The contexts of heavy drinking: A systematic review of the combinations of context-related factors associated with heavy drinking occasions

First semester college experiences: Associations with substance use and mental health

Introduction

Substance use (SU) and mental health (MH) concerns often occur as students transition from high school to college and may be associated with first semester experiences.

Methods

Incoming first-year college students at a U.S., predominantly white, midwestern university were recruited for an intervention study. Participants reported on substance use, mental health, and college experiences at the end of their first semester of college (n = 781; 62.9 % female, mean age = 18.06 [SD = 0.24]; 77.2 % non-Hispanic white; 84.6 % heterosexual). Data for these current analyses were cross-sectional.

Results

Identifying as Black, Indigenous, or another Person of Color, as a sexual minority, or as female was associated with more challenging first semester experiences. Social experiences that represent more social engagement were associated with greater substance use. College experiences reflecting an easier transition were associated with fewer mental health concerns. Alcohol use moderated the relation between academic challenges and mental health with stronger associations found at greater levels of alcohol use.

Conclusions

First semester experiences were related to student mental health and substance use, suggesting the importance of early, targeted support for students to adjust to campus life.

A systematic review of the associations between protective behavioral strategies and heavy alcohol consumption and consequences among young adults

OBJECTIVE

We systematically reviewed the literature to assess the association between use of alcohol protective behavioral strategies (PBS) and young adult heavy drinking and alcohol-related consequences.

METHOD

We followed the preferred reporting items for systematic review and meta-analysis guidelines to select and review research studies that were comprised of a sample of young adults ages 18-26, included PBS derived from one of 10 validated scales as an independent variable, measured heavy alcohol use or alcohol consequences as the dependent variable, and tested the direct association between the two. Studies were gathered via PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, APA PsycInfo, and Global Health. All identified study records underwent a two-step screening process and risk of bias assessment.

RESULTS

Data were extracted from 94 studies that met inclusion criteria; 16 studies (17%) examined associations with heavy alcohol use and 91 studies (97%) tested effects of PBS on alcohol consequences. All studies that measured a total effect of PBS use (summations across all strategies) found significant negative associations with heavy alcohol use and 91% were negatively associated with alcohol consequences. Most studies that examined subscales of PBS found at least one significant, negative relation with heavy alcohol use (73%) and alcohol-related consequences (78%), though effects varied across type of subscale (e.g., manner of drinking).

CONCLUSIONS

Our results support the use of PBS to address heavy alcohol consumption and related harms among young adults. Opportunities for refinement of current PBS in preventive interventions are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Drinking contexts, coping motive, simultaneous cannabis use, and high-intensity drinking among adults in the United States

AIMS

High-intensity drinking (HID), extreme drinking considerably above the level of heavy episodic drinking (HED), is associated with long-term health and social consequences. There is limited understanding of HID beyond young adulthood. This study aims to identify concurrent risk factors for HID, comparing age differences among all adults.

METHODS

Multinomial logistic and linear regression modeling was performed using a nationally-representative sample of adults (analytic n = 7956) from the 2015 and 2020 National Alcohol Surveys. The outcomes were any HID of 8-11 drinks and 12+ drinks for men, and 8+ drinks for women, and corresponding frequencies. Concurrent risk factors included coping motive, sensation seeking, simultaneous use of alcohol and cannabis (SAC), and drinking at a bar or party. Analyses were stratified by age (18-29 vs. older) and sex.

RESULTS

For younger men, sensation-seeking was significantly associated with HID (vs. no HED) at both levels and frequency of HID 8-11 drinks, while drinking to cope was only significant for 12+ drinks. For older men, drinking to cope was a consistent predictor for both HID level and its frequency, but sensation-seeking was not significant. Both coping and sensation-seeking were significantly associated with any HID for all women, while coping was significant for HID frequency for younger women. Frequent drinking at bars and parties were associated with greater odds of HID for all adults. With HED as referent, similar patterns of (though fewer significant) associations were observed.

CONCLUSIONS

Younger and older adults share similar risk factors for HID, with coping more consistent for older men.

How is alcohol consumption and heavy episodic drinking spread across different types of drinking occasion in Great Britain: An event-level latent class analysis

BACKGROUND

This paper aimed to (i) update a previous typology of British alcohol drinking occasions using a more recent and expanded dataset and revised modelling procedure, and (ii) estimate the average consumption level, prevalence of heavy drinking, and distribution of all alcohol consumption and heavy drinking within and across occasion types.

METHODS

The paper uses a cross-sectional latent class analysis of event-level diary data that includes characteristics of 43,089 drinking occasions in 2019 reported by 17,821 adult drinkers in Great Britain. The latent class indicators are characteristics of off-trade only (e.g. home), on-trade only (e.g. bar) and mixed trade (e.g. home and bar) drinking occasions. These describe companions, locations, purpose, motivation, accompanying activities, timings, consumption volume in units (1 UK unit = 8g ethanol) and beverages consumed.

RESULTS

The analysis identified four off-trade only, eight on-trade only and three mixed-trade occasion types (i.e. latent classes). Mean consumption per occasion varied between 4.4 units in Family meals to 17.7 units in Big nights out with pre-loading. It exceeded ten units in all mixed-trade occasion types and in Off-trade get togethers, Big nights out and Male friends at the pub. Three off-trade types accounted for 50.8% of all alcohol consumed and 51.8% of heavy drinking occasions: Quiet drink at home alone, Evening at home with partner and Off-trade get togethers. For thirteen out of fifteen occasion types, more than 25% of occasions involved heavy drinking. Conversely, 41.7% of Big nights out and 16.4% of Big nights out with preloading were not heavy drinking occasions.

CONCLUSIONS

Alcohol consumption varies substantially across and within fifteen types of drinking occasion in Great Britain. Heavy drinking is common in most occasion types. However, moderate drinking is also common in occasion types often characterised as heavy drinking practices. Mixed-trade drinking occasions are particularly likely to involve heavy drinking.

Contexts of Drinking- and Alcohol-Related Problems Among Whites and Hispanics on and off the US/Mexico border in California

BACKGROUND

This paper examines the association between drinking context use by Whites and Hispanics on and off the US/Mexico border and alcohol problems.

METHODS

Data come from a household sample of 1209 adults 18 to 39 years of age resident in Imperial County on the California/Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Data were collected on the phone or online and analyzed with an ordinal generalized linear model.

RESULTS

The pattern of statistically significant associations between the frequency and the volume of drinking in different contexts varies across problem types. Furthermore, some contexts of drinking are associated with problems in more than one area. For instance, frequency of drinking at bars/pubs is associated with social problems, risky sex, and fights, but not with injuries. Injuries are associated with the frequency of drinking at home alone or with family and at restaurants. Volume of drinking at bars/pubs is also significantly associated with three different contexts: social problems, injury, and fights. But the volume of drinking at the home of friends or relatives is associated with fights only. Border location is an effect modifier, changing the effect of frequency of drinking at bars and pubs from protective to a factor of risk for social problems and fights.

CONCLUSION

These results provide support for the social ecology of drinking and micro environmental factors or risk. The effect of border location on frequency of drinking in bars/pubs underlines the importance of the macro environment in problem generation.

Event-level risk for negative alcohol consequences in emerging adults: The role of affect, motivation, and context

OBJECTIVE

Decades of research has found support for the motivational model of alcohol use, such that positive/negative affect are indirectly associated with drinking behavior through drinking motives. However, research on event-level drinking motives is in its nascent stage, and studies have yet to consider how drinking context plays a role in the motivational pathway to both event- and person-level drinking behavior. Therefore, the present study seeks to test whether drinking context mediates the effect of affect and motivation on drinking outcomes at both the event- and person-level.

