ONGOING RESEARCH

Type Title Summary / Abstract Keywords Type of Research Author / Principle Investigator Completion Date
Paper The impact of international trade treaties on alcohol policy This paper, which is currently unfinished, will explore the way in which international trade treaties have impacted on alcohol policies, with a particular focus on the EU and TTIP. Industry research, Politics Public Report Jon Foster
Project Family Drinking While there is a significant amount of knowledge about the harms that children of dependent drinkers are exposed to, little is known about whether children are impacted by lower levels of parental drinking. This project aims to investigate whether a spectrum of impacts can be found across the range of parental drinking levels. Family interventions, Harm to others, Parenting Jon Foster 01/10/2016 01/04/2016
Paper Alcohol Consumption and Longitudinal Trajectories of Physical Functioning in Central and Eastern Europe: A 10-Year Follow-up of HAPIEE Study BACKGROUND: Physical functioning (PF) is an essential domain of older persons' health and quality of life. Health behaviors are the main modifiable determinants of PF. Cross-sectionally, alcohol consumption appears to be linked to better PF, but longitudinal evidence is mixed and very little is known about alcohol consumption and longitudinal PF trajectories. METHODS: We conducted longitudinal analyses of 28,783 men and women aged 45-69 years from Novosibirsk (Russia), Krakow (Poland), and seven towns of the Czech Republic. At baseline, alcohol consumption was measured by a graduated frequency questionnaire and problem drinking was evaluated using the CAGE questionnaire. PF was assessed using the Physical Functioning Subscale of the SF-36 instrument at baseline and three subsequent occasions. Growth curve modeling was used to estimate the associations between alcohol consumption and PF trajectories over 10-year follow-up. RESULTS: PF scores declined during follow-up in all three cohorts. Faster decline in PF over time was found in Russian female frequent drinkers, Polish female moderate drinkers, and Polish male regular heavy drinkers, in comparison with regular and/or light-to-moderate drinkers. Nondrinking was associated with a faster decline compared with light drinking only in Russian men. Problem drinking and past drinking were not related to the decline rate of PF. CONCLUSIONS: This large longitudinal study in Central and Eastern European populations with relatively high alcohol intake does not strongly support the existence of a protective effect of alcohol on PF trajectories; if anything, it suggests that alcohol consumption is associated with greater deterioration in PF over time. Abstinence, Epidemiology, Longitudinal, Moderate drinking, Physical functioning, Trajectories Jornal Article Yaoyue Hu
Paper Adverse Childhood Experiences and Alcohol Consumption in Midlife and Early Old-Age Aims: To examine the individual and cumulative effects of adverse childhood experiences (ACEs) on alcohol consumption in midlife and early old-age, and the role of ACEs in 10-year drinking trajectories across midlife. Methods: Data were from the Whitehall II study, a longitudinal British civil service-based cohort study (N = 7870, 69.5% male). Multinomial logistic regression was used to examine the individual and cumulative effects of ACEs on weekly alcohol consumption. Mixed-effect multilevel modelling was used to explore the relationship between ACEs and change in alcohol consumption longitudinally. Results: Participants who were exposed to parental arguments/fights in childhood were 1.24 (95% CI 1.06, 1.45) times more likely to drink at hazardous levels in midlife (mean age 56 years) after controlling for covariates and other ACEs. For each additional exposure to an ACE, the risk of hazardous drinking versus moderate drinking was increased by 1.12 (95% CI 1.03, 1.21) after adjusting for sex, age, adult socio-economic status, ethnicity and marital status. No associations between ACEs and increased risk of hazardous drinking in early old-age (mean age 66 years) were found. In longitudinal analyses, ACEs did not significantly influence 10-year drinking trajectories across midlife. Conclusion: The effect of exposure to parental arguments on hazardous drinking persists into midlife. Adverse childhood experiences, Change, Childhood, Epidemiology, Life course, Longitudinal, Older people, Trajectories Jornal Article Jessica Pui Kei Leung
