Opioid agonist treatment in transition: A cross-country comparison between Austria, Germany and Switzerland.

BACKGROUND AND AIMS: OAT is a well developed and successful treatment strategy for opioid dependent patients in Europe. It has significantly contributed to the fight against the HIV and HCV pandemics, leading to an increased life expectancy in this population. Building on the OAT experiences in Austria, Germany, and Switzerland and their models of care, the objective of this study is to analyse experiences and changes in patient structures to identify necessary adaptations for the system of care. METHODS: We analysed national register-based data from patients receiving OAT during the period spanning from 2010 to 2020 in Austria, Germany (cases), and Switzerland. We examined and compared OAT policies and practice at national levels through a review of literature and publicly available policy documents. RESULTS: Across these three countries, the life expectancy of OAT patients increased substantially. The mean age increased from 33.0 in 2010 to 39.1 in 2020 in Austria, from 35.6 years to 41.5 years in Germany (cases), and from 39.6 to 47.1 in Switzerland, respectively. In all three countries, the percentage of patients/cases aged 60 years and older increased more than tenfold between 2010 and 2020. CONCLUSIONS: Integrated support models, reliable care structures, internationally comparable high treatment coverage, flexible prescribing practices, and a wide range of available OAT medications are successful strategies. The experiences in these countries indicate that it is possible to address the complex and chronic nature of opioid dependence and its concurrent mental and physical health challenges, resulting in an increasing life expectancy of OAT patients.

Validation of the revised Alcohol Expectancy Task [rAET].

Alcohol expectancies are well-established determinants of alcohol consumption. Traditionally, expectancies were assessed using self-report questionnaires. However, researchers have increasingly begun to explore the use of pictographic assessments, for example, the revised Alcohol Expectancy Task [rAET]. The current research aimed to examine the factor structure of the task in relation to the hypothesised expectancy dimensions, participants' endorsement of these dimensions, and whether rAET scores are associated with drinking patterns. The rAET presents participants with several illustrated scenarios in which people are displaying emotions, following the Circumplex Model of Affect. For each scenario, participants select which type of drink the person presented in the illustration was most likely to have drunk. The rAET was administered online to a convenience sample (n = 1,192, female: 50.7%, Mage = 36.8, SD = 13.7). The confirmatory factor analysis demonstrated adequate fit of the hypothesised four-factor model. Mean comparisons demonstrated that positive expectancies were more pronounced than negative expectancies, and a distinction between arousal and sedation expectancies was found. Results of a structural equation model found that positive sedation and positive arousal were related to high drinking frequency. There were no links between usual quantity of alcohol use or binge drinking. It appears that the rAET can be successfully used to assess alcohol expectancies in terms of the emotions that are expected to occur from alcohol consumption. Future research is needed to establish the tool's assessment properties in different settings, and its utility in predicting alcohol consumption in different age groups, particularly children and young adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Negative but Not Positive Alcohol-Related Consequences Tend to Occur Above the Heavy Episodic Drinking Threshold: A Daily Study of Young Adult Heavy Drinkers.

AIMS: This study used event-level data to identify the threshold (i.e. number of standard alcoholic drinks) at which specific negative and positive alcohol-related consequences are likely to occur. METHODS: Ninety-six college students aged 18-20 reporting weekly heavy episodic drinking (HED) or at least one negative alcohol-related consequence in the past 2 weeks completed ecological momentary assessment over 28 days. Participants reported number of standard drinks consumed and negative (e.g. nausea) and positive (e.g. new friend) alcohol-related consequences on 492 drinking nights. The area under the receiver operating characteristic (AUROC) curve measured the ability of an increasing number of drinks consumed to discriminate between nights with versus without a given consequence. The Youden Index method was used to identify the optimal threshold of drinks for each consequence. Thresholds were examined for each consequence by participants' biological sex and heavy drinking status. RESULTS: Across subgroups, most consequences occurred on nights where participants reported higher consumption levels relative to nights where consequences did not occur. Thresholds for negative consequences ranged between four and nine drinks and thresholds for positive consequences were between three and six drinks. CONCLUSIONS: Many negative consequences are likely to occur following the traditional HED threshold of 4+/5+ drinks (females/males), with more severe consequences occurring at slightly higher thresholds. Positive consequences are likely to occur at lower thresholds. There may be an optimal number of drinks that maximize positive while minimizing negative consequences for heavy drinking college students.

