Alcohol segment-specific associations between the quality of the parent-child relationship and adolescent alcohol use.

BACKGROUND: There is much evidence that parents have an influence on the alcohol use of their children. However, in general the relationship is rather weak. A reason for this small association may be due to the fact that adolescents are a heterogeneous group and that, consequently, the association between the quality of the parent-child relationship and alcohol use varies for diverse subgroups, resulting in an overall small effect. In an earlier study we found five different segments for adolescents regarding their attitude towards alcohol. This article reports on a study into the differences between these segments with respect to the quality of the parent-child relationship and parental attitudes to alcohol. Moreover, we examined segment-specific associations of the quality of the parent-child relationship and alcohol use. METHODS: This study used data from a survey held among adolescents aged 12 to 18. A random sample of 59,073 adolescents was drawn from 67 municipalities in the south of the Netherlands. To assign respondents into one of the five segments, a questionnaire of 28 items concerning alcohol and approval from others from the original segmenting study was included in the internet version. Therefore, only the results of the internet version (N = 12,375 adolescents) were analysed. RESULTS: Both the quality of the parent-child relationship and the attitude of the parents towards the drinking behaviour of their children differed between the segments. Significant associations were found between the quality of the parent-child relationship and life-time and recent alcohol use and binge drinking. The interaction between the quality of the parent-child relationship and the segments was only significant for binge drinking. CONCLUSIONS: The quality of the parent-child relationship seemed to be most strongly associated with life-time alcohol use, suggesting that parents appear to play the most important role in the prevention of alcohol use. Moreover, the results showed segment-specific associations between the quality of the parent-child relationship and binge drinking, indicating that the role of parents in heavy drinking is different for the various segments.

Public opinion on imposing restrictions to people with an alcohol- or drug addiction: a cross-sectional survey.

PURPOSE: Alcohol- and drug addiction tends to evoke disapproval and rejection among people. This study provides insight into the origin of people's negative attitudes towards these people. Corrigan's attribution model is used to examine intentions of the Dutch public to impose restrictions to people who are addicted to alcohol or illicit drugs. METHODS: Data were derived from a cross-sectional survey among a representative panel of the Dutch population (N = 2,793). Path analyses were conducted to test the influence of attribution beliefs, emotional responses and familiarity with addictions on people's intentions to impose restrictions to these people. RESULTS: More than half of the respondents agreed with imposing restrictions to someone with an addiction such as excluding from taking public office or forbid to care for children. Corrigan's attribution model was partially applicable to explain people's intentions to impose restrictions, since only a rather small percentage of the variance in people's intentions was explained by the model. The perception of personal responsibility for an addiction and high expectancy of aggressiveness have a positive influence on intentions to impose restrictions. Feelings of anger and fear were also predictors of intentions to impose restrictions. CONCLUSIONS: The Dutch public showed high intentions to restrict people with an alcohol- or drug addiction which has an extensive impact on their life opportunities. Perceived aggressiveness, feeling of anger and fear, and perceived responsibility were associated with higher intentions to impose restrictions.

The effect of alcohol intake on cardiovascular disease and mortality disappeared after taking lifetime drinking and covariates into account.

BACKGROUND: Current alcohol intake has been associated with cardiovascular morbidity and mortality. The effect of past and lifetime drinking has received less attention. In the present study, the impact of current, past and lifetime drinking on cardiovascular events and all-cause mortality has been assessed. Secondly, the effect of accounting for covariates within these relationships has been studied. METHODS: The Lifestyle and Health study is a prospective cohort study in 2 regions of the Netherlands. Men and women aged 45 to 70 years registered in 34 general practices were followed over the period July 1996 to June 2001. At baseline, an extensive questionnaire had to be filled in. It included 3 questionnaires about alcohol intake: a Weekly Recall, a Quantity-Frequency about last year, and the Lifetime Drinking History questionnaire. Health problems were registered by the general practitioners. RESULTS: During follow-up, 679 men and 397 women had a cardiovascular event and 330 men and 204 women died. Current drinking was associated with lower risks of cardiovascular events (women) and all-cause mortality (men and women) compared with never drinkers. The relationships were strongest for alcohol intake measured with the Weekly Recall. Lifetime alcohol intake and alcohol intake in the distant past did not seem to be related to all-cause mortality or cardiovascular events. Adjustments for covariates weakened the relationships. CONCLUSIONS: Potential positive effects of drinking seem to be of a transient nature, as lifetime drinking and drinking in the past could not be related to all-cause mortality or cardiovascular events. The alleged benefits of current drinking at baseline diminished with increasing methodological quality and rigor.

