Exploring experiences with alcohol and how drinking has changed over time among minority ethnic groups with a diagnosed mental health problem.

INTRODUCTION: Minority ethnic groups are more likely to experience poor mental health but less likely to seek formal support. Mental health problems and alcohol use (including non-drinking) co-occur, the reasons for this among minority ethnic groups are not well understood. This study explored i) alcohol use among minority ethnic individuals with a mental health problem,ii) how alcohol was used before individuals received support for their mental health,iii) how alcohol changed whilst and after individuals received treatment for their mental health. METHODS: Participants were purposively sampled through community/online mental health organisations. Participants took part if they i)were not White British, ii) had a mental health diagnosis, iii) drank at hazardous and above levels or former drinkers. Telephone/online semi-structured interviews were conducted. Data were analysed using framework analysis with an intersectional lens. RESULTS: 25 participants took part. Four themes were developed; "drinking motivations", "mental health literacy and implications on drinking behaviour", "cultural expectations and its influence on mental health problems and drinking practices", and "reasons for changes in drinking". Themes reflect reasons for drinking and the role of understanding the range of mental health problems and implicit cultural expectations. An intersectional lens indicated gendered, ethnic and religious nuances in experiences with alcohol and seeking support. Engaging with formal support prompted changes in drinking which were facilitated through wider support. CONCLUSION: There were specific reasons to cope among minority ethnic individuals who have a mental health problem. Applying an intersectional lens provided an insight into the role of cultural and gendered expectations on mental health and drinking practices. Mental health literacy and implicit cultural expectations within specific minority ethnic groups can affect both mental health and drinking practices. Healthcare professionals and wider community play an important role in prompting changes in drinking among minority ethnic groups who have a mental health problem.

Alcoholic beverage types consumed by population subgroups in the United States: Implications for alcohol policy to address health disparities.

INTRODUCTION: We aimed to identify alcoholic beverage types more likely to be consumed by demographic subgroups with greater alcohol-related health risk than others, mainly individuals with low socio-economic status, racial/ethnic minority status and high drinking levels. METHODS: Fractional logit modelling was performed using a nationally representative sample of US adult drinkers (analytic N = 37,657) from the National Epidemiologic Survey on Alcohol and Related Conditions Waves 2 (2004-2005) and 3 (2012-2013). The outcomes were the proportions of pure alcohol consumed as beer, wine, liquor and coolers (defined as wine-/malt-/liquor-based coolers, hard lemonade, hard cider and any prepackaged cocktails of alcohol and mixer). RESULTS: Adults with lower education and low or medium income were more likely to drink beer, liquor and coolers, while those with a 4-year college/advanced degree and those with high income preferred wine. Excepting Asian adults, racial/ethnic minority adults were more likely to drink beer (Hispanics) and liquor (Blacks), compared with White adults. High- or very-high-level drinkers were more likely to consume liquor and beer and less likely to consume wine (and coolers), compared with low-level drinkers. High-level and very-high-level drinkers, who were less than 10% of all drinkers, consumed over half of the total volume of beer, liquor and coolers consumed by all adults. DISCUSSION AND CONCLUSIONS: Individuals with low socio-economic status, racial/ethnic minority status or high drinking level prefer liquor and beer. As alcohol taxes, sales and marketing practices all are beverage-specific, targeted approaches to reduce consumption of these beverages, particularly among individuals with these profiles, are warranted.

The Association between State-Level Structural Racism and Alcohol and Tobacco Use Behaviors among a National Probability Sample of Black Americans.

