Audit Questionnaire as part of Community Action Against Heavy Drinking
Alcohol and Alcoholism Advance Access published online on April 24, 2008




The purpose of the present study was to find out how well the alcohol questionnaire, AUDIT, as part of a wide community action was noticed, and if it had any effects especially among heavy drinkers.

As part of local community action campaign (‘Booze Weeks’), the AUDIT pamphlet was delivered to all households (90,000) in Tampere, Finland, and 500 randomly selected inhabitants were interviewed on telephone.

More than three quarters of those consuming alcohol had noticed the ‘Booze Weeks’ campaign and considered it necessary. Inhabitants who drank most frequently were also the most likely to have noticed the campaign and the AUDIT pamphlet.

As part of a wide community action, home-delivered self-help material is often noticed especially by heavy drinkers. They might come to realize their own heavy drinking and seek professional treatment.

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Alcohol measurement methodology in epidemiology: recent advances and opportunities
Addiction OnlineEarly Articles 16 April 2008


To review and discuss measurement issues in survey assessment of alcohol consumption for epidemiological studies.

The following areas are considered: implications of cognitive studies of question answering such as self-referenced schemata of drinking, reference period and retrospective recall, as well as the assets and liabilities of types of current (e.g. food frequency, quantity–frequency, graduated frequencies and heavy drinking indicators) and life-time drinking measures. Finally we consider units of measurement and improving measurement by detailing the ethanol content of drinks in natural settings.

Cognitive studies suggest inherent limitations in the measurement enterprise, yet diary studies show promise of broadly validating methods that assess a range of drinking amounts per occasion; improvements in survey measures of drinking in the life course are indicated; attending in detail to on- and off-premise drink pour sizes and ethanol concentrations of various beverages shows promise of narrowing the coverage gap plaguing survey alcohol measurement.

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National Drug Policy 2006-2011: Report on Consultation Feedback
Date of publication: April 2008

This document reports on feedback received during public consultation on the review of the National Drug Policy. It encompasses views expressed by stakeholders at the thirteen meetings, hui and fono throughout the country, and in the ninety-five written submissions on the Consultation Document.

The feedback received reflects a diverse range of individual and organisational beliefs on the role of government in relation to tobacco, alcohol and drug use. Comments on the policy direction set out in the Consultation Document were, however, for the most part positive.

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Govt, Nelson trade barbs over alcohol
Apr 27 2008

A war of words has erupted after federal Health Minister Nicola Roxon accused the former Howard government of fuelling teenage binge drinking.

Ms Roxon said a decision in 2000 to cut excise on pre-mixed alcoholic drinks - so-called alcopops - helped fuel the surge in excessive drinking by young people, particularly girls.

A furious Opposition Leader Brendan Nelson branded the claim an "outrageous slur".

Ms Roxon said the Rudd government's decision to lift the excise by 70 per cent would help tackle binge drinking by making the sugary, innocuous tasting drinks between 30 cents and $1.30 a bottle more expensive.

The tax increase will deliver about $2 billion a year to the government - a "big chunk" of which will go to preventative health schemes, Ms Roxon said.

She slammed the former government for cutting the excise, making pre-mixed drinks cheaper than bottled spirits.

"I think the previous government is partly responsible. I think they made a mistake. We're going to turn that around," Ms Roxon told the Nine Network.

"We can track the change in the way that young women have been drinking these products from the time that the Howard government changed the excise in 2000.

"We've seen patterns where it's gone from about 14 per cent of young girls drinking these products up to about 60 per cent.

"So, this is an explosion that we think needs to be tackled ... We have a problem that must be turned around and this is the place where we're starting."
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WHO Expert Committee on Problems Related to Alcohol Consumption

An expert committee is an international group of experts that provides WHO with the latest scientific and technical advice on a broad range of medical and public health subjects. Members of such expert groups are all drawn from the expert advisory panels and serve in their personal capacities rather than as representatives of governments or other bodies. Their views do not necessarily reflect the decisions or the stated policy of WHO. Membership of an expert committee lasts only for the duration of the meeting.

A resolution adopted at the Fifty-eighth World Health Assembly requested the Director-General "to report to the Sixtieth World Health Assembly on evidence-based strategies and interventions to reduce alcohol-related harm, including a comprehensive assessment of public-health problems caused by harmful use of alcohol", and to "draw up recommendations for effective policies and interventions to reduce alcohol-related harm" (resolution WHA58.26).

To this end, a WHO Expert Committee on Problems Related to Alcohol Consumption met in Geneva from 10-13 October 2006. The main objectives of the Expert Committee meeting were to review a range of public health problems attributable to alcohol consumption as well as scientific and empirical evidence of effectiveness of different policy options, and to provide technical recommendations on effective policies and interventions to reduce alcohol-related harm.

