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2.
BMC Public Health ; 21(1): 366, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33641667

RESUMO

BACKGROUND: Alcohol and firearms are commonly involved in suicide in the United States. State alcohol and firearm policies may impact alcohol and firearm related suicide, yet little is known about these relationships. This study examines relationships between state alcohol and firearm policies and suicides involving alcohol, guns, or both, and explores interactive policy associations. METHODS: Alcohol policies were assessed with the Alcohol Policy Scale. Firearm policies were assessed using the Gun Law Scorecard from Giffords Law Center. Suicide data from the National Violent Death Reporting System in 2015 covered 22 states. State- and individual-level GEE Poisson and logistic regression models assessed relationships between policies and firearm- and/or alcohol-involved suicides with a 1-year lag. RESULTS: In 2015, there were 8996 suicide deaths with blood alcohol concentration test results in the 22 included states. Of those deaths, alcohol and/or firearms were involved in 5749 or 63.9%. Higher alcohol and gun law scores were associated with reduced incidence rates and odds of suicides involving either alcohol or firearms (adjusted incidence rate ratios [IRR] 0.72 (95% CI 0.63, 0.83) for alcohol policies, 0.86 (95% CI 0.82, 0.90) for firearm policies). Relationships were similar for suicides involving both alcohol and firearms, and there was an interactive effect, such that states with restrictive policies for both had the lowest rates of suicides involving alcohol or guns. CONCLUSIONS: More restrictive alcohol and firearm policies are associated with lower rates and odds of suicides involving alcohol or firearms, and alcohol and firearms, and may be a promising means by which to reduce suicide.

3.
Am J Prev Med ; 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33589301

RESUMO

INTRODUCTION: Legal limits on the amount of cannabis sold per transaction in states with recreational cannabis may promote moderate use and limit diversion. However, state sales limits are heterogeneous and difficult to interpret in terms of tetrahydrocannabinol dose equivalents. METHODS: This cross-sectional study examined how transaction sales limits on recreational cannabis translate to tetrahydrocannabinol doses among U.S. states allowing commercial cannabis sales as of January 1, 2020. Weight-based quantity limits by cannabis type (flower/bud, concentrates, and edibles) were converted into grams of tetrahydrocannabinol content per transaction using known potency values in 2020. RESULTS: Weight-based sales limits for flower and concentrate vary considerably across states (range=1.0-2.5 oz for flower and 3.5-15.0 g for concentrate), whereas limits for edible cannabis are heterogeneous. A total of 4 states have independent limits for each product category, and 6 states place limits across all products sold in the transaction. Because no states impose limits on the potency of flower or concentrates, the small differences in the weight-based limits translate into large differences in grams of tetrahydrocannabinol allowed to be sold. Assuming a typical dose of 10 mg of tetrahydrocannabinol, current laws allow for sales of up to 560 (Alaska) to 2,283 (Michigan) doses per transaction on the basis of median product potencies. CONCLUSIONS: All states allow a large number of tetrahydrocannabinol doses per transaction, larger than what is typically consumed by daily users over a month. States concerned about public health and diversion should consider reducing sales limits and basing them on total tetrahydrocannabinol content across all purchased products.

4.
Artigo em Inglês | MEDLINE | ID: mdl-33248106
5.
MMWR Morb Mortal Wkly Rep ; 69(39): 1428-1433, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33001874

RESUMO

Excessive alcohol use is a leading cause of preventable death in the United States (1) and costs associated with it, such as those from losses in workplace productivity, health care expenditures, and criminal justice, were $249 billion in 2010 (2). CDC used the Alcohol-Related Disease Impact (ARDI) application* to estimate national and state average annual alcohol-attributable deaths and years of potential life lost (YPLL) during 2011-2015, including deaths from one's own excessive drinking (e.g., liver disease) and from others' drinking (e.g., passengers killed in alcohol-related motor vehicle crashes). This study found an average of 95,158 alcohol-attributable deaths (261 deaths per day) and 2.8 million YPLL (29 years of life lost per death, on average) in the United States each year. Of all alcohol-attributable deaths, 51,078 (53.7%) were caused by chronic conditions, and 52,921 (55.6%) involved adults aged 35-64 years. Age-adjusted alcohol-attributable deaths per 100,000 population ranged from 20.8 in New York to 53.1 in New Mexico. YPLL per 100,000 population ranged from 631.9 in New York to 1,683.5 in New Mexico. Implementation of effective strategies for preventing excessive drinking, including those recommended by the Community Preventive Services Task Force (e.g., increasing alcohol taxes and regulating the number and concentration of alcohol outlets), could reduce alcohol-attributable deaths and YPLL.†.


