Are Heavier drinkers' Views on Situational Drinking Norms Affected by Recent Experience of Harm from others' Drinking?

OBJECTIVE: The relation is investigated between situational drinking norms which accept heavier drinking and the experience of harm from others' drinking. How does the experience of such harm relate to the acceptance of heavier drinking in drinking situations? METHODS: Respondents in a 2021 combined sample from random digitally dialed mobile phones and a panel survey of Australian adults (n = 2,574) were asked what level of drinking is acceptable in 11 social situations, including 3 "wet" situations where drinking is generally acceptable. Besides their own drinking patterns, respondents were also asked about their experience of harm from others' drinking in the last 12 months. Focussing on respondents' answers concerning the wetter situations, regression analyses were used to examine the relation between experiencing such harm and views on how much drinking was acceptable in the situations. RESULTS: Heavier drinkers were more likely to have experienced harm from others' drinking. Among heavier drinkers, those who experienced such harm generally did not differ significantly in their normative acceptance of any drinking in "wet" situations but were more accepting of drinking enough to feel the effects. DISCUSSION: From these cross-sectional results, experiencing harm from others' drinking does not seem to result in less acceptance of drinking to intoxication; rather, experiencing such harm was associated with more acceptance of heavy drinking. However, these findings may be the net result of influences in both directions, with the acceptance of intoxication in wet situations being more common among heavier drinkers, whose drinking exposes them to harm from others' drinking.

Associations Between Heavy Episodic Drinking, Drinking While Gambling, and Risky Gambling.

INTRODUCTION: Understanding how patterns of drinking are associated with risky gambling in Australia is needed to inform an effective approach to minimise harm. METHODS: This cross-sectional questionnaire study reports on 2,704 subsampled participants who completed survey questions about their patterns of drinking. With logistic regressions, we examined whether frequency of heavy episodic drinking (HED) and alcohol use while gambling were associated with risky gambling while controlling for sociodemographic variables. RESULTS: Occasional HED and monthly HED were associated with any gambling (versus no gambling), but frequent HED was not significantly associated with gambling. The opposite pattern was found when predicting risky gambling. Occasional HED (i.e. less than monthly) was not significantly associated, but a higher frequency of HED (at least weekly) was associated with a higher likelihood of risky gambling. Drinking alcohol while gambling was associated with risky gambling, over and above HED. The combination of HED and use of alcohol while gambling appeared to significantly increase the likelihood of risky gambling. CONCLUSIONS: The association of HED and alcohol use while gambling with risky gambling highlights the importance of preventing heavy alcohol use among gamblers. The links between these forms of drinking and risky gambling further suggests that individuals who engage in both activities are specifically prone to gambling harm. Policies should therefore discourage alcohol use while gambling for example by prohibiting serving alcohol at reduced prices or to gamblers who show signs of being affected by alcohol and informing individuals of the risks associated with alcohol use while gambling.

The relationship between fathers' heavy episodic drinking and fathering involvement in five Asia-Pacific countries: An individual participant data meta-analysis.

BACKGROUND: This study aims to increase understanding of the relationship between heavy episodic drinking (HED) and fathers' involvement in parenting in five countries. The potential moderating effect of fathers' experiences of childhood trauma is also studied, controlling for the possible confounding of the effect of HED by father's attitudes toward gender equality, father's age and father's education. METHOD: United Nations Multi-Country Study on Men and Violence (UNMCS) survey data from 4562 fathers aged 18-49 years from Cambodia, China, Indonesia and Papua New Guinea (PNG) and Sri Lanka were used to assess the relationship between fathering involvement (e.g., helping children with their homework) and self-reported HED of 6+ drinks in one occasion vs. non-HED and abstaining. Moderating effects of a 13-item fathers' childhood trauma (FCT) scale were tested and analyses were adjusted for gender-inequitable attitudes using the Gender-Equitable Men scale score. Bivariate and adjusted individual participant meta-analyses were used to determine effect estimates for each site and across all sites. RESULTS: Fathers' HED was associated with less positive parental involvement after adjusting for gender-equitable attitudes, FCT, age and education. No overall interaction between HED and FCT was identified. Gender equitable attitudes were associated with fathering involvement in some countries but not overall (p = 0.07). CONCLUSIONS: Heavy episodic drinking was associated with reduced positive fathering involvement. These findings suggest that interventions to increase fathers' involvement in parenting should include targeting reductions in fathers' HED. Structural barriers to fathers' involvement should be considered alongside HED in future studies of fathers' engagement with their children.