Coping style mediates impact of stress on alcohol use: a prospective population-based study.

AIMS: This study examines the relationship between stressful life-events and alcohol use in a longitudinal cohort study, and investigates whether gender, coping style and social support modify this relationship. DESIGN, SETTING AND PARTICIPANTS: Data analysed in this paper come from a sample of 1608 men and 1645 women drawn randomly from the cohort known as the Dutch Lifestyle and Health Study, consisting of 16,210 men and women aged 45-70 years, who were followed-up for 4 years (1996-2000). MEASUREMENT: Alcohol use (recent and in the more distant past), occurrence of threatening life-events, coping style (action, cognitive and emotion coping), social support (perceived, actual support and social contacts) and other potential confounding factors were assessed with five annual self-administered questionnaires. The data were analysed with a mixed-effects modelling technique, controlling for interactions with time and gender. FINDINGS AND CONCLUSION: An interaction effect was found between experiencing a negative life-event and emotion coping on alcohol use. A positive relationship was found between the occurrence of negative life-events and alcohol use in subjects scoring high on emotion coping, and a negative one among subjects scoring low on emotion coping. Cognitive coping, action coping, actual support, social contacts and gender did not modify the relationship between life-events and alcohol use. However, having a more cognitive coping style or more social contacts was associated with a lower level of alcohol use, whereas having an action coping style and receiving more actual social support was associated with a higher drinking level. It seems plausible that people scoring high on emotion coping, characterized by a passive, resigned, indulgent and self-accusatory coping style, increase their alcohol use after experiencing a negative life-event.

A clients' perspective on demand-oriented and demand-driven health care.

BACKGROUND: In many Western European countries, there is an increasing request for demand-oriented and demand-driven approaches in health care. In these approaches, the emphasis is on the clients' perspective on healthcare policy and healthcare services. A study was conducted to gain insight into the clients' view of health care. METHODS: In 2004 a survey was conducted in the Netherlands among 4250 ambulatory mental health clients, by means of a postal questionnaire. To include clients with different experiences of mental health care, the sample was stratified according to the length of the treatment history. A total of 865 clients responded to the survey. RESULTS: Elements that are found to be important to most clients are that 'needs are determined in consultation with the client', that 'the client is treated in a pleasant manner' and that 'the professional informs the client about the possibilities in his/her situation'. Significant differences were found between groups with different background factors: income, education, age, sex and treatment history all had significant correlations. CONCLUSION: Most clients in ambulatory mental health care appreciate the demand-oriented and demand-driven approaches. However, not all the elements are appreciated in the same manner. In general, clients do not seem to care much about who makes the decisions, but they care much more about the way the decision-making process is carried out. Clients especially value being heard and being involved in the process as a serious party.

Predicting compulsive Internet use: it's all about sex!

The objective of this research was to assess the predictive power of various Internet applications on the development of compulsive Internet use (CIU). The study has a two-wave longitudinal design with an interval of 1 year. The first measurement contained 447 adult heavy Internet users who used the Internet at least 16 h per week and had Internet access at home for at least 1 year. For the second measurement, all participants were invited again, of whom 229 responded. By means of an online questionnaire, the respondents were asked about the time spent on various Internet applications and CIU. On a cross-sectional basis, gaming and erotica seem the most important Internet applications related to CIU. On a longitudinal basis, spending a lot of time on erotica predicted an increase in CIU 1 year later. The addictive potential of the different applications varies; erotica appears to have the highest potential.

Experienced and anticipated discrimination reported by individuals in treatment for substance use disorders within the Netherlands.

Experiences and expectations of discrimination (anticipated discrimination) may delay treatment seeking among people with substance use disorders. In addition, experienced and anticipated discrimination can be a barrier to successful recovery and rehabilitation. The aim of this study was to study the level of experienced and anticipated (the expectation to be rejected) discrimination among individuals in treatment for substance use disorders as well as the association between both concepts of discrimination. In addition, the association of experienced and anticipated discrimination with clinical and social characteristics was investigated. A cross-sectional survey among individuals in treatment for substance use disorders in the Netherlands was carried out in 2012. Individuals in treatment (N = 186) completed a self-reported questionnaire about experienced and anticipated discrimination. Descriptive statistics and chi-squared analyses were performed to investigate the level of experienced and anticipated discrimination and the association between both concepts. Linear regression analyses were used to investigate the association with clinical and social characteristics, such as occupational status and type of treatment. Individuals in treatment for substance use disorders reported high levels of experienced and anticipated discrimination. Respondents experienced most discrimination in family ties, intimate relationships and friendships. Experienced and anticipated discrimination were both positively correlated. Having complex substance use problems and a longer history of substance use problems was related to higher levels of experienced discrimination. In conclusion, experienced and anticipated discrimination were highly prevalent among individuals in treatment for substance use disorders. Attention in addiction treatment for adequate coping with discrimination may be needed in order to achieve successful social participation and rehabilitation of these individuals.

