Prevalence and characteristics of co-occurrence of smoking and increasing-and-higher-risk drinking: A population survey in England

BACKGROUND

Smoking and drinking alcohol both significantly contribute to mortality and morbidity, and there is a need to characterise the sociodemographic and health-related characteristics (e.g. mental distress) of people who do both in order to target resources. This study reports the prevalence and characteristics of adults in the general population in England who both drink alcohol at increasing-and-higher-risk levels and smoke.

METHODS

We used cross-sectional data from a monthly, nationally representative survey of adults in England (n = 37,258; April 2020-March 2022). Weighted data were used to report prevalence and unweighted data were used to report descriptive statistics for sociodemographic and health-related characteristics.

RESULTS

The prevalence of both smoking and increasing-and-higher-risk drinking was 4.6% (95% CI = 4.4-4.9; n = 1,574). They smoked a mean of 10.4 (SD = 8.86) cigarettes per day and had a mean AUDIT score of 12.8 (SD = 5.18). Nearly half (48.2%, n = 751) were trying to cut down on their smoking and 28.0% (n = 441) on their drinking. A quarter (25.3%, n = 397) had received General Practitioner advice on smoking while 8.7% (n = 76) had received advice on their drinking. Nearly half (48.6%, n = 745) reported experiencing psychological distress in the past month and 44.6% (n = 529) had a diagnosed mental health condition, both of which were higher than among all adults (28.1% and 29.1%, respectively).

CONCLUSION

In England, from April 2020 to March 2022, the prevalence of both smoking and increasing-and-higher-risk drinking was 4.6%. This group appears to experience high rates of mental health problems and targeted support is needed.

Factors associated with drinking behaviour during COVID-19 social distancing and lockdown among adults in the UK

BACKGROUND

To assess what factors were associated with reported changes to usual alcohol drinking behaviour during the start of lockdown in the United Kingdom (UK).

METHODS

Online cross-sectional survey of 30,375 adults in the UK from 21st March to 4th April 2020 (sample weighted). Logistic regression models were used to examine sociodemographic, drinking and COVID-19 factors associated with i) drinking less and ii) drinking more (versus same as usual).

RESULTS

Of 22,113 drinkers, 48.1 % reported drinking about the same, 25.7 % reported drinking less, and 26.2 % reported drinking more than usual over the past week. Drinking less was independently associated with being younger (OR = 0.88, p < .001), male (OR = 0.76, p < .001), BAME (OR = 0.76, p = .028), low income (OR = 0.74, p < .001), having COVID-19 (OR = 2.04, p < .001), adhering to COVID-19 protective behaviours (OR = 1.58, p = .020), stress about becoming ill from COVID-19 (OR = 1.26, p = .004) and not being a key worker (OR = 0.87, p = .030). Drinking more was independently associated with being younger (OR = 0.73, p < .001), female (OR = 1.36, p < .001), post-16 qualifications (OR = 1.21, p = .012), high income (OR = 1.43, p < .001), stress about catching (OR = 1.22, p = .020) or becoming ill from COVID-19 (OR = 1.28, p < .001), stress about finances (OR = 1.43, p < .001), and having an anxiety disorder (OR = 1.24, p = .011).

CONCLUSIONS

In a large, population sample of adults in the UK, around a quarter of drinkers reported drinking more alcohol and a quarter drinking less than usual during the COVID-19 related lockdown. Certain groups, such as those who are younger, female, of high socioeconomic position, have an anxiety disorder, and are stressed about finances or COVID-19 may need targeted alcohol reduction support during lockdown.

Factors associated with alcohol consumption and prescribed drugs with addiction potential among older women and men - the Nord-Trøndelag health study (HUNT2 and HUNT3), Norway, a population-based longitudinal study

BACKGROUND

Little is known about factors associated with alcohol consumption and use of drugs with addiction potential in older adults. The aim of this study was to explore the association between socio-demographic variables, physical and mental health and the later (11 years) use of frequent drinking, prescribed drugs with addiction potential and the possible combination of frequent drinking and being prescribed drugs with addiction potential in older adults (≥ 65 years).

METHODS

In this longitudinal study, we used data from two surveys of the Nord-Trøndelag Health Study (HUNT2 1995-1997 and HUNT3 2006-2008), a population based study in Norway. We totally included 10,656 individuals (5683 women) aged 54 years and older when they participated in HUNT2. Frequent drinking was defined as drinking alcohol 4 days or more per week. Data on prescribed drugs with addiction potential were drawn from the Norwegian Prescription Database. Drugs with addiction potential were defined as at least one prescription of benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years between 2005 and 2009.

RESULTS

The typical frequent drinker in HUNT3 was younger, more educated, lived in urban areas, and reported smoking and drinking frequently in HUNT2 compared to the non-frequent drinker in HUNT3. The typical user of prescribed drugs with addiction potential in HUNT3 was an older woman who smoked and was in poor health, suffered from anxiety, had been hospitalized in the last 5 years and used anxiety or sleep medication every week or more often in HUNT2. The typical individual in HUNT3 with the possible combination of frequent drinking and being prescribed drugs with addiction potential had more education, smoked, drank frequently and used anxiety or sleep medication in HUNT2.

CONCLUSION

Individuals who were identified as frequent drinkers in HUNT2 were more likely to be frequent drinkers in HUNT3, and to have the possible combination of frequent drinking and being prescribed drugs with addiction potential in HUNT3. Health care professionals need to be aware of use of alcohol among older adults using drugs with addiction potential.

A longitudinal examination of protective behavioral strategies and alcohol consumption among adult drinkers

Previous studies suggest that employing specific behavioral strategies when drinking can prevent excessive alcohol consumption and related harms. However, these studies have typically examined these 'protective behavioral strategies' (PBSs) in combination, limiting understanding of whether individual strategies differ in their effectiveness. Further, most existing research is cross-sectional in design, precluding the determination of causal relationships between PBS use and alcohol consumption. To address these research gaps, the present study sought to longitudinally (i) identify which individual PBSs are significantly related to reduced alcohol consumption over time and (ii) explore the effectiveness of individual PBSs among specific population groups. The sample comprised 1328 Australian adult drinkers (47% male) who completed an online survey assessing engagement in PBSs and alcohol consumption at two time points approximately four weeks apart. Reported enactment of the PBS 'Count your drinks' was associated with a significant reduction in alcohol consumption between T1 and T2. In contrast, enactment of the PBSs 'Ask a friend to let you know when you have had enough to drink', 'Put extra ice in your drink', 'Use a designated driver', and 'Leave drinking venues at a pre-determined time' was associated with an increase in alcohol consumption. The results thus suggest that many PBSs may not be effective in reducing alcohol consumption and that some may be associated with higher levels of intake. The results have implications for the development of harm-minimization campaigns designed to encourage drinkers to reduce their alcohol consumption.