KODY, an all-of-family response to co-occurring substance use and domestic violence: protocol for a quasi-experimental intervention trial.

BACKGROUND: The co-occurrence of domestic violence with alcohol and other drugs significantly increases the severity of abuse and violence experienced by family members. Longitudinal studies indicate that substance use is one of few predictors of men's continued use of, or desistance from, violence. Recent developments in men's behaviour change programs have focused on men's attitudes and behaviour towards their children, and the exploration of interventions that address the needs of all family members. However, the research evidence is limited on the most effective elements of men's behaviour change programs in promoting the safety and wellbeing of child and women victim survivors. This study aims to build on the existing evidence by trialling the KODY program which addresses harmful substance use by men who also perpetrate domestic violence; the safety and wellbeing of women and children; the needs of children in their own right, as well as in relationship with their mothers; and the development of an 'all-of-family' service response. The evaluation of these innovations, and the ramifications for policy development to support less fragmented service system responses, provide the rationale for the study. METHODS/DESIGN: A quasi-experimental design will be used to assess the primary outcomes of improving the safety and wellbeing of mothers and children whose (ex)partners and fathers respectively participate in KODY (the trial program), when compared with 'Caring Dads standard' (the comparison group). Psychometric tests will be administered to fathers and mothers at baseline, post-program and at 3-month follow up. Data collection will occur over three years. DISCUSSION: By building the evidence base about responses to co-occurring domestic violence and substance use, this study aims to develop knowledge about improving safety outcomes for women and children, and to better understand appropriate support for children in families living at the intersection of domestic violence and substance use. It is anticipated that study findings will point to the ramifications for policy development to support less fragmented service system responses. TRIAL REGISTRATION: An application for registration with the Australian and New Zealand Clinical Trials Registry ( https://www.anzctr.org.au/ ) was lodged on 20 December 2021 (Request number: 383206)-prospectively registered.

A multi-country analysis of informal caregiving due to others' drinking.

The burden of caring for drinkers is seldom articulated as a social concern, or integrated in service planning or alcohol policy. This study aims to examine prevalence and predictors of informal caregiving due to others' drinking cross-nationally by surveying 20,728 respondents (18-64 years) in 11 countries. The outcome variable was respondent-reported informal caregiving due to others' drinking, analysed by socio-demographic factors and drinking pattern using logistic regression and meta-analysis. Estimated overall prevalence of informal caregiving due to others' drinking ranged from 9% in Nigeria to 47% in Thailand. In most countries, females reported a higher rate than males of caring for children and other dependents, but males reported a higher rate of driving family or friends somewhere or picking them up. Logistic regression analysis found differences between high-income countries and low- and middle-income countries in the relationship of caregiving with employment and household composition. Respondent's own drinking was positively correlated with the prevalence of caregiving in 10 out of 11 countries. In general, younger adults and those who are themselves risky drinkers are more likely to have had caring responsibilities. Although problematic drinking is concentrated in specific subpopulations, the burden of care for others' drinking extends widely across the population.

Cross-National Comparisons and Correlates of Harms From the Drinking of People With Whom You Work.