Pre-drinking motives are directly associated with alcohol-related consequences even after adjusting for alcohol use on a given night: A consequence-specific analysis.

INTRODUCTION: Pre-drinking motives (PDM) are linked with different characteristics of pre-drinking occasions (e.g., fast-paced drinking, socializing, moving across locations) that are potentially related to adverse night-level consequences. This study examines the direct associations of three PDM dimensions (fun/intoxication, facilitation, and conviviality) with the occurrence of five consequences (hangover, impaired driving, blackout, risky sex, fight/injury) over and above amounts of alcohol consumed that night. METHODS: A sample of 138 young adult nightlife goers (55.1 % men, Mage = 19.0 SD = 2.4) in Switzerland reported PDM at baseline, and subsequently reported night-level alcohol use and consequences the next morning on 12.1 weekend nights on average (N = 1,663 participant-nights). Correlational analyses and multilevel logistic regression models assessed associations between PDM and night-level consequences. RESULTS: After adjusting for amounts consumed, age, sex and monthly pre-drinking frequency, conviviality PDM were associated with higher odds of risky sex (OR = 2.68) and lower odds of blackout (OR = 0.57) while fun/intoxication PDM were associated with lower odds of risky sex (OR = 0.35). Interaction analyses per gender showed that fun/intoxication PDM were associated with lower odds of impaired driving among women (OR = 0.25). Results remained the same when adjusting for general drinking motives, which were not associated with night-level consequences. CONCLUSION: PDM might better capture risk factors for experiencing night-level consequences than general drinking motives. Preventive intervention should make young people aware that pre-drinking is not only associated with higher amounts of alcohol consumed, but also with increased risks of specific night-level consequences, including blackouts and risky sexual behaviors, depending on the level of endorsement of each PDM.

Drinking location moderates the association between social group size and alcohol consumption among young adults: An event-level study.

INTRODUCTION: Previous studies have demonstrated relationships between social and environmental characteristics of the drinking context and alcohol use. However, the use of event-level data to investigate individual and joint relationships between such characteristics and alcohol use remains a gap in the literature. This study aimed to examine associations between drinking context (location and social group size) and alcohol consumption, and estimate the relationship between the interaction of context and alcohol consumption. METHODS: Using an Internet-based cellphone-optimised assessment technique, 183 Swiss young adults (mean: 23 years; range: 17-37 years) completed hourly assessments from 8 pm to midnight Thursday through Saturday for five consecutive weeks. Participants contributed 3454 hourly questionnaires. The number of drinks, the number of friends present and location (off-premise-home, outdoors; on-premise-bars, restaurants) were assessed based on the previous hour. Multilevel mixed-effects models were used to assess the relationships of interest. RESULTS: Being off-premise compared to on-premise was associated with fewer hourly drinks consumed (b = -0.44, P < 0.001). Greater numbers of friends present were associated with more drinks consumed (b = 0.02, P < 0.001). The association between number of friends and number of drinks consumed was significantly stronger for off-premise compared to on-premise locations (b = 0.03, P < 0.001). DISCUSSION AND CONCLUSIONS: Compared to off-premise locations, on-premise locations are associated with more hourly drinks consumed. However, the positive relationship between social group size and drinks consumed is significantly stronger for off-premise locations compared to on-premise locations. Findings have implications for tailored interventions focused on reducing alcohol consumption by young adults.

Changes in substance use and other reinforcing behaviours during the COVID-19 crisis in a general population cohort study of young Swiss men.

