Alcohol consumption, alcohol-related problems, problem drinking, and socioeconomic status

Addiction Research Institute (IVO), Erasmus University Rotterdam, The Netherlands.
Alcohol and Alcoholism (Impact Factor: 2.09). 03/1999; 34(1):78-88. DOI: 10.1093/alcalc/34.1.78
Source: PubMed

ABSTRACT In general, a lower socioeconomic status (SES) is related to a lower health status, more health problems, and a shorter life expectancy. Although causal relations between SES and health are unclear, lifestyle factors play an intermediate role. The purpose of the present study was to obtain more insight into the relation between SES, alcohol consumption, alcohol-related problems, and problem drinking, through a general population survey among 8000 people in Rotterdam. Odds ratios were calculated using educational level as independent, and alcohol consumption, alcohol-related problems, and problem drinking as dependent variables. Abstinence decreased significantly by increasing educational level for both sexes. For men, excessive drinking, and notably very excessive drinking, was more prevalent in the lowest educational group. For women, no significant relation between educational level and prevalence of excessive drinking was found. After controlling for differences in drinking behaviour, among men the prevalence of 'psychological dependence' and 'social problems' was higher in intermediate educational groups, whereas prevalence of 'drunkenness' was lower in intermediate educational groups. For women, a negative relation was found between educational level and 'psychological dependence'; prevalence of 'symptomatic drinking' was higher in the lowest educational group. Prevalence of problem drinking was not related to educational level in either sex. It is concluded that differences exist between educational levels with respect to abstinence, but only limited differences were found with respect to excessive drinking. Furthermore, there is evidence for higher prevalences of alcohol-related problems in lower educational levels, after controlling for differences in drinking behaviour, in both sexes.