WHO Expert Committee on Problems Related to Alcohol Consumption. Second Report. WHO Technical Report Series 944 (English) [pdf 731kb]

WHO Expert Committee on Problems Related to Alcohol Consumption. Second Report. WHO Technical Report Series 944 (French) [pdf 391kb]

WHO Expert Committee on Problems Related to Alcohol Consumption. Second Report. WHO Technical Report Series 944 (Arabic) [pdf 504kb]

WHO Expert Committee on Problems Related to Alcohol Consumption. Second Report. WHO Technical Report Series 944 (Chinese) [pdf 694kb]

WHO Expert Committee on Problems Related to Alcohol Consumption. Second Report. WHO Technical Report Series 944 (Russian) [pdf 417kb]

WHO Expert Committee on Problems Related to Alcohol Consumption. Second Report. WHO Technical Report Series 944 (Spanish) [pdf 389kb]

Download agenda (English) [pdf 44kb]

Download agenda (French) [pdf 16kb]

Report by the Secretariat to the Executive Board 121st Session (EB121/10) on the Second Report of the WHO Expert Committee on Problems Related to Alcohol Consumpt

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World Health Assembly set to discuss alcohol


The Health ministers from all over the world will discuss the health burden of alcohol in the forthcoming World Health Assembly to be held in Geneva 14-23 May. This is the follow up of the WHA resolution 58.26 Public health problems caused by harmful use of alcohol, from 2005, the first WHA resolution exclusively on alcohol since 1983. The documents for the alcohol issue are now available on the WHO site.
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WHA documents:

WHA resolution 58.26 Public health problems caused by harmful use of alcohol (pdf from WHO site)

A60/14 (pdf rfrm the WHO site)
Evidence-based strategies and interventions to reduce alcohol-related harm

A60/14 Add.1 (pdf from the WHO site)
Evidence-based strategies and interventions to reduce alcohol-related harm; Global assessment of public-health problems caused by harmful use of alcohol

EB121/10 (pdf from the WHO site)
Expert committees and study groups.
This document contains the WHO Expert Committee On Problems Related To Alcohol Consumption, Second report, Geneva, 10–13 October 2006. Part of the document
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Binge drinking Howard's fault: Roxon

April 27, 2008

Federal Health Minister Nicola Roxon has blamed the former Howard government for the rise in teenage binge drinking.

Ms Roxon said the decision to cut taxes on premixed alcoholic drinks eight years ago helped fuel the surge in excessive drinking by young people, particularly teenage girls.

The Rudd government overnight reversed the change, virtually doubling the excise on alcopops from midnight, pushing the cost of the drinks up by between 30 cents and $1.30 a bottle.

"We can track the change in the way that young women have been drinking these products from the time that the Howard government changed the excise in 2000," Ms Roxon told the Nine Network.

"We've seen patterns where it's gone from about 14 per cent of young girls drinking these products up to about 60 per cent.
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Press Release - Overall declines seen in tobacco, alcohol and illicit drug use, but some teen behaviours still risky

A new report from the Australian Institute of Health and Welfare (AIHW) shows that tobacco, alcohol and illicit drug use all fell between 2004 and 2007, but some results are still concerning, especially for teenagers and young people.

The 2007 National Drug Strategy Household Survey: first results report shows that the proportion of the population aged 14 years or older who smoked daily declined from 17.4% to 16.6% between 2004 and 2007.

‘This is one of the lowest daily smoking rates in the world,’ said AIHW spokesperson Mark Cooper-Stanbury.

Recent cannabis use dropped significantly from 11.3% to 9.1%, and a decline in methamphetamine use, from 3.2% to 2.3%, was also seen.

The survey findings suggest that there has been no increase in the use of crystal methamphetamine—or ‘ice’—in contrast to the general perception.

‘However, since the last survey, the proportion of both men and women reporting recent cocaine use has increased, but more so for men—from 1.3% to 2.2%,’ he said.

The report also raises concerns regarding Australia’s youth.

Around one-quarter of teenagers put themselves at risk of short-term alcohol-related harm at least once a month.

‘The proportion was higher among females (28.3%) than males (24.5%),’ said Mr Cooper-Stanbury.
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Taxes double on ready-to-drink alcohol

Anthony Deceglie

April 27, 2008

THE cost of popular alcohol drinks will soar by up to $1 a bottle from today as part of a Federal Government effort to reduce binge drinking among teenagers.

The price of ready-to-drink beverages, or ‘‘alcopops’’, will increase from between 30c to $1.30 a can or bottle depending on their alcohol content.