BACKGROUND AND AIMS: There are concerns about the potential impact of the coronavirus disease (COVID-19) pandemic on substance use (SU) and other reinforcing behaviours (ORB). This paper investigates changes in SU and ORB among young men during the COVID-19 crisis (i.e. March-June 2020). METHODS: Before and during the COVID-19 crisis, 2,344 young Swiss men completed questionnaires covering SU (i.e. alcohol, cigarettes, illegal cannabis), ORB (i.e. gaming, watching TV series, internet pornography) and sociodemographic and work-related characteristics (i.e. deterioration in the work situation, change in working hours, change in working hours from home, healthcare workers' and other professionals' contacts with potentially infected people, linguistic region, call up to military or civil protection unit, living situation, age). RESULTS: Latent-change score models showed significant decreases of 17% for drinking volume and frequency of heavy episodic drinking, and a significant increase of 75% for time spent gaming and watching TV series. Subgroups showed greater relative increases. French-speaking participants, those who experienced a deterioration in their work situation and healthcare workers in contact with potentially infected people reported increased cigarette use. Those without children increased gaming, whereas those who worked fewer hours, experienced a deterioration in their work situation or were French-speaking did more gaming and watched more TV series. Those who lived alone or were German-speaking watched more internet pornography. CONCLUSION: During the COVID-19 crisis, young Swiss men drank less alcohol and spent more time gaming and watching TV series. Changes in SU and ORB were not homogenous in the young Swiss men population.

Ten seconds of my nights: Exploring methods to measure brightness, loudness and attendance and their associations with alcohol use from video clips.

INTRODUCTION: Most evidence on associations between alcohol use behaviors and the characteristics of its social and physical context is based on self-reports from study participants and, thus, only account for their subjective impressions of the situation. This study explores the feasibility of obtaining alternative measures of loudness, brightness, and attendance (number of people) using 10-second video clips of real-life drinking occasions rated by human annotators and computer algorithms, and explores the associations of these measures with participants' choice to drink alcohol or not. METHODS: Using a custom-built smartphone application, 215 16-25-year-olds documented characteristics of 2,380 weekend night drinking events using questionnaires and videos. Ratings of loudness, brightness, and attendance were obtained from three sources, namely in-situ participants' ratings, video-based annotator ratings, and video-based computer algorithm ratings. Bivariate statistics explored differences in ratings across sources. Multilevel logistic regressions assessed the associations of contextual characteristics with alcohol use. Finally, model fit indices and cross-validation were used to assess the ability of each set of contextual measures to predict participants' alcohol use. RESULTS: Raw ratings of brightness, loudness and attendance differed slightly across sources, but were all correlated (r = .21 to .82, all p < .001). Participants rated bars/pubs as being louder (Cohen's d = 0.50 [95%-CI: 0.07-0.92]), and annotators rated private places as darker (d = 1.21 [95%-CI: 0.99-1.43]) when alcohol was consumed than when alcohol was not consumed. Multilevel logistic regressions showed that drinking in private places was more likely in louder (ORparticipants = 1.74 [CI: 1.31-2.32]; ORannotators = 3.22 [CI: 2.06-5.03]; ORalgorithm = 2.62 [CI: 1.83-3.76]), more attended (ORparticipants = 1.10 [CI: 1.03-1.18]; ORalgorithm = 1.19 [CI: 1.07-1.32]) and darker (OR = 0.64 [CI: 0.44-0.94]) situations. In commercial venues, drinking was more likely in darker (ORparticipants = 0.67 [CI: 0.47-0.94]; ORannotators = 0.53 [CI: 0.33-0.85]; ORalgorithm = 0.58 [CI: 0.37-0.88]) and louder (ORparticipants = 1.40 [CI: 1.02-1.92]; ORalgorithm = 2.45 [CI: 1.25-4.80]) places. Higher inference accuracies were found for the models based on the annotators' ratings (80% to 84%) and the algorithms' ratings (76% to 86%) than on the participants' ratings (69% to 71%). CONCLUSIONS: Several contextual characteristics are associated with increased odds of drinking in private and commercial settings, and might serve as a basis for the development of prevention measures. Regarding assessment of contextual characteristics, annotators and algorithms might serve as appropriate substitutes of participants' in-situ impressions for correlational and regression analyses despite differences in raw ratings. Collecting contextual data by means of sensors or media files is recommended for future research.