Healthcare professionals' regard towards working with patients with substance use disorders: comparison of primary care, general psychiatry and specialist addiction services.

BACKGROUND: Healthcare professionals are crucial in access to treatment for patients with substance use disorders. However, healthcare professionals often have negative attitudes towards this patient group. Healthcare professionals' regard for working with patients with substance use disorders was examined and three sectors in which professionals are working were compared. METHODS: General practitioners (GPs; N=180), healthcare professionals of general psychiatry (N=89) and specialists in addiction services (N=78) filled out a questionnaire in which regard for working with patients with substance use disorders was assessed. ANOVAs were used to compare the sectors and multiple linear regression analysis tested the association of regard with attribution beliefs, emotional reactions and other characteristics of healthcare professionals. RESULTS: Regard for working with patients with substance use disorders was different between the three sectors (GPs M=42.00; general psychiatry M=48.18; addiction specialists M=55.41; p=0.00, ω(2)=0.40). Attribution of personal responsibility and feeling of anger and fear were associated with lower regard scores. More familiarity with substance use problems, higher frequency of working with this patients group and more confidence in substance abuse treatment were positively associated with regard. Social desirability bias was present and was positively related to healthcare professionals' regard. CONCLUSIONS: Health care professionals of specialist addiction services showed higher regard for working with patients with substance use disorders compared to professionals of general psychiatry services and GPs. Improvement of education and shared care models in which healthcare professionals are supported by professionals specializing in addiction might address low regard.

Effects of interferential care: a community-based care program for persons with severe problems on several life areas.

BACKGROUND AND AIMS: Interferential care differs from the current community-based care programs in that it targets a larger, heterogeneous group and combines brokerage and full service elements in a multi-organizational care team. The team provides all the services itself, but with the aim to prepare clients within a few months for referral to regular (ambulant) healthcare services. The aim of this study was to assess the effectiveness of interferential care. METHODS: In a multisite, pretest-posttest design, 523 patients of three interferential care teams were followed. Quality of life, problem severity, problems with referral and engagement were assessed at baseline, at referral and again after 6 months. Analyses were performed using linear mixed modeling. RESULTS: Interferential care showed moderate to strong effects on quality of life and problem severity. These effects persisted (quality of life) or further improved (problem severity) until follow-up 6 months after referral to regular services. There were also small effects on both engagement and problems with referral. CONCLUSION: Interferential care offers significant improvements in quality of life and problem severity in persons who have severe problems on several life areas and who are currently not reached by healthcare services. It is a promising community-based care program for healthcare systems in which regular care already contains many elements of home-based practice.

A qualitative exploration of attitudes towards alcohol, and the role of parents and peers of two alcohol-attitude-based segments of the adolescent population.

BACKGROUND: An earlier study using social marketing and audience segmentation distinguished five segments of Dutch adolescents aged 12-18 years based on their attitudes towards alcohol. The present, qualitative study focuses on two of these five segments ('ordinaries' and 'ordinary sobers') and explores the attitudes of these two segments towards alcohol, and the role of parents and peers in their alcohol use in more detail. METHODS: This qualitative study was conducted in the province of North-Brabant, the Netherlands. With a 28-item questionnaire, segments of adolescents were identified. From the ordinaries and ordinary sobers who were willing to participate in a focus group, 55 adolescents (30 ordinaries and 25 ordinary sobers) were selected and invited to participate. Finally, six focus groups were conducted with 12-17 year olds, i.e., three interviews with 17 ordinaries and three interviews with 20 ordinary sobers at three different high schools. RESULTS: The ordinaries thought that drinking alcohol was fun and relaxing. Curiosity was an important factor in starting to drink alcohol. Peer pressure played a role, e.g., it was difficult not to drink when peers were drinking. Most parents advised their child to drink a small amount only. The attitude of ordinary sobers towards alcohol was that drinking alcohol was stupid; moreover, they did not feel the need to drink. Most parents set strict rules and prohibited the use of alcohol before the age of 16. CONCLUSIONS: Qualitative insight into the attitudes towards alcohol and the role played by parents and peers, revealed differences between ordinaries and ordinary sobers. Based on these differences and on health education theories, starting points for the development of interventions, for both parents and adolescents, are formulated. Important starting points for interventions targeting ordinaries are reducing perceived peer pressure and learning to make one's own choices. For the ordinary sobers, an important starting point includes enabling them to express to others that they do not feel the need to drink alcohol. Starting points for parents include setting strict rules, restricting alcohol availability at home and monitoring their child's alcohol use.

Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review.

BACKGROUND: Healthcare professionals are crucial in the identification and accessibility to treatment for people with substance use disorders. Our objective was to assess health professionals' attitudes towards patients with substance use disorders and examine the consequences of these attitudes on healthcare delivery for these patients in Western countries. METHODS: Pubmed, PsycINFO and Embase were systematically searched for articles published between 2000 and 2011. Studies evaluating health professionals' attitudes towards patients with substance use disorders and consequences of negative attitudes were included. An inclusion criterion was that studies addressed alcohol or illicit drug abuse. Reviews, commentaries and letters were excluded, as were studies originating from non-Western countries. RESULTS: The search process yielded 1562 citations. After selection and quality assessment, 28 studies were included. Health professionals generally had a negative attitude towards patients with substance use disorders. They perceived violence, manipulation, and poor motivation as impeding factors in the healthcare delivery for these patients. Health professionals also lacked adequate education, training and support structures in working with this patient group. Negative attitudes of health professionals diminished patients' feelings of empowerment and subsequent treatment outcomes. Health professionals are less involved and have a more task-oriented approach in the delivery of healthcare, resulting in less personal engagement and diminished empathy. CONCLUSIONS: This review indicates that negative attitudes of health professionals towards patients with substance use disorders are common and contribute to suboptimal health care for these patients. However, few studies have evaluated the consequences of health professionals' negative attitudes towards patients with substance use disorders.

Effectiveness of alcohol prevention interventions based on the principles of social marketing: a systematic review.

BACKGROUND: Alcohol education aims to increase knowledge on the harm related to alcohol, and to change attitudes and drinking behaviour. However, little (lasting) evidence has been found for alcohol education, in changing alcohol-related attitudes and behaviour. Social marketing uses marketing techniques to achieve a social or healthy goal, and can be used in alcohol education. Social marketing consists of eight principles: customer orientation, insight, segmentation, behavioural goals, exchange, competition, methods mix, and is theory based. This review investigates the application of social marketing in alcohol prevention interventions, and whether application of social marketing influences alcohol-related attitudes or behaviour. METHOD: A literature search was conducted in PubMed, PsychInfo, Cochrane and Scopus. Inclusion criteria were that original papers had to describe the effects of an alcohol prevention intervention developed according to one or more principles of social marketing. No limits were set on the age of the participants or on the kind of alcohol prevention intervention. The abstracts of the 274 retrieved studies were reviewed and the full texts of potentially relevant studies were screened. RESULTS: Six studies met the inclusion criteria and were included in this review. These six studies showed associations for the application of social marketing techniques on alcohol-related attitudes or behaviour; one study relates to participation in a drinking event, four to alcohol drinking behaviour, two to driving a car while under the influence of alcohol, two to recognition of campaign messages or campaign logo, and one to awareness of the campaign. However, no associations were also found. In addition, the studies had several limitations related to a control group, response rate and study methodology. CONCLUSION: Based on this review, the effect of applying the principles of social marketing in alcohol prevention in changing alcohol-related attitudes or behaviour could not be assessed. More research, with a good quality methodology, like using a randomized control trial and measuring short, medium, and long-term effects, is required on this topic. Policy implications are discussed.

The opinion of adolescents and adults on Dutch restrictive and educational alcohol policy measures.

OBJECTIVES: The main objective of this study is to explore the opinion of 16-22-year olds on alcohol policy measures compared to the opinion of adults older than 22 years. METHODS: Data was collected in 2008 by using a Dutch panel. This panel was based on a representative probability of households with 8280 members of 16 years and older. The study had a cross-sectional design and questionnaires were filled out through internet. RESULTS: According measures related to the availability of alcohol, the 16-18- and 19-22-year olds are significantly more negative about these policy measures than the respondents older than 22 years. Educational measures were more popular than restrictive availability measures among all three groups, and the opinions of the groups differed significantly from each other. Own alcohol use seemed to be the main predictor for the opinion on restrictive availability measures. CONCLUSIONS: The 16-22-year olds are more negative regarding restrictive availability measures and educational measures than adults older than 22 years, and the restrictive availability measures are less popular than the educational measures among the adolescents.