BACKGROUND: While research in high-income countries (HICs) has established high costs associated with alcohol's harm to others (AHTO) in the workplace, scant attention has been paid to AHTO in the workplace in lower- or middle-income countries (LMICs). AIM: To compare estimates and predictors of alcohol's impacts upon coworkers among workers in 12 countries. METHODS: Cross-sectional surveys from 9,693 men and 8,606 women employed in Switzerland, Australia, the United States, Ireland, New Zealand, Chile, Nigeria, Lao PDR, Thailand, Vietnam, India, and Sri Lanka. Five questions were asked about harms in the past year because of coworkers' drinking: Had they (i) covered for another worker; (ii) worked extra hours; (iii) been involved in an accident or close call; or had their (iv) own productivity been reduced; or (v) ability to do their job been affected? Logistic regression and meta-analyses were estimated with 1 or more harms (vs. none) as the dependent variable, adjusting for age, sex, rurality of location, and the respondent worker's own drinking. RESULTS: Between 1% (New Zealand) and 16% (Thailand) of workers reported that they had been adversely affected by a coworker's drinking in the previous year (with most countries in the 6 to 13% range). Smaller percentages (<1% to 12%) reported being in an accident or close call due to others' drinking. Employed men were more likely to report harm from coworkers' drinking than employed women in all countries apart from the United States, New Zealand, and Vietnam, and own drinking pattern was associated with increased harm in 5 countries. Harms were distributed fairly equally across age and geographic regions. Harm from coworkers' drinking was less prevalent among men in HICs compared with LMICs. CONCLUSIONS: Workforce impairment because of drinking extends beyond the drinker in a range of countries and impacts productivity and economic development, particularly affecting men in LMICs.

Children's experience of physical harms and exposure to family violence from others' drinking in nine societies.

AIM: To study caregiver reports of children's experience of physical harm and exposure to family violence due to others' drinking in nine societies, assess the relationship of harm with household drinking pattern and evaluate whether gender and education of caregiver affect these relationships. METHOD: Using data on adult caregivers from the GENAHTO (Gender and Alcohol's Harm to Others) project, child alcohol-related injuries and exposure of children to alcohol-related violence (CAIV) rates are estimated by country and pooled using meta-analysis and stratified by gender of the caregiver. Households with and without heavy or harmful drinker(s) (HHD) are compared assessing the interaction of caregiver gender on the relationship between reporting HHD and CAIV, adjusting for caregiver education and age. Additionally, the relationship between caregiver education and CAIV is analysed with meta-regression. RESULTS: The prevalence of CAIV varied across societies, with an overall pooled mean of 4% reported by caregivers. HHD was a consistent correlate of CAIV in all countries. Men and women in the sample reported similar levels of CAIV overall, but the relationship between HHD and CAIV was greater for women than for men, especially if the HHD was the most harmful drinker. Education was not significantly associated with CAIV. CONCLUSION: One in 25 caregivers with children report physical or family violence harms to children because of others' drinking. The adjusted odds of harm are significantly greater (more than four-fold) in households with a heavy or harmful drinker, with men most likely to be defined as this drinker in the household.

Harm from Known Others' Drinking by Relationship Proximity to the Harmful Drinker and Gender: A Meta-Analysis Across 10 Countries.

BACKGROUND: Drinking is a common activity with friends or at home but is associated with harms within both close and extended relationships. This study investigates associations between having a close proximity relationship with a harmful drinker and likelihood of experiencing harms from known others' drinking for men and women in 10 countries. METHODS: Data about alcohol's harms to others from national/regional surveys from 10 countries were used. Gender-stratified random-effects meta-analysis compared the likelihood of experiencing each, and at least 1, of 7 types of alcohol-related harm in the last 12 months, between those who identified someone in close proximity to them (a partner, family member, or household member) and those who identified someone from an extended relationship as the most harmful drinker (MHD) in their life in the last 12 months. RESULTS: Women were most likely to report a close male MHD, while men were most likely to report an extended male MHD. Relatedly, women with a close MHD were more likely than women with an extended MHD to report each type of harm, and 1 or more harms, from others' drinking. For men, having a close MHD was associated with increased odds of reporting some but not all types of harm from others' drinking and was not associated with increased odds of experiencing 1 or more harms. CONCLUSIONS: The experience of harm attributable to the drinking of others differs by gender. For preventing harm to women, the primary focus should be on heavy or harmful drinkers in close proximity relationships; for preventing harm to men, a broader approach is needed. This and further work investigating the dynamics among gender, victim-perpetrator relationships, alcohol, and harm to others will help to develop interventions to reduce alcohol-related harm to others which are specific to the contexts within which harms occur.

Seeking Help for Harm from Others' Drinking in Five Asian Countries: Variation Between Societies, by Type of Harm and by Source of Help.

