Co-occurrence of alcohol and cigarette use among adolescents.

Concurrent use of alcohol and cigarettes among adolescents is a serious public health issue. Trends in concurrent use of alcohol and cigarettes were determined using data from three comparable large statewide samples of 7-12th-grade students in New York State, from surveys conducted in 1983, 1990, and 1994. The prevalence of use of alcohol and cigarettes decreased from 1983 (23%) to 1990 (19%), and increased by 1994 (22%). Logistic regression analysis showed that these trends are highly significant, and that the probability of use of alcohol and cigarettes is higher for females than males, increases with age, and is lower for most ethnic minorities than for Whites. In the 1990s, Blacks, Hispanics, and Asians increased in their probability of concurrent use more than did Whites. Users of both alcohol and cigarettes are at increased risk of personal and social problems, as well as increased risk of delinquency. Drinking and smoking show synergistic effects on illicit drug use and drug problems.

Trends in combinational use of alcohol and illicit drugs among minority adolescents, 1983-1994.

Combinational use of substances refers to taking two or more substances together so that they affect the person at the same time. This pattern of substance use presents unique health and safety risks. Trends in combinational use of alcohol and marijuana or alcohol and cocaine were determined using data from three large comparable samples of students in grades 7-12 in New York State, from surveys conducted in 1983, 1990, and 1994. Each of the three samples was demographically diverse, permitting detailed analysis of trends in various adolescent subgroups according to gender, grade level (age), and race/ethnicity. These two forms of adolescent combinational use of alcohol and illicit drugs dropped sharply from 1983 to 1990, but increased or remained stable from 1990 to 1994. Use of alcohol and marijuana together increased sharply from 1990 to 1994, much more for blacks and Hispanics than for whites, while use of alcohol and crack or cocaine together remained stable at a low level in the 1990s. Both forms of combinational use increased in the 1990s more among younger adolescents than among older ones. Analyses controlling for rates of use also suggest that these forms of combinational use are incidental to the use of the individual substances, rather than uniquely sought "highs." Prevention programs should include warnings about the dangers of combinational use, especially for younger adolescents.

Alcohol and crime in China.

This study examines the pattern of alcohol involvement across violent and property crimes in China. We describe and discuss the cultural and biological differences between Chinese and Westerners concerning alcohol and the features of Chinese culture concerning violence. Drawing upon the disinhibition perspective in alcohol and crime, a specific hypothesis derived from the sociocultural context of Chinese society is that alcohol is more likely to be involved with violent crime than with property crime. Using data from a survey of inmates in China, we assess this hypothesis and the possible variables that may moderate this hypothesis. The data support the hypothesis that disinhibition is applicable to the alcohol-violence relationship in Chinese culture. However, the predicted pattern of alcohol use in violent and property crimes does not vary across different offender groups, which is inconsistent with some United States research. A tentative explanation is provided for this inconsistency.

Prevalence and determinants of alcohol-related problems.

In this study, we sought to determine what factors, in addition to alcohol consumption, were the best predictors of social and physical alcohol-related problems. Variables examined as possible predictors of problems included circumstances under which people drink, feelings of alienation, and religious affiliation. Data for this study were collected continually from 1984 to 1989 using a random telephone survey of 2094 New York State residents aged 18 or older; the study sample was comprised of the 1076 who had consumed alcohol in the previous 30 days. Stepwise regression analyses examined the main effects of all possible predictors of problems while controlling for alcohol consumption. Forced-entry regressions examined interaction effects of problem predictors while controlling for basic demographics. Drinking with breakfast, smoking marijuana, and drinking in bars alone were all significant predictors of more problems. This suggests that problems are associated with an aberrant lifestyle (i.e., different from a typical lifestyle), although it makes no assumption about motivations. Further investigation of this subject area is warranted to ascertain which population subgroups are the most vulnerable to alcohol-related problems and to guide the design of prevention programs.

Alcohol consumption and alcohol dependence in adults in New York State.

This objective of this study was to assess the differences by gender, age, race in the relationship between alcohol consumption and current alcohol dependence among adults in the general population. Logistic regression showed that, at levels of alcohol consumption below about six drinks per day, males have a higher probability of alcohol dependence than females, but that above about six drinks per day, females have a higher probability. Older adults are at less risk of dependence than younger drinkers; however, blacks and whites did not differ in their probability of dependence. Possible explanations for these results are discussed.

Trends in adolescent alcohol and other substance use: relationships to trends in peer, parent, and school influences.

