Changes in attitudes toward alcohol control policies in Lithuania: findings from two representative surveys in 2015 and 2020.

Background: A set of evidence-based alcohol control policy measures was adopted in the period 2016-2020 in Lithuania. The present study fills a knowledge gap on how changes in alcohol control policy are associated with attitudes toward different alcohol policy measures.Objective: This study aims to explore whether support for key alcohol control policy measures in Lithuania declined following implementation of alcohol control measures.Methods: Data came from the Standard European Alcohol Survey. Two representative surveys with the same questionnaire, were conducted in Lithuania in 2015 (N = 1513, 51.7% female, response rate was 38.9%) and 2020 (N = 1015, 50.6% female, response rate was 38.0%). Multi-stage stratified probability sampling was applied. Surveys were carried out using computer-assisted face-to-face interviews, descriptive statistics and multiple logistic regression analyses was applied. We used a binomial logistic regression analysis and the Pearson chi-square test.Results: There was a significant decline in a proportion of respondents who agreed that the number of alcohol selling places should be kept low (OR: 0.84, p = .032), alcohol prices should be kept high (OR: 0.83, p = .027), and the police should be allowed to randomly check whether the driver is sober (OR: 0.65, p < .001). The proportion of respondents who agree that individuals are responsible enough with their drinking significantly declined (OR: 0.76, p = .003).Conclusion: Support for restrictions on alcohol-selling points, increase in alcohol price, and random alcohol testing of drivers declined following the adoption of new alcohol control policy measures. Our findings might be beneficial for policy-makers planning alcohol control policies and information campaigns.

Prevalence of drug use before and during imprisonment in seven European countries (2014-2018).

Substance use is a global phenomenon that is particularly affecting the prison population. This study aimed to describe the prevalence of drug use among people in prison before and during incarceration in seven European countries and to compare it with the prevalence in the general population. Individual data collection was carried out between 2014 and 2018 with a model European Questionnaire on Drug Use among people in prison. A total of 12,918 people living in prison filled in the survey. People in prison report higher level of drug use when compared with the general population and the use of drug inside prison exist, although at lower levels when compared with predetention. Prisons can represent a point of access to engage individuals who use drugs in interventions that address drug use and risk factors related to both drug use and imprisonment.

MOTIVATION FOR ALCOHOL CONSUMPTIONS BY ADULTS: TRADITIONS OR AN ATTEMPT TO SOLVE MENTAL HEALTH PROBLEMS (EXEMPLIFIED BY THE CITY OF LVIV AND LVIV REGION, UKRAINE).

OBJECTIVE: The aim: To clarify motivation trends of alcohol consumption by adults in the city of Lviv and Lviv region and their mental health risk factors as compared to the specificity of motivation for alcohol consumption by the representatives of other European countries. PATIENTS AND METHODS: Materials and methods: The study is based on the data of the representative survey of Lviv region residents (1,200 persons) following the methodology RARHA adjusted for Ukraine and its statistical processing. RESULTS: Results: The results of the study point to the prevalence of social and recreational, traditional motives for alcohol consumption by Lviv region residents (consumption during solemn ceremonies and celebrations). Extremely important, as compared to other European countries, are social motives (the sense of belonging to an important social group). The importance of social factors for the respondents decreases a bit with age and considerably depends on the specific features of religious practices. A wide-spread motive is the striving for changing the emotional state, combined with higher abuse risk as compared to the people who drink on social occasions. CONCLUSION: Conclusions: The results of the study characterize the specificity of the motivational structure of alcohol consumption by Ukrainians as compared to the general European trends and can be used for the development of targeted regional prevention programs.

Psychometric properties of the Polish version of two screening tests for gambling disorders: the Problem Gambling Severity Index and Lie/Bet Questionnaire.

To date, no screening tests for gambling disorders have been adapted and validated in Central and Eastern Europe. The aim of this study is to adapt the Problem Gambling Severity Index (PGSI) and Lie/Bet questionnaire (Lie/Bet) and assess their psychometric properties once translated for use with the Polish population. A mixed sample (N = 300) was drawn from venues, social media, snowballing and treatment centers. PGSI had a higher coefficient of predictive power than Lie/Bet. However, differences between validated tests are not significant. Validation of screening tests of gambling disorders showed the necessity for verification of the scale of interpretation of results when conducting tests in Poland, changing cutoff values. The PGSI and Lie/Bet tests are short and easy to apply, they can be implemented in various types of institutions: for screening patients in primary health care facilities and for identifying comorbid gambling disorders in alcohol- and drug-dependence treatment facilities, and in social welfare centers.

