Binge Drinking Associations with Patrons' Risk Behaviors and Alcohol Effects after Leaving a Nightclub: Sex Differences in the "Balada com Ciência" Portal Survey Study in Brazil

Protective strategies and motivations to control drinking among Brazilian college students: a qualitative study

BACKGROUND

To develop prevention programs or early interventions to reduce alcohol consumption and related problems among college students, it is essential to understand their motivations for drinking and the spontaneous (effective and non-effective) strategies they employ to control, considering the social and cultural contexts influence. This study aimed to explore these factors and the student's application of selfcare in different situations and environments, as well as to identify their reasons for not drinking.

METHODS

The students were invited to participate using a snowball sampling, up to the theoretical saturation point. Qualitative individual semi-structured interviews were carried out and the interviews contents were analyzed using the NVivo software. The participants were 23 college students between 18 and 24 years old, with diverse patterns of alcohol use (low-risk to suggestive of dependence).

RESULTS

Data analysis highlighted three main themes: (a) Contexts (such as bars, "open bar" parties and others) and consumption patterns; (b) Protective Strategies (such as stop-drinking intervals, eating before or during drinking, returning home in the company of a friend); (c) Motivations to control drinking (such as sense of responsibility, bad previous experiences, family and religious issues). Protective strategies and motivation to control drinking were perceived to be less prominent in specific contexts that favor high alcohol consumption, as open bar parties.

CONCLUSIONS

Motivations and protective strategies varied according to the drinkers' profile, social situations and settings in which they consumed alcohol. The results highlight the need for preventive interventions planned for specific drinking patterns and contexts.

Effects of multi-component programmes in preventing sales of alcohol to intoxicated patrons in nightlife settings in the United Kingdom

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Alcohol service to intoxicated patrons in nightlife settings is common.

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Multi-component interventions can prevent alcohol over-service.

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Effects are stronger for interventions including enhanced law enforcement.

Introduction

Alcohol service to intoxicated patrons is common across nightlife settings and preventing such sales is a key priority globally. In England and Wales, three multi-component programmes have been implemented including: (1) community mobilisation, responsible beverage server (RBS) training and routine law enforcement; (2) community mobilisation and enhanced law enforcement; and, (3) community mobilisation, RBS training and enhanced law enforcement. This study estimates the association between sales of alcohol to pseudo-intoxicated patrons and implementation of three multi-component interventions in four nightlife settings.

Methods

Alcohol test purchases by pseudo-intoxicated actors were implemented at pre (n = 206) and post-intervention (n = 224). Actors/observers recorded venue and test purchase characteristics. Logistic regression assessed service refusal by intervention type, adjusting for venue/test purchase characteristics.

Results

Pre-intervention, 20.9% of sales were refused. Post-intervention, 42.1%, 68.8% and 74.0% of sales were refused in areas with intervention 1, 2, and 3 respectively. In adjusted analyses, compared to pre-intervention, the odds of service refusal were higher for all interventions, with the highest odds when the intervention included enhanced law enforcement (adjusted odds ratios, interventions 1, 2, 3: 2.6, 7.1, 14.4; p < 0.01). Service refusal was higher if the test purchase was implemented on a Saturday/Sunday night; and lower if implemented in a nightclub or if age verification was requested at the bar.

Conclusion

Community-based multi-component interventions were associated with significant increases in service refusal to pseudo-intoxicated actors in nightlife settings in England and Wales. Effects were stronger for interventions including enhanced law enforcement, and particularly if all intervention components were implemented.

Prevalence and sociodemographic factors associated with heavy drinking in Brazil: cross-sectional analyses of the National Health Survey

OBJECTIVE

This article aims to characterize the heavy drinking behavior in the Brazilian population, using data from the two editions of the "National Health Survey" (PNS), 2013 and 2019.

METHODS

The sample sizes in 2013 and 2019 were 60,202 and 88,943 individuals aged 18 years or older, respectively. The prevalence of the habit of heavy drinking (defined as 8 or more doses per week for women, and 15 or more doses for men) was estimated, and the confidence intervals were defined by sex, age group, schooling, skin color/race, marital status and household status (urban/rural). Poisson regression models were used to compare prevalence rates.

RESULTS

6.1% of Brazilians were heavy drinkers in 2013, and 7.3% in 2019. In the two editions of the PNS there was a gradient of reduction in heavy drinking throughout life, being the highest prevalence among young adults, men, with low schooling, single and living in the urban area.