Project The effectiveness of promotional campaigns associated with revised UK drinking guidelines: A prospective evaluation Alcohol is a major public health problem. In the UK, there were 8,416 deaths and over a million hospital admissions due to alcohol in 2013. Treating alcohol-related problems costs the NHS approximately £3.5 billion a year. Internationally, a common approach to reducing alcohol consumption is to publish low risk drinking guidelines (DG). These aim to tell the public about the risks of drinking above a particular amount of alcohol and encourage healthier drinking behaviours. DG are promoted in various ways including TV advertising campaigns, putting information on bottle labels and by doctors discussing drinking with their patients. Despite their widespread use, little is known about whether promoting DG affects people s behaviour or how they think about alcohol. Research opportunities are rare as DG are not updated very often and the last UK revisions occurred in 1995. However, in 2012, the UK Government s Alcohol Strategy announced that the country s DG would be reviewed. That review is on-going and new DG may be published in early 2016. We propose to evaluate what impact promoting the new DG has on the alcohol consumption of adults living in England. We will also examine whether there are any impacts on the way people think about alcohol (e.g. their knowledge of the risks of heavy drinking or how motivated they feel to drink less). The way people think about alcohol is important as changing this may be a first step to changing behaviour. Information on the impacts of promoting revised DG will come from survey data collected each month between March 2014 and October 2017. We will examine whether there are changes over time in how much people drink or in the way they think about alcohol. We will also collect data on which activities promoting the DG occur using interviews with people like NHS managers, Public Health England and alcohol charities. This information will be used to examine whether promotional activities coincide with changes in the survey data. A discussion group of adult drinkers from the general public has been established by the UK Centre for Tobacco and Alcohol Studies. This group will be asked to contribute to the project by, for example, advising on survey questions and suggesting additional areas for research based on the guidelines that are published and the promotional activity that occurs. The discussion group will also be asked to contribute to the interpretation of findings and identifying the key messages which should be communicated from the project. The results of the study will help governments when making decisions about which alcohol policies are most effective in improving public health. People running campaigns promoting public health guidance will also benefit by learning about the effects of different types of guidance. The results of the study will be communicated to a wide range of people by publishing papers in scientific journals and presenting to national and international conferences attended by different groups who may be interested (including the general public). We will make particular efforts to ensure people who promote public health guidance hear about the project so they can use the findings when designing promotional material. Finally, our research team has a strong track record in attracting news coverage of our work which helps the general public to hear about it. We will work with Sheffield s media team to promote our findings to journalists. Drinking guidelines, Policy evaluation John Holmes 31/10/2018 01/11/2015
Paper Comparison of brief interventions in primary care on smoking and excessive alcohol consumption: A population survey in England Background Brief interventions have a modest but meaningful effect on promoting smoking cessation and reducing excessive alcohol consumption. Guidelines recommend offering such advice opportunistically and regularly but incentives vary between the two behaviours. Aim To use representative data from the perspective of patients to compare the prevalence and characteristics of people who smoke or drink excessively and who receive a brief intervention. Design and setting Data was from a representative sample of 15 252 adults from household surveys in England. Method Recall of brief interventions on smoking and alcohol use, sociodemographic information, and smoking and alcohol consumption patterns were assessed among smokers and those who drink excessively (AUDIT score of ≥8), who visited their GP surgery in the previous year. Results Of 1775 smokers, 50.4% recalled receiving brief advice on smoking in the previous year. Smokers receiving advice compared with those who did not were more likely to be older (odds ratio [OR] 17-year increments 1.19, 95% confidence interval [CI] =1.06 