BACKGROUND: Structural racism is how society maintains and promotes racial hierarchy and discrimination through established and interconnected systems. Structural racism is theorized to promote alcohol and tobacco use, which are risk factors for adverse health and cancer-health outcomes. The current study assesses the association between measures of state-level structural racism and alcohol and tobacco use among a national sample of 1,946 Black Americans. METHODS: An existing composite index of state-level structural racism including five dimensions (subscales; i.e., residential segregation and employment, economic, incarceration, and educational inequities) was merged with individual-level data from a national sample dataset. Hierarchical linear and logistic regression models, accounting for participant clustering at the state level, assessed associations between structural racism and frequency of alcohol use, frequency of binge drinking, smoking status, and smoking frequency. Two models were estimated for each behavioral outcome, one using the composite structural racism index and one modeling dimensions of structural racism in lieu of the composite measure, each controlling for individual-level covariates. RESULTS: Results indicated positive associations between the incarceration dimension of the structural racism index and binge drinking frequency, smoking status, and smoking frequency. An inverse association was detected between the education dimension and smoking status. CONCLUSIONS: Results suggest that state-level structural racism expressed in incarceration disparities, is positively associated with alcohol and tobacco use among Black Americans. IMPACT: Addressing structural racism, particularly in incarceration practices, through multilevel policy and intervention may help to reduce population-wide alcohol and tobacco use behaviors and improve the health outcomes of Black populations.

Genetic correlation for alcohol consumption between Europeans and East Asians.

Genome-wide association studies (GWAS) have identified many genetic variants associated with alcohol consumption in Europeans and East Asians, as well as other populations. However, the genetic homogeneity and heterogeneity between these populations have not been thoroughly investigated, despite evidence of varying effect sizes of variants between ethnicities and the presence of population-specific strong signals of selection on loci associated with alcohol consumption. In order to better understand the relationship between Europeans and East Asians in the genetic architecture of alcohol consumption, we compared their heritability and evaluated their genetic correlation using GWAS results from UK Biobank (UKB) and Biobank Japan (BBJ). We found that these two populations have low genetic correlation due to the large difference on chromosome 12. After excluding this chromosome, the genetic correlation was moderately high ([Formula: see text] = 0.544, p = 1.12e-4) and 44.31% of the genome-wide causal variants were inferred to be shared between Europeans and East Asians. Given those observations, we conducted a meta-analysis on UKB and BBJ and identified new signals, including the CADM2 gene on chromosome 3, which has been associated with various behavioral and metabolic traits. Overall, our findings suggest that the genetic architecture of alcohol consumption is largely shared between Europeans and East Asians, but there are exceptions such as the enrichment of heritability on chromosome 12 in East Asians.

Protective factors in the relationship between perceived discrimination and risky drinking among American Indian adolescents.

INTRODUCTION: The relationship between perceived discrimination and risky drinking among American Indian (AI) youth is understudied, and the potential protective factors that may buffer this association are unknown. Therefore, the objective of this study was to examine protective factors across individual, family, school, peer, and cultural domains of the social ecology that might attenuate the relationship between perceived discrimination and risky drinking among AI adolescents. METHOD: Data were from the Substance Use Among American Indian Youth Study (Swaim and Stanley, 2018, 2021). AI youth who have used alcohol in their lifetime (n = 2516 within 62 schools) had an average age of 15.16 years (SD = 1.75) and 55.5% were female. Five sets of linear regressions were conducted. Risky drinking was regressed on demographic variables, alcohol use frequency, perceived discrimination, one protective factor (religiosity, parental monitoring, peer disapproval of alcohol use, school engagement, and ethnic identity), and one two-way interaction between perceived discrimination and the protective factor. RESULTS: Prevalence of risky drinking among lifetime drinkers was 40.1%. There were positive associations between perceived discrimination and risky drinking in all models (Bs range from.20 to.23; p <.001). Parental monitoring had a negative association with risky drinking (B = -0.255, p <.001). Religiosity was the only statistically significant moderator (B = -0.08, p = 0.01), indicating that religiosity weakened the relation between perceived discrimination and risky drinking. CONCLUSIONS: Religiosity may represent an important protective factor that could help guide efforts to prevent risky drinking in the face of discrimination among AI adolescents.

Alcohol consumption and risks of more than 200 diseases in Chinese men.