The aim of this study is to improve understanding of trends in adolescent substance use by comparing them with trends in peer substance use, school problem behavior, parental disapproval of alcohol and drugs, and exposure to school prevention information. These trends were determined using data from three large comparable representative surveys of 7-12th grade students in New York State conducted in 1983, 1990, and 1994. Analysis of variance was used to test the significance of the trends and to identify meaningful differences in trends by demographic subgroups (gender, grace level, and ethnicity). Adolescent alcohol and substance use declined in the 1980s, then increased from 1990 to 1994. Trends in friend's substance use and school problem behavior paralleled the alcohol and other substance use trends, consistent with their being part of the same adolescent problem behavior syndrome. Parental disapproval also followed a trend consistent with the substance use trends, i.e., parental disapproval increased in the 1980s but then decreased in the 1990s. However, the trend in school prevention influences did not parallel these substance use trends: student exposure to school primary prevention programs continued to increase from 1990 to 1994. Use of alcohol, cigarettes, marijuana, and other illicit drugs from 1990 to 1994, increased fastest among the younger students, despite increased school prevention exposure. Other factors must be sought as possible explanations of the increasing alcohol and substance use among adolescents.

The influence of parental drinking and closeness on adolescent drinking.

OBJECTIVE: This study examines the relationship of parental drinking and adolescent's closeness to parents to adolescent drinking behavior by focusing on three related issues: (1) the independent effects of parental drinking and closeness to parents on adolescent drinking, (2) the mediating role of closeness to parents for the effect of parental drinking, and (3) their interactive effects. METHOD: The issues were addressed with use of data from 378 respondents in a random-digit dialing sample of 625 male adolescents at age range 16 to 19 in the Buffalo area. Mother's and father's drinking and adolescent's closeness to mother and father were measured separately. Regression analyses were used to assess the effects of these measures on adolescent drinking regarding the three related issues. RESULTS: Only father's drinking has a direct effect on adolescent drinking. Although closeness to mother is a significant protection against adolescent drinking, mother's drinking has no effect on closeness to mother. In contrast, father's drinking has a significant effect on closeness to father, but closeness to father has no direct effect on adolescent drinking. Therefore, there is no mediating role of closeness to parents for the effect of parental drinking. Finally, there is an interaction between mother's drinking and closeness to mother, which indicates that adolescents whose mothers are heavy drinkers and who have low closeness to their mothers drink more heavily. CONCLUSIONS: Findings suggest that for the mother and the father there are different patterns of the relationship between parental drinking and closeness at work in explaining adolescent drinking.

Gambling and alcohol use among youth: influences of demographic, socialization, and individual factors.

Gambling and alcohol use are both prevalent among youth and these behaviors may have common predictors within four domains: sociodemographic, individual/psychological, socialization (parental and peer), and other problem behavior. Data were from two household samples of youth in the Buffalo, NY area. Both studies included the same measures of alcohol consumption and gambling frequency, and comparable measures of variables in the four domains. Multivariate analyses of variance revealed that impulsivity, moral disengagement, and delinquency (adolescent or peer delinquency) predicted alcohol consumption and gambling in both studies, even after controlling for demographic factors. Parental monitoring, cigarette use, and illicit drug use predicted alcohol consumption in both studies, but did not predict gambling once the demographic and individual factors were taken into account.

An outcome evaluation of a hospital-based early intervention program.

AIM: To determine the effectiveness of the Health Care Intervention Service (HIS), an early intervention program for general hospital patients with alcohol dependence or at risk for alcohol dependence. DESIGN, SETTING AND PARTICIPANTS: HIS consists of screening, assessment and assignment to either full or risk-reduction intervention. Full intervention includes a referral to treatment. Outcomes were compared across three groups: those who received a full intervention, those who received a risk-reduction intervention, and a comparison group of similar patients from hospitals with no HIS program. Patients were screened for alcohol involvement and interviewed during their hospitalization (prior to the intervention in HIS hospitals) and again 6 months following the intervention. FINDINGS: Full intervention was effective in increasing the probability of abstinence, reducing the number of heavy drinking days, and encouraging patients to accept the referral to treatment. Risk-reduction intervention was effective in reducing alcohol consumption and consequences, but only for those patients who had some signs of dependence at the first interview. CONCLUSIONS: HIS has demonstrated its effectiveness in a "real world" bureaucratic and clinical environment.

Alcohol, intelligence and violent crime in young males.