Assuntos
Alcoolismo/mortalidade , Expectativa de Vida/tendências , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
6.
MMWR Morb Mortal Wkly Rep ; 69(30): 981-987, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32730240

RESUMO

Excessive alcohol use is a leading cause of preventable death in the United States (1) and costs associated with it, such as those from losses in workplace productivity, health care expenditures, and criminal justice, were $249 billion in 2010 (2). CDC used the Alcohol-Related Disease Impact (ARDI) application* to estimate national and state average annual alcohol-attributable deaths and years of potential life lost (YPLL) during 2011-2015, including deaths from one's own excessive drinking (e.g., liver disease) and from others' drinking (e.g., passengers killed in alcohol-related motor vehicle crashes). This study found an average of 93,296 alcohol-attributable deaths (255 deaths per day) and 2.7 million YPLL (29 years of life lost per death, on average) in the United States each year. Of all alcohol-attributable deaths, 51,078 (54.7%) were caused by chronic conditions, and 52,361 (56.0%) involved adults aged 35-64 years. Age-adjusted alcohol-attributable deaths per 100,000 population ranged from 20.3 in New Jersey and New York to 52.3 in New Mexico. YPLL per 100,000 population ranged from 613.8 in New York to 1,651.7 in New Mexico. Implementation of effective strategies for preventing excessive drinking, including those recommended by the Community Preventive Services Task Force (e.g., increasing alcohol taxes and regulating the number and concentration of alcohol outlets), could reduce alcohol-attributable deaths and YPLL.†.


Assuntos
Alcoolismo/mortalidade , Expectativa de Vida/tendências , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Estados Unidos/epidemiologia , Adulto Jovem
7.
J Stud Alcohol Drugs ; 81(3): 331-338, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32527385

RESUMO

OBJECTIVE: Higher alcohol taxation is protective against alcohol-related morbidity and mortality. All states have specific (volume-based) excise taxes for alcohol that decrease if not adjusted for inflation. These taxes have diminished substantially in real terms since their inception after National Prohibition in the United States. The purpose of this study was to examine trends in the magnitude and frequency of changes in state specific excise taxes to document their erosion. METHOD: Alcohol excise tax data were examined for all 50 states from 1933 to 2018. Tax data were obtained from the Alcohol Policy Information System, Pacific Institute for Research and Evaluation, Wine Institute, and HeinOnline. Linear and logistic regression analyses were conducted for beer, wine, and distilled spirits taxes to examine trends in the frequency and inflation-adjusted magnitude of changes in taxes from the year of alcohol tax inception. RESULTS: From 1933 until 1970, beer, wine, and distilled spirits tax rates increased in value compared with inception rates, but by 2018 alcohol taxes had declined 66%, 71%, and 70%, respectively, compared with their inception values. The erosion of taxes after 1970 was driven primarily by declines in the magnitude of tax increases through the 1970s and 1980s, followed by declines in the frequency of tax increases in subsequent decades. CONCLUSIONS: The value of alcohol excise taxes has declined since 1970 from both insufficient tax increases and later infrequent tax increases. Laws that index rates to inflation could sustain the public health benefit of reduced morbidity and mortality resulting from higher alcohol tax rates.


Assuntos
Bebidas Alcoólicas/estatística & dados numéricos , Impostos/tendências , Humanos , Impostos/estatística & dados numéricos , Estados Unidos
8.
JAMA Netw Open ; 3(4): e202361, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32271389