This includes drinks such as Bacardi Breezers, rum and coke, vodka mudshakes, Vodka Cruisers and UDLs.

The cost rise is because of an increase on the excise on alcopops so it matches the excise of spirits. The excise rate on remixed drinks will rise from $39.36 a litre to $66.67 a litre of alcohol content.

This closes a tax loophole, whereby tax was lower on pre-mixed products compared with spirits.
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Inflation, Alcoholism Are Top Concerns of the Russians
Apr. 23, 2008

Most Russians view inflation, alcoholism and drug addiction the most burning problems of the country, showed the poll of All-Russia’s Center for Public Opinion Studies.

Of interest is that the Russians (66 percent) were mostly concerned about alcoholism and drug addiction two years ago. Today’s highlight is inflation (67 percent vs. 55 percent in 2006), while the problem of alcoholism and drug addiction sank to the second position (63 percent).

Inflation is again the key concern of the Russians when it comes to their personal problems. Some 55 percent of respondents were agitated about it two years ago vs. 68 percent today. The threat of alcoholism and drug addiction doesn’t appear so acute in the list of the personal troubles. It has just the fifth ranking vs. the second one in the list of the country’s problems. But unemployment appears of greater significance. It scores No. 7 in the personal rating vs. No. 11 in the rating of the country's difficulties.
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Parent Awareness of Youth Use of Cigarettes, Alcohol, and Marijuana

Highlights:

• SAMHSA's National Survey on Drug Use and Health includes a sample of parents and their children who live in the same household. These parent-child pairs are composed of a child aged 12 to 17 and his or her biological, step, adoptive, or foster parent.

• Based on SAMHSA's National Survey on Drug Use and Health, mothers were more likely than fathers to be aware of their child's substance use in the past year regardless of the household having only the mother or both parents.

• Fathers in two parent households were more likely than fathers in father-only households to be aware of their child's substance use in the past year.

• The older the child, the more likely that parents were aware of their child's alcohol and cigarette use in the past year.

• Past year substance use by youth was higher in one-parent households than those with both parents.

• Within one-parent households, substance use by youth was generally higher among youth in father-child pairs than mother-child pairs

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Measurement of direct ethanol metabolites suggests higher rate of alcohol use among pregnant women than found with the AUDIT—a pilot study in a population-based sample of Swedish women
Volume 198, Issue 4, Pages 407.e1-407.e5 (April 2008)

The objective of the study was to investigate whether biomarkers of alcohol consumption would provide additional information to the use of a validated alcohol questionnaire in pregnant women.

One hundred three pregnant women were included in the study. The women completed the Alcohol Use Disorders Identification Test (AUDIT) questionnaire, and a urine and hair sample was collected. The urine samples were used for determination of ethyl glucuronide (EtG) and ethyl sulfate and the hair samples for EtG and fatty acid ethyl esters (FAEE).

Twenty-six women (25.2%) were identified as possible alcohol consumers by the combined use of AUDIT and direct ethanol metabolites. Seven subjects had EtG or FAEE levels in hair highly suspicious of heavy drinking, but only 1 of these were positive according to the AUDIT questionnaire

The combined use of the AUDIT questionnaire and direct ethanol metabolites appear to identify more potential alcohol consumers among pregnant women than does the sole use of the AUDIT questionnaire.

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Request Reprint E-Mail: inger.sundstrom@kbh.uu.se

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Lifecourse socioeconomic predictors of midlife drinking patterns, problems and abstention: Findings from the 1958 British Birth Cohort Study
Drug and Alcohol Dependence Volume 95, Issue 3, 1 June 2008, Pages 269-278

Research suggests that outcomes associated with drinking may differ depending upon patterns of consumption, drinking related symptoms and social problems. This paper investigated socioeconomic predictors (measuring multiple indices, period and consistency of disadvantage) of midlife drinking patterns.

Socioeconomic information from the 1958 British Birth Cohort Study (n = 9146) included: manual socioeconomic position and owner/buyer residential tenure (7, 11, 16, 33 and 42 y), and educational attainment (33 y). At 45 y, the overlap between drinking patterns was explored using the Alcohol Use Disorders Identification Test. Patterns included: ‘Moderate-binge’ (binge drinkers with low-problem scores, consuming within UK sensible drinking weekly guidelines); Low-Problem Heavy (LPH) drinkers (regardless of binge); ‘Problem’ (and heavy or binge) and ‘Non-/occasional’ (≤monthly) drinkers. These categories were compared to ‘Low-risk’ drinkers.