Research has demonstrated a relationship between alcohol and violent behavior, but proof of a causal connection remains elusive. A recent review concluded that the key task that remained was to identify sub-groups of the population for which alcohol promotes violence. Because alcohol might induce violence by causing cognitive disruption (e.g., misunderstood communication), less intelligent persons could be vulnerable because they start out closer to the lower limit of comprehension. Our objective is to investigate the effect of lower intelligence on the alcohol/violence relationship. This analysis uses data from the Buffalo Longitudinal Study of Young Men to investigate this hypothesis. Males, 16 to 19 years of age (N = 596), were selected from Buffalo, NY, by random digit dialing. High-risk males were oversampled. Two interviews were conducted 18 months apart, including drinking, criminal offenses, and psychological traits. Verbal intelligence was measured by the Ammons Quick Test and visual-motor intelligence by the Trail Making Test. An analysis of covariance was conducted with wave 2 average alcohol consumption and both measures of intelligence as independent variables, violent offending as the dependent variable, and race, wave 1 alcohol and wave 1 violence as covariates. Results show a positive main effect of wave 2 alcohol consumption, but also interactions with both verbal and visual-motor intelligence. These interactions indicate that the prevalence of violence increases significantly at low intelligence and high alcohol consumption levels. A parallel analysis with nonviolent offending as the dependent variable failed to find significant interactions. The combination of heavy drinking and lower intelligence is associated with a synergistic surge of violent behavior.

The nexus between alcohol and violent crime.

The present study examines the nexus between alcohol and violent crime by specifying alcohol as a moderating variable that may interact with other major causes of violent crime. Four major causes of violent crime at the individual level are identified: deviant motives or attitudes, aggression and hostility, impulsivity, and problem-solving ability. Analyses are conducted at two levels of aggravated assault: prevalence of assault and frequency of assault. At the level of prevalence of assault, data indicate that the usual drinking pattern does not constitute an independent cause, but has significant interactions with two of the major causes: deviant attitudes and aggression and hostility. However, in the analysis of the frequency of assault, the findings indicate a pattern that both usual drinking pattern and drinking before offending have independent explanatory power for aggravated assault, but no interactions were found. These findings suggest that alcohol may have different roles in explaining different levels of violent offending.

Changes in alcohol use and alcohol-related problems among 7th to 12th grade students in New York State, 1983-1994.

Three comparable representative samples of 7th to 12th grade students in New York State were surveyed in 1983, 1990, and 1994 to determine changes in the patterns of alcohol use over the past decade. Each of the three samples was large (n = 27,335, 23,860, and 19,321, respectively), permitting detailed analysis of changes in alcohol use in various adolescent subgroups according to age, gender, and race/ethnicity. Previous research revealed that there were marked decreases in the prevalence of overall drinking, heavy drinking, and alcohol-related problems from 1983 to 1990, yet recent national reports indicate that since 1990 there has been an upsurge in substance use among adolescents. Whereas the proportion of drinkers did not significantly increase between 1990 and 1994, average consumption, heavy drinking, and alcohol-related problems all showed modest, but significant increases in the 1990s. Furthermore, between 1990 and 1994, the age distributions for alcohol use, heavy drinking, and alcohol problems changed, as evidenced by significant age by year of survey interactions. These findings indicate that adolescents are currently drinking, drinking heavily, and experiencing alcohol-related problems at younger ages that they were in past years. Prevention efforts should be targeted at delaying alcohol use in early adolescence.

Factors affecting the discriminant function analysis of blood chemistry profiles.

The discriminant function analysis (DFA) of a battery of blood chemistry tests is generally more sensitive and specific than single biochemical test in detecting alcoholism or hazardous drinking. This study examined factors affecting the DFA of blood chemistry profiles (BCP) from alcoholics (ALC) in treatment, primary care outpatients (PC), and the general population (GP). Our data indicate that of the 32 variables in the BCP, 14 are not correlated with alcohol intake or consequences and can be deleted from the set considered for use in the DFA. Confounding medical conditions in the data set used in the DFA did not adversely affect the correct classification of ALC or heavy drinkers. It was not necessary to use only extreme groups (e.g., alcoholics vs. light drinkers/abstainers) to develop the discriminant function. Transformation of some blood variables greatly improved the selection of key variables in the DFA. Another finding was that there was little benefit from fitting the DFA to the demographics of subjects. When the BCP was combined with the results of a brief questionnaire, the TWEAK, it only improved slightly the classification power of the DFA based only on the TWEAK questions.

Peer and parental influences on male adolescent drinking.