to 1.34), female (OR 1.35, 95% CI =1.10 to 1.65), have a disability (OR 1.44, 95% CI = 1.11 to 1.88), have made more quit attempts in the previous year (compared with no attempts: one attempt, OR 1.65, 95% CI = 1.32 to 2.08; ≥2 attempts, OR 2.02, 95% CI =1.49 to 2.74), and have greater nicotine dependence (OR 1.17, 95% CI =1.05 to 1.31) but were less likely to have no post-16 qualifications (OR 0.81, 95% CI = 0.66 to 1.00). Of 1110 people drinking excessively, 6.5% recalled receiving advice in their GP surgery on their alcohol consumption in the previous year. Those receiving advice compared with those who did not had higher AUDIT scores (OR 1.17, 95% CI =1.12 to 1.23) and were less likely to be female (OR 0.44, 95% CI = 0.23 to 0.87). Conclusion Whereas approximately half of smokers in England visiting their GP in the past year report having received advice on cessation, <10% of those who drink excessively report having received advice on their alcohol consumption. alcohol drinking, brief advice, Brief Intervention, counselling, Smoking Jornal Article Brown, J
Paper Impacts of drinking-age legislation on alcohol-impaired driving crimes among young people in Canada, 2009–13 Background and aim In Canada, the minimum legal drinking age (MLDA) is 18 years in Alberta, Manitoba and Québec and 19 in the rest of the country. Given that public health organizations have not only recommended increasing the MLDA to 19 years, but also have identified 21 years as ideal, the current study tested whether drivers slightly older than the MLDA had significant and abrupt increases in alcohol-impaired driving (AID) crimes, compared with their counterparts just younger than the MLDA. Design Regression–discontinuity approach. Setting Canada. Sample AID criminal incidents by drivers aged 15–23 years (female, n =10706;male,n =44973).Measurements Police-reported AID incidents from the Canadian 2009–13 Uniform Crime Reporting Survey. Findings Significant gender × MLDA effects supported gender-specific models. Compared with males slightly younger than the MLDA, those just older had abrupt increases in AID incidents of 42.8% [95% confidence interval (CI) = 20.4–66.3%, P < 0.001], 28.1% (95% CI = 16.0–40.7%, P < 0.001) and 35.1% (95% CI = 22.4–48.4%, P < 0.001) in provinces with an MLDA of 18 years, 19 years and across the country, respectivel y. Among females, AID incidents increased by 39.9% (95% CI = 1.9–79.6%, P = 0.040) in provinces with an MLDA of 18 years, and b y 19.4% (95% CI = 2.1–37.4%, P = 0.028) at the national level. Concl us ion R elease from drinking-age restrictions appears to be associated with increases in alcohol-impaired dri ving offenses among y oung drivers in Canada, ranging from 28 to 43% among males and from 19 to 40% among females. PhD Russ Callaghan
Paper Estimating under- and over-reporting of drinking in national surveys of alcohol consumption: identification of consistent biases across four English-speaking countries Background and Aims Questions about drinking ‘yesterday’ have been used to correct under-reporting of typical alcohol consumption in surveys. We use this method to explore patterns of over- and under-reporting of drinking quantity and frequency by population subgroups in four countries. Design Multivariate linear regression analyses comparing estimates of typical quantity and frequency of alcohol consumption with and without adjustments using the yesterday method. Setting and Participants Survey respondents in Australia (n = 26 648), Canada (n = 43 371), USA (n = 7969) and England (n = 8610). Measurements Estimates of typical drinking quantities and frequencies over the past year plus quantity of alcohol consumed the previous day. Findings Typical frequency was underestimated by less frequent drinkers in each country. For example, after adjustment for design effects and age, Australian males self-reporting drinking ‘less than once a month’ were estimated to have in fact drunk an average of 14.70 (± 0.59) days in the past year compared with the standard assumption of 6 days (t = 50.5, P < 0.001). Drinking quantity ‘yesterday’ was not significantly different overall from self-reported typical quantities during the past year in Canada, the United States and England, but slightly lower in Australia (e.g. 2.66 versus 3.04 drinks, t = 20.4, P < 0.01 for women). Conclusions People who describe themselves as less frequent drinkers appear to under-report their drinking frequency substantially, but country and subgroup-specific corrections can be estimated. Detailed questions using the yesterday method can help correct under-reporting of quantity of drinking. PhD Tim Stockwell
