Trends and projection in the proportion of (heavy) cannabis use in Germany from 1995 to 2021
  • 2024
  • Ingår i: Addiction. - 0965-2140 .- 1360-0443. ; 119:2, s. 311-321
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: To measure the current trends of cannabis use in Germany, measure trends in the proportion of heavy cannabis users and estimate future cannabis use rates.Design: Repeated waves of the Epidemiological Survey on Substance Abuse, a cross-sectional survey conducted between 1995 and 2021 with a two-stage participant selection strategy where respondents completed a survey on substance use delivered through the post, over the telephone or on-line.Setting: Germany.Participants/cases: German-speaking participants aged between 18 and 59 years living in Germany who self-reported on their cannabis use in the past 12 months (n = 78 678). With the application of a weighting scheme, the data are nationally representative.Measurements: Questions on the frequency of cannabis use in the past 12 months and self-reported changes in frequency of use due to the COVID-19 pandemic.Findings: The prevalence of past 12-month cannabis users increased from 4.4% [95% confidence interval (CI) = 3.7, 5.1] in 1995 to 10.0% (95% CI = 8.9, 11.3) in 2021. Modeling these trends revealed a significant increase that accelerated over the past decade. The proportion of heavy cannabis users [cannabis use (almost) daily or at least 200 times per year] among past-year users has remained steady from 1995 (11.4%, 95% CI = 7.7, 16.5) to 2018 (9.5%, 95% CI = 7.6, 11.9), but significantly increased to 15.7% (95% CI = 13.1, 18.8) in 2021 during the COVID-19 pandemic. Extrapolating from these models, the prevalence of 12-month cannabis users in 2024 is expected to range between 10.4 and 15.0%, while the proportion of heavy cannabis users is unclear.Conclusions: Trends from 1995 to 2021 suggest that the prevalence of past 12-month cannabis users in Germany will continue to increase, with expected rates between 10.4 and 15.0% for the German-speaking adult population, and that at least one in 10 cannabis users will continue to use cannabis heavily (almost daily or 200 + times in the past year).
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9.
  • Pabst, Alexander, et al. (författare)
  • Decomposing social inequalities in alcohol consumption in Germany 1995-2015 : an age-period-cohort analysis
  • 2019
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 114:8, s. 1359-1368
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims Previous research indicates that compared with individuals with lower socio-economic status (SES), individuals in higher SES groups are more often drinkers but those who drink report drinking smaller amounts more frequently. We aimed to decompose trends in self-reported alcohol consumption in Germany into age, period and birth cohort effects and examine whether these effects varied by SES. Design Age-period-cohort (APC) analysis using data from eight waves of the cross-sectional German Epidemiological Survey of Substance Abuse (ESA) collected between 1995 and 2015. Setting Germany. Participants The analytical sample included n=65821 individuals aged 18-64years reporting alcohol use within the last 30days. Measurements Alcohol measures included drinking prevalence, alcohol volume and prevalence of episodic heavy drinking (EHD). Educational attainment was used as an indicator of SES. A series of generalized linear and logistic regression models, including both main and interaction effects of age, period and cohort with SES, were estimated. Findings Regression models revealed significant interactions between APC effects and SES on two alcohol consumption measures. Higher SES was consistently associated with drinking prevalence across age (P<0.001), period (P=0.016) and cohort (P=0.016), and with volume of drinking in younger cohorts (P=0.002) and 50+-year-olds (P=0.001). Model results were inconclusive as to whether or not APC effects on EHD prevalence differed by SES. Conclusions In Germany, there are positive associations between socio-economic status and alcohol consumption during the life-course, over time and among birth cohorts. Three groups appear vulnerable to risky drinking: high socio-economic status young birth cohorts who drink high average quantities, low socio-economic status young birth cohorts who show a risky drinking pattern and high socio-economic status adults in their 50s and older who increase their drinking volume beyond that age.
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10.
  • Piontek, Daniela, et al. (författare)
  • Trends in alcohol-related mortality in East and West Germany, 1980-2014 : age, period and cohort variations
  • 2018
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 113:5, s. 836-844
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims Several indicators suggest that the extent and trends of alcohol-related mortality differ between East and West Germany. Regional drinking patterns and differences in health-care systems are assumed to affect the risk of dying from an alcohol-induced disease. The study addresses two questions: (1) what are the unbiased and independent age, period and cohort effects on alcohol-related mortality trends in Germany; and (2) do these trends differ between East and West Germany? Methods Data on alcohol-related mortality for East and West Germany came from the national causes of death register for the years 1980-2014. Analyses included all deaths fully attributable to alcohol based on the International Classification of Diseases (ICD-9 and ICD-10). Gender-stratified age-period-cohort analyses were conducted using the intrinsic estimator model. Results Age effects showed a concave pattern with a peak at ages 55-64years in both regions. Incidence rate ratios (IRR) in East Germany were highest in the years 1990-1994 (men and women: IRR=1.52) and declined thereafter. In West Germany, IRR were lowest in 1980-1984 (men: IRR=0.81, women: IRR=0.75) and stabilized at approximately 1.10 since 1995-1999. Cohort effects showed continuously lower IRR for those born after 1955-1959 in the East and those born after 1945-1949 in the West. Patterns for males and females were comparable. Conclusions The results suggest that alcohol-related mortality showed different trends in East and West Germany, which can be explained partly by different drinking patterns before and changes in the health-care system after the reunification.
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