Acetaldehyde as an underestimated risk factor for cancer development: role of genetics in ethanol metabolism

Chronic ethanol consumption is a strong risk factor for the development of certain types of cancer including those of the upper aerodigestive tract, the liver, the large intestine and the female breast.

Multiple mechanisms are involved in alcohol-mediated carcinogenesis. Among those the action of acetaldehyde (AA), the first metabolite of ethanol oxidation is of particular interest. AA is toxic, mutagenic and carcinogenic in animal experiments. AA binds to DNA and forms carcinogenic adducts.

Direct evidence of the role of AA in alcohol-associated carcinogenesis derived from genetic linkage studies in alcoholics. Polymorphisms or mutations of genes coding for AA generation or detoxifying enzymes resulting in elevated AA concentrations are associated with increased cancer risk.

Approximately 40% of Japanese, Koreans or Chinese carry the AA dehydrogenase 2*2 (ALDH2*2) allele in its heterozygous form. This allele codes for an ALDH2 enzyme with little activity leading to high AA concentrations after the consumption of even small amounts of alcohol.

When individuals with this allele consume ethanol chronically, a significant increased risk for upper alimentary tract and colorectal cancer is noted. In Caucasians, alcohol dehydrogenase 1C*1 (ADH1C*1) allele encodes for an ADH isoenzyme which produces 2.5 times more AA than the corresponding allele ADH1C*2.

In studies with moderate to high alcohol intake, ADH1C*1 allele frequency and rate of homozygosity was found to be significantly associated with an increased risk for cancer of the upper aerodigestive tract, the liver, the colon and the female breast.

These studies underline the important role of acetaldehyde in ethanol-mediated carcinogenesis.

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Request Reprint E-Mail: helmut_karl.seitz@urz.uni-heidelberg.de
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Ethanol elevates physiological all-trans-retinoic acid levels in select loci through altering retinoid metabolism in multiple loci: a potential mechan

All-trans-retinoic acid (atRA) supports embryonic development, central nervous system function, and the immune response. atRA initiates neurogenesis and dendritic growth in the hippocampus and is required for spatial memory; superphysiological atRA inhibits neurogenesis, causes teratology and/or embryo toxicity, and alters cognitive function and behavior. Because abnormal atRA shares pathological conditions with alcoholism, inhibition of retinol (vitamin A) activation into atRA has been credited widely as a mechanism of ethanol toxicity.

Here, we analyze the effects of ethanol on retinoid concentrations in vivo during normal vitamin A nutriture, using sensitive and analytically robust assays. Ethanol either increased or had no effect on atRA, regardless of changes in retinol and retinyl esters. Acute ethanol (3.5 g/kg) increased atRA in adult hippocampus (1.6-fold), liver (2.4-fold), and testis (1.5-fold). Feeding dams a liquid diet with 6.5% ethanol from embryonic day 13 (e13) to e19 increased atRA in fetal hippocampus (up to 20-fold) and cortex (up to 50-fold), depending on blood alcohol content. One-month feeding of the 6.5% ethanol diet increased atRA in adult hippocampus (20-fold), cortex (2-fold), testis (2-fold), and serum (10-fold). Tissue-specific increases in retinoid dehydrogenase mRNAs and activities, extrahepatic retinol concentrations, and atRA catabolism combined to produce site-specific effects.

Because a sustained increase in atRA has deleterious effects on the central nervous system and embryo development, these data suggest that superphysiological atRA contributes to ethanol pathological conditions, including cognitive dysfunction and fetal alcohol syndrome.

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Request Reprint E-Mail: jna@berkeley.edu
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Alcohol-Induced Blackout

For a long time, alcohol was thought to exert a general depressant effect on the central nervous system (CNS). However, currently the consensus is that specific regions of the brain are selectively vulnerable to the acute effects of alcohol.

An alcohol-induced blackout is the classic example; the subject is temporarily unable to form new long-term memories while relatively maintaining other skills such as talking or even driving.

A recent study showed that alcohol can cause retrograde memory impairment, that is, blackouts due to retrieval impairments as well as those due to deficits in encoding.

Alcoholic blackouts may be complete (en bloc) or partial (fragmentary) depending on severity of memory impairment. In fragmentary blackouts, cueing often aids recall. Memory impairment during acute intoxication involves dysfunction of episodic memory, a type of memory encoded with spatial and social context.

Recent studies have shown that there are multiple memory systems supported by discrete brain regions, and the acute effects of alcohol on learning and memory may result from alteration of the hippocampus and related structures on a cellular level.