Fun/intoxication pre-drinking motives lead indirectly to more alcohol-related consequences via increased alcohol consumption on a given night.

INTRODUCTION: Pre-drinking increases alcohol use on drinking nights, which is associated with various adverse alcohol-related consequences but what motivates people to do so, i.e. the role of pre-drinking motives (PDM) in this link, is unclear. The current study examined a) the association of three PDM factors (fun/intoxication, facilitation, and conviviality) with average night-level alcohol use, b) whether PDM are associated with adverse alcohol-related consequences (hangover, drunk driving, blackout, risky sex, injury, and fights) and c) whether PDM mediates the link between night-level alcohol use and negative consequences. METHODS: A sample of 204 young adult nightlife goers (48.8% males, Mage = 19 SD = 2.4) from Switzerland reported PDM at baseline, and subsequently participated in a 2-month event-level study. Regressions models assessed direct and mediated associations. RESULTS: Fun/intoxication PDM predicted alcohol use in subsequent drinking nights (11.3 nights per participant on average), but not the two other PDM. No direct link between PDM and consequences was found. However, fun/intoxication PDM lead indirectly to more adverse consequences through higher alcohol use. CONCLUSION: This study shows that predominantly 'fun/intoxication' predrinkers are at increased risk for alcohol consumption and consequences, but not those who predrink for conviviality or facilitation motives. The outcomes thus suggest the importance of specific PDM in preventing alcohol use for instance by tailoring interventions based on individuals' PDM in order to curb drinking and its associated consequences among young adults on weekend nights out.

Shooting shots: Estimating alcoholic drink sizes in real life using event-level reports and annotations of close-up pictures.

INTRODUCTION AND AIMS: Drinks consumed in real life are diverse, in terms of beverage type, container size and alcohol by volume. To date, most ecological momentary assessment studies have assessed drinking amounts with 'standard' drinks, although their event-level design allows for more advanced assessment schemes. The purpose of this empirical study is to compare participants' estimates of alcoholic drink characteristics, assessed using drink-specific questions, with estimates generated by annotators based on pictures of the same drinks. DESIGN AND METHODS: On weekend nights, 186 young adults took 1484 close-up pictures of their drinks using a custom-built smartphone application. Participants reported the beverage type, drink size and alcohol by volume. Annotators described the beverage type, container size and filling level. Correspondence between participants' and annotators' estimates was explored using descriptive statistics, difference tests and correlations. RESULTS: Annotators were unable to precisely identify the beverage types in most pictures of liqueurs, spirits and mixed drinks. Participants' drink size estimates converged with annotators' estimates of the container size for beer (41 cl corresponding to 16 g of pure alcohol) and mixed drinks (28 cl/35 g), and of the content size for wine (10 cl/9 g). However, annotators estimated larger sizes for liqueur/fortified wine (12 cl/14 g vs. 7 cl/9 g) and spirits (8 cl/26 g vs. 4 cl/10 g) than participants. DISCUSSION AND CONCLUSIONS: Annotations of pictures should be considered as a complement to participants' reports rather than a substitute. Except for wine, real-life drinks vary largely and often exceed 10 g 'standard' drinks.

Do different drinks make you feel different emotions? Examination of young adolescents' beverage-specific alcohol expectancies using the Alcohol Expectancy Task.

The aim of this paper is to explore whether in the eyes of young adolescents the consumption of different alcoholic beverages is associated with different alcohol expectancies, namely beliefs on what emotional outcomes take place when alcohol is consumed. 283 nine to 12-year olds from Switzerland completed the Alcohol Expectancy Task (AET). Participants were asked to assign one of 12 beverages (four alcoholic, eight non-alcoholic) to 16 adults depicting four emotional states (happy, angry, relaxed, sad). General linear modelling was used to examine beverage attributions across the four different emotional states. Beer was the most commonly attributed beverage across all 16 adults depicted. Happy and angry persons were most commonly attributed beer. Gender variations were found for relaxed persons, with females predominantly attributed champagne and males predominantly attributed beer. Young adolescents predominantly gave white wine to sad persons. Findings reveal a level of nuanced knowledge existing among young adolescents with minimal drinking experience, in that they hold very different expectancies for different beverages, prompting for future investigations to examine beverage-specific expectancies. Furthermore, findings showing beverage-specific expectancies among young adolescents may have implications for researchers' considerations of how alcohol-related knowledge and expectancies develop throughout childhood.