AIMS: This study aims to measure the prevalence rates and patterns of help-seeking behavior as a consequence of being harmed by drinkers in five Asian countries (India, Sri Lanka, Vietnam, Lao PDR and Thailand). METHODS: A total of 9832 respondents aged 18-65 years from the WHO/ThaiHealth Collaborative Project were surveyed between 2012 and 2014 about their experiences of being negatively affected due to another's drinking, and whether and where they sought help, focusing on four adverse aspects of harms from others' drinking. RESULTS: The prevalence of seeking help from any source in the past year due to harm from others' drinking ranged from 7% to 20%. The most common service used by those who were affected by other people's drinking was asking for help from friends, followed by calling the police and using health-related services. The largest proportion of help-seeking was among those reporting property harm, followed by those being harmed physically and sexually by drinkers. CONCLUSION: Given a wide range of harms from others' drinking in the general population and different needs of those affected, prevalence rates for help-seeking behavior due to others' drinking in South and South East Asian countries were low and the help sought was often informal. There is a large knowledge gap in our understanding of the mechanisms of help-seeking behavior and the pathways for access to help among those affected. Further studies are important for enhancing the social response services available and making these more accessible to those who need help.

Measuring Time Spent Caring For Drinkers and Their Dependents.

AIMS: To quantify the extent of time spent by family and friends caring for drinkers and their dependents, to estimate the cost of this time and to measure which factors predict time spent caring. METHODS: Data are from a nationwide Alcohol's Harm to Others Survey of 2649 Australians, in which 778 respondents reported they were harmed by a known drinker. Time spent on four caring activities was self-reported by these respondents and tallied to estimate how many hours they spent caring for the drinker, the drinker's children or other dependents. Bivariate and multivariate linear regression models were employed to examine factors predicting time spent caring. RESULTS: Respondents who reported they were harmed by a drinker they knew had spent on average 32 h caring for this drinker and their dependents in the past 12 months. Applying these figures to the Australian population, but discounting by 90% because this time may be seen be a voluntary demonstration of connection, an annual cost of caring in 2008 would amount to AU$250 million. A significant positive association was found between time spent caring and the drinking level and drinking frequency of the heavy drinking other person. CONCLUSION: Caring for drinking family members, friends, co-workers and a drinker's dependents can be a substantial burden. Policy approaches that reduce population drinking and individual risky drinking levels are potential means to reduce the burden of caring due to others' drinking.

Accessing supports due to others' harmful drinking.

INTRODUCTION: Alcohol's harm to others (AHTO) refers to harms caused to those other than the drinker. The current paper estimates the prevalence of formal and informal supports sought due to AHTO and examines whether the type of support accessed varies by sociodemographic, economic and harm-related characteristics. METHODS: An Australian sample of 2574 people completed the 2021 AHTO survey, out of which 888 perceived they experienced harm from another's drinking. Prevalence of accessing services and supports was measured. Additionally, several sociodemographic factors, economic factors and harm-related factors were included in multivariable logistic regression models predicting service/support use. Specifically, four models were constructed probing use of any service/support, use of police, use of counselling services and use of family/friend support. RESULTS: Of the survey sample, 12.4% accessed any support/service. Seeking support from family and/or friends was most common, followed by police, counselling, healthcare services and being admitted to hospital. Women had higher odds of accessing counselling and family/friend support. Respondents with a higher education level and two or more financial stressors had higher odds of accessing police and counselling. Respondents harmed by a stranger had higher odds of accessing police, whereas respondents harmed by someone they know had higher odds of seeking support from family/friends. Experiencing more severe harm was associated with greater odds of accessing any support. DISCUSSION AND CONCLUSIONS: Several sociodemographic and economic factors were associated with accessing different supports. These findings may inform service development, interventions and policy changes for people affected by others' drinking.

A global review of the impact on women from men's alcohol drinking: the need for responding with a gendered lens.