RESUMO

Importance: The use of benzodiazepines or alcohol together with opioids increases overdose risk, but characterization of co-involvement by predominant opioid subtype is incomplete to date. Understanding the use of respiratory depressants in opioid overdose deaths (OODs) is important for prevention efforts and policy making. Objective: To assess the prevalence and number of alcohol- or benzodiazepine-involved OODs by opioid subtypes in the United States from 1999 to 2017. Design and Setting: This repeated cross-sectional analysis used data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (WONDER) database of all opioid-involved poisoning deaths from January 1, 1999, to December 31, 2017, for the United States. State-level binge drinking prevalence rates for 2015 to 2017 were obtained from the Behavior Risk Factor Surveillance System of the Centers for Disease Control and Prevention, and benzodiazepine prescribing rates for 2012 (most recent available data) were obtained from IMS Health, a commercial database. Data were analyzed from July 10, 2018, to May 16, 2019. Main Outcomes and Measures: Prevalence of alcohol or benzodiazepine co-involvement for all OODs and by opioid subtype, nationally and by state. Results: From 1999 to 2017, 399 230 poisoning deaths involved opioids, of which 263 601 (66.0%) were male, and 204 560 (51.2%) were aged 35 to 54 years. Alcohol co-involvement for all opioid overdose deaths increased nonlinearly from 12.4% in 1999 to 14.7% in 2017. By opioid subtype, deaths involving heroin and synthetic opioids (eg, fentanyl; excluding methadone) had the highest alcohol co-involvement at 15.5% and 14.9%, respectively, in 2017. Benzodiazepine co-involvement in all OODs increased nonlinearly from 8.7% in 1999 to 21.0% in 2017. Benzodiazepines were present in 33.1% of prescription OODs and 17.1% of synthetic OODs in 2017. State-level rates of binge drinking were significantly correlated with alcohol co-involvement in all OODs (r = 0.34; P = .02). State benzodiazepine prescribing rates were significantly correlated with benzodiazepine co-involvement in all OODs (r = 0.57; P < .001). Conclusions and Relevance: This study found that alcohol and benzodiazepine co-involvement in opioid-involved overdose deaths was common, varied by opioid subtype, and was associated with state-level binge drinking and benzodiazepine prescribing rates. These results may inform state policy initiatives in harm reduction and overdose prevention efforts.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Analgésicos Opioides/envenenamento , Benzodiazepinas/efeitos adversos , Overdose de Drogas/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estados Unidos/epidemiologia
9.
Am J Prev Med ; 58(5): 622-629, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32192802

RESUMO

INTRODUCTION: Motor vehicle crashes are a leading cause of injury death in the U.S. Restrictive alcohol policies protect against crashes involving alcohol above the legal blood alcohol concentration of 0.08%. Characteristics of motor vehicle crash fatalities involving blood alcohol concentrations below the limit and their relationships to alcohol control policies have not been well characterized. METHODS: Motor vehicle crash fatality data and crash and decedent characteristics from 2000 to 2015 came from the Fatality Analysis Reporting System and were analyzed in 2018-2019. Alcohol Policy Scale scores characterized alcohol policy environments by state-year. Generalized estimating equation alternating logistic regression models assessed these scores and the odds that a fatality involved alcohol below the legal threshold. RESULTS: Of 612,030 motor vehicle crash fatalities, 223,471 (37%) died in alcohol-involved crashes, of which 33,965 (15% of alcohol-involved fatalities or 6% of all fatalities) had a blood alcohol concentration <0.08%. A 10 percentage point increase in Alcohol Policy Scale score, approximating the interquartile range among states, was associated with reduced odds of fatalities involving alcohol <0.08% vs 0.00% (AOR=0.91, 95% CI=0.89, 0.93). These findings held across multiple subgroup analyses by decedent and crash characteristics. Similar results were found for odds of alcohol involvement <0.05% vs 0.00% (AOR=0.90, 95% CI=0.88, 0.93), and ≥0.05% but <0.08% vs <0.05% (AOR=0.93, 95% CI=0.89, 0.96). CONCLUSIONS: The number of lower blood alcohol concentration fatalities is substantial. States with more restrictive alcohol policies tend to have reduced odds of lower blood alcohol concentration motor vehicle crashes than states with weaker policies.