A rapid increase in blood alcohol concentration (BAC) is most consistently associated with the likelihood of a blackout. However, not all subjects experience blackouts, implying that genetic factors play a role in determining CNS vulnerability to the effects of alcohol. This factor may predispose an individual to alcoholism, as altered memory function during intoxication may affect an individual‟s alcohol expectancy; one may perceive positive aspects of intoxication while unintentionally ignoring the negative aspects.

Extensive research on memory and learning as well as findings related to the acute effects of alcohol on the brain may elucidate the mechanisms and impact associated with the alcohol- induced blackout.

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Including a Screening and Brief Alcohol Intervention Program in the Care of the Obstetric Patient

Alcohol is the drug most commonly abused by pregnant women and the leading cause of preventable birth defects across the United States.

Screening, Brief Intervention, and Referral for Treatment is a program developed by the Emergency Nurses Association that has demonstrated success in treating patients who have alcohol use disorders.

This interventional program can be useful to perinatal nurses caring for pregnant women with alcohol use disorders in a variety of settings.

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Request Reprint E-Mail: vkeough@luc.edu
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Teenage drinking, alcohol availability and pricing: a cross-sectional study of risk and protective factors for alcohol-related harms in school childre

There is a lack of empirical analyses examining how alcohol consumption patterns in children relate to harms. Such intelligence is required to inform parents, children and policy relating to the provision and use of alcohol during childhood. Here, we examine drinking habits and associated harms in 15-16 year olds and explore how this can inform public health advice on child drinking.

There is no safe level of alcohol consumption for 15-16 year olds. However, while abstinence removes risk of harms from personal alcohol consumption, its promotion may also push children into accessing drink outside family environments and contribute to higher risks of harm.

Strategies to reduce alcohol-related harms in children should ensure bingeing is avoided entirely, address the excessively low cost of many alcohol products, and tackle the ease with which it can be accessed, especially outside of supervised environments.

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Immigrant generation, selective acculturation, and alcohol use among Latina/o adolescents

Do alcohol use and binge drinking among Latina/o adolescents increase in the second and third generation?

This study explores generational differences in alcohol use behaviors for three Latina/o ethnic groups.

For Mexican and Cuban adolescents, but not Puerto Ricans, immigrant generation was associated with alcohol use. For Mexican, but not Cuban adolescents, acculturation mediated the effect of immigrant generation on alcohol use behaviors.

Although generally social capital and a co-ethnic presence were protective factors against alcohol use behaviors, we found that some forms of social capital were actually risk factors for Cubans and Puerto Ricans.

Our results provide support for segmented-assimilation theory.

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Request Reprint E-Mail: teitle@montana.edu
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Alcohol abuse prevention in young people: An economic simulation

Severe alcohol abuse can lead to death and disability. A large number of educational programmes for young people's drinking behaviour have been developed to counteract alcohol abuse.

The aim of this research was to assess whether those programmes are rational from an economic point of view. It relies on a systematic review of economic evaluation analysis providing evidence on the status of those programmes.

Only one study met all the inclusion criteria. This result suggested the performance of an economic evaluation of secondary data. A second systematic literature review with different inclusion criteria was therefore carried out. Nine studies met the inclusion criteria, but only three provided evidence of effectiveness.

According to our simulations, if the interventions are effective they are also cost-effective. In other words if they can provide evidence of a decrease in alcohol use and abuse they can also provide evidence that the interventions are rational from an economic point of view.

The review suggests two final comments. First, the current investment in preventive programmes is very limited. Secondly, larger studies and more adequate systems of evaluation.

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Request Reprint E-Mail: guglielmo.pacileo@unibocconi.it
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Predicting Teenage Beliefs Concerning the Harm Alcohol and Cannabis Use may do in Eight European Countries

Data are from the European School Survey Project on Alcohol and other Drugs (ESPAD) in eight countries (Sweden, United Kingdom, France, Malta, Slovenia, Hungary, Bulgaria, and the Czech Republic) in spring 2003.

Two scales were constructed, measuring beliefs that alcohol and cannabis harm people. Relationships of these scales with measures of parental control, parental attitudes, respondent's own drug use, friend's drug use, and gender were assessed within each country.

Both at the country and the individual level, subject's own drug use showed strong inverse relationships with risk perceptions. Parental control and parental attitudes also showed associations with risk perception but these seemed largely mediated by the parental influence on subject's own use and by choice of friends.

In countries with low prevalence of drug use the extent to which the predictor variables accounted for risk perceptions was lowest. Also the predictor variables showed greater associations with cannabis risk perception than with alcohol risk perception. For cannabis the explained variance in risk of harm varied from 8.1% in Sweden to 30.4% in the Czech Republic. For alcohol harm this range was from 3.1% in Bulgaria to 15.1% in Malta.