METHOD

Data for this Stage 1 Registered Report will come from a recently completed ecological momentary assessment (EMA) study in emerging adults. The study collected data on 131 emerging adults, of whom 107 reported event-level social and solitary drinking during the EMA period. Multilevel structural equation modeling will be used to test whether predrinking affect is associated with predrinking motives, and whether drinking context (social vs. solitary drinking) mediates the effect of drinking motives on drinking outcomes. Models will parse within-/between-person variance, allowing the present study to test whether drinking context serves as a mechanism of risk in the motivational model at the event-level, or solely at the between-person level. Findings will inform personalized interventions and motivational models of drinking behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Social and contextual factors associated with drinking before, during and after watching Australian Football League games: A pilot ecological momentary assessment study

INTRODUCTION

The aim of this study was to: (i) determine the feasibility of using ecological momentary assessment to collect data from Australian Football League (AFL) fans; (ii) explore pre-game, during-game and post-game consumption patterns of AFL fans; and (iii) explore the social and setting-related factors associated with risky single occasion drinking (5+ drinks) among AFL fans.

METHODS

Thirty-four participants completed up to 10 ecological momentary assessment surveys before, during and after 63 AFL games (n = 437 completed surveys). Surveys collected data about their drinking, and their social and environmental milieu (e.g., location, company). Binary logistic regression analyses clustered by participant identified which game-day characteristics were associated with higher odds of risky single occasion drinking. Significant differences between pre-game, during-game and post-game drinking on social and environmental factors were explored using pairwise comparisons.

RESULTS

Risky single occasion drinking was more likely when games began in the early-afternoon (1-3 pm) than late-afternoon (3-6 pm), when participants watched the game at a stadium or pub compared to home, and when participants watched the game with friends compared to family. Pre-drinking was more likely before night games and post-drinking was more likely after day games. Drinking during the game was heavier when watching the game at a pub and when watching with a combined group of friends and family.

DISCUSSION AND CONCLUSIONS

Preliminary findings suggest that social and contextual factors matter in the way alcohol is consumed while watching AFL games. These findings require further investigation in larger samples.

Drinking before sporting events in Australia: An ecological momentary assessment study

This study investigates the individual and event-level correlates of drinking prior to attending Australian Football League (AFL) games among a sample of Australian spectators.

A total of 30 adults (20% female, mean age = 32) completed a series of questionnaires (n = 417) before, during, and after an AFL match on a Friday, Saturday, or Sunday. Cluster-adjusted regression analyses were conducted to examine the impact of individual-level (age, gender, drinking habits) and event-level factors (time and day of game, location of viewing the game, viewing with friends or family) on drinking prevalence and the number of drinks consumed prior to the game.

41.4% of participants engaged in drinking before attending an AFL match with a mean of 2.3 drinks consumed by those who reported pre-game consumption. Those aged 30 and over were significantly more likely to engage in pre-game consumption (OR = 14.44, p = 0.024) and consumed significantly more pre-game (B = 1.39, p = 0.030). Drinking before the game was significantly more likely before night games than daytime games (OR = 5.24, p = 0.039). Those who watched the game on-premise consumed significantly more before the game than those who watched the game at a private residence or at home (B = 1.06, p = 0.030). Those who watched games with family also drank significantly less prior to the game than those who attended without family (B=-1.35, p = 0.010).

Addressing the contextual factors associated with drinking before the sporting events, such as the time of the game, may assist with efforts to reduce risky alcohol consumption and related harm.

Impact of COVID-19's Economic Burden on Alcohol-Related Problems: An Indirect Effect of Depression, Stress, and Anxiety

The COVID-19 pandemic resulted in global monumental upheaval. Many people were displaced from their jobs and sources of income. COVID-19 was also linked to increased mental health difficulties and increased alcohol consumption and problems. The current study aims to identify the indirect effect of depression, stress, and anxiety on the relations between the economic burden of COVID-19 and alcohol problems. Participants (N = 344) were recruited via Amazon's Mechanical Turk (MTurk). Participants completed a questionnaire about substance use, mood, and the economic burden of COVID-19. Eligible participants were 18 years or older, consumed alcohol or cannabis within the past week, and verified through Amazon. Results indicated significant indirect effects of depression, stress, and anxiety on the association between the economic burden of COVID-19 and alcohol problems regardless of use. Findings revealed large effect sizes, suggesting that mental health symptomatology may have a large impact on the association between COVID-19's economic burden and alcohol-related problems. Findings suggest mental health difficulties indirectly effect the association between COVID-19's economic burden and alcohol-related problems. Intervention efforts targeting mental health may be beneficial in reducing alcohol problems among individuals experiencing distress due to large-scale public health impact, such as the COVID-19 pandemic.

Attempts to Influence the Value of Alcohol by Manipulating Social Influence and Context

Background: Recent cognitive neuroscience models of value-based decision-making suggest value-based choices for alcohol are sensitive to various inputs, such as context and social influence. In two online experiments, we tested whether manipulating these inputs influenced proxies for alcohol value. Experiment 1: 157 social drinkers were presented with 4 hypothetical scenarios (drinking alone, with friends who are also drinking, with friends but trying to "cut-down" for health reasons, with friends who aren't drinking) in a within-subjects design, and completed the Brief Assessment of Alcohol Demand after each as a measure of value. Value for alcohol (number of drinks purchased) was greatest when drinking with friends who were also drinking compared to drinking alone (d = 0.95), friends not drinking (d = 1.49) and friends drinking/health related (d = 1.59). Value for alcohol was also greater when drinking alone compared to with friends who were not drinking (d = 0.55), and also with friends drinking/health related (d = 0.62). Experiment 2: 241 participants were randomly allocated to see one of four categories of images in a 2 (context: bar vs house) x 2 (social influence: enjoy vs not enjoy) design, before completing a Concurrent Choice Task for alcohol and Visual Analog Scales. There were no significant effects found on either task, both taken as proxies for value. Conclusion: There was inconclusive evidence that the value for alcohol could be manipulated by social context. This could be explained by greater saliency of the manipulation in asking participants to imagine themselves in a hypothetical situation as opposed to presenting images depicting drinking scenarios.

Young Adult Physical, Social, and Temporal Contexts of Simultaneous Alcohol and Marijuana Use

OBJECTIVE

Simultaneous alcohol and marijuana (SAM) use is reported to be associated with heavier alcohol and marijuana use and more negative consequences, but less is known about the social, physical, and temporal contexts of SAM use.

METHOD

Young adults (N = 326, 51.2% male, 49.1% White non-Hispanic) who reported past-month SAM use completed up to 14 daily surveys across five bursts that assessed SAM use and negative consequences and social, physical, and temporal contexts. We used multilevel models to examine SAM use contexts' associations with alcohol/marijuana quantity and consequences.

RESULTS

The social context of alone only (vs. with others only) was associated with consuming fewer drinks. Physical contexts that included using both at home and outside the home (vs. only at home) were associated with greater alcohol and marijuana quantity and negative consequences (but not after controlling for alcohol quantity); use outside the home only (vs. only at home) was associated with more alcohol use, more alcohol consequences (but not after controlling for alcohol quantity), and fewer marijuana consequences (even after controlling for marijuana quantity). The temporal context of first engaging in SAM use before 6 P.M. (vs. after 9 P.M.) was associated with greater alcohol and marijuana quantity and more marijuana consequences (but not after controlling for number of hours high), and first engaging in SAM use between 6 and 9 P.M. was associated with more hours high.