Alcohol consumption accounts for ~3 million annual deaths worldwide, but uncertainty persists about its relationships with many diseases. We investigated the associations of alcohol consumption with 207 diseases in the 12-year China Kadoorie Biobank of >512,000 adults (41% men), including 168,050 genotyped for ALDH2- rs671 and ADH1B- rs1229984 , with >1.1 million ICD-10 coded hospitalized events. At baseline, 33% of men drank alcohol regularly. Among men, alcohol intake was positively associated with 61 diseases, including 33 not defined by the World Health Organization as alcohol-related, such as cataract (n = 2,028; hazard ratio 1.21; 95% confidence interval 1.09-1.33, per 280 g per week) and gout (n = 402; 1.57, 1.33-1.86). Genotype-predicted mean alcohol intake was positively associated with established (n = 28,564; 1.14, 1.09-1.20) and new alcohol-associated (n = 16,138; 1.06, 1.01-1.12) diseases, and with specific diseases such as liver cirrhosis (n = 499; 2.30, 1.58-3.35), stroke (n = 12,176; 1.38, 1.27-1.49) and gout (n = 338; 2.33, 1.49-3.62), but not ischemic heart disease (n = 8,408; 1.04, 0.94-1.14). Among women, 2% drank alcohol resulting in low power to assess associations of self-reported alcohol intake with disease risks, but genetic findings in women suggested the excess male risks were not due to pleiotropic genotypic effects. Among Chinese men, alcohol consumption increased multiple disease risks, highlighting the need to strengthen preventive measures to reduce alcohol intake.

Exploring substance misuse behaviors among black girls in detention: Intersections of trauma, sex, and age.

High risk substance misuse, trauma and gang involvement are prevalent in adolescents and often occur with youth involved with the youth punishment system. Evidence suggests that system involvement is related to trauma histories, substance misuse, as well as gang involvement. This study investigated the associations between individual and peer factors and their relationship to problem drug and alcohol use among Black girls involved with the youth punishment system. Data were collected from 188 Black girls in detention at baseline, as well as 3 and 6 month follow up periods. Measures assessed were abuse history, trauma history, sex while using drugs and alcohol, age, government assistance, and drug use. Significant findings from the multiple regression analyses indicated that younger girls were more likely to have a higher prevalence of having a drug problem than older girls at baseline. Having sex while on drugs and alcohol at the 3 month follow up period was correlated with drug use. These findings highlight how individual and peer factors can influence problem substance misuse, their behavior and peer relationships among Black girls in detention.

Racial/Ethnic Differences in Psychometric Properties of Alcohol-Related Behaviors in the USA.

OBJECTIVE: Alcohol-related behaviors are often examined using surveys assessing participants' self-report of attitudes/actions. However, racial/ethnic differences exist in scale construction and evaluation, and surveys evaluating alcohol behaviors lack invariance across ethnic groups. These dissimilarities may be due to deep-rooted differences in ethnic classification of unhealthy substance use behaviors. METHODS: We examined factor structure of "Number of days per month drank alcohol in past 12 months," "Number of days had one or more drinks in past 30 days," and "Number of days had four/five or more drinks in past 30 days," administered during the 2017 National Survey on Drug Use and Health. Factorial invariance was examined across 12- to 17-year-old White, Black/African American, Asian American, and Hispanic/Latinx boys and girls endorsing alcohol use. A multigroup confirmatory factor analysis statistically determined whether the factor structure was invariant across groups. RESULTS: The alcohol scale lacked invariance across all groups, indicating racial/ethnic group identification is related to alcohol-related cognitions. CONCLUSIONS: Psychometric properties of scales assessing alcohol-related behaviors generalized across racial/ethnic groups require evaluation.

Predictors of Alcohol Use Among Latinx Men in South Florida: Machismo as a Correlate of Alcohol Use Frequency and Quantity.

Previous studies have found Latinx cultural values to be positively associated with healthy behaviors. This study aims to examine socioeconomic and cultural correlates of alcohol use among Latinx adult men living in Miami-Dade County, Florida. The study sample included 122 Latinx adult men (mean age = 44, SD = 10), predominantly of South and Central American origin. Data was collected using REDCap. Interviews included the Timeline Follow-Back scale for alcohol use. Results indicate that Caribbean participants were significantly less likely to report drinking in the past 90 days (aOR = 0.08, p = 0.042) compared to their Venezuelan counterparts. Higher machismo scores were associated with low drinking frequency (aRR = 0.67, p = 0.043), while no significant associations were found between machismo and other drinking outcomes. Drinking quantity and frequency are significantly associated with higher income and authorized immigration status in the US among Latinx men in South Florida. Higher machismo scores were associated with low drinking frequency.