BACKGROUND: Global evidence shows that men's harmful alcohol use contributes to intimate partner violence (IPV) and other harms. Yet, interventions that target alcohol-related harms to women are scarce. Quantitative analyses demonstrate links with physical and verbal aggression; however, the specific harms to women from men's drinking have not been well articulated, particularly from an international perspective. AIM: To document the breadth and nature of harms and impact of men's drinking on women. METHODS: A narrative review, using inductive analysis, was conducted of peer-reviewed qualitative studies that: (a) focused on alcohol (men's drinking), (b) featured women as primary victims, (c) encompassed direct/indirect harms, and (d) explicitly featured alcohol in the qualitative results. Papers were selected following a non-time-limited systematic search of key scholarly databases. RESULTS: Thirty papers were included in this review. The majority of studies were conducted in low- to middle-income countries. The harms in the studies were collated and organised under three main themes: (i) harmful alcohol-related actions by men (e.g. violence, sexual coercion, economic abuse), (ii) impact on women (e.g. physical and mental health harm, relationship functioning, social harm), and (iii) how partner alcohol use was framed by women in the studies. CONCLUSION: Men's drinking results in a multitude of direct, indirect and hidden harms to women that are cumulative, intersecting and entrench women's disempowerment. An explicit gendered lens is needed in prevention efforts to target men's drinking and the impact on women, to improve health and social outcomes for women worldwide.

Main findings: Women experience a multitude of direct, indirect and hidden harms from a male intimate partner's alcohol drinking, particularly in LMIC settings.Added knowledge: This review consolidates global qualitative evidence from diverse women's lived experience and adds a broader understanding of harm from men's alcohol drinking, beyond physical and verbal abuse shown in quantitative evidence.Global health impact for policy and action: Policy and intervention efforts that take an explicit gendered and intersectional lens on men's harmful drinking have potential to greatly improve health and social outcomes for women globally.

Harm from the drinking of people you know: A range of effects from different relationships.

AIMS: To describe the range of effects experienced due to the drinking of people respondents know and analyze risk and protective factors for harm from the drinking of partners and household members, other relatives and friends and co-workers. DESIGN, SETTING AND PARTICIPANTS: Surveys of 2574 participants' experiences were obtained from two samples: 1000 people responded to random digitally dialled Australian mobile calls and 1574 participants responded from the Life in AustraliaTM panel survey. MEASUREMENTS: Respondents were asked whether they had been negatively affected in the previous 12 months by the drinking of persons they knew who were 'a heavy drinker or drank a lot sometimes' and the nature of these harms. Weighted logistic regressions were used to analyze differences in rates of key negative outcomes from known others' drinking by gender, age and socio-economic status. FINDINGS: Almost two thirds [60.2%; 95% confidence interval (CI) = 57.7%-62.7%] of participants reported having heavy drinkers in their lives and 21.8% (95% CI = 19.8%-23.9%) reported being negatively affected by the drinking of people they knew well in some way. Participants reported a gamut of effects, including, most commonly, adverse social effects: having to transport relatives and friends who had been drinking, role failure and faults, being emotionally hurt or neglected, serious arguments, family problems, having to care for drinkers and verbal abuse. Less commonly, respondents reported physical or sexual harm, property damage, financial stress and threats from others' drinking. Women (odds ratio = 1.49; 95% CI = 1.13-1.95), younger people, rural, Australian-born (vs. respondents born overseas in non-English speaking countries) and more frequent drinkers were more likely to report harm from a drinker they knew than their counterparts after adjusting for other variables in the model. CONCLUSIONS: Australians appear to be commonly adversely affected by the drinking of people they know. Harms from known drinkers are more likely to be experienced by women than men, particularly from the people they live with and other relatives.

The burden of alcohol-related caring for others in Australia in the 2021 pandemic period.

OBJECTIVE: The magnitude of caring for others due to excessive alcohol use is unclear in Australia and internationally. This study explores the prevalence, sociodemographic predictors, and consequences of informal care for others due to alcohol use. METHOD: A survey on harm from others' drinking was conducted among 2,574 Australian adults in November 2021 from national random digit dial and "Life in Australia" panel samples to elicit representative data. Respondents who indicated they had "heavy drinker/s" in their lives (n= 1,585), were asked about their experience of caring for these drinkers and their dependents in the last 12 months. Weighted logistic and linear regressions examined a) sociodemographic factors associated with informal care due to others' drinking, and b) the impact of the caregiving burden on caregiver's financial status, overall health, and quality of life. RESULTS: Overall, 20% of participants reported caregiving responsibilities arising from others' drinking. Older age, unemployment, residing in capital cities and reporting birth in a non-English speaking background country were associated with a reduced likelihood of caregiving, whereas higher education and more frequent risky drinking were associated with an increased likelihood. Caregivers reported significantly higher financial disadvantage, a lower quality of life and poorer overall health. CONCLUSIONS: One in five adults reported caring for drinkers in the previous 12 months, with this associated with negative consequences for those providing care. Service providers, health promotion practitioners and policy makers should focus upon younger age groups, those who live in regional areas, and those born in Australia who are at greater risk of being burdened by caregiving due to others' alcohol use.