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Request Reprint E-Mail: p.m.miller@blueyonder.co.uk
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Self-esteem and gender influence the response to risk information among alcohol using college students

Individuals with high self-esteem who engage in risky health behaviours often minimize the associated health risks; individuals with low self-esteem do not demonstrate such minimization. The influence of gender on health risk perceptions is less clear.

This study examined the influences of gender and self-esteem upon college students' responses to an alcohol risk message.

Three-hundred-and-four alcohol-using college students read an NIAAA sponsored message regarding the risks associated with alcohol use.

Results revealed that self-esteem and gender significantly and independently predicted alcohol-related attitudes, intentions, and follow-up behaviour. Females, especially those with low self-esteem, demonstrated greater alcohol-related concerns immediately after reading the message, while males exhibited more self-serving attitudes. In addition, high self-esteem participants and males reported fewer intentions to reduce drinking behaviour.

At follow-up, higher self-esteem was associated with greater drinking frequency relative to lower self-esteem. Furthermore, males with higher self-esteem reported the greatest binge frequency compared with all other groups.

These findings suggest that individuals with higher self-esteem and males are particularly resistant to information regarding the negative consequences of alcohol use.

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Request Reprint E-Mail: cneumann@forest.edu
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Adolescent and young adult perceptions of Australian alcohol advertisements

There is substantial evidence that children and youth are exposed to and recall alcohol advertising, and increasing evidence of associations between liking alcohol advertisements and under-age drinking. Alcohol advertising in Australia, as in many industrialized countries, is subject to a self-regulatory code developed and administered by the alcohol industry.

The purpose of the current study was to investigate young people's perceptions of the messages in recent alcohol advertisements and whether these perceptions support the industry view that self-regulation is effective in protecting young people from inappropriate messages about alcohol. .

The respondents perceived messages in the advertisements regarding several social benefits of consuming alcohol, including that the advertised product would make them more sociable and outgoing, help them have a great time, help them fit in, help them feel more confident, help them feel less nervous, and help them succeed with the opposite sex.

All of these messages transgress the terms of the self-regulatory code for alcohol advertising. There was also a strong association between emotional responses to the advertisements and stated intentions to try the advertised products.

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Request Reprint E-Mail: sandraj@uow.edu.au
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Female Substance Abuse Treatment Admissions Aged 12 to 17

Adolescence (ages 12 to 17) is a crucial phase of human development, during which females and males experience different biological, social, and cognitive changes. Findings from the National Survey on Drug Use and Health (NSDUH) show that compared to adolescent males nationwide, adolescent females had significantly higher rates of past month illicit drug use other than marijuana. Females also had higher rates of current alcohol use, cigarette use, past year nonmedical pain reliever use, depression, and alcohol dependence.

Understanding the characteristics of adolescent female substance abuse treatment admissions can help to inform public health policy and build prevention and intervention programs that are gender specific.

Using the 2007 Treatment Episode Data Set (TEDS), this report examines the characteristics of female substance abuse treatment admissions aged 12 to 17. In 2007, of the nearly 132,000 admissions aged 12 to 17, approximately 30 percent or slightly more than 40,000 were female admissions.

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Alcohol Focus Scotland Annual Report

Since last year’s report, Alcohol Focus Scotland has:

1. Responded to the Scottish Government’s alcohol consultation “Changing Scotland’s relationship with alcohol” and is now campaigning for the introduction of minimum pricing.
2. Worked with City & Guilds to launch the Certificate for Staff Working in Scottish Licensed Premises and Staff Workbook.
3. Ran a publicity campaign encouraging women who are pregnant or trying for a baby to avoid alcohol.
4. Secured funding for the continuation of the Community Action on Alcohol project and set up the National Communities Group.
5. Organised successful national conferences on licensing and counselling, with record numbers of delegates attending both.
6. Launched the Scottish Network of Alcohol Practitioners for the Young (SNAPY) – a network to share good practice, skills and resources when working with young people affected by their own or someone else’s drinking.
7. Developed the ‘Rory learning resource’, a toolkit which teachers, counsellors and social workers can use to help children cope with parental alcohol misuse.
8. Improved our links with European and international alcohol agencies and hosted the Education group of the International Council on Alcohol and Addictions (ICAA).
9. Developed AFS Alcohol Support Online, a web-based support and counselling service which was piloted in Aberdeen.
10. Responded to around 200 media enquiries and generated our own press, online, radio and TV coverage on a wide range of alcohol issues.

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Minimum pricing for alcohol - joint letter to press

The debate on minimum pricing for alcohol has become increasingly polarised. Some believe that the rising burden of harm due to alcohol demands effective government intervention and others believe that concern for Scotland's health is not sufficient grounds for curbing market freedoms that have enabled unprecedented growth in the production, trade and promotion of alcohol.

