Reflecting adult drinking culture: prevalence of alcohol use and drinking situations among Japanese junior high school students in Japan

A descriptive study of solitary death in Yokohama City

BACKGROUND

The solitary death rate in Japan is expected to continue increasing because of its growing super-aged society and the rapid growth of home care in the country. To accurately determine the actual status of solitary deaths, we used a novel analysis method of combining vital statistics and ambulatory care information in Yokohama City.

METHODS

Data of persons who died at home in 2013 were obtained from death certificate notifications. We also obtained the emergency transportation records that matched the cases of these death certificate notifications. Then, we gathered information regarding age, gender, marital status, and cause of death for the matched cases.

RESULTS

There were 1890 "suspected unnatural deaths," in which most solitary deaths could be included, among all citizens who died at home (n = 4847). We were able to match 1503 of these cases with emergency transportation records. These 1503 cases were divided into two groups, "solitary death" (n = 349) and "un-solitary death" (n = 1154) according to the postmortem interval until finding (PMI-f). Pearson's χ2 tests conducted for the two groups revealed that there were significant differences regarding the proportion of persons who were elderly, unmarried, male, and had a hepatic disease and senility. A logistic regression analysis also showed that an increased likelihood of a prolonged PMI-f was associated with males and an unmarried status with hepatic diseases.

CONCLUSIONS

Unmarried, male sex, and liver diseases are independent risks for solitary death in Yokohama City.

Drinking among Japanese Youth -a Paradox for Theories of Alcohol Availability?

Aims

By presenting the paradoxical case of Japan this study aims to highlight the importance of cross-cultural data to understanding different drinking patterns. Why is it that a country with high alcohol availability does not present higher figures of consumption? Why is it that Japanese youth, who can buy their alcohol even from vending machines, do not engage in heavier drinking than they apparently do? Does Japan teach Western countries a lesson in this regard?

Methods and Data

The discussion is based on data from the WHO Alcohol Database together with different survey-based studies undertaken in Japan. These empirical data are connected to general literature on Japanese culture and Japanese society.

Results and Conclusions

The data presented confirm the importance of analysing the cultural dimension when studying drinking patterns. Even though structural variables regarding availability are significant in explaining alcohol consumption, cross-cultural data alert us to the importance of including cultural values in our analyses. Japan does possibly represent a ‘deviant case’ regarding alcohol research, thus confirming this perspective. It is neither possible, nor desirable, to transplant collectivistic Japanese values into Western countries. However, we can ask what might be the Western functional equivalent to Japanese group control. Counteracting the increasing age-based segmentation in Western societies is perhaps the most potent answer to this question.

Relations of participation in organized activities to smoking and drinking among Japanese youth: contextual effects of structural social capital in high school

OBJECTIVES

This cross-sectional study examined the effect of school-level structural social capital on smoking and drinking among Japanese youth.

METHODS

Self-administered anonymous questionnaires were distributed to 3248 students at 29 high schools across Okinawa, Japan in 2008. Structural social capital was measured by students' participation in organized activities: student council, extracurricular activities, volunteer activities, community sports clubs, and youth associations. Contextual-level social capital was measured by aggregated school-level individual responses.

RESULTS

At the individual level, extracurricular activity participation was negatively associated with smoking and drinking, whereas participation in youth associations was positively associated with smoking and drinking. School-level extracurricular activity participation was negatively associated with smoking among boys, whereas school-level participation in youth associations was positively associated with smoking among boys and girls and drinking among boys.

CONCLUSIONS

This study suggests that structural social capital measured by participation in organized activities, especially extracurricular activities, might be an important way for youths to attain good health. This study also supports the idea that particular type of activities, such as youth associations, can lead to the so-called "dark side of social capital".

Alcohol-related negative consequences among drinkers around the world

AIMS

This paper examines (i) gender and country differences in negative consequences related to drinking; (ii) relative rates of different consequences; and (iii) country-level predictors of consequences.