10.
J Stud Alcohol Drugs ; 81(1): 58-67, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32048602

RESUMO

OBJECTIVE: U.S. policymakers and public health practitioners lack composite indicators (indices) to assess and compare the restrictiveness of state-level alcohol policy environments, conceptualized as the presence of multiple policies in effect in a particular place and time. The purposes of this study were to characterize the alcohol policy environment in each U.S. state and Washington, DC, in 2018, and to examine changes during the past 20 years. METHOD: State-specific Alcohol Policy Scale (APS) scores from 1999 to 2018 were based on 29 policies, after weighting each present policy by its efficacy and degree of implementation. Modified APS scores were also calculated on the basis of two sets of mutually exclusive policy subgroups. RESULTS: APS scores in 2018 varied considerably between states, ranging from 25.6 to 67.9 on a theoretical scale of 0 to 100; the median score was 43.5 (based on a 0-100 range), and 43 states had scores less than 50. The median change in state APS scores from 1999 to 2018 was positive (+4.9, range: -7.4 to +10.3), indicating increases in the restrictiveness of policy environments, with decreases in only five states. The increases in APS scores were primarily attributable to the implementation of stronger impaired-driving laws, whereas policies to reduce excessive drinking were unchanged. There was no correlation between states' excessive drinking policy scores and their impaired-driving scores (r = .05, p = .74). CONCLUSIONS: Based on this policy scale, few states have restrictive policy environments. Although states adopted policies targeting impaired driving during the study period, there was no change in policies to reduce excessive drinking.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Política Pública/tendências , Condução de Veículo/legislação & jurisprudência , District of Columbia , Humanos , Estados Unidos
11.
MMWR Morb Mortal Wkly Rep ; 69(2): 30-34, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31945030

RESUMO

Each year, excessive drinking accounts for one in 10 deaths among U.S. adults aged 20-64 years (1), and approximately 90% of adults who report excessive drinking* binge drink (i.e., consume five or more drinks for men or four or more drinks for women on a single occasion) (2). In 2015, 17.1% of U.S. adults aged ≥18 years reported binge drinking approximately once a week and consumed an average of seven drinks per binge drinking episode, resulting in 17.5 billion total binge drinks, or 467 total binge drinks per adult who reported binge drinking (3). CDC analyzed 2011-2017 Behavioral Risk Factor Surveillance System (BRFSS) data to assess trends in total annual binge drinks per adult who reported binge drinking in the United States overall and in the individual states. The age-adjusted† total annual number of binge drinks per adult who reported binge drinking increased significantly from 472 in 2011 to 529 in 2017. Total annual binge drinks per adult who reported binge drinking also increased significantly from 2011 to 2017 among those aged 35-44 years (26.7%, from 468 to 593) and 45-64 years (23.1%, from 428 to 527). The largest percentage increases in total binge drinks per adult who reported binge drinking during this period were observed among those without a high school diploma (45.8%) and those with household incomes <$25,000 (23.9%). Strategies recommended by the Community Preventive Services Task Force§ for reducing excessive drinking (e.g., regulating alcohol outlet density) might reduce binge drinking and related health risks.


Assuntos
Bebedeira/tendências , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Bebedeira/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
12.
Clin Gastroenterol Hepatol ; 18(7): 1651-1652, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31926338
13.
Am J Prev Med ; 58(1): 79-88, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31806270

RESUMO

INTRODUCTION: Harnessing engagement in online searching and social media may provide complementary information for monitoring alcohol use, informing prevention and policy evaluation, and extending knowledge available from national surveys. METHODS: Relative search volumes for 7 alcohol-related keywords were estimated from Google Trends (data, 2014-2017), and the proportion of alcohol use-related Twitter posts (data, 2014-2015) was estimated using natural language processing. Searching/posting measures were created for all 50 U.S. states plus Washington, D.C. Survey reports of alcohol use and summaries of state alcohol policies were obtained from the Behavioral Risk Factor Surveillance System (data, 2014-2016) and the Alcohol Policy Scale. In 2018-2019, associations among searching/posting measures and same state/year Behavioral Risk Factor Surveillance System reports of recent (past-30-day) alcohol use and maximum number of drinks consumed on an occasion were estimated using logistic and linear regression, adjusting for sociodemographics and Internet use, with moderation tested in regressions that included interactions of select searching/posting measures and the Alcohol Policy Scale. RESULTS: Recent alcohol use was reported by 52.93% of 1,297,168 Behavioral Risk Factor Surveillance System respondents, which was associated with all state-level searching/posting measures in unadjusted and adjusted models (p<0.0001). Among drinkers, most searching/posting measures were associated with maximum number of drinks consumed (p<0.0001). Associations varied with exposure to high versus low levels of state policy controls on alcohol. CONCLUSIONS: Strong associations were found among individual alcohol use and state-level alcohol-related searching/posting measures, which were moderated by the strength of state alcohol policies. Findings support using novel personally generated data to monitor alcohol use and possibly evaluate effects of alcohol control policies.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Comportamento de Busca de Informação , Fatores de Risco , Mídias Sociais/estatística & dados numéricos , Governo Estadual , Consumo de Bebidas Alcoólicas/prevenção & controle , Sistema de Vigilância de Fator de Risco Comportamental , District of Columbia , Feminino , Regulamentação Governamental , Humanos , Masculino , Pessoa de Meia-Idade , Política Pública , Estados Unidos/epidemiologia
14.
Chem Biol Interact ; 315: 108885, 2020 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-31678112