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Available from: Henk Garretsen, Sep 02, 2015
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    • "Another important factor which has been emphasised by Ahmed (2005) is that in contrast to human drug users who generally have concurrent access to a wide variety of alternative reinforcers in addition to drugs, experimental animals usually have no options in their environment other than drug reinforcement. Findings in humans with low socio-economic status, in which there are fewer opportunities for alternative forms of reinforcement, show that these individuals have higher rates of smoking (for review, see Hiscock et al. 2012) and alcoholism (Grant 1997; van Oers et al. 1999). In laboratory settings, the presence of alternative reinforcers has been shown to alter drug use in humans (for review, see Higgins 1997), in monkeys (for review, see Campbell and Carroll 2000), and in rats in both discrete choice procedures (Ahmed 2005; Lenoir et al. 2007) and under concurrent reinforcement schedules (Cosgrove et al. 2002; Kanarek et al. 1995; Klebaur et al. 2001; Mattson et al. 2001), indicating their efficacy at competing for behavioural output. "
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    ABSTRACT: Background The availability of alternative reinforcement has been shown to reduce drug use, but it remains unclear whether it facilitates a reduction or cessation of drug seeking or taking. Objectives We compared the effects of punishment of cocaine seeking or taking behaviour after brief or extended cocaine-taking histories when behavioural reallocation was facilitated or not by making available an alternative ingestive reinforcer (sucrose). Methods In the first experiment, punishment of either seeking or taking responses was introduced immediately after training on the seeking-taking chained schedule. In the second experiment, punishment of cocaine seeking was introduced after 12 additional days of either 1 or 6 h daily access to cocaine self-administration. In both experiments, beginning 1 week before the introduction of punishment, a subset of rats had concurrent nose poke access to sucrose while seeking or taking cocaine. Results The presence of an alternative source of reinforcement markedly facilitated behavioural reallocation from punished cocaine taking after acquisition. It also facilitated punishment-induced suppression of cocaine seeking after an extensive cocaine self-administration history likely by prompting goal-directed motivational control over drug use. However, a significant proportion of rats were deemed compulsive—maintaining drug use after an extensive cocaine history despite the presence of abstinence-promoting positive and negative incentives. Conclusion Making available an alternative reinforcer facilitates disengagement from punished cocaine use through at least two different processes but remains ineffective in a subpopulation of vulnerable animals, which continued to seek cocaine despite the aversive consequence of punishment and the presence of the alternative positive reinforcer.
    Psychopharmacology 06/2014; 232(1). DOI:10.1007/s00213-014-3648-5 · 3.99 Impact Factor
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    • "Ineffectiveness of addressing alcohol consumption in the present study can be explained by the following: (i) stable drinking patterns achieved at older age are more difficult to change [65]; (ii) weekly alcohol consumption was significantly higher among low SES older adults in this study. It has been reported that middle and high SES adults exert a better control on alcohol consumption and among whom, alcohol interventions can be more successful [66] and (iii) use of personalised reports, booklet on ageing and drinking, and drinking diaries, not employed in this study, have previously proved to be effective in reducing the amount of alcohol consumption in older individuals [67]. At baseline, a higher percentage of control adults practiced any form of physical activity though from baseline to follow-up, the percentage of adults in the intervention group increased from 52.0% to 81.6%. "
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    ABSTRACT: Background. Low calcium intake, a risk factor of osteoporosis and subsequent fractures, has been previously reported among post-menopausal women in Mauritius. Objective. To assess the effectiveness of a theory-based educational intervention in improving the calcium intake, self-efficacy, and knowledge of older Mauritians. Methodology. The study was conducted as a pre- and post-test design which was evaluated through a baseline, immediate postintervention, and 2-month follow-up assessments. Participants were adults (n = 189) aged ≥40 years old from 2 urban community-based centres. The intervention group (IG) (n = 98) participated in 6 weekly interactive lessons based on the health belief model (HBM). The main outcome measures were calcium intake, HB scale scores, knowledge scores, and physical activity level (PAL). Anthropometric measurements were also assessed. Results. The IG significantly increased its baseline calcium intake, knowledge and self-efficacy (P < 0.001) at post-assessments. A significant decrease in waist circumference in the IG was noted (P < 0.05) after intervention. PAL significantly increased by 12.3% at post-test and by 29.6% at follow-up among intervention adults when compared to the CG (P < 0.001). Conclusion. A theory-driven educational intervention is effective in improving the dietary calcium intake, knowledge, self-efficacy, and PAL of older community-based Mauritian adults.
    The Scientific World Journal 12/2013; 2013:750128. DOI:10.1155/2013/750128 · 1.73 Impact Factor
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    • "However, the literature is not unanimous on this [31-34]. Reporting alcohol consumption is strongly related to the sociodemographic characteristics [35] that can be included in the imputation model in order to reduce non-response bias. We only included age and sex in the imputation model because other sociodemographic variables were not related to the missingness mechanism. "
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    ABSTRACT: BACKGROUND: Multiple Imputation as usually implemented assumes that data are Missing At Random (MAR), meaning that the underlying missing data mechanism, given the observed data, is independent of the unobserved data. To explore the sensitivity of the inferences to departures from the MAR assumption, we applied the method proposed by Carpenter et al. (2007). This approach aims to approximate inferences under a Missing Not At random (MNAR) mechanism by reweighting estimates obtained after multiple imputation where the weights depend on the assumed degree of departure from the MAR assumption. METHODS: The method is illustrated with epidemiological data from a surveillance system of hepatitis C virus (HCV) infection in France during the 2001-2007 period. The subpopulation studied included 4343 HCV infected patients who reported drug use. Risk factors for severe liver disease were assessed. After performing complete-case and multiple imputation analyses, we applied the sensitivity analysis to 3 risk factors of severe liver disease: past excessive alcohol consumption, HIV co-infection and infection with HCV genotype 3. RESULTS: In these data, the association between severe liver disease and HIV was underestimated, if given the observed data the chance of observing HIV status is high when this is positive. Inference for two other risk factors were robust to plausible local departures from the MAR assumption. CONCLUSIONS: We have demonstrated the practical utility of, and advocate, a pragmatic widely applicable approach to exploring plausible departures from the MAR assumption post multiple imputation. We have developed guidelines for applying this approach to epidemiological studies.
    BMC Medical Research Methodology 06/2012; 12(1):73. DOI:10.1186/1471-2288-12-73 · 2.17 Impact Factor
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