Cambios en el consumo de alcohol en España de 1990 a 2019 / Changes in alcohol consumption in Spain between 1990 and 2019

España es uno de los países de la Unión Europea donde el consumo de alcohol disminuyó en las últimas décadas. Este estudio tuvo como objetivo identificar las diferentes fases de consumo de alcohol desde 1990. Los datos de consumo de alcohol per cápita en adultos entre 1990 y 2019 se analizaron para determinar las tendencias temporales utilizando el modelo de regresión Joinpoint. Se realizó un análisis adicional utilizando series temporales interrumpidas entre 1962 y 2016 con datos del Sistema de Información Global sobre Alcohol y Salud. Además, se recopilaron datos de la encuesta sobre el alcohol y otras drogas en España y se realizó una revisión narrativa para identificar las posibles razones que expliquen los cambios de tendencia encontrados. Cinco puntos de cambio fueron identificados: disminución del 3,2% por año de 1990 a 1995, aumento del 1,1% por año de 1995 a 2000, período de estabilidad de 2000 a 2006, disminución del 4,5% por año de 2006 a 2011 y período de estabilidad a partir del 2011. Este cambio en la tendencia puede explicarse por las diferentes medidas en políticas de salud pública implementadas por el gobierno español, así como por el cambio en el patrón de consumo que presentó la sociedad, cambiando las preferencias de las bebidas alcohólicas del vino a la cerveza y aumentando el binge drinking. Futuros estudios deberían analizar si las medidas de salud pública han sido efectivas; esto permitiría trabajar con ellas en España y en otros países.(AU)

Spain is one of the countries of the European Union in which alcohol consumption has decreased in the past decades. The aim of this paper is to distinguish different phases of the level of alcohol consumption in Spain since 1990. Adult alcohol consumption per capita data between 1990 and 2019 were analysed for temporal trends using the Joinpoint regression model. An additional analysis using interrupted timeseries between 1962 and 2016 was performed using data from Global Information System on Alcohol and Health. Data from the survey on alcohol and other drugs in Spain were collected and a narrative review was conducted to identify possible reasons for the trends found. Five point changes were identified on the timeline between 1990 and 2019, including: a decrease of 3.2% per year from 1990 to 1995, an increase of 1.1% per year from 1995 to 2000, a period of stability from 2000 to 2006, a decrease of 4.5% per year from 2006 to 2011, and a period of stability from 2011 onwards. These changes can largely be explained by the different public health measures carried out by the Spanish government, as well as the change in the pattern of consumption in society, which shifted its alcoholic beverage preference from wine to beer, and increased its binge-drinking behaviour. Further studies such as interrupted time-series analyses should test if indeed the hypothesized measures on public health have been effective; this could inform future policies in Spain and in other countries.(AU)

Early evidence for beer drinking in a 9000-year-old platform mound in southern China.

Alcoholic beverages played an essential role in rituals in ancient societies. Here we report the first evidence for beer drinking in the context of burial ritual in early Holocene southern China. Recent archaeological investigations at Qiaotou (9,000-8,700 cal. BP) have revealed a platform mound containing human burials and high concentrations of painted pottery, encircled by a human-made ditch. By applying microfossil (starch, phytolith, and fungi) residue analysis on the pottery vessels, we found that some of the pots held beer made of rice (Oryza sp.), Job's tears (Coix lacryma-jobi), and USOs. We also discovered the earliest evidence for using mold saccharification-fermentation starter in beer making, predating written records by 8,000 years. The beer at Qiaotou was likely served in rituals to commemorate the burial of the dead. Ritualized drinking probably played an integrative role in maintaining social relationships, paving the way for the rise of complex farming societies four millennia later.

Effect of alcohol prohibition on liver cirrhosis mortality rates in Canada from 1901 to 1956: A time-series analysis.