CONCLUSIONS

SAM use contexts such as using with others, using outside the home, and using earlier in the evening are typically associated with greater alcohol/marijuana quantity and consequences.

Strategies to maintain recovery from alcohol problems during the COVID-19 pandemic: Insights from a mixed-methods national survey of adults in the United States

The COVID-19 pandemic has been associated with poorer mental health and, in some cases, increased alcohol consumption; however, little is known about the pandemic's effects on people in recovery from alcohol use disorder (AUD), especially how they have coped with novel stressors. Our mixed-methods study investigated strategies used to maintain recovery during the pandemic, with attention to variation by gender. We analyzed data obtained in fall 2020 from an online US national survey of adults with resolved AUD (n = 1,492) recruited from KnowledgePanel, a probability-based cohort of non-institutionalized adults maintained by Ipsos for internet-based research. Participants endorsed possible coping strategies on a 19-item choose-all-that-apply list, which were analyzed using chi-square tests. In addition, 1,008 participants provided text responses to an open-ended question about their strategies to maintain recovery during the pandemic, which were coded and analyzed using an inductive, thematic approach. The majority of our sample met criteria for severe lifetime AUD (72.9%), reported being in recovery more than five years (75.5%), and had never used specialty AUD services or mutual-help groups (59.7%). The ordering of the coping strategies was quite similar for women and men; however, the top strategy (talking with family and friends by phone, text, or video) was endorsed more frequently by women than men (49.7% vs. 36.1%; p < .001). Among qualitative themes, "staying connected" was the most common. It was dominated by statements about family, with women mentioning children more often than men. Among other themes, "cognitive strategies" mirrored established therapeutic modalities, and "active pursuits" aligned with many recent recommendations for service providers working with substance-using populations during the pandemic. A minority of participants invoked "willpower" for recovery or stated that pandemic restrictions helped by reducing exposure to relapse risks. These findings shed light on recovery mechanisms during the COVID-19 pandemic and suggest potential intervention targets to support recovery during other catastrophic events, such as natural disasters.

Alcohol use contexts (social settings, drinking games/specials, and locations) as predictors of high-intensity drinking on a given day among U.S. young adults

BACKGROUND

This study examined whether variability in young adult drinking social settings, drinking games/drink price specials, and locations differentiated daily high-intensity drinking (HID) likelihood; whether contexts varied by legal drinking age and college status (attending a 4-year college full-time); and whether legal drinking age and college status moderated drinking context/intensity associations.

METHODS

Participants (n = 818 people, 46.3% female) were part of the Young Adult Daily Life Study in 2019 to 2022. They were originally selected because they were past 30-day drinkers from the 2018 U.S. national probability Monitoring the Future 12th grade sample and because they reported one or more days of alcohol use during 14-day data collection bursts across the following 4 years (n = 5080 drinking days). Weighted multilevel modeling was used to estimate drinking context/intensity associations. Drinking intensity was defined as moderate (females 1 to 3, males 1 to 4 drinks), binge (4 to 7, 5 to 9 drinks), or HID (8+, 10+ drinks). Models controlled for other within-person (weekend, historical time period) and between-person (sex and race/ethnicity) covariates.

RESULTS

Contexts differentiating HID and binge drinking days included drinking with large groups, strangers, pregaming, drinking games, and more drinking locations. Legal drinking age was associated with lower odds of free drinks but greater odds of drinking at bars/restaurants. College status was associated with lower odds of drinking alone or free drinks, but greater odds of drinking with friends, large groups, pregaming, drinking games, discounted price drinks, and at bars/restaurants, parties, and more drinking locations. Legal drinking age and college status moderated some context-intensity associations.

CONCLUSIONS

Social settings, pregaming, drinking games, and drinking at more locations were associated with increased risk of HID on a given day. Legal drinking age and college status were associated with specific drinking contexts and moderated some context/intensity associations. Incorporating the contexts associated with HID into interventions may help to reduce HID and related consequences in young adults.

A real opportunity to modify cardiovascular risk through primary care and prevention: A pilot study

Cardiovascular diseases (CVDs) represent a major threat to health and primary prevention outstands as the most effective instrument to face this issue, addressing multiple risk factors at a time and influencing behavioral patterns. Community nurses have been involved in many interdisciplinary prevention activities, resulting in effective control of CV risk factors. We conducted a pilot study aiming at describing the impact on the CV risk profile of an 18-month interdisciplinary intervention on lifestyle habits. From September 2018 to May 2020, four general practitioners (GPs) working in the Roman neighborhood of Torresina recruited patients having a cardiovascular risk score (CRS) equal to or higher than 3% and lower than 20%; those patients were included in a nutritional, physical, and psychological counseling program. Assessments of patients' health status were led at baseline, 6, 12, and 18 months by a nutritionist, a physiotherapist, a psychologist, their GPs, and a community nurse. The CRS was estimated at every examination, based on the Italian Progetto Cuore algorithm. A total of 76 patients were included (mean age of 54.6 years; 33 men and 43 women). Mean CRS showed a significant reduction between baseline and 12 months (from 4.9 to 3.8); both total cholesterol and systolic blood pressure (SBP) significantly decreased at 6 months of follow-up (respectively, from 211.1 to 192 and from 133.1 to 123.1). Nonetheless, the reduction was later maintained only for SBP. However, during the last 6 months of the intervention, the COVID-19 pandemic broke out, thus, it is not possible to know how much the results achieved at 18 months were influenced by the restrictive measures introduced by the Italian government. When stratifying according to the presence of hypertension/diabetes and physical activity, no differences in the CRS could be highlighted between the two groups. Our pilot study proved that an interdisciplinary counseling intervention program can improve CV risk profile and could be further spread to people that, according to their CRS, would benefit more from changes in lifestyles.

The role of positive affect in the association between stress and college student alcohol use

OBJECTIVE

To examine the associations among stress, positive affect, binge drinking, and coping drinking motives.

PARTICIPANTS

Students (n = 351, M_age=19.7, 74.6% female) at a northeastern public university.

METHODS

Participants completed an online survey assessing perceived stress, frequency of experiencing positive emotions, frequency of binge drinking, and coping drinking motives.

RESULTS

Stress and positive emotions were not significantly related to frequency of binge drinking but were significantly correlated with coping motives for drinking. Regression analyses with all predictors, age, and gender in the model revealed the same: stress and positive emotion were not significantly related to binge drinking but were significantly related to coping motives. The interaction between stress and positive emotions predicting frequency of binge drinking or coping motives was nonsignificant.

CONCLUSIONS

Findings suggest the utility of exploring positive emotions in risk and resilience research focused on college student drinking and of targeting positive emotions to decrease students' coping-related alcohol use.

Alcohol Consumption During the First Year of the COVID-19 Pandemic in the United States: Results From a Nationally Representative Longitudinal Survey

INTRODUCTION

Alcohol consumption and risky drinking behavior increased in the early phases of the COVID-19 pandemic in the United States, but it is not known if and for whom those changes were sustained over the longer term. This study analyzes longitudinal data on drinking patterns during the first year of the COVID-19 pandemic in the United States.

METHODS

A nationally representative longitudinal survey was used to assess alcohol consumption patterns among respondents 21 years and older who reported drinking between February and November 2020 (N = 557) overall and by subgroups.