The contexts of heavy drinking: A systematic review of the combinations of context-related factors associated with heavy drinking occasions.

BACKGROUND: The amount of alcohol consumed during an occasion can be influenced by physical and social attributes of the setting, characteristics and state of individuals, and the interactions of these components. This systematic review identifies and describes the specific combinations and sequences of context-related factors that are associated with heavy drinking occasions. MATERIALS AND METHODS: We conducted a systematic literature search of MEDLINE, Embase and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Eligible articles were event-level and event-based studies that quantitatively analysed associations of sequences or combinations of context-related factors with event-level alcohol consumption. We extracted information on study design, sample, variables, effect estimates and analytical methods. We compiled a list of combinations and sequences associated with heavier drinking (i.e., 'risky contexts') and with lighter drinking ('protective contexts'). The review protocol was registered with PROSPERO (registration number: CRD42018089500). RESULTS: We screened 1902 retrieved records and identified a final sample of 65 eligible studies. Daily mood, day of week, location and drinking group characteristics are important drivers of whether an individual engages in a heavy drinking occasion. The direction and magnitude of some associations differed by gender, age, personality and motives, such that in particular social or physical contexts, some people may feel compelled to drink more while others are compelled to drink less. Very few sequences of factors were reported as being associated with event-level alcohol consumption. CONCLUSIONS: Contexts or factors are experienced in specific sequences that shape the broader drinking context and influence drinking behaviours and consequences but are under-studied. Event-level studies such as those using ecological momentary assessment can harness new technologies for data collection and analysis to improve understandings of why people engage in heavy drinking. Continued event-level research will facilitate public health interventions and policies that reduce heavy drinking and alcohol-related harms.

The Role of Sex and Age on Pre-drinking: An Exploratory International Comparison of 27 Countries.

AIMS: This exploratory study aims to model the impact of sex and age on the percentage of pre-drinking in 27 countries, presenting a single model of pre-drinking behaviour for all countries and then comparing the role of sex and age on pre-drinking behaviour between countries. METHODS: Using data from the Global Drug Survey, the percentages of pre-drinkers were estimated for 27 countries from 64,485 respondents. Bivariate and multivariate multilevel models were used to investigate and compare the percentage of pre-drinking by sex (male and female) and age (16-35 years) between countries. RESULTS: The estimated percentage of pre-drinkers per country ranged from 17.8% (Greece) to 85.6% (Ireland). The influence of sex and age on pre-drinking showed large variation between the 27 countries. With the exception of Canada and Denmark, higher percentages of males engaged in pre-drinking compared to females, at all ages. While we noted a decline in pre-drinking probability among respondents in all countries after 21 years of age, after the age of 30 this probability remained constant in some countries, or even increased in Brazil, Canada, England, Ireland, New Zealand and the United States. CONCLUSIONS: Pre-drinking is a worldwide phenomenon, but varies substantially by sex and age between countries. These variations suggest that policy-makers would benefit from increased understanding of the particularities of pre-drinking in their own country to efficiently target harmful pre-drinking behaviours.

What Reminds Young People That They Drank More Than Intended on Weekend Nights: An Event-Level Study.