A recent opinion by the Advocate General of the European Court of Justice which considered the legality of minimum pricing for tobacco has reignited claims that the introduction of minimum alcohol pricing in Scotland could be illegal. However, the European Commission stated in July 2009 that the Council Directive covering excise duties on alcohol "does not prohibit Member states from setting minimum retail prices for alcoholic beverages". This suggests that minimum pricing is permissible under EU trade law if it applies to domestic and imported products alike and it does not constitute a barrier to trade. If the prices set were shown to be a barrier to the free movement of goods then there would need to be a public policy justification that the harm is so great to allow rules governing international trade to be overridden. With the number of alcohol-related deaths in Scotland increasing by 150% in a generation and alcohol related harm costing Scotland over £2 billion pounds every year, we believe that such a case could be made.

It is sometimes argued that taxation offers a more effective and less trade-restrictive means of increasing alcohol prices, however, alcohol retailers do not necessarily pass tax increases on to consumers. Alcohol is frequently used as a 'loss leader'. If tax increases are not passed on, the price of alcohol doesn't go up and people can keep on drinking the same amount. Minimum pricing, on the other hand, cannot be undercut by loss-leading and below-cost selling.

Controls on price and availability have been identified as one of the most effective measures that governments can implement to reduce harm caused by alcohol. Minimum pricing is not a panacea and needs to be part of a broader strategy but without effective controls on price and availability, any other policy measures will have limited effect.

Read Full Letter

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Public hearing on harmful use of alcohol

The WHO Secretariat held a web-based public hearing to provide an opportunity to everyone to give their views on the best ways to reduce harmful use of alcohol. Contributions to the public hearing could be submitted via a dedicated website or by fax in any of the six official UN languages (i.e. Arabic, Chinese, English, French, Russian and Spanish) from 1 October to 15 November 2008.

340 contributions were sent in by individuals, civil society groups, WHO Member States and government institutions, academic and research institutions, economic operators and other interested parties. In providing their contribution the participants were encouraged to focus on the following questions:

• What are your views on effective strategies to reduce alcohol-related harm
• From a global perspective, what are the best ways to reduce problems related to harmful use of alcohol?
• In what ways can you or your organization contribute to reduce harmful use of alcohol?

Received submissions

:: Volume I: Summary of submissions [pdf 3.52Mb]

:: Volume II: WHO Member States, Government Institutions, Intergovernmental Organizations and Academia-Research [pdf 3.45Mb]

:: Volume III: Nongovernmental organizations [pdf 7.77Mb]

:: Volume IV: Alcohol industry, trade and agriculture [pdf 5.45Mb]

:: Volume V: Other organizations and entities [pdf 3.49Mb]

:: Volume VI: Individuals [pdf 3.79Mb]

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Qld wants talks on drink-driving limit

Queensland's police commissioner has called for a nationwide discussion about lowering the allowable drink-driving limit to zero.

Commissioner Bob Atkinson on Thursday said he backed a zero blood alcohol limit for Queensland drivers in the face of "the slaughter and wholesale injury" of the road toll. . . . . . .

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‘Amaze Me,’ Mother Said, So That’s What She Did

In “Lit,” her searing new memoir, Mary Karr recalls that she and her impossible mother used to play a game, when they were driving or her mother was bored or sprawled on her bed with a hangover: “Tell me a story she liked to say, meaning charm me — my life in this Texas suckhole is duller than a rubber knife. Amaze me

This game, aided and abetted by her father’s abundant storytelling gifts — his ability to regale his drinking buddies with all manner of startling tales — would fuel Ms. Karr’s own hunger for putting “marks on paper.” Even when she was a child, stapling together a book of rhymes she’d done in crayon, she knew that writing was a way she “could puncture the soap bubble” of her mother’s misery, that writing was a way to seize people’s attention and enthrall them. . . . . .

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Britain's alcohol market: how minimum alcohol prices could stop moderate drinkers subsidising those drinking at hazardous and harmful levels

Discounting of alcoholic products is universal in UK supermarkets with some chains selling own brand spirits for less than the duty payable per item. Eighty per cent of alcohol purchases are made by 30% of the population and this group are the main beneficiaries.

In December 2008 the government announced its intention to consult on modifications to the Licensing Act 2003 to enable the introduction of mandatory conditions for the sale of alcoholic products in order to curtail alcohol harm.

In this article it is shown that families in Britain have nothing to fear from the introduction of a 50p/unit minimum price of alcohol as the overall effect should be a reduction in average weekly supermarket bills for the majority while harmful and hazardous drinkers will pay more.