RESULTS

Compared with February, drinks per month in April and November 2020 significantly ( P ≤ 0.01) increased by 36% and 38%, respectively. The proportion exceeding drinking guidelines significantly increased by 27% and 39%, and increases for binge drinking were 26% and 30% (both P = 0.01). February to November increases in proportion exceeding drinking guidelines were significantly larger for women (54% increase) than for men (32%), and for Black (508%) than for White respondents (16%). Drinks per month significantly increased more for respondents with children in the household (64%) than for those without children (20%). There also was a significantly larger increase in drinks per month for those who reported drinking to cope (57% increase) and those who reported drinking for enhancement (40%) than for those who did not.

CONCLUSIONS

Self-reported alcohol consumption and risky drinking patterns increased during the first year of the COVID-19 pandemic. Monitoring alcohol consumption changes, with a focus on marginalized groups, is warranted to plan behavioral health services and inform prevention for future pandemics.

Momentary predictors of binge eating episodes and heavy drinking episodes in individuals with comorbid binge eating and heavy drinking

PURPOSE

The co-morbidity of binge eating and heavy drinking (BE + HD) is a serious concern due to the high prevalence rates and associated elevated severity. Clarifying the momentary factors that increase risk for binge eating and heavy drinking among BE + HD is important for expanding theoretical models of BE + HD and informing treatment recommendations. The current study used ecological momentary assessment (EMA) to compare the momentary processes maintaining binge eating between BE + HD and individuals with binge eating only (BE-only) and to identify the momentary risk factors for binge eating episodes and heavy drinking episodes among BE + HD.

METHODS

Participants (BE + HD: N = 14; BE-only: N = 37) were adults with clinically significant binge eating who completed between 7 and 14 days of EMA prior to treatment.

RESULTS

The presence of food and within-day dietary restraint predicted higher odds of binge eating for both groups. Among BE + HD, the presence of alcohol and dietary restraint increased risk for subsequent binge eating and subsequent heavy drinking, and the absence of food increased risk for subsequent heavy drinking.

CONCLUSION

These results offer preliminary support for treatment interventions for BE + HD that focus on reducing dietary restraint and teaching strategies for urge management in situations with palatable food or alcohol. Future research should study the maintenance mechanisms of BE + HD with larger, more diverse samples and using study design approaches with more experimenter control (i.e., laboratory experiments).

LEVEL OF EVIDENCE

Level IV, multiple time series without intervention.

Event-level contextual predictors of high-intensity drinking events among young adults

BACKGROUND

Drinking events are characterized by social and physical contexts that are associated with level of alcohol consumption. Ecologically valid data is needed to delineate aspects of the drinking context that are most likely to precipitate excessive alcohol consumption.

METHODS

We utilized event-level data from a longitudinal study that included repeated daily surveys administered in two 28-day bursts. Data from 341 college student past-month alcohol and cannabis users (Mage=19.79; 53 % women; 74 % White) produced a total of 4107 alcohol use days. Generalized linear mixed effects models were used to predict drinking level (moderate: 1-3/1-4 for women/men; heavy-episodic drinking (HED): 4-7/5-9; high-intensity drinking (HID), 8+/10+) by social (e.g., with friends) and physical (e.g., at a party) contexts. We conducted analyses for the first and last drink reported, controlling demographic and study characteristics.

RESULTS

Being at a party, friend's house, or with strangers at the last drink reported were associated with HID compared to HED, while being at home, alone, or with family were protective for HID. No first drink contexts were associated with HID relative to HED. Witnessing others who were intoxicated was consistently associated with HID.

CONCLUSIONS

Social settings such as parties and those with intoxicated persons were associated with risk for HID. The context of drinks at the end of an event are salient signals of level of alcohol consumption. Preventive interventions, particularly those that deliver strategies in real time, should consider accounting for contextual risk factors to reduce harms associated with excessive alcohol consumption.

Domestication of drinking: a survey study of changes in types of drinking occasions during periods of increasing and decreasing alcohol consumption in the 2000s in Finland

BACKGROUND AND AIMS

In Finland, per-capita alcohol consumption increased in the early 2000s and decreased after 2007. Our aim was to determine how these changes originated from changes in drinking practices.

DESIGN

Repeated cross-sectional general-population surveys.

SETTING

Finland in 2000, 2008 and 2016.

PARTICIPANTS

Finnish residents aged 15-69 years (n = 6703, response rate 59-78%).

MEASUREMENTS

Event-level data on drinking occasions (n = 21 097). Types of drinking occasions (drinking practices) were identified with latent class analysis using occasion characteristics. The aggregated volume of consumption and intoxication occasions were decomposed into contributions from drinking practice classes and years.

FINDINGS

Nine drinking occasion types were identified: three at home without company other than family (51% of occasions in 2016), three socializing occasions in different places and with different company (33%) and three party occasion types (16%). Both the frequency of drinking occasion types and the occasion type-specific amounts of alcohol consumed contributed to aggregate-level changes in alcohol use. Drinking at home without external company (with family only; for men, also alone) contributed most to the increase in alcohol use before 2008. Big parties in homes and bars became less common in the 2000s, contributing most to the decline in drinking after 2008.

CONCLUSIONS

The rise in per-capita alcohol consumption in Finland in the early 2000s appears to have been linked mainly to an increase in lighter drinking occasions at home without external company. The fall in per-capita drinking after 2007 was linked mainly to a decrease in big parties in homes and in licensed premises. Changes in drinking frequency and the amounts of alcohol consumed per occasion changed in the same direction as alcohol affordability.

A critical review of front-loading: A maladaptive drinking pattern driven by alcohol's rewarding effects

Front-loading is a drinking pattern in which alcohol intake is skewed toward the onset of reward access. This phenomenon has been reported across several different alcohol self-administration protocols in a wide variety of species, including humans. The hypothesis of the current review is that front-loading emerges in response to the rewarding effects of alcohol and can be used to measure the motivation to consume alcohol. Alternative or additional hypotheses that we consider and contrast with the main hypothesis are that: (1) front-loading is directed at overcoming behavioral and/or metabolic tolerance and (2) front-loading is driven by negative reinforcement. Evidence for each of these explanations is reviewed. We also consider how front-loading has been evaluated statistically in previous research and make recommendations for defining this intake pattern in future studies. Because front-loading may predict long-term maladaptive alcohol drinking patterns leading to the development of alcohol use disorder (AUD), several future directions are proposed to elucidate the relationship between front-loading and AUD.

Recreation and Alcohol Consumption in Sub-Saharan Africa: Addressing Gender and Age Differences in Urban Areas-Praia, Cabo Verde

BACKGROUND

Reducing alcohol consumption and improving urban planning in African cities are public health priorities. The aim of this study was to explore gender and age differences in recreational activity participation and its link with self-reported alcohol consumption in three urban areas of Praia.

METHODS

A questionnaire was applied to a probabilistic sample of 1912 adults, with a median age of 35.0 (IQR: 26.0-48.8) years, living in informal, transition, and formal areas of the capital of Cabo Verde.

RESULTS

More than 80% of the participants reported rarely or never participating in recreational activities. Going daily or weekly to the café was the most reported recreational activity, regardless of the urban area. Participation in recreational activities was higher in men than women, decreasing with age in both cases. Alcohol consumption was significantly higher in men than women (72.4% versus 47.4%, p < 0.001). Multiple logistic regression models showed that going at least once to the bar/nightclub (for men and women) and going to the café (for women) were associated with alcohol consumption. Furthermore, age (for women), in a protective way, and having children (for men) appeared to be associated with alcohol consumption.