RESUMO

BACKGROUND: Although more restrictive alcohol control policies (e.g., higher alcohol taxes) are related to lower levels of alcohol consumption, little is known about the relationship between alcohol policies and rates of alcohol-attributable cancer. METHODS: State alcohol policy restrictiveness, as measured by a validated policy scale, were related to state rates of six alcohol attributable cancers in the U.S. from 2006 to 2010 in a lagged, cross-sectional linear regression that controlled for a variety of state-level factors. Cancer mortality rates were from the Center for Disease Control and Prevention's Alcohol-Related Disease Impact application, which uses population-attributable fraction methodology to calculate mortality from cancers of the esophagus, larynx, liver, oropharynx, prostate (male only) and breast (female only). RESULTS: More restrictive state alcohol policies were associated with lower cancer mortality rates for the six cancer types overall (beta [ß] -0.33; 95% confidence interval [CI] -0.59, -0.07), and among men (ß -0.45; 95% CI -0.81, -0.10) and women (ß -0.21; 95% CI -0.40, -0.02). A 10% increase in the restrictiveness of alcohol policies (based on the mean APS among states) was associated with an 8.5% decrease in rates of combined alcohol-attributable cancers. In all analyses stratified by cancer subtype and sex, the associations were in the hypothesized direction (i.e., more restrictive state policy environments were associated with lower rates of alcohol-attributable cancers), with the exception of laryngeal cancer among women. CONCLUSION: Strengthening alcohol policies is a promising prevention strategy for alcohol-related cancer.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Etanol/efeitos adversos , Neoplasias/mortalidade , Adulto , Estudos Transversais , Feminino , Humanos , Masculino
15.
Clin Gastroenterol Hepatol ; 18(8): 1831-1841.e5, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31734449

RESUMO

BACKGROUND & AIMS: Many individuals presumed to have nonalcoholic fatty liver disease (NAFLD) consume moderate amounts of alcohol. Little is known about patterns of alcohol use in patients with NAFLD or how drinking behaviors affect liver fat. METHODS: We conducted a cross-sectional study of 2475 participants of the Framingham Heart Study with hepatic steatosis, as determined by computed tomography. We performed multivariable-adjusted logistic regression models to evaluate the association between alcohol drinking patterns and hepatic steatosis. Models were adjusted for sociodemographic factors, diet, and the components of the metabolic syndrome. We excluded heavy alcohol users, defined as women who consume more than 14 alcohol drinks per week and men who consume more than 21 alcohol drinks per week. RESULTS: In our sample (mean age, 49.8 ± 10.2 y; 50.3% women), the prevalence of hepatic steatosis was 17.5%. The total number of alcohol drinks per week and the maximum drinks consumed per drinking day each were associated with hepatic steatosis (adjusted odds ratio [aOR], 1.15; 95% CI, 1.02-1.29 and aOR 1.15; 95% CI, 1.02-1.30). Binge drinking occurred in 25.4% of individuals with presumed NAFLD and was associated with an increased odds of hepatic steatosis (aOR, 1.45; 95% CI, 1.06-1.98) among alcohol users. In a beverage-specific analysis, alcohol use patterns were associated with hepatic steatosis among beer drinkers, but not among wine drinkers. CONCLUSIONS: In a cross-sectional study of participants of the Framingham Heart Study with hepatic steatosis, we observed an association between alcohol use and liver fat, even after excluding heavy alcohol users from our analysis. Alcohol use therefore appears to be a risk factor for NAFLD. Prospective studies are needed to validate these findings and determine if alcohol use should be a focus for research, prevention, and treatment of presumed NAFLD.