Exclusion of the non-English-speaking world from the scientific literature: Recommendations for change for addiction journals and publishers.

Background: While English is only the native language of 7.3% of the world's population and less than 20% can speak the language, nearly 75% of all scientific publications are English. Aim: To describe how and why scientific contributions from the non-English-speaking world have been excluded from addiction literature, and put forward suggestions for making this literature more accessible to the non-English-speaking population. Methods: A working group of the International Society of Addiction Journal Editors (ISAJE) conducted an iterative review of issues related to scientific publishing from the non-English-speaking world. Findings: We discuss several issues stemming from the predominance of English in the scientific addiction literature, including historical drivers, why this matters, and proposed solutions, focusing on the increased availability of translation services. Conclusion: The addition of non-English-speaking authors, editorial team members, and journals will increase the value, impact, and transparency of research findings and increase the accountability and inclusivity of scientific publications.

Alcohol's harm to others in 2021: Who bears the burden?

BACKGROUND AND AIMS: Alcohol's harm to others (AHTO) has become a key driver of national and international alcohol policy. This study aimed to produce a contemporary, comprehensive estimate of the correlates and harms from others' drinking in 2021 in Australia. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Across Australia, 2574 adults (1380 women; 1172 men) were sampled via two cross-sectional survey modes: a random-digit dial mobile phone sample of 1000 people and 1574 people from the Life in Australia™ panel survey. In 2021 participants were asked about harms they had experienced from the drinking of family, friends, co-workers and the public in the past year. Applying combined sample weights from each mode, bivariable and adjusted multivariable logistic regressions were used to analyse differences in rates of AHTO by participant gender, age, residence in rural or metropolitan regions, country of birth, education and employment. FINDINGS: In 2021, 23.6% reported being negatively affected by strangers' drinking and 21.3% by the drinking of someone they knew, with 34.3% reporting being negatively affected a lot or a little by either; 42.4% of respondents reported specific harms from strangers' drinking. Thus, 48.1% of respondents reported any harm (negative effects or specific harms) from others' drinking. Women, younger people, Australian-born and heavier episodic drinkers reported significantly higher rates of AHTO compared with other respondents. Smaller percentages (7.5%) of participants reported being harmed substantially by others' drinking, including by people they knew (5.8%) or strangers (2.3%). Stratified analyses showed that heavier drinking, furloughed, younger men who were born overseas in English-speaking countries were affected by others' drinking, whereas women were affected regardless of these factors (apart from age). CONCLUSIONS: More than one-third of Australian adults appear to have been negatively affected by others' drinking in 2021, with women, younger people and heavier drinkers at greater risk. Substantial harm appears to be more likely to arise from the drinking of people Australians know than from strangers' drinking.

Trends in alcohol expenditure in Australia from 1984 to 2015-2016: An exploratory study.

INTRODUCTION: Excessive alcohol use is associated with non-communicable diseases and social problems, such as work absence, financial problems and family violence. Expenditure and expenditure shares on alcohol are valuable measures to monitor financial activities on this risk behaviour. The aim of this paper is to report trends in alcohol expenditure in Australia over the last two decades. METHODS: Data are from six waves of Australian Household Expenditure Surveys from 1984 to 2015-2016. We explored trends of alcohol expenditure among Australians and in different socio-demographic groups in the last 30 years. We further examined changes of expenditure on different on- and off-premises beverages over time. RESULTS: Absolute alcohol expenditure has remained the same between the 1980s and 2016, after accounting for inflation. However, a declining trend in relative alcohol expenditure as a proportion of total household expenditure was found across nearly all demographic groups (e.g., sex, age, employment, household income), except for women aged 45-54, who showed an increasing trend of alcohol expenditure after 1998-1999. DISCUSSION AND CONCLUSIONS: The current study shows declines in relative alcohol expenditure, which may reflect declines in alcohol's relative importance within the elements of the person's lifestyle they need to pay for and/or increased awareness of alcohol's health and social harms. Further longitudinal analysis should explore additional predictors of household expenditure on alcohol. Results suggest that current bi-annual indexation increases in alcohol tax should account for increases in income to ensure the effectiveness of pricing. Moreover, attention is needed to address drinking among middle-aged females.