CONCLUSIONS

This study provides new data on the recreational environment in Praia and can contribute to the development of local and national public health policies and interventions in line with several SDGs to reduce alcohol consumption, enhance healthy leisure/recreation practices, and promote better living conditions for its inhabitants.

Assessing alcohol use in situ: Correlates of self-report vs. objective alcohol consumption

Associations between self-report and objective measurement of young adult alcohol use are weakened by excessive consumption levels; therefore, associations between correlates of alcohol use and consumption likely also differ by alcohol measurement. This study examined the extent to which correlates of heavy drinking measured via self-report are also indicators of heavy drinking measured objectively. Data were collected from 164 bar patrons (54% male; 73% White, 12% Black, 15% Other; 15% Hispanic) as they exited the bar. Participants completed an intercept survey including self-reported measures of drinking, demographics, and social-environmental factors. A breath alcohol concentration (BrAC) reading was also obtained using a handheld breathalyzer device. Correlations between two self-reported outcomes, number of drinks consumed prior to and at the bar, and BrAC were significant among those in the lowest quartile of BrAC readings, but largely non-significant at moderate and high BrAC levels. Intention to get drunk that night was a robust predictor of alcohol consumption across self-reported outcomes and BrAC. Social factors (presence of drinking peers, witnessing drunk others) were predictive of self-reported alcohol use but not BrAC. AUDIT-C score was the only additional alcohol behavior predictive of objectively measured alcohol use. Self-reported outcomes and BrAC, as well as their association with key correlates, diverge at high levels of intoxication, when preventive intervention is most needed. Implications for further research and alcohol prevention practice are discussed.

Alcohol Consumption on the Heaviest Drinking Occasion and Hangovers during the First Dutch COVID-19 Lockdown

The purpose of this study was to compare alcohol consumption between the heaviest drinking occasion in the period before the coronavirus disease 2019 (COVID-19) lockdown (15 January–14 March 2020) and the first COVID-19 lockdown period (15 March–11 May 2020) in the Netherlands, including the presence and severity of associated hangovers. The analysis included a sub-sample from the “Corona Lockdown: how fit are you?” (CLOFIT) study, comprising N = 761 participants who reported consuming alcohol in 2020. Overall, on the heaviest drinking occasion during the first COVID-19 lockdown period a significant reduction in number of alcoholic drinks consumed on the heaviest drinking occasion, drinking duration, and estimated BAC was observed. A significant reduction was also observed for subjective intoxication and next-day hangover severity. During the lockdown period, a significant reduction in the frequency of alcohol hangovers was reported. Several age and sex differences were observed. Specifically, men consumed significantly more alcohol than women and experienced hangovers significantly more frequently, both before and during the lockdown. With regard to age, young adults (18–35 years old) significantly reduced their alcohol intake on the heaviest drinking occasion during the lockdown and also reported lower ratings of subjective intoxication and hangover severity. No significant changes were seen for individuals above 35 years old. In conclusion, the first COVID-19 lockdown in the Netherlands was associated with reduced alcohol intake on the heaviest drinking occasion and a reduction in the severity of hangovers, particularly among young male adults.

Prospective Effects of UPPS-P Impulsivity and Typical Drinking Context on Future Drinking Behavior

OBJECTIVE

Research suggests that impulsivity is a risk factor for problem drinking, but prior studies have yet to examine typical drinking context as a potential moderator of relations between impulsivity and drinking outcomes. Guided by Person-Environment Transactions Theory, the current study tested whether five facets of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking) interacted with typical drinking context to prospectively predict drinking quantity.

METHOD

Young adult participants (N = 448; mean age = 22.27) were recruited from a southwestern university and the surrounding community. Data from a baseline survey (Time [T] 1) and a 1-year follow-up (T2) were used for the current analyses. Impulsivity (UPPS-P Impulsive Behavior Scale), typical drinking context, and typical drinking quantity were assessed at T1, and typical drinking quantity at T2.

RESULTS

Context items were loaded onto latent factors comprising high-arousal (e.g., at a tailgate, large house party) and low-arousal (e.g., at a restaurant, on a date) drinking contexts. In univariate (separated by UPPS-P facet) and multivariate (UPPS-P facets together) models, lack of premeditation and positive urgency interacted with high-arousal drinking contexts to predict T2 drinking, such that individuals at high/mean levels of impulsivity drank more heavily the more frequently they drank in high-arousal contexts. Only interactions in univariate models remained significant after a false discovery correction, although effect sizes were very similar across univariate and multivariate models.

CONCLUSIONS

Individuals high in positive urgency and lack of premeditation may be particularly vulnerable to riskier drinking behavior in high-arousal environments. Findings advance the literature on context-specific cues that may be important intervention targets, particularly for individuals high in positive urgency and lack of premeditation.

Prospective Effects of UPPS-P Impulsivity and Typical Drinking Context on Future Drinking Behavior

OBJECTIVE

Research suggests that impulsivity is a risk factor for problem drinking, but prior studies have yet to examine typical drinking context as a potential moderator of relations between impulsivity and drinking outcomes. Guided by Person-Environment Transactions Theory, the current study tested whether five facets of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking) interacted with typical drinking context to prospectively predict drinking quantity.

METHOD

Young adult participants (N = 448; mean age = 22.27) were recruited from a southwestern university and the surrounding community. Data from a baseline survey (Time [T] 1) and a 1-year follow-up (T2) were used for the current analyses. Impulsivity (UPPS-P Impulsive Behavior Scale), typical drinking context, and typical drinking quantity were assessed at T1, and typical drinking quantity at T2.

RESULTS

Context items were loaded onto latent factors comprising high-arousal (e.g., at a tailgate, large house party) and low-arousal (e.g., at a restaurant, on a date) drinking contexts. In univariate (separated by UPPS-P facet) and multivariate (UPPS-P facets together) models, lack of premeditation and positive urgency interacted with high-arousal drinking contexts to predict T2 drinking, such that individuals at high/mean levels of impulsivity drank more heavily the more frequently they drank in high-arousal contexts. Only interactions in univariate models remained significant after a false discovery correction, although effect sizes were very similar across univariate and multivariate models.

CONCLUSIONS

Individuals high in positive urgency and lack of premeditation may be particularly vulnerable to riskier drinking behavior in high-arousal environments. Findings advance the literature on context-specific cues that may be important intervention targets, particularly for individuals high in positive urgency and lack of premeditation.

Incorporating Social Networks and Event-Specific Information in a Personalized Feedback Intervention to Reduce Drinking Among Young Adults

AIMS

To correct risky alcohol use among young adults, current personalized feedback interventions (PFIs) use social influence information related to distal referent groups. Although current PFIs have been effective, little consideration has been given to strategies applying more concrete sources of social influence, namely the influence of specific people within one's social network during actual drinking contexts. The current study evaluated a novel PFI, providing feedback regarding the presence or absence of particular individuals within a participant's close network along with the number of drinks consumed and consequences experienced during several specific drinking occasions.

METHODS

TurkPrime users (N = 338) identified five close others with whom they sometimes drank. They also provided details about their five most recent drinking occasions and noted which of their network members were present. Participants were then randomized to receive or not receive feedback consisting of a list of drinking events, negative consequences and who was present.

RESULTS

Feedback participants intended to consume fewer drinks over the next month relative to control (b = -0.25, P = 0.001). Analyses were inconclusive as to whether this effect was stronger for those who received more feedback (b = -0.01, P = 0.857).