Why Is Per Capita Consumption Underestimated in Alcohol Surveys? Results from 39 Surveys in 23 European Countries.

AIMS: The aims of the article are (a) to estimate coverage rates (i.e. the proportion of 'real consumption' accounted for by a survey compared with more reliable aggregate consumption data) of the total, the recorded and the beverage-specific annual per capita consumption in 23 European countries, and (b) to investigate differences between regions, and other factors which might be associated with low coverage (prevalence of heavy episodic drinking [HED], survey methodology). METHODS: Survey data were derived from the Standardised European Alcohol Survey and Harmonising Alcohol-related Measures in European Surveys (number of surveys: 39, years of survey: 2008-2015, adults aged 20-64 years). Coverage rates were calculated at the aggregated level by dividing consumption estimates derived from the surveys by alcohol per capita estimates from a recent global modelling study. Fractional response regression models were used to examine the relative importance of the predictors. RESULTS: Large variation in coverage across European countries was observed (average total coverage: 36.5, 95% confidence interval [CI] [33.2; 39.8]), with lowest coverage found for spirits consumption (26.3, 95% CI [21.4; 31.3]). Regarding the second aim, the prevalence of HED was associated with wine- and spirits-specific coverage, explaining 10% in the respective variance. However, neither the consideration of regions nor survey methodology explained much of the variance in coverage estimates, regardless of the scenario. CONCLUSION: The results reiterate that alcohol survey data should not be used to compare or estimate aggregate consumption levels, which may be better reflected by statistics on recorded or total per capita consumption.

Unrecorded Alcohol Consumption in Seven European Union Countries.

INTRODUCTION: Unrecorded alcohol, that is, alcohol not reflected in official statistics of the country where it is consumed, contributes markedly to overall consumption of alcohol. However, empirical data on unrecorded alcohol consumption are scarce, especially in high-income countries. This study measures the contribution of unrecorded alcohol in 7 member states of the European Union. METHODS: Two categories of unrecorded consumption were assessed in general population surveys (reducing alcohol related harm Standardized European Alcohol Survey; n = 11,224): home-made alcohol and cross-border shopping. Country-specific logistic regressions were used to link respondent characteristics to odds of acquisition of unrecorded alcohol. Total per capita alcohol consumption was estimated under different assumptions of calculating unrecorded alcohol consumption. RESULTS: Individuals with higher drinking levels were more likely to acquire unrecorded alcohol in all 7 countries. In some countries, male sex and more affluent social class were also positively linked to acquisition of unrecorded alcohol. There was a substantial contribution of unrecorded alcohol to overall consumption in 5 out of 7 member states (Croatia, Finland, Greece, Hungary, Portugal), but not in Poland or Spain. In Greece, up to two-thirds of all alcohol consumed was estimated to be unrecorded. CONCLUSION: Unrecorded alcohol contributes to overall consumption even in high-income countries, and thus needs to be monitored. In monitoring, as many categories of unrecorded alcohol as possible should be clearly defined (e.g., surrogate alcohol) and included in future surveys.

Alcohol and cigarette use among adolescents with type 1 diabetes.

In this study, we compare the prevalence of alcohol and cigarette use among Polish adolescents with type 1 diabetes mellitus (T1DM) (n = 209), aged 15-18 years, with that of a large cohort of their healthy peers, using standardized questionnaire used in the European School Survey Project on Alcohol and Drugs (ESPAD). The lifetime, previous year, and past 30-day prevalence of alcohol consumption was high among adolescents with T1DM but lower than in the controls (82.8 vs 92.0%, 71.7 vs 85.6%, and 47.5 vs 69.7%, respectively, p < 10-5). The lifetime and 30-day prevalence of cigarette use was also lower among patients than the controls (54.6 vs 65.5%, p = 0.001 and 27.3 vs 35.9%, p = 0.012, respectively). Patients who admitted smoking exhibited worse metabolic control than non-smokers (p < 0.0001) and had a higher chance of developing diabetic ketoacidosis. The incidence of severe hypoglycemia was higher among those who reported getting drunk in the previous 30 days (p = 0.04) and lifetime smoking (p = 0.01). CONCLUSIONS: Although alcohol and cigarette consumption is lower than in controls, it is common among teenagers with type 1 diabetes, effecting metabolic control and causing the risk of acute diabetes complications. Better prevention strategies should be implemented in this group of patients in their early teen years. What is Known: • Substance use remains a significant cause of morbidity and mortality among teenagers with type 1 diabetes. • Current medical literature contains inconsistent data on the prevalence of alcohol and cigarette use among adolescents with type 1 diabetes, mostly due to methodological problems with conducting such surveys. What is New: • Methodological approach: we used a validated questionnaire from the European School Survey Project on Alcohol and Other Drugs (ESPAD) and compared the results to a large national control group of 12,114 healthy students who took part in ESPAD in 2011.