CONCLUSIONS

The high prevalence rates expose the need to consider the habit of heavy drinking as a risk factor for the health of the Brazilian population, and the urgency to adopt strategies to reduce it.

Ride hailing app use and drunk/drugged driving among young adult nightclub patrons

OBJECTIVE

Nightclub patrons who consume alcohol and drugs in these venues would appear to be an important population to target with on-demand ride hailing app (RHA) services to reduce drunk/drugged driving (DUI). The present study is an exploratory examination of RHA use to avoid DUI behavior, as well as the perceived barriers and benefits of such RHA use, among young adult nightclub patrons in Miami who use drugs.

METHODS

Completers of a 2011-2015 randomized controlled trial of brief interventions to reduce health risk behaviors among young adult nightclub patrons were recruited to participate in a single self-administered computer-assisted interview about health risks, driving behaviors, and RHA perceptions and use. Recruitment (N = 123) began in June 2016 and ended in July 2017. Bivariable logistic regression and ANOVA models examined group differences between: (a) those who had used an RHA to avoid DUI vs. not; and (b) those who used RHAs as their primary mode of transportation to nightclubs vs. not.

RESULTS

About half were female (52.8%); median age was 29; 59.4% Hispanic, 31.7% Black, 8.1% white, 0.8% other race/ethnicity. Recent alcohol and marijuana use were almost universally endorsed, and more than half reported recent use/misuse of cocaine (72.4%), MDMA (63.4%), and prescription benzodiazepines (62.6%) and opioids (56.9%). More than 80% reported driving under the influence of alcohol and/or drugs in the past 12 months, and 17.1% experienced a DUI arrest in the prior two years. Almost two-thirds (65.9%) of participants had used an on-demand RHA to avoid DUI, but self-driving or riding in another's car were the most common (76.4%) primary modes of transportation to clubs. RHAs were the primary mode of travel to clubs for 21 (17.1%) respondents. Participants whose friends strongly disapproved of DUI were more than twice as likely to have used RHAs for this reason compared to those who had not done so. Those reporting RHA use to avoid DUI were less likely than others to have driven under the influence in the past 12 months and were somewhat more likely to endorse DUI-related risks. Those who used alternate modes of transportation were more likely than those who used RHAs as their primary mode of transportation to clubs to endorse the expense of RHAs and the lack of RHA drivers near their favorite clubs as barriers to RHA use to travel to nightclubs.

CONCLUSIONS

This novel study among a high-risk population points to the potential for on-demand RHAs to reduce DUI behaviors and arrests among young adult nightclub patrons who consume alcohol and/or drugs in the context of the club experience. Our findings point to key educational, peer support, and structural targets for intervention to increase the use of RHAs among this population, specifically, club-based incentives for increasing RHA availability and affordability. Research is needed to fully elucidate the findings of this exploratory study, including potential differences in intervention approaches depending on the location-specific public transportation options.

Signs of altered psychomotor capacity and use of alcohol and other drugs among nightclub patrons who drive in the city of São Paulo, Brazil

Objectives: To investigate the occurrence of signs of altered psychomotor capacity (SAPC) associated with the violation of the dry law at the exits of nightclubs in the city of São Paulo, Brazil.Methods: Data from drivers participating in the Balada com Ciência project were used. Alcohol dosages were measured with breathalyzer test. The use of other drugs was obtained by interviewees' self-report. SAPC (speech, walking, glazed eyes, and alcohol odor) were verified by the interviewers at the time of the interview and categorized as "no sign" or "at least one sign". All measurements were evaluated at the exit of the nightclubs. The population description considered the sample weighting. Logistic regression analysis evaluated the association between the occurrence of SAPC, alcohol and other drugs use, controlling for sociodemographic variables.Results: At nightclubs, the SAPC among drivers are about 8 times higher when the breath alcohol concentration is above 0.05 mg/L if compared with those who did not drink alcohol, and about 30 times higher when the alcohol concentration was ≥ 0.34 mg/L in exhaled air. This finding is not generally verified in the literature for those who report the use of drugs inside nightclubs, which is interesting, since 20.4% of the interviewed population reported using drugs in the places surveyed.Conclusion: This study suggests the potential of using the Perham (2007) physical test for alcohol intoxication in sobriety checkpoints at the exit of nightclubs. However, the verification of these signs is not enough for the identification of drug use by drivers.