DESIGN SETTING AND PARTICIPANTS

Multi-level analyses used survey data from the Gender, Alcohol, and Culture: An International Study (GENACIS) collaboration.

MEASUREMENTS

Measures included 17 negative consequences grouped into (i) high endorsement acute, (ii) personal and (iii) social. Country-level measures included average frequency and quantity of drinking, percentage who were current drinkers, gross domestic product (GDP) and Human Development Index (HDI).

FINDINGS

Overall, the three groupings of consequences were reported by 44%, 12% and 7% of men and by 31%, 6% and 3% of women, respectively. More men than women endorsed all consequences, but gender differences were greatest for consequences associated with chronic drinking and social consequences related to male roles. The highest prevalence of consequences was in Uganda and lowest in Uruguay. Personal and social consequences were more likely in countries with higher usual quantity, fewer current drinkers and lower scores on GDP and HDI. However, significant interactions with individual-level quantity indicated a stronger relationship between consequences and usual quantity among drinkers in countries with lower quantity, more current drinkers and higher scores on GDP and HDI.

CONCLUSIONS

Both gender and country need to be taken into consideration when assessing adverse drinking consequences. Individual measures of alcohol consumption and country-level variables are associated with experiencing such consequences. Additionally, country-level variables affect the strength of the relationship between usual quantity consumed by individuals and adverse consequences.

Does social trust at school affect students' smoking and drinking behavior in Japan?

This study examined the individual and contextual effects of cognitive social capital at school on cigarette smoking and alcohol drinking in Japanese high school students. Self-administered questionnaires were distributed to 3248 students in grades 10-12 (aged 15-18 years) at 29 public high schools across Okinawa, Japan in 2008. The individual-level cognitive social capital studied was generalized trust. Using multi-level logistic regression models, the effects of individual- and contextual-level cognitive social capital on smoking and drinking were analyzed. Contextual-level cognitive social capital was measured on the basis of aggregated individual responses to the trust question at school level. After adjustment for the covariates, individual-level trust was negatively associated with smoking and drinking among boys and girls. Similarly, after adjustment for the covariates, school-level trust showed an inverse association with smoking for girls. A similar but not statistically significant association was observed for boys. On the other hand, school-level trust was not associated with drinking among boys or girls. After adjustment for individual-level trust and the covariates, these findings were in the same direction, but the school-level trust for girls no longer had a significant contextual effect on smoking. The findings suggest evidence of the individual effect of cognitive social capital on adolescents' smoking and drinking, and that the contextual effect of social capital on smoking was inconclusive. In addition, no association of contextual-level social capital with drinking was observed.

Synaptic and behavioral interactions of oseltamivir (Tamiflu) with neurostimulants

Oseltamivir (Tamiflu), a neuraminidase inhibitor, is widely used for treatment of influenza. Because abnormal behaviors have been observed in some Japanese teenagers following oseltamivir use, its safety has been questioned. Oseltamivir is known to alter neuronal function and behavior in animals, particularly when administered in combination with ethanol. Based on this, it has been hypothesized that interactions of oseltamivir with other drugs may result in altered CNS excitability in this study. It has been found that injection of ephedrine and caffeine overcame inactivity induced by oseltamivir and ethanol but did not alter changes in novelty seeking behavior in a Y-maze test. In ex-vivo hippocampal slices, oseltamivir carboxylate (OTC), an active form of oseltamivir, alters excitability in the absence of ethanol. In slices pretreated with OTC, long-term depression (LTD), a form of synaptic plasticity that is correlated with Y-maze performance was not altered if caffeine or ephedrine was administered individually. However, LTD could not be induced in slices pretreated with OTC if caffeine and ephedrine were administered simultaneously. These observations suggest that combination of oseltamivir with other neurostimulants may alter synaptic plasticity and this may contribute to behavioral changes associated with the drug.