The reach of a free hepatitis B vaccination programme: results of a Dutch study among drug users.

BACKGROUND: The objective of the study was to explore the reach of an ongoing hepatitis B vaccination programme in terms of awareness of the programme among drug users (DUs), vaccination uptake and compliance, as well as to investigate reasons for non-participation. METHODS: Ethnographic mapping and targeted sampling were used to recruit 309 DUs in three regions in the Netherlands. Results were based on univariate statistics (Chi-square and t-tests) and multivariate logistic regression analysis. RESULTS: Of the sample, 63% were aware of the free vaccine, and 44% said they had been vaccinated. DUs who visited drug consumption rooms were more likely to be aware of the programme than those who did not. Vaccination uptake was negatively associated with older age of onset of drug use. Uptake was positively associated with being informed personally about the free vaccination by drug service staff. A history of STD infection, and having sexual intercourse with casual partners were negatively associated with compliance with the vaccination schedule (receiving three vaccinations). CONCLUSION: Our results suggest that marginalised DUs have been reached by the programme. Attention should be paid to those at risk of hepatitis B infection through sexual contacts, since they are less likely to be fully vaccinated. Most importantly, our results suggest that immediate vaccination on location after personal communication is one of the most effective ways to increase vaccination uptake.

European approach to assertive outreach for substance users: assessment of program components.

Model programs for assertive outreach for substance users (an active and persistent type of community-based health care) are still in their infancy. Most programs were formulated in the United States, and one problem is the lack of feasible and effective models for application in Europe. Therefore, in 2003 all assertive outreach programs for substance users in The Netherlands (n = 277) received a questionnaire about their main program components. The programs were found to differ in case-finding methods, label, focus, corporate strategy, care package, and team structure. The only association found was between the program strategy (referral or long-term care) and the program focus (nuisance reduction or care). Contextual and practical reasons for the differences between the programs are discussed as well as the implications for practice and future studies.

Alcohol and illicit drug use among emergency room patients in the Netherlands.

AIMS: To clarify alcohol and illicit drug use within the emergency room population in three different regions in The Netherlands, focusing on whether interventions for these substances should be region specific. METHODS: Alcohol and illicit drug use were assessed using a self-report questionnaire filled in by the patients, and by combining self-report with staff judgement on alcohol and illicit drug use. RESULTS: Data on alcohol use (self-reported and staff judgement combined) resulted in prevalence rates of 4.9-18.2%. Patients positive for alcohol are more likely to be male, aged 48-58 years, more likely to be a frequent excessive drinker, and to have injuries as a result of violence. Patients positive for illicit drugs are more likely to be male, aged 28-38 years, unemployed, and frequent excessive drinkers. Among men aged 18-35 years with a Dutch cultural background, some differences emerge regarding alcohol consumption between the various hospitals, but most variation exists in the case of illicit drug use. CONCLUSIONS: This paper confirms that the emergency room seems to provide an opportunity to initiate interventions regarding alcohol use and seems to suggest that this is independent of the region concerned. However, in the case of illicit drug use interventions seem to be more region specific.

Measuring alcohol use: "quantity frequency variability" and "weekly recall" compared among Turks and Moroccans in the Netherlands.

The aim of the present study was to test the quality of the "Quantity Frequency Variability" (QFV) measure and the "Weekly Recall" (WR) measure among second-generation Turks and Moroccans in The Netherlands. Data were gathered in an experimental study conducted in 2002, in Rotterdam, the second largest city in the Netherlands. A sample of 744 second-generation Turks and 753 second-generation Moroccans, aged 16 years and older, was approached to participate in the study. The response rate was 40.3% among Turks and 37.5% among Moroccans, which resulted in 300 Turks (mean age 21.8, of which 51.7% were male) and 282 Moroccans (mean age 20.1, of which 44.9% were male) participating in the experimental study. Differences in item non-response rates and alcohol reports between both measures were analyzed among the drinking sample; i.e., 95 Turks (31.7%) and 26 Moroccans (9.2%). Data showed higher alcohol reports with the QFV measure compared to the WR measure. Furthermore, item non-response rates were significantly lower for the QFV measure compared to the WR measure. The results suggest that, compared to the WR measure, the QFV measure is a more appropriate instrument to study the prevalence of alcohol use among second-generation Turks and Moroccans. Limitations of the study are discussed.