OBJECTIVE: Young people often drink more alcohol than intended over the course of a night. This study investigates individual and night-specific factors predicting young people's acknowledgment of having drunk more than intended. METHOD: Using the Youth@Night smartphone application, 176 people aged 16-25 documented 757 Friday and Saturday nights. Participants recorded their drinking intentions at the beginning of the night, the composition of the social and physical environment over the course of the night, and, the next morning, the previous night's total consumption and whether they had drunk more than intended or experienced other alcohol-related consequences. Bivariate statistics and multilevel logistic regressions were used based on the 361 nights during which 139 participants (53.2% men, mean age = 19.3) exceeded their drinking intentions. RESULTS: Participants acknowledged higher consumption than intended on 36.7% of nights. At the night level, higher drinking intentions than usual (odds ratio [OR] = 1.36, 95% CI [1.13, 1.65]), attending a larger number of locations than usual (OR = 1.84, 95% CI [1.11, 3.04]), having a hangover the next morning (OR = 3.23, 95% CI [1.50, 6.95]), or spending more money than planned (OR = 3.12, 95% CI [1.56, 6.26]) were associated with acknowledgment of drinking more than intended. No individual characteristics were associated with acknowledgment of exceeding drinking intentions. CONCLUSIONS: Young people not only tend to drink more than intended on weekend nights but also often fail to acknowledge this the next morning. Event based prevention measures aimed at narrowing the gap between drinking intentions and quantities of alcohol consumed are recommended.

After how many drinks does someone experience acute consequences-determining thresholds for binge drinking based on two event-level studies.

BACKGROUND AND AIMS: The threshold of 4+/5+ drinks per occasion has been used for decades in alcohol research to distinguish between non-risky versus risky episodic drinking. However, no study has assessed the validity of this threshold using event-level data. This study aimed to determine the optimal thresholds for the detection of five acute alcohol-related consequences (hangover, blackout, risky sex, fights and injury) using data from two event-level studies. DESIGN: An event-level study to assess the ability to use the number of drinks consumed to discriminate between nights with and without consequences using the area under the receiver operating characteristic (AUROC) curve. Optimal thresholds were determined using the Youden Index based on sensitivity and specificity. Separate thresholds were estimated for gender and age groups (16-17 versus 18-25). SETTING: Lausanne and Zurich, Switzerland. PARTICIPANTS: Three hundred and sixty-nine participants aged 16-25 years. MEASUREMENTS: On 3554 weekend nights, participants reported total number of alcoholic drinks consumed the previous night and acute consequences (hangover, blackout, risky sex, fights and injury) FINDINGS: Hangover was the most frequently reported consequence and injury the least for both genders. Throughout age groups and studies, optimal thresholds for any consequence, and for hangover only, were equal to 4+/5+ (40+/50+ g alcohol) while those for blackouts, risky sex, fights and injuries were up to three drinks higher. Adolescents tended to experience consequences more often and at slightly lower drinking levels than did adults. For all consequences but injuries, the optimal thresholds were one to two drinks lower for women than for men. CONCLUSIONS: Event-level data collection techniques appear particularly suitable to estimate thresholds at which acute alcohol-related consequences occur. Binge drinking thresholds of 4+/5+ (women/men) drinks, equivalent to 40+/50+ g pure alcohol, predict the occurrence of consequences accurately in general but are too low to predict severe acute alcohol-related consequences.

The Spirit Is Willing, But the Flesh is Weak: Why Young People Drink More Than Intended on Weekend Nights-An Event-Level Study.

BACKGROUND: Heavy alcohol use is common among young adults on weekend nights and is assumed to be intentional. However, little is known about the extent to which heavy consumption is planned prior to the onset of drinking and what factors contribute to drinking more than intended. This study investigates drinking intentions at the beginning of an evening and individual and situational factors associated with a subsequent consumption over the course of multiple nights. METHODS: Using a smartphone application, 176 young people aged 16 to 25 (mean age = 19.1; 49% women) completed questionnaires on drinking intentions, consumption, and drinking environments before, during, and after multiple Friday and Saturday nights (n = 757). Multilevel regressions were used to investigate individual-level and night-level factors associated with previous drinking intentions and subsequent deviations from intentions. RESULTS: Participants intended to consume 2.5 drinks (SD = 2.8) per night yet consumed 3.8 drinks (SD = 3.9) on average. Drinking intentions were higher among those who frequently went out at night and engaged in more frequent predrinking. Participants drank more than intended on 361 nights (47.7%). For both genders, the number of drinks consumed before 8 pm, attending multiple locations, and being with larger groups of friends contributed to higher consumption than intended at the individual and the night levels. Heavier consumption than intended also occurred when drinking away from home for men and when going to nightclubs for women. CONCLUSIONS: Making young adults aware of the tendency to drink more than intended, particularly when drinking begins early in the evening, moves from location to location, and includes large groups of friends, may be a fruitful prevention target. Structural measures, including responsible beverage service, may also help in preventing excessive drinking at multiple locations.