CONCLUSIONS

Results provide preliminary support for the efficacy of a novel social influence-based intervention, which provides personalized feedback indicating social contexts that are more and less likely to lead to negative alcohol-related experiences.

Drinking location moderates the association between social group size and alcohol consumption among young adults: An event-level study

INTRODUCTION

Previous studies have demonstrated relationships between social and environmental characteristics of the drinking context and alcohol use. However, the use of event-level data to investigate individual and joint relationships between such characteristics and alcohol use remains a gap in the literature. This study aimed to examine associations between drinking context (location and social group size) and alcohol consumption, and estimate the relationship between the interaction of context and alcohol consumption.

METHODS

Using an Internet-based cellphone-optimised assessment technique, 183 Swiss young adults (mean: 23 years; range: 17-37 years) completed hourly assessments from 8 pm to midnight Thursday through Saturday for five consecutive weeks. Participants contributed 3454 hourly questionnaires. The number of drinks, the number of friends present and location (off-premise-home, outdoors; on-premise-bars, restaurants) were assessed based on the previous hour. Multilevel mixed-effects models were used to assess the relationships of interest.

RESULTS

Being off-premise compared to on-premise was associated with fewer hourly drinks consumed (b = -0.44, P < 0.001). Greater numbers of friends present were associated with more drinks consumed (b = 0.02, P < 0.001). The association between number of friends and number of drinks consumed was significantly stronger for off-premise compared to on-premise locations (b = 0.03, P < 0.001).

DISCUSSION AND CONCLUSIONS

Compared to off-premise locations, on-premise locations are associated with more hourly drinks consumed. However, the positive relationship between social group size and drinks consumed is significantly stronger for off-premise locations compared to on-premise locations. Findings have implications for tailored interventions focused on reducing alcohol consumption by young adults.

Association between age at first alcohol use and heavy episodic drinking: An analysis of Thailand's smoking and alcohol drinking behavior survey 2017

According to evidence from developed countries, age at first alcohol use has been identified as a determinant of heavy episodic drinking (HED). This study aimed to investigate the association between age at first alcohol use and HED using data from the Smoking and Drinking Behavior Survey 2017, a Thai nationally representative survey. Binary logistic regression was used to examine the association. This study used data from 23,073 current drinkers in the survey. The survey participants were chosen to represent the Thai population aged 15 years and older. The prevalence of HED and frequent HED among Thai drinkers was 18.6% and 10.1%, respectively. Age at first drinking <20 years was associated with higher odds of HED (adjusted OR, 1.43; 95% CI, 1.26–1.62) and frequent HED (adjusted OR, 1.31; 95% CI, 1.12–1.53) relative to age at first drinking ≥25 years. Regular drinking, drinking at home, and exposure to alcohol advertising increased the odds of HED. Drinking at home was associated with frequent HED. There was a significant interaction between the effect of age at first alcohol use and sex on HED and frequent HED with a stronger effect of age at first alcohol use observed in females. This study provides evidence from a developing country that early onset of alcohol use is associated with HED. Effective measures such as tax and pricing policy should be enforced to delay the onset of drinking.

Natural Observation of Alcohol Price and Promotions at Bars: Implications for Alcohol Misuse Prevention

Alcohol misuse among young adults remains a primary public health concern given the wide range of short- and long-term physical, social, and societal consequences of the behavior. On-premise drinking establishments, which allow alcohol consumption on site (i.e., bars), are frequent locations for young adult alcohol use. Risks for alcohol misuse within the bar setting are key factors to identify for prevention. Notably, alcohol price and promotions are associated with alcohol consumption among young adults. This study sought to develop and pilot test an observational protocol to assess the alcohol environment at on-premise drinking establishments. Following qualitative exploration of salient risk factors in these settings through focus groups with young adults, an observational tool was adapted and tested in a feasibility study. The refined tool was then pilot tested with two independent data collectors conducting natural observation at 13 establishments in the downtown nightlife district of a small, southeastern city. High interrater reliability was noted. Descriptive summary statistics of bar characteristics demonstrate low alcohol prices with variability across types of alcohol (e.g., beer, wine, and liquor), greater numbers of alcohol promotions inside rather than outside the building, and higher rates of manual versus electronic age verification procedures. Observational assessment of alcohol price and marketing at on-premise drinking establishments as described in this study is needed to inform prevention policy and programs to reduce harms associated with young adult alcohol misuse.

Gender and Childhood Victimization: A Longitudinal Study of Heavy Drinking in Young Adulthood

The present longitudinal study, for 12 years, followed a group of young adults, examining (1) whether/how victimization in childhood increased the likelihood of heavy drinking; (2) whether depression mediated the strain-heavy drinking relationship; and (3) whether/how relationships among strain, depression, and heavy drinking differed across two gender groups. Data came from the National Longitudinal Survey of Youth 1997 cohort, dating 2004-2015 (5 interview waves and 22,549 person-wave measurements total). We linked consumption of 5+ drinks (during the month prior) to four discrete measures of violent victimization, to one measure of stressful events, and to depression. We needed to consider repeat measures of the same variables over time, so we used generalized estimating equations (GEE) to analyze data. Depression was found to increase heavy drinking uniformly. Empirical evidence confirmed that in the strain-heavy drinking relationship, depression plays a minor mediating role. Gender moderated heavy drinking's associations. Specifically, bullying in childhood raised risk for female respondents. The current strain was associated with a higher risk of heavy drinking among male respondents. Childhood victimization, as well as current life stress, play an important role in depression and heavy drinking. Future research should focus on the development of specific, targeted care to reduce heavy drinking's harm and promote equity among Americans.

Alcohol consumption changes following COVID-19 lockdown among French-speaking Belgian individuals at risk for alcohol use disorder

We investigated changes in alcohol consumption following the COVID-19 lockdown among French-speaking Belgian individuals at risk for severe alcohol use disorder. Participants (N = 299) at risk for alcohol use disorder (AUD, i.e., score higher than 19 at the Alcohol Use Disorder Identification Test), and 299 moderate drinkers (MOD, i.e., score lower than 8) individually matched for age, gender and education provided self-reports of alcohol consumption changes (i.e., number of alcohol units consumed during a typical week before and during lockdown). AUD were more likely (91.31%) than MOD (71.57%) to modify their consumption following lockdown (p < 0.0001). They were more likely to decrease (65.89% vs. 35.12%, p < 0.0001) and less likely to increase (25.42% vs. 36.45%, p = 0.004) their consumption than MOD. Analyses of post-pre lockdown differences in alcohol consumption showed that AUD presented a stronger decrease than MOD (-13.97 units/week vs. -0.07, p < 0.0001). Among individuals who decreased consumption, AUD decreased more (-27.92 vs. -2.74, p < 0.0001) than MOD. Among those who increased consumption, AUD increased more (17.32 vs. 2.44, p < 0.0001) than MOD. We thus observed sharp consumption increases or conversely abrupt decreases in individuals at high risk of alcohol use disorder, underscoring the need to develop prophylactic interventions for this population during such sanitary crises, to avoid brutal changes of the alcohol consumption pattern. Efforts should be made to mitigate consumption increases but also to favor progressive rather than sudden decreases in order to prevent damaging withdrawal symptoms.