Alcohol Use Severity among Hispanic Emerging Adults: Examining Intragroup Marginalization, Bicultural Self-Efficacy, and the Role of Gender within a Stress and Coping Framework.

Most research on cultural stressors and alcohol has focused on intercultural stressors. Continuing to exclude intracultural stressors (e.g., intragroup marginalization) from alcohol research will yield a biased understanding of the experiences of Hispanics living in a bicultural society. As we amass more studies on intracultural stressors, research will be needed to identify mutable sociocultural factors that may mitigate the association between intracultural stressors and alcohol. To address these limitations, we examined the association between intragroup marginalization and alcohol use severity and the extent to which gender and bicultural self-efficacy may moderate this association. A convenience sample of 200 Hispanic emerging adults ages 18-25 (men = 101, women = 99) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Higher intragroup marginalization was associated with higher alcohol use severity. Gender functioned as a moderator whereby intragroup marginalization was associated with higher alcohol use severity among men, but not women. Also, higher social groundedness functioned as a moderator that weakened the association between intragroup marginalization and alcohol use severity. Role repertoire did not function as a moderator. Our findings are significant because they enhance the reliability of the association between intragroup marginalization and alcohol use severity, and the moderating effect of gender in this respective association. This emerging line of research suggests that alcohol interventions targeting Hispanics may have a significant limitation by not accounting for intracultural stressors.

Drinking in Mexico by Whites and Hispanics on and off the US/Mexico border in California.

This paper compares drinking patterns of Whites and Hispanics who after crossing the U.S./Mexico border drink and do not drink in Mexico. Data came from a household survey of 1,209 adults 18 to 39 years of age in California. Residence near the US/Mexico border increases the likelihood of drinking in Mexico (AOR = 4.57; 95%CI = 2.45-8.52; p < .001). Hispanics (AOR = 1.91; 95%CI = 1.26-2.90; p < .01), those who drink more frequently (AOR = 1.05; 95%CI = 1.02-1.09; p < .01) and those who drink six or more drinks in day (AOR = 1.91; 95%CI = 1.26-2.29; p < .01) are more likely than Whites and lighter drinkers to report this behavior. Crossing the U.S./Mexico border to drink is influenced by living close to the border, Hispanic ethnicity, and drinking many drinks in a day.

Domains matter: A prospective investigation of traditional feminine gender roles and alcohol use among Latinas.

Scholars suggest traditional feminine gender roles (TFGRs) influence alcohol use among U.S. Latinas, but relevant literature is limited. This two-wave study examined how multi-dimensional internal (i.e., beliefs) and external (i.e., practices) TFGR processes related to drinking among college-bound Latina emerging adults across time. TFGRs characterized by virtue predicted less alcohol engagement, while some TFGR dimensions (e.g., subordinate) predicted more. TFGR practices more strongly predicted cross-sectional alcohol outcomes than TFGR beliefs, although some TFGR beliefs predicted later drinking. These findings highlight the utility of assessing multiple TFGR dimensions and domains to better understand the link between TFGRs and drinking among Latinas.

The copita question: Exploring alcohol consumption among Latina women.

We explored whether Dominican women underreport alcohol consumption according to questionnaire wording and examined factors associated with their alcohol use through structured interviews in Spanish. We measured consumption with the word "alcohol" and with the common colloquialisms "copita/trago/vinito." We used logistic regressions to examine associations between alcohol consumption, demographics, and alcohol-related norms. Of 419 female participants, 411 completed alcohol-related questions. Most (n=343, 83.5%) were current drinkers and 88 (21%) reported having never consumed alcohol but also that they occasionally drink a "copita/trago/vinito." This indicates alcohol use is potentially underreported among Dominican women. Alcohol-related research should incorporate culturally sensitive language to improve accuracy.

Age varying polygenic effects on alcohol use in African Americans and European Americans from adolescence to adulthood.