Long-term trends in drinking habits among Swedish teenagers: National School Surveys 1971-1999

The purpose of the study is to describe the long-term trends in drinking habits among Swedish students aged 15-16 years. Data were collected from 1971 to 1999, using self-administered questionnaires from nationally representative random cluster samples of school classes, totalling on average 6000 students per year. The highest proportion of alcohol consumers among both boys and girls, about 90%, was seen in the 1970s; this percentage decreased to about 80% in the 1980s and remained at that level through the 1990s. The estimated average annual consumption of pure alcohol was 4 litres for boys in 1977. It fell to 2.1 litres in 1988 and rose to 3.9 litres in 1999. The tendency was similar for girls, with 3.5 litres consumed in 1977, about 1.5 litres in the 1980s and 2.3 litres in 1999. Also frequent binge drinking and intoxication were reported by the largest proportions in the 1970s; the figures decreased in the 1980s and rose again among both boys and girls in the first part of the 1990s. Hence, although fewer of the students in this age group are alcohol consumers at the end of the 1990s compared with the 1970s, those who drink are approaching the high consumption levels of the 1970s. The beverages of choice are beer and spirits.

Neuroexcitatory actions of Tamiflu and its carboxylate metabolite

Oseltamivir (Tamiflu) is now being stockpiled by several governments as a first line treatment for an anticipated outbreak of avian influenza caused by H5N1. However, abnormal behaviors and death associated with the use of Tamiflu have developed into a major issue in Japan where Tamiflu is often prescribed for seasonal influenza. Thus, it is critical to determine neuropsychiatric effects of oseltamivir and to establish methods for safe administration. Using juvenile rats and rat hippocampal slices, we investigated whether oseltamivir has adverse effects on the central nervous system. Systemic injection of oseltamivir (50mg/kg i.p.) produced no change in behavior within 2h. However, prior injection of oseltamivir significantly altered the duration of loss of lightning reflex following ethanol injection (3.3g/kg, i.p.). Ethanol injection in the presence of oseltamivir also resulted in enhanced hypothermia. In the CA1 region of hippocampal slices, oseltamivir (100 microM) induced paired-pulse facilitation in population spikes without changes in excitatory postsynaptic potentials. Similarly, 3 microM oseltamivir carboxylate, the active metabolite of oseltamivir, facilitated neuronal firing, though the facilitation did not involve GABAergic disinhibition. Moreover, oseltamivir carboxylate produced further facilitation following administration of 60mM ethanol. These findings indicate that oseltamivir has effects on the central nervous system, especially when combined with other agents.

Culture Change and Ethnic-Minority Health Behavior: An Operant Theory of Acculturation

Data on acculturation and ethnic-minority health indicate that acculturation has opposite effects on the same health behavior among different ethnic groups; opposite effects on different health behaviors within an ethnic group; opposite effects on the same health behavior for the women vs. the men of most ethnic groups; and no effect whatsoever on some health behaviors for some ethnic groups. This evidence is so incoherent that it is unintelligible, and hence it continues to be largely useless to health psychology and behavioral medicine. This paper presents a new theory of acculturation that renders these confusing data coherent by predicting such changes in minority health behavior a priori. By so doing, the operant model of acculturation has the potential to improve health promotion and disease prevention and thereby reduce ethnic health disparities.

Association of age at onset of cigarette and alcohol use with subsequent smoking and drinking patterns among Japanese high school students

This study examined relationships between age of smoking and drinking initiation, and subsequent patterns of smoking and drinking among Japanese high school students. Self-administered anonymous questionnaires were conducted using a sample of 1,466 students in grades 10 through 12 at seven public senior high schools in urban areas of Okinawa, Japan. After controlling for demographic variables, students who began smoking at age 12 or younger were more likely to become heavy smokers and heavy drinkers than those who began smoking at ages 15 or older. Age of smoking initiation was not related to risks for current smoking and current drinking. Students who started drinking at age 12 or younger, and at 13 or 14 years, were significantly associated with current smoking, current drinking, heavy smoking, and heavy drinking, compared to students who began drinking at ages 15 or older. Early onset smoking and drinking represent significant predictors for subsequent use of cigarettes and alcohol. These findings suggest that smoking and drinking prevention programs should begin during elementary school.