A Rapid Review on the Influence of COVID-19 Lockdown and Quarantine Measures on Modifiable Cardiovascular Risk Factors in the General Population

Preceding coronavirus outbreaks resulted in social isolation, which in turn is associated with cardiovascular consequences. Whether the current COVID-19 pandemic negatively impacts cardiovascular health is unclear. The aim of the rapid review was to investigate, whether COVID-19 lockdown influences modifiable cardiovascular risk factors (i.e., physical inactivity, sedentary behaviour, smoking, alcohol use, unhealthy diet, obesity, bad blood lipids, and hypertension) in the general population. Medline and EMBASE were searched until March 2021. Title, abstracts, and full texts were screened by one reviewer and 20% by a second reviewer. Only studies using probability sampling were included in order to ensure the representativeness of the target population. Data extraction and critical appraisal were done by one reviewer and double-checked by another reviewer. We identified 32 studies that fulfilled our inclusion criteria. Findings show that physical activity decreased, and sedentary behaviour increased among all age groups during the COVID-19 lockdown. Among adults, alcohol consumption increased, dietary quality worsened, and the amount of food intake increased. Some adults reported weight gain. Studies on children and adolescents were sparse. This rapid review found a high number of epidemiological studies on the impact of COVID-19 lockdown measures on modifiable cardiovascular risk factors, but only a few used probability sampling methods.

Alcohol consumption changes during the first COVID-19 lockdown: an online population survey in a convenience sample of French-speaking Belgian residents

An online survey among French-speaking Belgians (N=7711) investigated self-reported changes in alcohol consumption during the first COVID-19-related lockdown (March 17^th - May 4^th 2020). Population-weighted estimates indicated that 31.37% of the population increased consumption during lockdown, 30.32% decreased consumption and 38.31% reported unchanged consumption. The magnitude of change was higher for "decreasers" than "increasers", resulting in a slight reduction in overall consumption. A multiple regression analysis revealed that age, occupational status, number of cohabitants, perceived alcohol accessibility, drinking motivations and previous consumption predicted consumption changes. The lockdown was thus associated with consumption modifications among French-speaking Belgians, without a prevailing direction of change.

Ten seconds of my nights: Exploring methods to measure brightness, loudness and attendance and their associations with alcohol use from video clips

Introduction

Most evidence on associations between alcohol use behaviors and the characteristics of its social and physical context is based on self-reports from study participants and, thus, only account for their subjective impressions of the situation. This study explores the feasibility of obtaining alternative measures of loudness, brightness, and attendance (number of people) using 10-second video clips of real-life drinking occasions rated by human annotators and computer algorithms, and explores the associations of these measures with participants’ choice to drink alcohol or not.

Methods

Using a custom-built smartphone application, 215 16-25-year-olds documented characteristics of 2,380 weekend night drinking events using questionnaires and videos. Ratings of loudness, brightness, and attendance were obtained from three sources, namely in-situ participants’ ratings, video-based annotator ratings, and video-based computer algorithm ratings. Bivariate statistics explored differences in ratings across sources. Multilevel logistic regressions assessed the associations of contextual characteristics with alcohol use. Finally, model fit indices and cross-validation were used to assess the ability of each set of contextual measures to predict participants’ alcohol use.

Results

Raw ratings of brightness, loudness and attendance differed slightly across sources, but were all correlated (r = .21 to .82, all p < .001). Participants rated bars/pubs as being louder (Cohen’s d = 0.50 [95%-CI: 0.07–0.92]), and annotators rated private places as darker (d = 1.21 [95%-CI: 0.99–1.43]) when alcohol was consumed than when alcohol was not consumed. Multilevel logistic regressions showed that drinking in private places was more likely in louder (OR_participants = 1.74 [CI: 1.31–2.32]; OR_annotators = 3.22 [CI: 2.06–5.03]; OR_algorithm = 2.62 [CI: 1.83–3.76]), more attended (OR_participants = 1.10 [CI: 1.03–1.18]; OR_algorithm = 1.19 [CI: 1.07–1.32]) and darker (OR = 0.64 [CI: 0.44–0.94]) situations. In commercial venues, drinking was more likely in darker (OR_participants = 0.67 [CI: 0.47–0.94]; OR_annotators = 0.53 [CI: 0.33–0.85]; OR_algorithm = 0.58 [CI: 0.37–0.88]) and louder (OR_participants = 1.40 [CI: 1.02–1.92]; OR_algorithm = 2.45 [CI: 1.25–4.80]) places. Higher inference accuracies were found for the models based on the annotators’ ratings (80% to 84%) and the algorithms’ ratings (76% to 86%) than on the participants’ ratings (69% to 71%).

Conclusions

Several contextual characteristics are associated with increased odds of drinking in private and commercial settings, and might serve as a basis for the development of prevention measures. Regarding assessment of contextual characteristics, annotators and algorithms might serve as appropriate substitutes of participants’ in-situ impressions for correlational and regression analyses despite differences in raw ratings. Collecting contextual data by means of sensors or media files is recommended for future research.

Using machine learning to identify predictors of imminent drinking and create tailored messages for at-risk drinkers experiencing homelessness

Adults experiencing homelessness are more likely to have an alcohol use disorder compared to adults in the general population. Although shelter-based treatments are common, completion rates tend to be poor, suggesting a need for more effective approaches that are tailored to this understudied and underserved population. One barrier to developing more effective treatments is the limited knowledge of the triggers of alcohol use among homeless adults. This paper describes the use of ecological momentary assessment (EMA) to identify predictors of “imminent drinking” (i.e., drinking within the next 4 h), among a sample of adults experiencing homelessness and receiving health services at a homeless shelter. A total of 78 mostly male (84.6%) adults experiencing homelessness (mean age = 46.6) who reported hazardous drinking completed up to five EMAs per day over 4 weeks (a total of 4557 completed EMAs). The study used machine learning techniques to create a drinking risk algorithm that predicted 82% of imminent drinking episodes within 4 h of the first drink of the day, and correctly identified 76% of nondrinking episodes. The algorithm included the following 7 predictors of imminent drinking: urge to drink, having alcohol easily available, feeling confident that alcohol would improve mood, feeling depressed, lower commitment to being alcohol free, not interacting with someone drinking alcohol, and being indoors. The research team used the results to develop intervention content (e.g., brief tailored messages) that will be delivered when imminent drinking is detected in an upcoming intervention phase. Specifically, we created three theoretically grounded message tracks focused on urge/craving, social/availability, and negative affect/mood, which are further tailored to a participant’s current drinking goal (i.e., stay sober, drink less, no goal) to support positive change. To our knowledge, this is the first study to develop tailored intervention messages based on likelihood of imminent drinking, current drinking triggers, and drinking goals among adults experiencing homelessness.

Combinations of Drinking Occasion Characteristics Associated with Units of Alcohol Consumed among British Adults: An Event-Level Decision Tree Modeling Study

BACKGROUND

Alcohol consumption is influenced by the characteristics of drinking occasions, for example, location, timing, or the composition of the drinking group. However, the relative importance of occasion characteristics is not yet well understood. This study aims to identify which characteristics, and combinations of characteristics, are associated with units consumed within drinking occasions. It also tests whether accounting for occasion characteristics improves the prediction of consumption compared to using demographic information only.

METHODS

The data come from a cross-sectional, nationally representative, online market research survey. Our sample includes 18,409 British drinkers aged 18 + who recorded the characteristics of 46,072 drinking occasions using 7-day retrospective drinking diaries in 2018. We used decision tree modeling and nested linear regression to predict units consumed in occasions using information on drinking location/venue, occasion timing, company, occasion type (e.g., a quiet night in), occasion motivation, drink type and packaging, food eaten and entertainment/ other activities during the occasion. We estimated models separately for 6 age-sex groups and controlled for usual drinking frequency, and social grade in nested linear regression models. Open Science Framework preregistration: https://osf.io/42epd.