Ideal, expected and perceived descriptive norm drunkenness in UK nightlife environments: a cross-sectional study

Background

Drunkenness is common in nightlife environments and studies suggest it can be considered both desirable and normal by nightlife users. We aimed to compare UK nightlife users’ ideal levels of drunkenness to their expected drunkenness on a night out and their perceptions of descriptive nightlife norms.

Methods

A cross-sectional survey with nightlife patrons (n = 408, aged 18–35) in three cities. Using a scale from 1 (completely sober) to 10 (very drunk), participants rated: personal drunkenness at survey; expected drunkenness on leaving nightlife; perceived descriptive drunkenness norm in the city’s nightlife; and ideal personal drunkenness. Analyses were limited to those who had or were intending to consume alcohol.

Results

Almost half of participants (46.8%) expected to get drunker than their reported ideal level on the night of survey, rising to four fifths of those with the highest levels of expected drunkenness. 77.9% rated typical nightlife drunkenness ≥8 but only 40.9% expected to reach this level themselves and only 23.1% reported their ideal drunkenness as ≥8. Higher expected drunkenness was associated with higher ideal drunkenness, higher perceived drunkenness norm and later expected home time.

Conclusions

Nightlife users’ perceptions of typical drunkenness in nightlife settings may be elevated and many of the heaviest drinkers are likely to drink beyond their ideal level of drunkenness. Findings can support emerging work to address cultures of intoxication in nightlife environments and suggest that interventions to correct misperceptions of normal levels of nightlife drunkenness may be of benefit.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6802-5) contains supplementary material, which is available to authorized users.

Typology of Nightclubs in São Paulo, Brazil: Alcohol and Illegal Drug Consumption, Sexual Behavior and Violence in the Venues

BACKGROUND

Nightclubs are venues in which excessive alcohol use and illegal drug consumption occur in addition to other high-risk behaviors, such as violence and sexual risk behaviors. Environmental factors common in nightclubs and the personal characteristics of patrons might increase the risk of these events. To better understand the relationship between these factors, typologies were formulated that clustered nightclubs according to definite profiles to identify differences to be taken into consideration in preventive interventions.

OBJECTIVES

The present study aim was to construct a typology of nightclubs in São Paulo, Brazil.

METHODS

This typology was constructed using mixed methods research through the triangulation of several data sources as follows: 307 hours of ethnographic observation at 31 nightclubs, 8 focus group sessions with nightclub patrons (n = 34) and 30 semi-structured interviews with nightclub employees. Content analysis and qualitative typology were used.

RESULTS

Four nightclub types were defined based on four analyzed thematic axes (Intoxicating, Violent, Dancing and Highly Sexualized nightclubs). Excessive alcohol use was detected in almost all of the investigated nightclubs, and drug use was observed in approximately one-third of them. Triangulation of the data revealed a relationship among environmental factors (especially alcohol sales strategies and promotion and the availability of areas for sex) and a more considerable presence of high-risk behaviors.

CONCLUSIONS

The study shows that nightclubs are settings in which high-risk behaviors are potentiated by facilitating environmental factors as well as by the lack of laws restricting excessive alcohol use stimulated by the promotion strategies applied at these venues.

Web-based alcohol intervention for nightclub patrons: Opposite effects according to baseline alcohol use disorder classification

BACKGROUND

This study aimed to test the effectiveness of a Web-based intervention in preventing alcohol abuse among nightclub patrons.

METHODS

A probabilistic sample of the patrons of 31 nightclubs in São Paulo, Brazil, was invited to participate in an online screening using the Alcohol Use Disorders Identification Test (AUDIT). A total of 1057 patrons met the inclusion criteria to participate in the randomized controlled trial, with data collection at 0, 3, 6, and 12 months. At baseline, participants were classified into 2 AUDIT score groups: a "high-risk" group (AUDIT ≥8; 44%) and a "low-risk" group (AUDIT <8; 56%). In both groups, the intervention subgroup was exposed once to a personalized normative feedback screen with information on the participant's alcohol consumption and its potential consequences.

RESULTS

After 12 months, no differences were found between the intervention and the control conditions in either risk group. In the "high-risk" group, there were significant reductions of both the AUDIT score and the prevalence of binge drinking (BD) over time in both the control and the intervention subgroups. In addition, an effect of the intervention was observed at 6 months, i.e., there was an estimated 13% reduction in the AUDIT score in favor of the intervention subgroup (odds ratio [OR] = 0.87; 95% confidence interval [CI]: 0.76, 1.00). In the "low-risk" group, both the control patrons and those receiving the intervention had increased AUDIT scores.