Using data from males aged 16-19 in Buffalo, NY, the present study examines two social mechanisms by which parents and peers influence adolescent drinking--behavioral and attitudinal transmission--and compares the patterns of behavioral and attitudinal transmission for parents and for peers. The study also assesses the relative importance of parents and peers in accounting for adolescent alcohol behavior. The findings indicate that both alcohol behavior and attitudes of parents and peers are significant predictors of adolescent drinking. However, the prediction patterns are reversed. Parental attitudes are more important than parental alcohol behavior, while peer alcohol behavior is more important than peer attitudes. Overall, peers have more influence on adolescent drinking than parents. There is a significant interaction of parental alcohol-related attitudes and age, which indicates that parental alcohol-related attitudes exert a greater effect on younger (i.e., age 16-17) males' alcohol use.

Alcohol consumption among the elderly in a general population, Erie County, New York.

OBJECTIVES: Relatively few studies of drinking among the elderly have been completed despite the growing proportional representation of the elderly in the US population. This study sought to estimate the prevalence of and to observe whether active or health-oriented lifestyles are associated with heavy drinking among the elderly. METHODS: Random-digit dialing telephone interviews were conducted with 2325 Erie County, New York, general population residents aged 60 years or older. RESULTS: The prevalence of heavy drinking was 6%. Adjusted analyses showed positive associations between heavy drinking and being male, having suburban residency, and currently using cigarettes. Negative relationships were observed between heavy drinking and socioeconomic status, rural residency, and degree of health orientation. Age and level of active lifestyle were not significant contributors to the model. CONCLUSIONS: Of the studied variables, health orientation offers the greatest opportunity to address heavy drinking among the elderly.

Detection of alcohol problems in primary care outpatients under different conditions.

Outpatients from two primary care clinics in a county hospital were screened for alcohol problems under three conditions. The objective was to determine whether patients would report more drinking and alcohol-related problems if self-report information was gathered in a research setting and/or if patients knew that their doctors would not be informed about their self-reports. The data indicate that patients' self-reports of alcohol consumption or problems were not affected by their knowledge that doctors would know their responses, and that interviews conducted in medical settings did not corrupt self-report data.

Alcohol and other drug use among Hispanics in New York State.

Surveys have generally shown that Hispanics in the United States have lower than the national average rates of drinking, along with average rates of heavy drinking and drug use. Acculturation has been shown to be related to drinking and drug use. This study reports results from a large general population telephone survey conducted in New York State. Hispanic New York State residents were lower than the national average in drinking and heavy drinking when demographic variables were held constant. Gender differences in substance use were greater for Hispanics than for non-Hispanics, with males higher than females. Among Hispanic groups, Puerto Ricans were high and Dominicans were low in drug use. Among Hispanics, more frequent use of English was associated with higher drinking and drug use rates. Traditional Hispanic attitudes and closeness to country or origin were not related to substance use.

Drinking, problem drinking and life stressors in the elderly general population.

OBJECTIVE: Research shows that although heavy drinking in the United States is less prevalent among older persons, some maintain or increase heavy drinking. Late-onset heavy drinking is believed to be related to stressors of aging such as retirement or bereavement, particularly when coping resources or social supports are inadequate. This study investigated that relationship. METHOD: In 1990-91, a random-digit-dial telephone survey was conducted with 2,325 Erie County, New York, residents aged 60 or older. Heavy drinkers were oversampled. Questions included demographics, drinking quantity-frequency, alcohol dependence/problems, stressful life events, chronic stresses, coping resources and social supports. Analyses were conducted to examine the relationship between drinking and stress. RESULTS: There was no bivariate correlation between average alcohol consumption and acute or chronic stress. Logistic regressions with interaction terms show that stress has no relationship to heavy drinking (average alcohol consumption of 2+ drinks/day) regardless of coping style or social supports. Logistic regressions predicting late-onset heavy drinking also produced negative results. Chronic stress was, however, positively related to alcohol dependence and problems. CONCLUSIONS: Treatment and prevention programs for the elderly should not be based on the assumption that life stresses are a direct cause of drinking, although they may exacerbate consequences of drinking.

Gender comparisons of alcohol consumption in alcoholic and nonalcoholic populations.

The purpose of this study was to examine the similarities and differences between male and female drinkers in terms of the estimated functional impact of alcohol intake on drinking occasions. Alcohol consumption on drinking occasions was documented in male and female alcoholics and occasional drinkers in face-to-face interviews and also in a general population statewide sample by means of a telephone survey. Expression of ethanol intake in terms of grams of ethanol consumed per kilogram of total body water yielded data consistent with the notion that blood concentrations of ethanol achieved by females on drinking occasions may have been quite similar to the values achieved by males. However, important gender differences were also found in terms of an older age of onset of regular drinking, less frequent alcohol intake and a higher percentage of abstainers among females.