Substance Use among European Students: East - West Comparison between 1995 and 2011.

AIM: The aim of the study was to investigate long-term trends differences in student substance misuse between countries of former Eastern Bloc (FEB) and Western Europe (WEST). Overall data on student substance misuse gathered in five waves of the European School Survey Project on Alcohol and other Drugs (ESPAD) conducted between 1995 and 2011 were pooled and analysed. Findings were compared between FEB and WEST countries at the five time-points of data collection. METHODS: Over 396,000 of 16 years old students from thirteen FEB and thirteen WEST countries completed anonymous ESPAD questionnaires. The following data were compared by Wilcoxon test: proportion of students with experience of taking a legal drug at less than 13 years of age (early onset), regular tobacco use, emerging signs of alcohol abuse, and differences in prevalence of illegal drug use. RESULTS: Significant differences in selected variables were found in the early onset of legal and illegal drug use between FEB and WEST countries. On the contrary, no significant differences were present when several random samples from the pool of 26 participating countries were drawn and compared. This strengthens our confidence that the differences between FEB and WEST countries did not occur due to chance. CONCLUSIONS: Student drug use in FEB countries tended to follow the trends and patterns of legal and illegal drug use in WEST countries with some time lag. At the times of decline in use of both, legal and illegal substances in the WEST countries, the FEB countries were experiencing increase and later on stabilisation in drug use. The possible explanatory factors including the impact of profound political, cultural and socio-economic changes following the fall of the Iron Curtain in 1989 were discussed. The implications of these trends and suggestions for drug prevention strategies were outlined.

High regional variability of HIV, HCV and injecting risks among people who inject drugs in Poland: comparing a cross-sectional bio-behavioural study with case-based surveillance.

BACKGROUND: People who inject drugs (PWID) are an important group at risk of blood borne infections in Poland. However, robust evidence regarding the magnitude of the problem and geographical variation is lacking, while coverage of prevention remains low. We assessed the potential of combining bio-behavioural studies and case-based surveillance of PWID to gain insight into preventive needs in Poland. METHODS: Results of a bio-behavioural human immunodeficiency virus (HIV) and hepatitis C virus (HCV) prevalence study among ever injectors in six regions in Poland were compared with HIV case-based surveillance trends from 2000 to 2012. Logistic regression was used for multivariable analyses in the prevalence study. The case surveillance data were correlated with prevalence data, by region, to determine surveillance validity and identify any recent trends. RESULTS: HIV seroprevalence (18% overall) differed more than ten-fold across regions (2.4% to 32%), but HCV seroprevalence and the proportion of PWID sharing needles/syringes in the past 12 months were similar, 44% to 68% and 22% to 29%, respectively. In multivariable models accounting for socio-demographic factors, duration of injecting history and needle sharing practices, regional differences were significant for both HIV and HCV seroprevalence with adjusted odds ratios varying up to a factor of 12.6 for HIV and 3.8 for HCV. The number of new cases of HIV diagnosed in each region during the bio-behavioural study period was strongly correlated (r = 0.93) with HIV prevalence. There was an overall decreasing trend in the number of new diagnoses of HIV over time. However, a transient increase in three regions was preceded by a higher proportion of people with short injecting history (≤5 years) and a high prevalence of HCV coinciding with a low prevalence of HIV in the bio-behavioural study. CONCLUSIONS: Bio-behavioural and case-based data were consistent with respect to the regional distribution of HIV and also provided complementary information, with the proportion of new injectors and high HCV prevalence predicting increases in HIV case rates. We identified three regions in Poland that appear to be at increased need for preventive measures. Data point to the need for a stronger investment in harm reduction programmes in Poland.