Factors associated with volatile solvent use among junior high school students in Kanto, Japan

AIMS

To estimate the relative association between life-time volatile solvent use and risk factors for usage.

DESIGN

Cross-sectional anonymous questionnaire survey.

SETTING

Junior high schools in Kanto, Japan.

PARTICIPANTS

Junior high school students (n = 7744).

MEASUREMENTS

Data on life-time and past-year solvent use, demographic variables, urbanization, regularity of waking patterns, school life, family life, peer relationships, prior alcohol and cigarette use and knowledge on harmful effects of solvent use.

FINDINGS

Uni- and multivariate logistic regression analyses were conducted to estimate crude and adjusted odds ratios for each index. The primary findings were (1) 'smoking cigarettes nearly every day' (adjusted OR = 9.88, 95% Cl = 3.74, 26.12) and peer pressure measured by 'been tempted to use solvents' (adjusted OR = 9.53, 95% Cl = 4.84, 18.74) demonstrated the highest adjusted odds ratios; (2) being male (adjusted OR = 2.56, 95% Cl = 1.37, 4.76), seeing school life as 'not at all enjoyable' (adjusted OR = 2.69, 95% Cl = 1.03, 7.01) and family environment as 'neither good nor bad' (adjusted OR = 2.15, 95% Cl = 1.19, 3.88) also showed significant association; (3) life-time alcohol use did not show a significant association in the multivariate model (adjusted OR = 0.80, 95% Cl = 0.30, 2.12); and (4) solvent use appeared independent of knowledge regarding its effects ('death by acute intoxication', 'psychotic symptoms', 'amotivational syndrome', 'flashbacks' adjusted ORs all non-significant).

CONCLUSION

Alcohol use may not function as a gateway to solvent use in Japan. The reasons may be culture-bound. A longitudinal study is required to test this hypothesis.

Patterns of health-risk behavior among Japanese high school students

This study explored patterns of health-risk behaviors among Japanese high school students and examined if a cluster and an accumulation of health-risk behaviors existed. Self-administered questionnaires were employed in 1999 using a sample of 1,466 students (male 50.5%, female 49.5%) in grades 10 through 12 at seven public senior high schools in Okinawa, Japan. Health-risk behaviors studied included cigarette smoking, alcohol use, thinner use, nonuse of seat belts, suicide ideation, sexual intercourse, weight loss practices, and physical inactivity. Among male and female students, cigarette smoking, alcohol use, and sexual intercourse clustered. Accumulation of these risk behaviors also occurred because the observed proportion was greater than the expected proportion assuming independent occurrence. Vocational high school students and upper graders were strongly associated with accumulation of health risk behaviors. These findings identify a high-risk target group among Japanese adolescents and suggest that preventive intervention strategies should take into consideration the cluster and accumulation of health-risk behaviors.

Sleep loss and daytime sleepiness in the general adult population of Japan

There are few epidemiological studies on sleep loss and daytime sleepiness in the general adult population of Japan. A total of 4000 adult people, aged 20 and over, were randomly drawn from five areas of Japan, and 3030 individuals were interviewed and completed a questionnaire including information about sleep duration and sleep problems. Overall, 29% slept less than 6 h at night, 23% reported having insufficient sleep, and 6% took sleep enhancing medications. The prevalence rates were 21% for symptoms of insomnia and 15% for excessive daytime sleepiness. Symptoms of insomnia were more prevalent in the elderly, whereas young people were more likely to report short sleep duration, subjective insufficient sleep and excessive daytime sleepiness. A multiple logistic regression model revealed that excessive daytime sleepiness had significant associations with young people, short sleep duration, insomnia symptoms, subjective insufficient sleep and sleep enhancing medication use. Short sleep duration was the strongest predictor of excessive daytime sleepiness. The findings indicate that sleep loss and excessive daytime sleepiness in the Japanese adult population are common, and comparable to those reported in Western countries. Excessive daytime sleepiness in the general adult population seems more likely to be attributed to short sleep duration.