The country-level effects of drinking, heavy drinking and drink prices on pre-drinking: An international comparison of 25 countries.

INTRODUCTION AND AIMS: The practice and adverse consequences of pre-drinking have been documented within a dozen countries, but little remains known about the differences between countries or the country-specific determinants of pre-drinking. This study aims to estimate the percentage of pre-drinkers in different countries and the impact of country-level indicators such as the price of alcohol and the prevalence of drinkers and of heavy drinkers. DESIGN AND METHODS: Using data from the Global Drug Survey, the percentage of pre-drinkers was estimated for 25 countries from 65 126 respondents. Bivariate and multivariate multilevel models were used to model the impact of the on-premise/off-premise drinks price ratio, the prevalence of current drinkers and of heavy drinkers on the percentage of pre-drinkers. RESULTS: The estimated percentage of pre-drinkers per country ranged from 17.7% (Greece) to 85.4% (Ireland). Across all countries, the higher the prevalence of current drinkers, the higher the percentage of pre-drinkers. In addition, an interaction between the prevalence of heavy drinkers and the price ratio was found. In countries with a low price ratio, the higher the prevalence of heavy drinkers, the higher the percentage of pre-drinkers. The opposite effect was observed in countries with high price ratios. DISCUSSION AND CONCLUSIONS: Pre-drinking appears to be a worldwide phenomenon. The significant effects of all three indicators demonstrate the role of country-level determinants underpinning the prevalence of pre-drinking across countries. Policy makers could use the reported findings for initiating campaigns to reduce pre-drinking behaviour. [Labhart F, Ferris J, Winstock A, Kuntsche E. The country-level effects of drinking, heavy drinking and drink prices on pre-drinking: An international comparison of 25 countries.

Reciprocal Influences of Drinking Motives on Alcohol Use and Related Consequences: A Full Cross-Lagged Panel Study Among Young Adult Men.

Using a full cross-lagged model, this study investigates the extent to which drinking motives predict alcohol use and related consequences, and vice versa. At baseline and 15 months later, 4575 men (mean age = 19.4 years) in Switzerland completed a questionnaire assessing drinking motives, average weekly consumption, risky single-occasion drinking, and alcohol-related consequences. Results indicated that social and enhancement motives more strongly influenced alcohol use over time than the other way round. Coping motives predicted an increase in alcohol-related consequences, and vice versa. Higher social motives predicted an increase in coping motives while higher coping motives predicted a decrease in enhancement motives. These results suggest that social and enhancement motives amplify each other in early adulthood and predict increases in risky drinking. Structural measures aimed at reducing opportunities to engage in heavy drinking are recommended. Additionally, the detection of young adult men vulnerable to maladaptive coping behaviors appears important for alcohol prevention strategies.

Drinking with mixed-gender groups is associated with heavy weekend drinking among young adults.