RESULTS

Our 6 final models accounted for between 55% and 71% of the variance in drinking occasion alcohol consumption. Beyond demographic characteristics (1 to 9%) and occasion duration (24 to 60%), further occasion characteristics and combinations of characteristics accounted for 31 to 70% of the total explained variance. The characteristics most strongly associated with heavy alcohol consumption were long occasion duration, drinking spirits as doubles, and drinking wine. Spirits were also consumed in light occasions, but as singles. This suggests that the serving size is an important differentiator of light and heavy occasions.

CONCLUSIONS

Combinations of occasion duration and drink type are strongly predictive of alcohol consumption in adults' drinking occasions. Accounting for characteristics of drinking occasions, both individually and in combination, substantially improves the prediction of alcohol consumption.

Where and What You Drink Is Linked to How Much You Drink: An Exploratory Survey of Alcohol Use in 17 Countries

This paper aimed to explore the differences in subjective experiences of intoxication depending on drinking location and drink type. Methods: Data came from 32,194 respondents to The Global Drug Survey (GDS) 2015, an annual, cross-sectional, online survey. Respondents selected their usual drinking location (home alone: home with partner/family: house parties: pubs/bars or clubs) and usual drink (wine; beer/cider/lager; spirits or alcopops/coolers). They indicated how many drinks they required to reach three stages of intoxication (feeling the effects; an ideal stage of intoxication; and the tipping point) and how frequently they reached each stage. Results: Drink type affected grams of alcohol reported to reach the tipping point: 109 gm wine, 127 gm alcopops, 133 gm of beer, and 134 gm of spirts. Respondents who drank at home alone, or in clubs reached their tipping point more frequently compared to other locations. Conclusions: Where people drink, and the type of alcohol they drink, affected the amount of alcohol reported to reach different stages of intoxication. Understanding why different drinking locations, and drink types lead to a need for greater consumption to reach an ideal state of drunkenness, such as social cues from other people who drink, may enable people to reduce their drinking.

Alcohol's Harm to Others: Does the Drinking Location Matter?

In order to curb alcohol's harm to others, it is important to identify the contexts where people experience such harm. Objectives: To examine whether frequency of drinking in four different locations was associated with increased likelihood of experiencing harm from others' drinking. Methods: Data stem from surveys conducted in the five Nordic countries in 2015 (N = 7065, aged 18-64 years) as part of the European Union's Joint Action on Reducing Alcohol Related Harm (RARHA). Three types of harm from others' drinking in the past 12 months were measured: verbally abused by, harmed physically by, and experienced a serious argument with someone who had been drinking. Respondents also reported frequency of drinking in their own home, in others' homes, in a pub/bar/club/restaurant, and outdoors the past 12 months. Results: Country-pooled adjusted analyses showed that higher frequency of drinking in pubs/bars/clubs/restaurants, outdoors and in someone else's home was associated with increased likelihood of experiencing all three harms. Frequent drinking in one's own home was weakly associated with experience of harm. Women, young individuals, respondents without tertiary level of education and individuals who reported drinking almost daily were at increased risk of experiencing harm from others' drinking. Conclusions: Frequent drinking on licensed premises and outdoors was most clearly associated with experiencing harm from others' drinking, suggesting that these are important arenas for preventive efforts. Women, young individuals, those with low educational level and the most frequent drinkers are important target groups for preventive efforts.

The socio-environmental context of simultaneous alcohol and marijuana use among young adults: Examining day-level associations

INTRODUCTION AND AIMS

Simultaneous alcohol and marijuana (SAM) use is reported by roughly 30% of young adult drinkers. Among SAM users, SAM use days have more negative substance-related consequences than single-substance days. Little information is available about contextual factors contributing to the likelihood of SAM use on a particular day. This study compared days on which individuals reported SAM use relative to days on which they reported alcohol but not marijuana use in terms of physical location, engagement in risky activities and social context of use.

DESIGN AND METHODS

Participants were 148 young adults (57% female) reporting past-month SAM use and past two-week binge drinking. Participants completed up to 14 daily surveys assessing substance use behaviour and socio-environmental characteristics of use.

RESULTS

For those <21 years, only using at home was associated with greater odds of SAM use. For those 21+, using at a friend's house and outdoors were associated with increased odds of use; using at a bar/club was associated with lower odds. Using alone was associated with lower odds of use for those 21+. Engagement in risky activities (pre-gaming and drinking games) was not associated with SAM use.

DISCUSSION AND CONCLUSIONS

SAM days are linked with use in private settings and social situations. Despite experiencing more harms on SAM days, SAM use is not more likely than alcohol use alone to occur in certain environments and situations traditionally found to be linked with increased risk. Findings may provide key insight for developing context-informed interventions focused on SAM use.

Drinking contexts and their association with acute alcohol-related harm: A systematic review of event-level studies on adults' drinking occasions

ISSUES

Event-level alcohol research can inform prevention efforts by determining whether drinking contexts-such as people or places-are associated with harmful outcomes. This review synthesises evidence on associations between characteristics of adults' drinking occasions and acute alcohol-related harm.

APPROACH

We systematically searched Ovid MEDLINE, Ovid PsycInfo and the Web of Science Social Sciences Citation Index. Eligible papers used quantitative designs and event-level data collection methods. They linked one or more drinking contexts to acute alcohol-related harm. Following extraction of study characteristics, methods and findings, we assessed study quality and narratively synthesised the findings.

PROSPERO ID

CRD42018119701.

KEY FINDINGS

Searches identified 95 eligible papers, 65 (68%) of which study young adults and 62 (65%) of which are set in the United States, which limits generalisability to other populations. These papers studied a range of harms from assault to drink driving. Study quality is good overall although measures often lack validation. We found substantial evidence for direct effects of drinking context on harms. All of the contextual characteristics types studied (e.g. people, place, timing, psychological states, drink type) were consistently associated with harms. Certain contexts were frequently studied and associated with harms, in particular, weekend drinking, drinking in licensed premises and concurrent illicit drug use.

IMPLICATIONS

The findings of our review indicate target drinking contexts for prevention efforts that are consistently associated with increased acute alcohol-related harm.

CONCLUSION

A large range of contextual characteristics of drinking occasions are directly associated with acute alcohol-related harm, over and above levels of consumption.

The effect of SMS behavior change techniques on event-level desire to get drunk in young adults

Text messaging (SMS) interventions incorporating a combination of behavior change techniques can assist reductions in alcohol consumption among young adult hazardous drinkers, but mechanisms of action remain unknown. In this secondary analysis, we test the hypothesis that desire to get drunk (DD) recorded prior to drinking episodes would mediate SMS intervention effects on the likelihood of event-level heavy drinking (4 +/5 + drinks for women/men). We recruited young adult hazardous drinkers to a trial where they were randomized to 1 of 5 SMS interventions: TRACK (self-monitoring of alcohol use), PLAN (feedback on drinking plans and DD), USE (postdrinking feedback on alcohol consumed), GOAL (goal prompts/support), and COMBO (i.e., 4 interventions combined). Up to 3 days per week for 14 weeks, when participants reported a plan to drink, they were asked to report DD on a scale from 0 (none) to 8 (completely) and next day asked to recall drink quantity. Multilevel structural equation models showed that DD mediated the treatment effect of GOAL on heavy drinking. This work illustrates the importance of goal support features in digital alcohol interventions and the utility of measuring desire to get drunk as a key mediator in alcohol studies. (PsycINFO Database Record (c) 2020 APA, all rights reserved).