A literature overview of the relationship between life-events and alcohol use in the general population.

AIMS: A critical review of the evidence of effects of stressful life-events on alcohol use in the general population, with a particular focus on study design. METHODS: A literature search in Medline was conducted, covering the period from 1990 to 2005, to identify articles in which the relationship between life-events and alcohol use in the general population (i.e. non-problem drinking population) was investigated. Samples with a limited age range (e.g. college students) were excluded. Twelve studies with a cross-sectional design, and four articles with a longitudinal design were included in this review. RESULTS: Four cross-sectional studies found evidence that experiencing life-events is related to higher alcohol use, three other studies, however, found no such association. The relationship between specific life-events and alcohol use in the five remaining cross-sectional studies is less clear-cut. Being a victim of crime was associated with higher alcohol use, but divorce and financial problems were related to both higher and lower alcohol use. Health-related life-events were found to be associated with lower alcohol use. In studies with a longitudinal design, it was found that health-related life-events and financial problems caused a decrease in alcohol use, and life-events related to spouse, friends and relatives, and retiring led to an increase in alcohol use. CONCLUSIONS: Evidence points towards a relationship between the occurrence of life-events and alcohol use in the general population. The direction of the effect is, however, not unequivocal. When life-events are operationalized or categorized separately they are not only related to an increased alcohol use but also to a decreased alcohol use. Specification of the model to be tested, including buffering factors such as gender, social support, coping resources, as well as baseline consumption, is important for a correct estimation of the effect of negative life-events.

Self-reported alcohol use among Dutch emergency room patients: variations in prevalence rates owing to methodological differences.

AIMS: This study compared different methods of assessing self-reported alcohol use among emergency room patients in order to explain the variations in reported prevalence rates. METHODS: Alcohol use prior to patient's injury or illness was assessed in one hospital by a self-report questionnaire in three different ways: (i) administered by emergency room staff, (ii) administered by research staff, or (iii) sent to the patient's home by post. RESULTS: Results show variations in self-reported alcohol use 6 h prior to the injury or illness ranging from 4.6 to 9.1%; these variations may be explained by sample selection bias and characteristics of the included study populations. When self-report is combined with staff judgement the corresponding prevalence rates are 6.8% for research staff and 16.2% for emergency room staff. This shows that the latter judge the patient's alcohol use more efficiently than the research staff. Using research staff 24 h a day resulted in almost no sample bias. Data collection via emergency room staff leads to the highest alcohol use prevalence rates and to the highest sample bias; this was influenced by the emergency room characteristics. A retrospective mail survey results in an older sample with age-related (lower) alcohol use and emergency room characteristics related to this age group. CONCLUSIONS: Future studies using patient self-report among emergency room samples should consider carefully the influence of sample selection bias. The combination of the research staff handing out the questionnaire and the emergency room staff giving their judgement on the patient's alcohol use seems to be a useful method.

The effect of data collection mode and ethnicity of interviewer on response rates and self-reported alcohol use among Turks and Moroccans in the Netherlands: an experimental study.

AIMS: To test the effects of data collection mode and ethnicity of interviewers on response rates and self-reported alcohol use among second-generation Turks and Moroccans in Rotterdam, The Netherlands. METHODS: Two hundred and sixty-nine Turks and 271 Moroccans were interviewed face-to-face, and 475 Turks and 482 Moroccans received a mailed questionnaire. Half of the Turks and Moroccans randomly allocated to the interview mode were ethnically matched to the interviewer; the remainder were allocated to a Dutch interviewer. RESULTS: Turks and Moroccans more often responded to a face-to-face interview than to a mailed questionnaire. No effect of ethnicity of interviewer on response rates was demonstrated. With respect to the effects on alcohol reports, Turks and Moroccans tended to report a higher alcohol use in the mailed survey than in the face-to-face interview. They reported significantly more often excessive drinking in the mail survey than in the face-to-face interviews. Ethnicity of the interviewer resulted in Turks and Moroccans reporting a higher prevalence of alcohol use during the previous 6 months when interviewed by a Dutch interviewer compared with an ethnically matched interviewer. CONCLUSIONS: Among second-generation Turks and Moroccans, mail surveys seem most suitable to measure mean and excessive alcohol use. However, interviews held by Dutch interviewers seem to be the most appropriate method to study the prevalence of alcohol use during the previous 6 months.