By paying less for non-alcoholic products sold by supermarkets, moderate drinkers should no longer be effectively subsidising the alcohol purchased by the harmful and hazardous group.

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Kevin Rudd plans to curb alcohol-fuelled violence

PRIME Minister Kevin Rudd will spearhead a fresh battle against binge drinking amid a growing outbreak of alcohol-fuelled violence.

Mr Rudd has called for confronting advertising campaigns to warn young Australians about the dangers of excessive drinking, a sober rethink on the concentration of liquor licences in CBD areas and adequate resourcing for police. . . . . .

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Long-Term Strategies to Reduce the Stigma Attached to Addiction, Treatment, and Recovery within the City of Philadelphia (With Particular Reference to

The purpose of this document is to: 1) review the historical and scientific research on the social/professional stigma related to addiction, with a particular focus on the stigma experienced by people in medication-assisted treatment and long-term medication-assisted recovery, and 2) outline strategies that could be used by the Philadelphia Department of Behavioral Health and Mental Retardation Services and its many community partners to reduce addiction/recovery-related stigma.

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ICAP Papers for WHO Consultation

In May 2008, the World Health Assembly adopted a resolution that calls for the development of a global strategy to reduce harmful alcohol use. Following a period of stakeholder and regional consultations, the World Health Organization (WHO) will formulate the draft strategy in 2009 and submit it for approval to the World Health Assembly in 2010.

The six papers below are referenced versions of papers submitted on behalf of the ICAP sponsors about key areas of reducing harmful drinking where alcohol producers can demonstrate particular competence, legitimacy, and technical strength and where industry input has been welcomed by WHO. These papers were contributions to the web-based public hearing held by WHO from 1 October–15 November 2008 as part of the stakeholder consultation stage in the process of developing the draft global strategy. All stakeholder submissions to the hearing are posted on the WHO website: http://www.who.int/substance_abuse/activities/hearing/en/print.html.

The six papers were expanded by the authors and published in the new book Working Together to Reduce Harmful Drinking, edited by Marcus Grant and Marjana Martinic (Routledge, 2009). It is suggested that these papers are used in conjunction with the book, its supporting materials (see www.icap.org/Publications/WorkingTogether), and ICAP's Health and Issues Briefings that offer overviews of current research on health, interventions, and policy.

• Reducing Harmful Drinking: Industry Contributions (for a summary of this paper, click here; also available in Russian)
  by Brett Bivans and Marjana Martinic
• Alcohol Production (for a summary of this paper, click here)
  by Ron Simpson
• Alcohol Distribution (for a summary of this paper, click here)
  by Graeme Willersdorf
• Alcohol Availability (for a summary of this paper, click here)
  by Adrian Botha
• Pricing of Beverage Alcohol (for a summary of this paper, click here)
  by Godfrey Robson
• Alcohol Marketing (for a summary of this paper, click here)
  by Roger Sinclair

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ICAP Periodic Review on Drinking & Culture

Alcohol consumption is an integral part of the social fabric in many countries. Yet the role occupied by drinking is quite different across countries and cultures, and is reflected in local customs, patterns, and attitudes. Despite this wide diversity, the lingua franca of the alcohol field is English, as are the publications that provide the evidence base most commonly used in international policy discussions. As a result, much of the research published in other languages and reflecting different cultural contexts and approaches escapes broader notice.

The ICAP Periodic Review on Drinking and Culture is an electronic publication that seeks to help remedy this disparity. Its key objectives are to:

1. give greater exposure to research not currently published or widely available in English;
2. broaden the range of cultural perspectives and the evidence base used in the crafting of policy and prevention.

Each issue of the Periodic Review presents English translations of abstracts of publications appearing in language areas currently underrepresented in major English-language research databases. Coverage of the Periodic Review is limited to psychosocial and socio-cultural research, to focus on drinking culture, behavior, patterns, and psychosocial outcomes.

Identification and selection of key research to be featured and all editorial decisions are carried out by an Editorial Group, consisting of experts from diverse geographic, linguistic, and disciplinary areas

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On Being Responsible

This report—a companion piece to in-depth information on our Web site—has a dual purpose. First, it describes our contr ibution to creating a culture of responsible alcohol consumption—what we call Our Thinking About Drinking strategy. This is our most signif icant corporate responsibility issue and we explore it here in some detail. Visit our Issues Forum (www.ourthinkingaboutdrinking.com) for more information on alcohol issues, and join in the conversation on responsible drinking.

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Professor David Nutt attacks ministers over ‘failure’ on alcohol

Alcohol is the “gateway drug” that remains the greatest threat to society, and the Government’s failure to address the problem epitomises its disregard for scientific evidence, Professor David Nutt said yesterday. . . . . .