Project Epidemiology of Fetal Alcohol Spectrum Disorders (FASD) and alcohol use in pregnancy My thesis explores the epidemiology of fetal alcohol spectrum disorders (FASD) and alcohol use in pregnancy. Epidemiology, Fetal alcohol spectrum disorders, Prenatal alcohol exposure Cheryl McQuire
Paper Adolescent smoking and tertiary education: opposing pathways linking socio-economic background to alcohol consumption Background and Aims If socio-economic disadvantage is associated with more adolescent smoking, but less participation in tertiary education, and smoking and tertiary education are both associated with heavier drinking, these may represent opposing pathways to heavy drinking. This paper examines contextual variation in the magnitude and direction of these associations. Design Comparing cohort studies. Setting United Kingdom. Participants Participants were from the 1958 National Child Development Study (NCDS58; n = 15 672), the British birth cohort study (BCS70; n = 12 735) and the West of Scotland Twenty-07 1970s cohort (T07; n = 1515). Measurements Participants self-reported daily smoking and weekly drinking in adolescence (age 16 years) and heavy drinking (> 14/21 units in past week) in early adulthood (ages 22–26 years). Parental occupational class (manual versus non-manual) indicated socio-economic background. Education beyond age 18 was coded as tertiary. Models were adjusted for parental smoking and drinking, family structure and adolescent psychiatric distress. Findings Respondents from a manual class were more likely to smoke and less likely to enter tertiary education (e.g. in NCDS58, probit coefficients were 0.201 and –0.765, respectively; P < 0.001 for both) than respondents from a non-manual class. Adolescent smokers were more likely to drink weekly in adolescence (0.346; P < 0.001) and more likely to drink heavily in early adulthood (0.178; P < 0.001) than adolescent non-smokers. Respondents who participated in tertiary education were more likely to drink heavily in early adulthood (0.110 for males, 0.182 for females; P < 0.001 for both) than respondents with no tertiary education. With some variation in magnitude, these associations were consistent across all three cohorts. Conclusions In Britain, young adults are more likely to drink heavily both if they smoke and participate in tertiary education (college and university) despite socio-economic background being associated in opposite directions with these risk factors. alcohol, Education, Life course, pathways, Smoking, socioeconomic position Jornal Article Michael J Green
Paper A systematic review of alcohol screening and assessment measures for young people: a study protocol Introduction Alcohol consumption creates a significant public health burden, and young people who drink alcohol place themselves at risk of harm. Expert guidance and reviews have highlighted the pressing need for reliable and valid, age-appropriate alcohol screening and assessment measures for young people. The proposed systematic review will evaluate existing alcohol screening and assessment measures for young people aged 24 and under. Methods and analysis Six electronic databases will be searched for published and grey literature. In addition, reverse and forward citation searching and consultation with experts will be performed. Three sets of search terms will be combined, including alcohol use/problems, young people and validation studies. The titles and abstracts of reports from the searches will be screened, and potentially relevant full-text reports will be retrieved and independently assessed for inclusion by two reviewers based on prespecified criteria. Discrete validation studies within included reports will then be assessed for eligibility. There will be an a priori basic quality threshold for predictive validity, internal and test–retest for studies to warrant full data extraction. Studies above the quality threshold will be assessed for quality using the modified consensus-based standards for the selection of health measurement instruments checklist and a quality assessment tool for diagnostic accuracy studies. Dissemination This review will highlight the best performing measures both for screening and assessment based on their psychometric properties and the quality of the validation studies supporting their use. Providing clear guidance on which existing measures perform best to screen and assess alcohol use and problems in young people will inform policy, practice and decision-making, and clarify the need for further research. Trial registration number International Prospective Register of Systematic Reviews, CRD42016053330. Jornal Article Paul Toner