Socioeconomic disadvantage was consistently associated with moderate-binge, non-/occasional and problem but not LPH drinking. The highest risk was associated with multiple and persistent disadvantage across childhood and adulthood; this risk was partially accounted for education. Non-/occasional and moderate-binge drinking was predicted by disadvantage during childhood alone. The socioeconomic disadvantage of non-/occasional drinkers was not explained by past problem or heavy drinking.

Socioeconomic disadvantage across the lifecourse was consistently linked to specific drinking patterns. Furthermore, associations linking socioeconomic disadvantage with drinking patterns will typically be underestimated if multiple and persistent disadvantage is not investigated. The role of persistent socioeconomic disadvantage in the poor health of non-drinkers and moderate-binge drinkers needs investigation.

The findings support current initiatives targeting the reduction of social and individual costs associated with specific drinking patterns.

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Request Reprint E-Mail: Tanya.Caldwell@anu.edu.au
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Alcohol Drinking, Cigarette Smoking, and Risk of Colorectal Adenomatous and Hyperplastic Polyps
American Journal of Epidemiology 2008 167(9):1050-1058;



The authors evaluated alcohol drinking and cigarette smoking in relation to risk of colorectal polyps in a Nashville, Tennessee, colonoscopy-based case-control study.

In 2003–2005, cases with adenomatous polyps only (n = 639), hyperplastic polyps only (n = 294), and both types of polyps (n = 235) were compared with 1,773 polyp-free controls. Unordered polytomous logistic regression was used to calculate adjusted odds ratios and 95% confidence intervals.

Consumption of at least five alcoholic drinks per week was not strongly associated with development of polyps. Odds ratios for all polyp types were increased for dose, duration, and pack-years of cigarette smoking and were stronger for hyperplastic polyps than for adenoma.

Compared with never smoking, dose-response relations were particularly strong for current smoking and duration; for 35 years of smoking, odds ratios were 1.9 (95% confidence interval (CI): 1.4, 2.5) for adenomatous polyps only, 5.0 (95% CI: 3.3, 7.3) for hyperplastic polyps only, and 6.9 (95% CI: 4.4, 11.1) for both types of polyps.

Compared with current smoking, time since cessation was associated with substantially reduced odds; for 20 years since quitting, odds ratios were 0.4 (95% CI: 0.3, 0.6) for adenoma only, 0.2 (95% CI: 0.1, 0.3) for hyperplastic polyps only, and 0.2 (95% CI: 0.2, 0.4) for both polyp types.

These findings support the adverse role of cigarette smoking in colorectal tumorigenesis and suggest that quitting smoking may substantially reduce the risk of colorectal polyps.


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"Culture of Drinking" and Individual Problems with Alcohol Use
American Journal of Epidemiology 2008 167(9):1041-1049




Binge drinking is a substantial and growing health problem. Community norms about drinking and drunkenness may influence individual drinking problems.

Using data from the New York Social Environment Study (n = 4,000) conducted in 2005, the authors examined the relation between aspects of the neighborhood drinking culture and individual alcohol use. They applied methods to address social stratification and social selection, both of which are challenges to interpreting neighborhood research.

In adjusted models, permissive neighborhood drinking norms were associated with moderate drinking (odds ratio (OR) = 1.28, 95% confidence interval (CI): 1.05, 1.55) but not binge drinking; however, social network and individual drinking norms accounted for this association.

By contrast, permissive neighborhood drunkenness norms were associated with more moderate drinking (OR = 1.20, 95% CI: 1.03, 1.39) and binge drinking (OR = 1.92, 95% CI: 1.44, 2.56); the binge drinking association remained after adjustment for social network and individual drunkenness norms (OR = 1.58, 95% CI: 1.20, 2.08).

Drunkenness norms were more strongly associated with binge drinking for women than for men (p_interaction = 0.006).

Propensity distributions and adjustment for drinking history suggested that social stratification and social selection, respectively, were not plausible explanations for the observed results.

Analyses that consider social and structural factors that shape harmful drinking may inform efforts targeting the problematic aspects of alcohol consumption.

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In vivo and in vitro ethanol exposure in prenatal rat brain: GABA_B receptor modulation on dopamine D₁ receptor and protein kinase A

Synapse Volume 62, Issue 7 , Pages 534 - 543



We have investigated the effects of prenatal ethanol exposure on GABA_B receptors (GABA_BRs), protein kinase A (PKA), and DA D₁ receptor (DAD₁R) expressions.

GABA_B1R and GABA_B2R showed different age-dependent expressions in in vivo fetal rat forebrain from gestational days (GD) 15.5 to 21.5 upon 10% ethanol treatment to mother, with and without baclofen at a dose of 10 mg/kg body weight/day. The protein level changes could not be attributed to changes in the level of transcription since GABA_BR mRNA presented different expression patterns upon in vivo ethanol treatment.