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Three-Year Changes in Adult Risk Drinking Behavior in Relation to the Course of Alcohol-Use Disorders*

This study examines the associations between the course of alcohol-use disorder (AUD) and changes in average daily volume of ethanol intake, frequency of risk drinking, and maximum quantity of drinks consumed per day over a 3-year follow-up interval in a sample of U.S. adults.

There were positive changes in all consumption measures associated with developing an AUD and negative changes associated with remission of an AUD, even among individuals who continued to drink. Increases and decreases associated with onset and offset of dependence exceeded those associated with onset/offset of abuse only, and the decreases associated with full remission from dependence exceeded those associated with partial remission.

There were few changes in consumption among individuals whose AUD status did not change. Interactions of AUD transitions with other factors indicate that development of an AUD is associated with a greater increase in consumption among men, possibly reflecting their greater total body water and lower blood alcohol concentration in response to a given dose of ethanol, and among individuals with high baseline levels of consumption.

Changes in consumption associated with onset and offset of AUD are substantial enough to have important implications for the risk of associated physical and psychological harm.

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Alcohol and Cigarette Use and Misuse Among Hurricane Katrina Survivors: Psychosocial Risk and Protective Factors

The present study examined survivors' use and misuse of cigarettes and alcohol following Hurricane Katrina. We also examined several psychosocial factors that we expected would be associated with higher or lower rates of substance use following the hurricane.

Results revealed that survivors were smoking cigarettes, consuming alcohol, and experiencing alcohol consumption-related problems at a substantially higher rate than expected based on pre-hurricane prevalence data.

Results also suggested that certain psychosocial factors were associated with participants' substance use and misuse following the hurricane.

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Request Reprint E-Mail: floryk@mailbox.sc.edu
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The Relationship Between Terrorism and Distress and Drinking: Two Years After September 11, 2001

This study examined: 1) the prevalence of negative beliefs related to terrorism and 2) whether these beliefs were related to distress and drinking. .

A sizable percentage of respondents experienced terrorism-related negative beliefs. Higher negative belief scores were related to greater distress and problematic drinking in 2003, controlling for sociodemographic variables and (in most cases) pre-9/11 distress and drinking.

Study limitations were noted and future research was recommended.

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Request Reprint E-Mail: Jrichman@psych.uic.edu
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CALL FOR PROPOSALS “National Drinking Cultures”

The Alcohol Education and Research Council (AERC) invites proposals to undertake the above study. The Drinkaware Trust is providing the AERC with funding for the study.

This is an initial study over nine months. The intention is that the study will then continue for a further four years. The objectives of the study are to establish:

• A rich picture of the different drinking cultures currently occurring in the UK, taking into consideration age, location, ethnicity and how each of these relate to each other
• A set of measures to allow analysis of changes in these cultures, when undertaking future updates of the study. These should consider the metrics established by Drinkaware as organisational Key Performance Indicators (Annex 1)
• An analysis and commentary on what may happen in the UK if the identified cultural trends continue
• Recommendations for how to address these trends
• Recommendations for how this initial study should be developed over the next five years

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Alcohol Advertising on Boston's Massachusetts Bay Transportation Authority Transit System: An Assessment of Youths' and Adults' Exposure

We investigated the frequency with which alcohol advertisements appeared on Massachusetts Bay Transportation Authority (MBTA) transit lines in Boston, MA, and we calculated adult and youths' exposure to the ads.

Advertisers reached the equivalent of half of all Boston Public School transit passengers aged 11 to 18 years and the equivalent of nearly half of all transit passengers in the Boston area with an alcohol advertisement each day. Because of the high exposure of underage youths to alcohol advertisements, we recommend that the MBTA prohibit alcohol advertising on the Boston transit system.

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Request Reprint E-Mail: mbsiegel@bu.edu
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Incorporating Measurement Non-Equivalence in a Cross-Study Latent Growth Curve Analysis

A large literature emphasizes the importance of testing for measurement equivalence in scales that may be used as observed variables in structural equation modeling applications.

When the same construct is measured across more than one developmental period, as in a longitudinal study, it can be especially critical to establish measurement equivalence, or invariance, across the developmental periods. Similarly, when data from more than one study are combined into a single analysis, it is again important to assess measurement equivalence across the data sources.

Yet, how to incorporate non-equivalence when it is discovered is not well described for applied researchers. Here, we present an item response theory approach that can be used to create scale scores from measures while explicitly accounting for non-equivalence.

We demonstrate these methods in the context of a latent curve analysis in which data from two separate studies are combined to create a single longitudinal model spanning several developmental periods.