Risk perception and risk aversion among people who use New Psychoactive Substances.

INTRODUCTION: New Psychoactive Substances (NPS) are often considered to be harmful and less safe alternatives to traditional recreational drugs. Yet we have little knowledge of the ways in which risk aversion affects NPS risk perception and how risk judgements differ across types of NPS. In the analysis that follows, we investigate whether the perceived severity of risk is amplified or attenuated by users' experiences, risk avoidance strategies and modes of knowledge on risk. MATERIAL AND METHODS: The data were derived from a Polish cross-sectional study on patterns of NPS use and associated risks. A convenience sample of 605 users of NPS (Mean age = 22; range 15-49 years) completed a questionnaire. A principal component analyses and ordinal regression models were used to reveal the latent variables indicating modes of knowledge on NPS risk and risk avoidance strategies, and to determine the associations between risk aversion and perceived personal risk of NPS use. RESULTS: Several precautionary measures were employed by the majority of participants in the study. The perception of individual risk differed across NPS types. Principal component analysis yielded three components in both risk avoidance strategies ('avoiding mixes', 'precautionary measures', 'planning') and modes of knowledge on risk ('experience', 'technical knowledge', 'harm reduction'). However, ordinal regression models show that perceptions of risk are only partially affected by the modes of knowledge on NPS risk and by risk avoidance strategies. DISCUSSION: The results indicate that risk perception largely depends on NPS type. The perception of risk is driven by both modes of knowledge and risk avoidance strategies. However, they have different impacts on how individuals judge risk across various types of NPS. The perspective of risk perception should inform policy-makers and prevention experts to focus their efforts on honest and substantive risk communication. CONCLUSIONS: The present study shows that individuals tend to rely on various strategies of risk avoidance, which indicates the need to improve the substantive communication on NPS risks, with a particular focus on the types of NPS, which could help people using them make informed choices.

A new perspective on European drinking cultures: a model-based approach to determine variations in drinking practices among 19 European countries.

BACKGROUND AND AIMS: In recent decades, alcohol drinking in the European Union has been characterized by increasing homogenization of levels of drinking coupled with an overall decrease. This study examined whether we can still distinguish distinct practices of drinking by addressing two research questions: (1) are drinking practices still characterized by the choice of a certain alcoholic beverage; and (2) how do drinking practices vary across countries? DESIGN: Cross-sectional study: latent-class analyses of drinking variables and fractional response regression analyses of individual characteristics for individual-level class endorsement probabilities, respectively. SETTING: Nineteen European countries and one autonomous community. PARTICIPANTS: A total of 27 170 past-year drinkers aged 18-65 years in 2015. MEASUREMENTS: Data were collected through the Standardized European Alcohol Survey included frequency of past-year drinking, pure alcohol intake per drink day, occurrence of monthly risky single-occasion drinking and preferred beverage, together with socio-demographic data. FINDINGS: Three latent classes were identified: (1) light to moderate drinking without risky single-occasion drinking [prevalence: 68.0%, 95% confidence interval (CI) = 66.7-69.3], (2) infrequent heavy drinking (prevalence: 12.6%, 95% CI = 11.5-13.7) and (3) regular drinking with at least monthly risky single-occasion drinking (prevalence: 19.4%, 95% CI = 18.1-20.9). Drinking classes differed considerably in beverage preference, with women reporting a generally higher share of wine and men of beer drinking. Light to moderate drinking without risky single-occasion drinking was the predominant drinking practice in all locations except for Lithuania, where infrequent heavy drinking (class 2) was equally popular. Socio-demographic factors and individual alcohol harm experiences (rapid alcohol on-line screen) explained up to 20.5% of the variability in class endorsement. CONCLUSIONS: Beverage preference appears to remain a decisive indicator for distinguishing Europeans' drinking practices. In most European countries, multiple drinking practices appear to be present.

Comparing subjective intoxication with risky single-occasion drinking in a European sample.