INTRODUCTION AND AIMS: The extent to which alcohol consumption in Canada was affected by alcohol prohibition in the early 20th century remains unclear. Since there is a dearth of data on consumption during this time, we estimated the effect of alcohol prohibition on alcohol consumption, as measured by changes in liver cirrhosis mortality rates in Canada. DESIGN AND METHODS: Annual liver cirrhosis mortality data were obtained for 1901 to 1956 for the provinces of Alberta, British Columbia, Manitoba, New Brunswick, Nova Scotia, Ontario and Saskatchewan. Changes in death rates were assessed, by province, using autoregressive integrated moving average models. Results were pooled across provinces using a fixed effects meta-analysis. A secondary fixed effects meta-analysis was performed which only included provinces with data for before, during and after prohibition, and excluded provinces with data only beginning during prohibition. RESULTS: Prohibition was associated with a statistically significant decrease in liver cirrhosis death rates only in Nova Scotia (P = 0.01). Pooling of provincial results indicated that prohibition resulted in 0.39 (95% confidence interval 0.06, 0.72; P = 0.02) fewer liver cirrhosis deaths per 100 000 people. In the restricted meta-analysis, prohibition resulted in 0.65 (95% confidence interval 0.18, 1.12; P < 0.01) fewer liver cirrhosis deaths per 100 000 people. DISCUSSION AND CONCLUSIONS: Although alcohol prohibition in Canada did not eliminate alcohol consumption, our findings suggest that prohibition was associated with reduced consumption, as evidenced by a reduction in liver cirrhosis mortality rates. Further, it's important to reflect on alcohol's history in Canada and use those policy lessons to guide the construction of effective cannabis legislation.

La decisión de Trajano: un punto de vista neurológico / Trajan's decision: a neurological point of view

El emperador de Roma Marco Ulpio Trajano gobernó el Imperio romano desde el año 98 hasta el 117 d.C., y fue el primer emperador de origen no itálico y el hombre que llevó al Imperio a su máxima extensión geográfica. La muerte de Trajano está rodeada de misterio, dada la polémica adopción de Adriano como su sucesor justo antes del momento de su fallecimiento, así como los rumores de envenenamiento por parte de su mujer, Plotina. Además, a pesar de las escasas fuentes literarias disponibles, se han documentado episodios de «parálisis», «apoplejía», «hidropesía», diarrea y episodios inespecíficos de «enfermedad» relacionados con el empeoramiento de su salud los meses antes de su muerte. Su especial afición al vino y los hábitos de vida relacionados con la personalidad del emperador pudieron estar asociados con su delicado estado de salud durante el último año de su gobierno, si bien no es posible descartar otros procesos patológicos con afectación neurológica asociados a los últimos años de vida del optimus princeps, los cuales pudieron interferir con sus últimas decisiones como gobernante. En este artículo se revisan las fuentes históricas disponibles con el objeto de analizar, desde el punto de vista neurológico, los últimos momentos del emperador con el que Roma alcanzó su máximo esplendor militar

The emperor of Rome, Marco Ulpio Trajano, ruled the Roman Empire from 98 to 117 AD, being the fi rst emperor of non-Italian origin and the man who took the Empire to its maximum geographical extent. Trajan's death is surrounded by mystery, given Adriano's controversial adoption as his successor just before his death, as well as rumors of poisoning by his wife, Plotina. In addition, despite the limited literary sources available, episodes of 'paralysis', 'stroke', 'dropsy', diarrhea and nonspecifi c episodes of 'illness' have been documented, related to the worsening of his health the months before his death. His special love of wine and life habits related to the personality of the emperor, could be associated with his delicate state of health during the last year of his government, although it is not possible to rule out other pathological processes with neurological involvement associated with the last years of life of the optimus princeps, which could interfere with his last decisions as ruler. In this article, the historical sources available are reviewed in order to analyze, from the neurological point of view, the last moments of the emperor with which Rome reached its máximum military splendor

Historical Persistence of Alcohol-Induced Mortality in the Russian Federations: Legacy of Early Industrialization.

AIMS: The study aims to investigate insofar regional differences in alcohol-induced mortality in Russia, which emerged during the early industrialization of the country, persisted over a prolonged period of time (from late nineteenth to early twenty-first century), surviving fundamental political and social changes Russia experienced. METHODS: Multivariate regression models with historical and contemporary data on alcohol-induced mortality in Russian regions were estimated to document the persistence of spatial patterns of mortality, as well as to identify the possible mediating variables. Numerous robustness checks were used to corroborate the results. RESULTS: Alcohol-induced male mortality in Russian regions in 1880s-1890s is significantly and strongly correlated with male mortality due to accidental alcohol poisoning in Russian regions in 2010-2012. For female mortality, no robust correlation was established. The results for male mortality do not change if one controls for a variety of other determinants of alcohol-induced mortality and are not driven by outlier regions. Consumption of strong alcohol (in particular vodka) appears to be the mediator variable explaining this persistence. CONCLUSIONS: Hazardous drinking behavioral patterns, once they emerge and crystalize during the periods of fragmentation of the traditional society and the early onsets of modernization and urbanization, can be extremely persistent. Even highly intrusive policy interventions at a later stage (like those of the Soviet government) may turn out to be insufficient to change the path-dependent outcomes.

Trends in Single, Dual, and Poly Use of Alcohol, Cigarettes, and Marijuana Among US High-School Students: 1991-2017.