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Effectiveness and cost-effectiveness of a stepped care intervention for alcohol use disorders in primary care: pilot study

Screening for alcohol use disorders identifies a wide range of needs, varying from hazardous and harmful drinking to alcohol dependence. Stepped care offers a potentially resource-efficient way of meeting these needs, but requires evaluation in a randomised controlled trial.

To evaluate the feasibility, effectiveness and cost-effectiveness of opportunistic screening and a stepped care intervention in primary care.

Both groups reduced alcohol consumption 6 months after randomisation with a greater, although not significant, improvement for the stepped care intervention. Motivation to change was greater following the stepped care intervention. The stepped care intervention resulted in greater cost savings compared with the minimal intervention.

Stepped care was feasible to implement in the primary care setting and resulted in greater cost savings compared with minimal intervention.

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Request Reprint E-Mail: drummond@iop.kcl.ac.uk
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Polymorphisms in Alcohol Metabolizing Genes and the Risk of Head and Neck Cancer in a Brazilian Population

The incidence of head and neck cancer (HNC) in Brazil has increased substantially in recent years. This increase is likely to be strongly associated with alcohol and tobacco consumption, but genetic susceptibility also should be investigated in this population. The aim of this study was to evaluate the association of polymorphisms in genes of alcohol metabolism enzymes and the risk of HNC.

Chronic alcohol intake increased approximately four times the risk of HNC. The mutant genotype ADH1B Arg⁴⁸His was more frequent in controls (12.7%) than HNC patients (5.8%) conferring protection for the disease . Similar results were observed for individuals with ADH1B*2 or ADH1B*2/ADH1C*1 mutated haplotypes. Multiple regression analyses showed that individuals with the mutant genotype ADH1B Arg⁴⁸His who consume alcohol >30 g/L/day have more than four times the risk for HNC .

The fast alcohol metabolizing genotypes may prevent HNC when the amount of alcohol intake is <30.655>

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Request Reprint E-Mail: gfgattas@usp.br _______________________________________________

Alcoholic Pancreatitis: Pathogenesis, Incidence and Treatment with Special Reference to the Associated Pain

Alcoholic pancreatitis continues to stir up controversy. One of the most debated points is whether from onset it is a chronic disease or whether it progresses to a chronic form after repeated episodes of acute pancreatitis.

Histological studies on patients with alcoholic pancreatitis have shown that the disease is chronic from onset and that alcoholic acute pancreatitis occurs in a pancreas already damaged by chronic lesions.

Genetic factors may also play a role in the pathogenesis of alcoholic disease.

The incidence of chronic alcoholic pancreatitis seems to have decreased in the last twenty years.

Finally, recent therapeutic studies which have shown medical or surgical approaches capable of reducing the pain episodes in chronic pancreatitis patients will be described.

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Request Reprint E-Mail: raffaele.pezzilli@aosp.bo.it
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The modulating effect of the androgen receptor on craving in alcohol withdrawal of men is partially mediated by leptin

We reported recently that a functional relevant CAG trinucleotide repeat of the androgen receptor influences craving of men in alcohol withdrawal. It is known to modulate serum concentrations of leptin, which affects hypothalamic appetite regulation. Its plasma levels are elevated during chronic alcohol consumption, normalize within periods of abstinence and are associated with craving.

The aim of this study was to further elucidate the role of leptin in mediating the effects of the mentioned polymorphism on craving in men undergoing alcohol withdrawal.

This report suggests that the investigated polymorphism mediates its effect on craving of men in alcohol withdrawal mostly through the regulation of leptin. Nevertheless future studies are needed to further explore the functionality of the androgen receptor gene in terms of craving.

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Request Reprint E-Mail: bernd.lenz@uk-erlangen.de
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Effect of alcohol consumption on the liver detoxication capacity as measured by [13C2]aminopyrine and L-[1-13C]phenylalanine breath tests

The aim of this study was to investigate the hepatic microsomal and cytosolic functions by using the 13CO2 breath test in healthy subjects either before or after consumption of red wine.

Moderate alcohol consumption does not induce significant short-term changes of the microsomal and the cytosolic function of the human liver in healthy subjects.

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Request Rerprint E-Mail: klaus-dieter.wutzke@med.uni-rostock.de
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Subtypes of Alcohol and Intimate Partner Violence: A Latent Class Analysis

The investigation explored whether subtypes of relapse to violence exist for different levels of intimate partner violence and drinking behavior among men who relapse to both alcohol and violence after alcoholism treatment.

Findings revealed that two classes of violence best described the sample of men that relapsed to violence. Class 1 contained males who had perpetrated more days of violence, relapsed to violence faster, more frequently relapsed to alcohol, and had a higher percentage of males identified as meeting diagnostic criteria for antisocial personality disorder compared to those in class 2.