Using in vitro cultivated cortical neurons from GD 17.5 fetuses, we also explored the modulatory effects of ethanol on PKA and DAD₁R through GABA_BRs, under 50 M baclofen and 100 M phaclofen administrations, with or without 100 mM of ethanol treatment in the culture media.

The results showed that 20 min ethanol treatment without baclofen or phaclofen had increasing effects on both the GABA_BRs. Further, baclofen and phaclofen administration significantly affected PKA and GABA_BR levels upon 20 min and 1 h ethanol treatment. In contrast, DAD₁R showed increasing effects upon ethanol treatment, which was modulated by GABA_BR's agonist baclofen and antagonist phaclofen.

Therefore the present study suggested that the GABA_BR activity could modulate ethanol's cellular effects, which possibly including PKA and DAD₁R activities, and may be an underlying cause of ethanol's effects.

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Alcohol, Tobacco Products Aimed At Teens?

Among Concerns: Caffeinated, Fruity Drinks That Contain Alcohol, Flavored Tobacco

America's youth are inundated with visual appeals to drink and smoke, CBS News correspondent Randall Pinkston reports.

While the alcohol and tobacco industries insist their products are aimed at adults, critics charge beverages like Sparks and colored tobacco products are tailor-made for teens. There are fruit-flavored cigars and energy drinks that are high-caffeine - and in a new twist, up to 9 percent alcohol.

"Alcohol and caffeine are really double trouble when they're marketed to kids and when they create the illusion of alertness with the impairment of alcohol," said Connecticut attorney general Richard Blumenthal.

It's not only the content that worries the critics - it's the marketing. From the names, Tilt, Sparks, Joose, to the colorful packaging and cartoon-like images.

"Well, they are influencing younger kids with all these flavors and that's not good," said Maria Gomez. "When they get older, they might be addicted to these things."

And that is what concerns prosecutors of 28 states and the District of Columbia, who are accusing breweries of promoting products that are "highly attractive to underage youth."
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View Video "Marketing to Minors"
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New Online Course with CEU's Available

Acamprosate: A New Medication for Alcohol Use Disorders

The Center for Substance Abuse Treatment's Knowledge Application Program (CSAT KAP) is pleased to offer its first online e-learning course, Acamprosate: A New Medication for Alcohol Use Disorders. The course provides information about the use, side effects, and contraindications of acamprosate; information to discuss with clients; and a comparison of medications used to treat alcohol use disorders.

The course is self-paced so that users can log out and return later to continue where they left off. The course includes interactive exercises, case examples, and a test. Counselors who successfully complete the course receive one NAADAC-approved continuing education unit (CEU) at no cost and can print out their CEU certificate.

Access e-Learning Course— Acamprosate: A New Medication for Alcohol Use Disorders

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O'Malley delays signing 'alcopop' bill

By Bradley Olson |Sun reporter

April 24, 2008

Gov. Martin O'Malley has put off signing a bill that would allow so-called "alcopops" -- fruity libations such as Mike's Hard Lemonade -- to continue to be taxed and distributed as if they were beer, saying he needs more time to think about the measure.

The law, which passed by wide margins in both legislative chambers, is controversial because activists, such as the group Mothers Against Drunk Driving, believe the drinks are marketed to underage drinkers and that the broader distribution and lower taxes they have traditionally enjoyed in Maryland make them more available to teenagers.

O'Malley met this morning with the CEO of MADD, leaders of several state and national public health organizations and several parents in Maryland whose children have been killed recently in drunk driving incidents, all of whom urged him to veto the bill, which he said today that he had planned on signing.
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Punch hits out at 'tax on binge drinking'
Nick Huber
guardian.co.uk,
Thursday April 24 2008

The chief executive of Britain's biggest pub company has attacked the recent above-inflation rise in alcohol duty, dismissing government claims that it could discourage binge drinking as "ridiculous".

Giles Thorley, chief executive of Punch Taverns, warned today that the 6% rise in alcohol duty, announced in the March Budget, could even encourage excessive drinking because customers may choose to buy more cheaper alcohol from supermarkets and drink heavily at home.

"The pub is the home of responsible drinking. The number of restrictions that already exist as result of recent government legislation means that you are much safer drinking in the pub than anywhere else," he said.

"We all get frustrated by the way that politicians use an excuse to pass on what is effectively a straight tax hike. The suggestion that (the rise in alcohol duty) was designed to mitigate the issues of binge drinking is quite frankly ridiculous."
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