CONCLUSION

The results suggest that the time effect of participating in the study may have had a beneficial outcome in reducing harmful drinking among patrons in the "high-risk" group. The intervention is not recommended to the "low-risk" group.

Effectiveness of a web-based intervention in reducing binge drinking among nightclub patrons

OBJECTIVE

To evaluate the effectiveness of a web-based intervention in reducing binge drinking among nightclub patrons after six months.

METHODS

We carried out a website survey with probabilistic sample in 31 nightclubs in the city of São Paulo, Brazil, which originated a randomized controlled trial with 1,057 participants. Those classified as problem drinkers (n = 465) using the Alcohol Use Disorders Identification Test were randomized into two study groups – intervention and control. The web-based intervention consisted of exposing the participants to a normative feedback screen about their alcohol consumption, characterizing the risks associated with amount consumed, money spent on drinks, drinking and driving, risk classification of Alcohol Use Disorders Identification Test, and tips to reduce damage.

RESULTS

There was a significant reduction in the practice of binge drinking in the week estimated at 38% among participants in the intervention group after six months (p < 0.05). However, there was no significant reduction in the outcomes when we analyzed the intervention and control groups and at baseline and after sixth months, simultaneously.

CONCLUSIONS

We cannot conclude that digital tools reduce the pattern of binge drinking among party goers in São Paulo. More studies are needed with this methodology because of its attractiveness to this type of group, given the privacy and speed that personalized information is transmitted.

Alcohol-related blackouts among college students: impact of low level of response to alcohol, ethnicity, sex, and environmental characteristics

Objective:

To explore how a genetically-influenced characteristic (the level of response to alcohol [LR]), ethnicity, and sex relate to environmental and attitudinal characteristics (peer drinking [PEER], drinking to cope [COPE], and alcohol expectancies [EXPECT]) regarding future alcohol-related blackouts (ARBs).

Methods:

Structural equation models (SEMs) were used to evaluate how baseline variables related to ARB patterns in 462 college students over 55 weeks. Data were extracted from a longitudinal study of heavy drinking and its consequences at a U.S. university.

Results:

In the SEM analysis, female sex and Asian ethnicity directly predicted future ARBs (beta weights 0.10 and -0.11, respectively), while all other variables had indirect impacts on ARBs through alcohol quantities (beta weights ~ 0.23 for European American ethnicity and low LR, 0.21 for cannabis use and COPE, and 0.44 for PEER). Alcohol quantities then related to ARBs with beta = 0.44. The SEM explained 23% of the variance.

Conclusion:

These data may be useful in identifying college students who are more likely to experience future ARBs over a 1-year period. They enhance our understanding of whether the relationships of predictors to ARBs are direct or mediated through baseline drinking patterns, information that may be useful in prevention strategies for ARBs.

Alcohol-Induced Blackouts: A Review of Recent Clinical Research with Practical Implications and Recommendations for Future Studies

BACKGROUND

Alcohol-induced blackouts, or memory loss for all or portions of events that occurred during a drinking episode, are reported by approximately 50% of drinkers and are associated with a wide range of negative consequences, including injury and death. As such, identifying the factors that contribute to and result from alcohol-induced blackouts is critical in developing effective prevention programs. Here, we provide an updated review (2010 to 2015) of clinical research focused on alcohol-induced blackouts, outline practical and clinical implications, and provide recommendations for future research.

METHODS

A comprehensive, systematic literature review was conducted to examine all articles published between January 2010 through August 2015 that focused on vulnerabilities, consequences, and possible mechanisms for alcohol-induced blackouts.

RESULTS

Twenty-six studies reported on alcohol-induced blackouts. Fifteen studies examined prevalence and/or predictors of alcohol-induced blackouts. Six publications described the consequences of alcohol-induced blackouts, and 5 studies explored potential cognitive and neurobiological mechanisms underlying alcohol-induced blackouts.

CONCLUSIONS

Recent research on alcohol-induced blackouts suggests that individual differences, not just alcohol consumption, increase the likelihood of experiencing an alcohol-induced blackout, and the consequences of alcohol-induced blackouts extend beyond the consequences related to the drinking episode to include psychiatric symptoms and neurobiological abnormalities. Prospective studies and a standardized assessment of alcohol-induced blackouts are needed to fully characterize factors associated with alcohol-induced blackouts and to improve prevention strategies.