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Request Reprint E-Mail: Keith_Klostermann@urmc.rochester.edu
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Drunken fruit flies help scientists find potential drug target for alcoholism

A group of drunken fruit flies have helped researchers from North Carolina State and Boston universities identify entire networks of genes—also present in humans—that play a key role in alcohol drinking behavior. This discovery, published in the October 2009 print issue of the journal GENETICS, provides a crucial explanation of why some people seem to tolerate alcohol better than others, as well as a potential target for drugs aimed at preventing or eliminating alcoholism. In addition, this discovery sheds new light on many of the negative side effects of drinking, such as liver damage. . . . . . .

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l-Cysteine reduces oral ethanol self-administration and reinstatement of ethanol-drinking behavior in rats

Our previous findings have shown that l-cysteine, a non essential amino acid, prevented ethanol (EtOH) induced conditioned place preference.

The aim of the present study was to examine the effect of l-cysteine on the acquisition and maintenance of oral EtOH self-administration and on the reinstatement of EtOH-drinking behavior in Wistar rats.

The animals that had access to EtOH solution discriminated between the active and inactive nose-pokes and showed rates of active nose-pokes significantly higher than the tap water group.

Furthermore, rats self-administering EtOH (10%) also demonstrated extinction behavior and gradually reinstated active nose-poke responding when EtOH was reintroduced. l-cysteine reduced both the acquisition and maintenance of oral EtOH self-administration.

The reduced reinstatement of EtOH-drinking behavior was paralleled by a significant reduction of EtOH intake and correlated with blood and brain EtOH levels.

The efficacy of l-cysteine on the various phases of alcohol drinking in rats, could represent an interesting pharmacological approach and could open a new line of research for the development of therapies to reduce EtOH intake in alcoholic patients.

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Request Reprint E-Mail: :apeana@uniss.it

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Russia Tries, Once Again, to Rein in Vodka Habit

MYTISHCHI, Russia — It was late on a Monday afternoon at the drunk tank in this Moscow suburb, but it could have been any day, at any hour, at any similar facility across this land. People would come. They always do. Such is Russia’s ruinous penchant for the bottle — and the challenge facing a new government policy to curb it. . . . . .

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Are biomarkers of chronic alcohol misuse useful in the assessment of DWI recidivism status?

A first driving while impaired by alcohol (DWI) conviction is a key opportunity to identify offenders who are at high risk for recidivism. Detection of alcohol use disorder (AUD) is a major target of current DWI assessments. However, offenders frequently underreport their alcohol consumption, and use of biomarkers has been proposed as a more objective indicator. Among the best established are aspartate aminotranferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), mean corpuscular red blood cell volume (MCV), carbohydrate-deficient transferrin (CDT), and thiamine. To our knowledge, no research has directly verified whether AUD biomarkers predict DWI recidivism status. Using a cross-sectional design, this study tested three hypotheses related to the utility of biomarkers in DWI assessment.

The present findings suggest that biomarkers of chronic patterns of heavy drinking may not be adequate to capture the multiple processes that appear to promote recidivism (e.g., binge drinking, other risky behavioural and personality features). Despite their objectivity, caution is warranted in the interpretation of a positive score on these biomarkers in DWI assessment. Longitudinal research is needed to more comprehensively explore the relationship between positive biomarkers in first-time offenders and their risk of becoming recidivists.

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Request Reprint E-Mail: thomas.brown@mcgill.ca

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How will Alcohol Sales in the UK be Affected if Drinkers Follow Government Guidelines?

The proportion of alcohol consumption that is above government guidelines ('risky drinking') has been estimated in several countries, suggesting that reductions in risky drinking would lead to significant declines in total alcohol consumption. However, this has not previously been conducted transparently in the UK. Furthermore, existing studies have under-explored the importance of several methodological decisions, as well as not closely examining the meaning of these figures for debates on 'corporate social responsibility' (CSR).

Risky drinking accounts for 55–82% of the total consumption by 18- to 64-year olds, depending on the definition of risky drinking used. If only alcohol above the government guidelines is counted, this falls to 22–47%. Consumption by underage drinkers accounts for 4.5% of the total consumption, while consumption by drink-drivers accounts for 0.5–8.0% depending on the assumptions made.

Methodologically, the study shows that at least two decisions have considerable importance: the definition of risky drinking used and whether we count all drinking (as in most previous studies) or only drinking above guidelines. Substantively, these studies do not directly show that drink companies' profitability would be affected by declines in risky drinking. Nevertheless, they are valuable for present debate in themselves and form the basis of a more complex analysis of alcohol CSR.

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