Objectives. To evaluate trends in patterns (single, dual, or poly) of current use of alcohol, cigarettes, and marijuana (ACM) among youths in the United States. Methods. I used data from the 1991-2017 Youth Risk Behavior Surveys (n = 203 663) to report average annual percentage change (AAPC) and linear trends of single, dual, and poly use of ACM among youths. Results. From 1991 to 2017, the prevalence of marijuana-only use increased from 0.6% to 6.3% (AAPC = 7.4) while the prevalence of use of alcohol only or cigarettes only significantly declined. Dual use of alcohol and marijuana increased from 3.6% to 7.6% (AAPC = 2.4), while dual use of alcohol and cigarettes declined from 11.8% to 1.7% (AAPC = -7.5). The prevalence of poly use of ACM declined from 9.4% to 4.4%. There is an enlarged disparity in use of marijuana only by race/ethnicity with an increase of 11.5% among non-Hispanic Blacks and an increase of 8.1% among Hispanics, compared with an increase of 3.4% among non-Hispanic Whites. Conclusions. The use patterns of ACM among youths have changed with a surge in use of marijuana only, especially among racial/ethnic minorities.

Global alcohol exposure between 1990 and 2017 and forecasts until 2030: a modelling study.

BACKGROUND: Alcohol use is a leading risk factor for global disease burden, and data on alcohol exposure are crucial to evaluate progress in achieving global non-communicable disease goals. We present estimates on the main indicators of alcohol exposure for 189 countries from 1990-2017, with forecasts up to 2030. METHODS: Adult alcohol per-capita consumption (the consumption in L of pure alcohol per adult [≥15 years]) in a given year was based on country-validated data up to 2016. Forecasts up to 2030 were obtained from multivariate log-normal mixture Poisson distribution models. Using survey data from 149 countries, prevalence of lifetime abstinence and current drinking was obtained from Dirichlet regressions. The prevalence of heavy episodic drinking (30-day prevalence of at least one occasion of 60 g of pure alcohol intake among current drinkers) was estimated with fractional response regressions using survey data from 118 countries. FINDINGS: Between 1990 and 2017, global adult per-capita consumption increased from 5·9 L (95% CI 5·8-6·1) to 6·5 L (6·0-6·9), and is forecasted to reach 7·6 L (6·5-10·2) by 2030. Globally, the prevalence of lifetime abstinence decreased from 46% (42-49) in 1990 to 43% (40-46) in 2017, albeit this was not a significant reduction, while the prevalence of current drinking increased from 45% (41-48) in 1990 to 47% (44-50) in 2017. We forecast both trends to continue, with abstinence decreasing to 40% (37-44) by 2030 (annualised 0·2% decrease) and the proportion of current drinkers increasing to 50% (46-53) by 2030 (annualised 0·2% increase). In 2017, 20% (17-24) of adults were heavy episodic drinkers (compared with 1990 when it was estimated at 18·5% [15·3-21·6%], and this prevalence is expected to increase to 23% (19-27) in 2030. INTERPRETATION: Based on these data, global goals for reducing the harmful use of alcohol are unlikely to be achieved, and known effective and cost-effective policy measures should be implemented to reduce alcohol exposure. FUNDING: Centre for Addiction and Mental Health and the WHO Collaborating Center for Addiction and Mental Health at the Centre for Addiction and Mental Health.

A Brief History of Awareness of the Link Between Alcohol and Fetal Alcohol Spectrum Disorder.

OBJECTIVE: Fetal alcohol spectrum disorder (FASD) is a medical term used to describe a range of mental and physical disabilities caused by maternal alcohol consumption. The role of alcohol as a teratogen and its effects on the cellular growth of the embryo and the fetus were not determined on scientific grounds until the late 1960s. However, the link between alcohol use during pregnancy and its harms to offspring might have been observed frequently over the many thousands of years during which alcohol has been available and used for social and other reasons. METHODS AND RESULTS: Using sources ranging from the biblical Book of Judges (pre-1700) up until the first public health bulletin (1977), we seek to provide an overview of the academic debate around early historical accounts ostensibly attributed to the awareness of alcohol as a prenatal teratogen as well as to describe the social and political influences that sculpted developments leading to the public recognition of FASD. CONCLUSIONS: Our analysis provides a brief overview of the discourse regarding historical awareness of the detrimental effects of prenatal alcohol exposure on fetal development leading to the formal recognition of FASD as a distinct clinical entity. Further research will be required to fully appreciate the scientific, medical, and societal ills associated with prenatal alcohol exposure.

Introduction: Alcohol and Alcoholism.