In most epidemiological literature, harmful drinking-a drinking pattern recognized as closely linked to alcohol-attributable diseases-is recorded using the measure risky single-occasion drinking (RSOD), which is based on drinking above a certain quantity. In contrast, subjective intoxication (SI) as an alternative measure can provide additional information, including the drinker's subjective perceptions and cultural influences on alcohol consumption. However, there is a lack of research comparing both. The current article investigates this comparison, using data from the Standardized European Alcohol Survey from 2015. We analysed the data of 12,512 women and 12,516 men from 17 European countries and one region. We calculated survey-weighted prevalence of SI and RSOD and compared them using Spearman rank correlation and regression models. We examined the role of the required quantity of alcohol needed for the drinker to perceive impairments and analysed additional demographic and sociodemographic characteristics as well as drinking patterns. In the most locations, the prevalence of SI was lower or equal to the prevalence of RSOD. Both prevalence estimates were highly correlated. Almost 8% of the variance in the difference between the individual-level frequencies of the SI and RSOD measures was explained by the individual quantity of alcohol needed to perceive impairments. Sociodemographic characteristics and drinking patterns explained less than 20% in the adjusted perceived quantity of alcohol needed. In conclusion, our results indicated that subjective measures of intoxication are not a preferable indicator of harmful drinking to the more conventional measures of RSOD.

How Attitudes toward Alcohol Policies Differ across European Countries: Evidence from the Standardized European Alcohol Survey (SEAS).

Alcohol policy endorsements have changed over time, probably interacting with the implementation and effectiveness of alcohol policy measures. The Standardized European Alcohol Survey (SEAS) evaluated public opinion toward alcohol policies in 20 European locations (19 countries and one subnational region) in 2015 and 2016 (n = 32,641; 18-64 years). On the basis of the SEAS report, we investigated regional differences and individual characteristics related to categories of alcohol policy endorsement. Latent class analysis was used to replicate cluster structure from the SEAS report and to examine individual probabilities of endorsement. Hierarchical quasi-binomial regression models were run to analyze the relative importance of variables of interest (supranational region, gender, age, educational achievement, and drinking status) on class endorsement probability, with random intercepts for each location. The highest support for alcohol control policies was recorded in Northern countries, which was in contrast to the Eastern countries, where the lowest support for control policies was found. Across all locations, positive attitudes toward control policies were associated with the female gender, older age, and abstaining from alcohol. Our findings underline the need to communicate alcohol-related harm and the implications of alcohol control policies to the public in order to increase awareness and support for such policies in the long run.

Validation of the "problematic use of narcotics" (PUN) screening test for drug using adolescents.

The aim of the study was to examine psychometric properties of the PUN screening test concerning illicit drug problem use by adolescents. The criterion standard for the test's validity was a diagnostic interview conducted by trained specialists. Respondents were reached by snowball sampling in 58 randomly chosen Polish local communities. A total of 1344 adolescent (37% female) aged 13 to 18 years, who used any illicit drug at least once in the past 12 months, participated. The majority (89%) had no contacts with any drug therapy facilities. 41% were diagnosed as occasional drug users and 59% as problematic users or dependents. Logistic regression analysis showed that 10 out of the basic set of 25 test items were most powerful in differentiating occasional and problematic users. A test score of 2 or higher was optimal for identifying problem drug use (sensitivity: 0.88, specificity: 0.79, PPV: 0.86, NPV: 0.81). Validity was not affected by age or sex. These results confirmed the PUN test potential as a brief screening tool.

Breaking the Taboo: Illicit Drug Use among Adolescents with Type 1 Diabetes Mellitus.

BACKGROUND: The aim of the study was to explore the prevalence of illicit drug use in a group of Polish adolescents with type 1 diabetes (DM1) in comparison with a national cohort of their healthy peers. METHODS: Two hundred and nine adolescents with DM1, aged 15-18 years, were studied in 2013 with an anonymous questionnaire prepared for the European School Survey Project on Alcohol and Other Drugs (ESPAD). The control group was a representative sample of 12114 students at the same age who took part in ESPAD in 2011. Metabolic control was regarded as good if self-reported HbA1c was <8% or poor if HbA1c was ≥8%. RESULTS: Lifetime prevalence of illicit drug use was lower among adolescents with DM1 than in the control group [58 (28%) versus 5524 (46%), p = 10(-5)]. Cannabis preparations were the most frequently used substances [38 (18.3%) versus 3976 (33.1%), p = 10(-5)], followed by tranquilizers, sedatives, and amphetamine. Lifetime and last 12-month use of cannabis were associated with poorer glycemic control (HbA1c ≥ 8%), p < 0.01 and 0.02, respectively. CONCLUSIONS: Adolescents with DM1 report using illicit drugs to a lesser extent than their healthy peers. The use of cannabis is associated with a poorer metabolic control in teens with DM1.