AIMS: To investigate how gender composition of the drinking group affects young adults' alcohol consumption on weekend evenings over and above the effect of drinking-group size. DESIGN: Using the internet-based cellphone-optimized assessment technique (ICAT), participants completed online questionnaires on their cell phones every hour from 8 p.m. to midnight on Thursday, Friday and Saturday evenings during five consecutive weekends. SETTING: French-speaking Switzerland. PARTICIPANTS: Convenience sample of 183 young adults (53.0% female, mean age = 23.1) who completed a total of 4141 hourly assessments. MEASUREMENTS: Alcohol consumption and number of male and female friends present assessed at 8 p.m., 9 p.m., 10 p.m., 11 p.m. and midnight. FINDINGS: Results of three-level negative binomial regression analyses showed that women consumed significantly more drinks per hour when drinking in mixed-gender groups (Z-values ranging from 2.9 to 5.3, all P < 0.01) and significantly fewer drinks when drinking with men only (Z = -2.7, P < 0.01), compared with drinking with women only. Men reported consuming more drinks per hour in mixed-gender groups of equal gender composition (Z = 2.4, P < 0.05) or mixed-gender groups with men in the majority (Z = 2.2, P < 0.05) and fewer hourly drinks when drinking with women only (Z = -4.9, P < 0.001), compared with drinking with men only. Drinking-group size predicted the hourly number of drinks for women (Z = 6.0, P < 0.001) and men (Z = 5.5, P < 0.001). CONCLUSIONS: Drinking-group gender composition is associated with number of drinks consumed per hour, over and above the impact of the drinking-group size. Young adults report consuming more drinks per hour when drinking with mixed-gender groups than with same-gender groups.

Predrinking, alcohol use, and breath alcohol concentration: A study of young adult bargoers.

Predrinking (preloading, pregaming) has been found to be related to alcohol use and intoxication. However, most research relies on estimates of blood alcohol concentration and does not control for usual drinking pattern. We assessed whether predrinking was associated with subsequent alcohol consumption and breath alcohol concentration (BrAC) among 287 young adult bargoers (173 men [60.3%], Mage = 21.86 years, SD = 2.55 years) who were recruited in groups in an entertainment district of a midsized city in Ontario, Canada. We also examined whether predrinking by other group members interacted with individual predrinking in relation to amount consumed/BrAC. Adjusting for nesting of individuals within groups in hierarchical linear models, predrinkers were found to consume more drinks in the bar district and over the entire night compared to nonpredrinkers and had higher BrACs at the end of the night controlling for drinking pattern. A group- by individual-level interaction revealed that individual predrinking predicted higher BrACs for members of groups in which at least half of the group had been predrinking but not for members of groups in which less than half had been predrinking. This study confirms a direct link of predrinking with greater alcohol consumption and higher intoxication levels. Group- by individual-level effects suggest that group dynamics may have an important impact on individual drinking. Given that predrinking is associated with heavier consumption rather than reduced consumption at the bar, initiatives to address predrinking should include more effective policies to prevent intoxicated people from entering bars and being served once admitted.

Identifying risky drinking patterns over the course of Saturday evenings: An event-level study.

Gaining a better understanding of young adults' excessive drinking on nights out is crucial to ensure prevention efforts are effectively targeted. This study aims to identify Saturdays with similar evening drinking patterns and corresponding situation-specific and person-specific determinants. Growth mixture modeling and multilevel logistic regressions were based on 3,084 questionnaires completed by 164 young adults on 514 evenings via the Internet-based cell phone optimized assessment technique (ICAT). The results showed that the 2-group solution best fitted the data with a "stable low" drinking pattern (64.0% of all evenings, 0.2 drinks per hour on average, 1.5 drinks in total) and an "accelerated" drinking pattern (36.0%, increased drinking pace from about 1 drink per hour before 8 p.m. to about 2 drinks per hour after 10 p.m.; 11.5 drinks in total). The presence of more same-sex friends (ORwomen = 1.29, 95% CI [1.09-1.53]; ORmen = 1.35, 95% CI [1.15-1.58], engaging in predrinking (ORwomen = 2.80, 95% CI [1.35-5.81]; ORmen = 3.78, 95% CI [1.67-8.55] and more time spent in drinking establishments among men (ORmen = 1.46, 95% CI [1.12-1.90] predicted accelerated drinking evenings. Accelerated drinking was also likely among women scoring high on coping motives at baseline (ORwomen = 2.40, 95% CI [1.43-4.03] and among men scoring high on enhancement motives (ORmen = 2.36, 95% CI [1.46-3.80]. To conclude, with a total evening consumption that is almost twice the threshold for binge drinking, the identified accelerated drinking pattern signifies a burden for individual and public health. Promoting personal goal setting and commitment, and reinforcing self-efficacy and resistance skills training appear to be promising strategies to impede the acceleration of drinking pace on Saturday evenings.