This article discusses alcohol use throughout history. The discovery and cultivation of wine and beer and distillation of spirits are explored. The article spans prehistory, Egypt, Ancient Greece, Ancient Rome, Europe, and the Americas; and the religions Judaism, Christianity, and Islam. Also explored are the history and distillation of rum, gin, and champagne. Effects of alcohol use on society are discussed.

Race, alcohol and general paralysis: Emil Kraepelin's comparative psychiatry and his trips to Java (1904) and North America (1925).

This article examines Emil Kraepelin's notion of comparative psychiatry and relates it to the clinical research he conducted at psychiatric hospitals in South-East Asia (1904) and the USA (1925). It argues that his research fits awkwardly within the common historiographic narratives of colonial psychiatry. It also disputes claims that his work can be interpreted meaningfully as the fons et origio of transcultural psychiatry. Instead, it argues that his comparative psychiatry was part of a larger neo-Lamarckian project of clinical epidemiology and was thus primarily a reflection of his own long-standing diagnostic practices and research agendas. However, the hospitals in Java and America exposed the institutional constraints and limitations of those practices and agendas.

Use of alcohol and drugs with addiction potential among older women and men in a population-based study. The Nord-Trøndelag Health Study 2006-2008 (HUNT3).

BACKGROUND: Little is known about the consumption habits of older adults in Norway with respect to alcohol and the use of drugs with addiction potential, such as benzodiazepines, z-hypnotics and opioids, among regular drinkers. We studied the prevalence of self-reported consumption of alcohol on a regular basis in community-living older men and women (≥ 65 years). Furthermore, we investigated the prevalence of dispensed prescribed drugs with addiction potential in older men and women who were regular drinkers. METHODS: We used data from the Nord-Trøndelag Health Study 2006-2008 (HUNT3). Of 12,361 older adults in the HUNT3 study, 11,545 had answered the alcohol consumption item and were included in our study. Regular drinkers were defined as consuming alcohol one or more days a week. Data on dispensed drugs with addiction potential were drawn from the Norwegian Prescription Database. Addiction potential was defined as at least one prescription for benzodiazepines, z-hypnotics or opioids during one year for a minimum of two consecutive years. RESULTS: In total 28.2% of older Norwegian adults were regular drinkers. Men in the study were more likely to be regular drinkers than women. Drugs with addiction potential were used by 32.4% of participants, and were more commonly used by women. Nearly 12% of participants used benzodiazepines, 19% z-hypnotics and 12.4% opioids. Among regular drinkers, 29% used drugs with addiction potential, which was also more common among women. Adjusted for age, gender and living situation, use of z-hypnotics was associated with regular alcohol intake, while use of opioids was associated with no regular alcohol intake. CONCLUSION: The prevalence of the use of drugs with addiction potential was high in a Norwegian population of older adults who reported regular consumption of alcohol. Strategies should be developed to reduce or prevent alcohol consumption among older adults who use drugs with addiction potential.

The Psychohistory of Child Maltreatment Among Antebellum Slaveholders: Part II.

In the psychohistory of the antebellum South, the extent of child abuse in slaveholder families is important for understanding how members of the southern elite were reared and the extent to which they were infected with the toxic residue of their elders' passions and rages. It is argued that the Old South was a developing region, rather than an already developed one. Consequently, the rate of child abuse that is characteristic of contemporary postindustrial societies is not the proper paradigm for conceptualizing the abuse rate in slaveholder families. It is proposed instead that the rate of child abuse in contemporary developing societies is a better fit for estimating abuse in the antebellum South. Societal and familial variables impinging on the abuse of slaveholder children­corporal punishment, alcohol consumption, hyper-masculinity, a traumatogenic culture of violence, wife abuse, maternal ambivalence and neglect, miscegenation and incest are discussed, as is the likelihood of maltreatment by slaves. Using a study of child abuse across 28 nations, tentative rates of abuse are proposed.

History and the future: Looking back to look forward?

History is often dismissed as of little utility in the analysis of policy. This paper provides a justification for its use as evidence. It surveys the rise of the use of history, including public history and history and policy. It looks at two issues which draw on the author's own work: the relationship between regulation and culture for smoking and alcohol; and the response to electronic cigarettes in the light of smoking and public health history. It analyses what history can contribute. Responses are time dependent and change is an essential parameter in understanding policy. Historical research can challenge stereotypes, for example that prohibition was abandoned because it 'failed'. It also forms the bedrock of historical interpretation, which is mutable and often misunderstood outside the profession. History provides policy analysis rather than policy prescription and is a challenging approach, not just a convenient support for established positions. The paper concludes that history is far from moribund as a policy science.