16.
J Stud Alcohol Drugs ; 80(4): 408-414, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31495377

RESUMO

OBJECTIVE: At least one type of tax is applied to the sale of alcoholic beverages in all U.S. states. The purpose of this study was to characterize the composition and magnitude of alcohol taxes in states and to assess the relationship between total alcohol taxes (federal plus state) and the cost of excessive drinking. METHOD: The amount of tax (in dollars per standard drink) by state was estimated from data on state ad valorem excise, specific excise, and sales taxes in 2010 obtained from the Alcohol Policy Information System and Tax Foundation. These taxes were summed, and specific excise taxes were assessed as a proportion of total state taxes. Tax data on beer were analyzed for all 50 states. Tax data for wine and distilled spirits were restricted to the 32 license states and Washington, D.C., with fully privatized distribution systems. Total alcohol taxes for the 32 license states were compared on a per-drink basis with published state estimates of the cost of excessive drinking in these states in 2010. RESULTS: Specific excise taxes accounted for a weighted median of 20.1% of total state alcohol tax revenue in the 32 license states and Washington, D.C. The median total alcohol tax per drink (based on all federal and state taxes) was $0.21, which accounted for 26.7% of the median cost to government and 10.3% of the median total economic cost of excessive drinking. CONCLUSIONS: Specific excise taxes account for one fifth of state alcohol taxes in the 32 license states; but even considering all tax types, total alcohol taxes account for only one tenth of alcohol-related costs.


Assuntos
Bebidas Alcoólicas/economia , Custos e Análise de Custo/estatística & dados numéricos , Impostos/economia , Consumo de Bebidas Alcoólicas/economia , Cerveja/economia , Humanos , Estados Unidos , Vinho/economia
17.
Alcohol Clin Exp Res ; 43(6): 1234-1243, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31166048

RESUMO

BACKGROUND: Although restrictive state alcohol policy environments are protective for individuals' binge drinking, research is sparse on the effect of alcohol policies on alcohol's harms to others (AHTO). We examined the lagged associations between efficacy of U.S. state alcohol policies and number of harms from others' drinking 1 year later. METHODS: Individuals with AHTO data in a nationally representative sample of U.S. adults (analytic sample n = 26,744) that pooled the 2000, 2005, 2010, and 2015 National Alcohol Surveys and a 2015 National Alcohol's Harm to Others Survey were linked with prior-year state policy measures. We used 2 measures from the Alcohol Policy Scale (APS)-effectiveness in reducing (i) binge drinking and (ii) impaired driving, based on experts' efficacy judgments regarding 29 state alcohol policies. Three 12-month AHTO measures (due to another drinker) were experiencing: (i) either family/marriage difficulties or financial troubles; (ii) being assaulted or vandalized; and (iii) passenger with drunk driver or traffic accident. Multilevel models accounting for clustering within states and stratified by age-groups (<40 vs. ≥40) examined associations between the APS and AHTO measures, controlling for individual covariates (gender, race, education, employment and marital status, family problem-drinking history) of the victim. RESULTS: Only for those aged <40, the lagged APS-Binge drinking and APS-Impaired driving scores were each inversely associated with aggression-related harms and, separately, with drunk driving-related harm from someone else's drinking (ps < 0.05 to < 0.01). Family/financial harms were not associated with APS scores for either age-group. Composite AHTO measures (any of 3 harm-types) also were inversely associated with stronger state alcohol policy environments (ps < 0.05 to <0.01). CONCLUSIONS: State alcohol policies may be effective in reducing, to a meaningful degree, aggression-related harms and vehicular hazards due to other drinkers, but mainly in those under 40.


Assuntos
Bebedeira/legislação & jurisprudência , Comportamento Criminoso , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
18.
Am J Prev Med ; 57(2): 172-179, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31239088

RESUMO

INTRODUCTION: Intimate partner violence (IPV) results in deaths of both primary and corollary (i.e., nonintimate partner) victims. Alcohol use is a known risk factor for IPV, yet the relationship between alcohol policies and IPV homicides is unclear. This repeated cross-sectional study characterizes alcohol involvement, and the relationship between alcohol policies and alcohol involvement, among victims of IPV homicides in the U.S. METHODS: Homicide victim data from 17 states in the National Violent Death Reporting System from 2003 to 2012 were analyzed in 2017-2018. Alcohol Policy Scale scores characterized alcohol policies by state year and were used in generalized estimating equation logistic regression models to predict the odds of alcohol involvement among victims of IPV homicide. RESULTS: Among victims of IPV homicide, 36.5% of primary and 41.1% of corollary victims had a blood alcohol concentration (BAC) >0.00%. Of the victims with a positive BAC, 67.6% had a BAC ≥0.08%. In adjusted models, a 10-percentage point increase in Alcohol Policy Scale score was associated with reduced odds of having a positive BAC (AOR=0.77, 95% CI=0.64, 0.93) and having a BAC ≥0.08% (AOR=0.82, 95% CI=0.68, 0.99) among all victims, primary victims (AOR=0.78, 95% CI=0.63, 0.98; AOR=0.82, 95% CI=0.65, 1.04), and corollary victims (AOR=0.61, 95% CI=0.42, 0.89; AOR=0.68, 95% CI=0.48, 0.97). CONCLUSIONS: Alcohol use was prevalent among victims of IPV homicide, and more-restrictive alcohol policies were associated with reduced odds of alcohol involvement. Strengthening alcohol policies is a promising strategy to reduce alcohol-involved IPV homicide victimization.