High Intensity Drinking (HID) Assessed by Maximum Quantity Consumed Is an Important Pattern Measure Adding Predictive Value in Higher and Lower Income Societies for Modeling Alcohol-Related Problems.

Adjusting for demographics and standard drinking measures, High Intensity Drinking (HID), indexed by the maximum quantity consumed in a single day in the past 12 months, may be valuable in predicting alcohol dependence other harms across high and low income societies. The data consisted of 17 surveys of adult (15,460 current drinkers; 71% of total surveyed) in Europe (3), the Americas (8), Africa (2), and Asia/Australia (4). Gender-disaggregated country analyses used Poison regression to investigate whether HID (8-11, 12-23, 24+ drinks) was incrementally influential, beyond log drinking volume and HED (Heavy Episodic Drinking, or 5+ days), in predicting drinking problems, adjusting for age and marital status. In adjusted models predicting AUDIT-5 for men, adding HID improved the overall model fit for 11 of 15 countries. For women, 12 of 14 countries with available data showed an improved fit with HID included. The results for the five Life-Area Harms were similar for men. Considering the results by gender, each country showing improvements in model fit by adding HID had larger values of the average difference between high intensity and usual consumption, implying variations in amounts consumed on any given day. The amount consumed/day often greatly exceeded HED levels. In many societies of varying income levels, as hypothesized, HID provided important added information on drinking patterns for predicting harms, beyond the standard volume and binging indicators.

Can alcohol policy prevent harms to women and children from men's alcohol consumption? An overview of existing literature and suggested ways forward.

The World Health Organization's list of cost-effective alcohol control policies is a widely-used resource that highlights strategies to address alcohol-related harms. However, there is more evidence on how recommended policies impact harms to people who drink alcohol-such as physical health problems caused by heavy alcohol use-than on secondhand harms inflicted on someone other than the person drinking alcohol, i.e., alcohol's harms to others. In this essay, we describe evidence of impacts of alcohol policy on harms to women and children resulting from men's alcohol consumption, as well as options for making policies more relevant for reducing intimate partner violence and child abuse. We begin with an overview of harms to women and children resulting from men's alcohol consumption and review cost-effective alcohol policies with potential to reduce these harms based on likely mechanisms of action. Next, we present a rapid review of reviews to describe existing evidence of impacts of these policies on the outcomes of physical violence, sexual violence, and child abuse and neglect. We found little evidence of systematic evaluation of impacts of these important alcohol policies on harms to women and children. Thus, we advocate for increased attention in evaluation research to the impacts of alcohol policies on harms experienced by women and children who are exposed to men who drink alcohol. We also argue for more consideration of a broader range of policies and interventions to reduce these specific types of harm. Finally, we present a conceptual model illustrating how alcohol policies may be supplemented with other interventions specifically tailored to reduce alcohol-related harms commonly experienced by women and children as a result of men's alcohol use.

Exploiting motherhood: Do mummy drinking sites offer real support or are they mainly alcohol marketing?

Even as women's roles have expanded substantially beyond traditional sex stereotypes, women are still commonly portrayed as uncomplaining caregivers, long-suffering intimate partners and in control of family matters, all while maintaining a sexualised femininity. Nowhere are these stereotypes and expectations more apparent than for mothers. However, some social media are exploiting mothers by inappropriately offering alcohol consumption as a solution to the challenges of parenting. This is a very timely topic, given the impacts of COVID-19 on family and home life, and potential for an increase in alcohol-related problems and health harms. We address these issues and offer alternatives to alcohol consumption as an easy solution to countering challenges of parenthood.