Assuntos
Consumo de Bebidas Alcoólicas , Causas de Morte , Homicídio/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Feminino , Humanos , Violência por Parceiro Íntimo/etnologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia
19.
MMWR Morb Mortal Wkly Rep ; 68(16): 365-368, 2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31022164

RESUMO

Drinking alcohol during pregnancy can cause fetal alcohol spectrum disorders (FASDs), including birth defects that involve central nervous system impairment, behavioral disorders, and impaired intellectual development, which can lead to difficulties with school and employment. A recent study in four U.S. communities found a 1.1%-5.0% prevalence of FASDs among first-grade students (1). Drinking during pregnancy might also be a risk factor for other adverse pregnancy and birth outcomes, including miscarriage and stillbirth (2). CDC estimated the prevalence of self-reported current drinking (at least one alcohol drink in the past 30 days) and binge drinking (consuming four or more drinks on at least one occasion in the past 30 days) among pregnant women aged 18-44 years, using 2015-2017 data from the Behavioral Risk Factor Surveillance System (BRFSS). Current drinking and binge drinking in the past 30 days were reported by 11.5% and 3.9% of pregnant women, respectively. Among pregnant women who binge drink, the average frequency of binge drinking in the past 30 days was 4.5 episodes, and the average intensity of binge drinking (the average largest number of drinks reported consumed on any occasion among binge drinkers) was 6.0 drinks. Increased implementation of evidence-based community-level and clinic-level interventions, such as universal alcohol screening and brief counseling in primary and prenatal care, could decrease the prevalence of drinking during pregnancy, which might ultimately reduce the prevalence of FASDs and other adverse pregnancy and birth outcomes.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Bebedeira/epidemiologia , Gestantes/psicologia , Adolescente , Adulto , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Humanos , Estado Civil/estatística & dados numéricos , Gravidez , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
20.
J Stud Alcohol Drugs ; 80(1): 63-68, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30807276

RESUMO

OBJECTIVE: Alcohol use causes approximately 10% of deaths among adults ages 20-65 in the United States. Although previous research has demonstrated differential age-related risk relationships, it is difficult to estimate the magnitude of selection bias attributable to premature mortality based on existing cohort studies, the average age of which is greater than 50 years. The objective of our study was to assess the distribution of mortality-related harms and benefits from alcohol among adults ages 20 and older in comparison with the distribution among those older than age 50. METHOD: Data from the Centers for Disease Control and Prevention's Alcohol-Related Disease Impact software application from 2006-10 were used to determine the distribution of alcohol-attributable deaths (AADs) and the years of potential life lost (YPLLs) that was caused or prevented by alcohol for 54 conditions by 15-year age groupings (20-34, 35-49, 50-64, 65+) in the United States. We also determined the proportion of net deaths and YPLLs occurring in each age group, overall and by cause of death. RESULTS: Adults ages 20-49 years experienced 35.8% of the deaths and 58.4% of the YPLLs caused by alcohol, whereas the same group accrued only 4.5% of AADs and 14.2% of YPLLs gained. Overall, 46.3% of the total net deaths and 64.7% of the net YPLLs occurred among those ages 20-49; adding net deaths occurring among those ages 20-49 to those occurring after age 50 would result in an 86.3% relative increase in net deaths. CONCLUSIONS: Because of premature mortality, alcohol-mortality associations based on cohort studies may underestimate negative health consequences compared with those observed among the general population.


Assuntos
Consumo de Bebidas Alcoólicas/mortalidade , Transtornos Relacionados ao Uso de Álcool/mortalidade , Mortalidade Prematura , Adulto , Idoso , Causas de Morte , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Viés de Seleção , Estados Unidos/epidemiologia , Adulto Jovem
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