Genetic effects on alcohol use can vary over time but are often examined using longitudinal models that predict a distal outcome at a single time point. The vast majority of these studies predominately examine effects using White, European American (EA) samples or examine the etiology of genetic variants identified from EA samples in other racial/ethnic populations, leading to inconclusive findings about genetic effects on alcohol use. The current study examined how genetic influences on alcohol use varied by age across a 15 year period within a diverse ethnic/racial sample of adolescents. Using a multi-ethnic approach, polygenic risk scores were created for African American (AA, n = 192) and EA samples (n = 271) based on racially/ethnically aligned genome wide association studies. Age-varying associations between polygenic scores and alcohol use were examined from age 16 to 30 using time-varying effect models separately for AA and EA samples. Polygenic risk for alcohol use was found to be associated with alcohol use from age 22-27 in the AA sample and from age 24.50 to 29 in the EA sample. Results are discussed relative to the intersection of alcohol use and developmental genetic effects in diverse populations.

Racial discrimination, depressive symptoms, ethnic-racial identity, and alcohol use among Black American college students.

BACKGROUND: Racial discrimination is prevalent among Black Americans, and may increase risk for alcohol use and related problems. Understanding the mediating and moderating factors in the pathways linking racial discrimination to alcohol use outcomes is important for prevention and intervention efforts. We tested depressive symptoms as a mediator and ethnic-racial identity as a moderator in the relation between racial discrimination and alcohol use outcomes among Black American young adults. METHODS: We used data from 2 independent samples of Black American young adults recruited from different regions in the United States. The first sample included 383 Black American young adults (Mage = 20.65, SD = 2.28; 81% female), and the second sample included 165 Black American young adults (Mage = 21.56, SD = 4.92; 75% female). RESULTS: Racial discrimination was associated with alcohol consumption and problems indirectly via depressive symptoms across the 2 independent samples. Moderation was evident for one sample such that high private regard levels buffered the association between racial discrimination and alcohol consumption, whereas high public regard levels exacerbated the association between racial discrimination and depressive symptoms. CONCLUSIONS: Racial discrimination experiences put Black American young adults at risk for alcohol use and related problems through increased depressive symptoms. Ethnic-racial identity may buffer or exacerbate these associations depending on the specific dimension. The findings imply the need to target depressive symptoms and alcohol use simultaneously to promote health and well-being among Black Americans. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Alcohol-related suicide across Australia: a geospatial analysis.

BACKGROUND: The acute effects of alcohol consumption are a major risk factor for suicide. Positive blood alcohol concentrations are present in almost one-third of all suicides at time of death. These suicides are defined as alcohol-related suicides. This cross-sectional study examines the geospatial distribution/clustering of high proportions of alcohol-related suicides and reports on socioeconomic and demographic risk factors. METHODS: National Coronial Information System (NCIS) data were used to calculate proportions of suicides with alcohol present at the time of death for each level 3 statistical areas (SA3) in Australia. A density analysis and hotspot cluster analysis were used to visualise and establish statistically significant clustering of areas with higher (hotspots) and lower (coldspots) proportions. Subsequently, socioeconomic and demographic risk factors for alcohol use and suicide were reported on for hot and cold spots. RESULTS: Significant clustering of areas with higher proportions of alcohol-related suicide occurred in northern Western Australia, the Northern Territory and Queensland, as well as inland New South Wales and inland Queensland. Clustering of SA3s with significantly lower proportions occurred in major city and inner regional Sydney and Melbourne. Conclusion and implications for public health: Results from this study identify areas in which prevention strategies should target alcohol use and can be used to inform prevention strategy design. Additionally, hotspots and coldspots identified in this study can be used for further analysis to better understand contextual risk factors for alcohol-related suicide.

Patient self-report versus medical records for smoking status and alcohol consumption at Aboriginal Community Controlled Health Services.

OBJECTIVE: This study assessed the level of agreement, and predictors of agreement, between patient self-report and medical records for smoking status and alcohol consumption among patients attending one of four Aboriginal Community Controlled Health Service (ACCHSs). METHODS: A convenience sample of 110 ACCHS patients self-reported whether they were current smokers or currently consumed alcohol. ACCHS staff completed a medical record audit for corresponding items for each patient. The level of agreement was evaluated using the kappa statistic. Factors associated with levels of agreement were explored using logistic regression. RESULTS: The level of agreement between self-report and medical records was strong for smoking status (kappa=0.85; 95%CI: 0.75-0.96) and moderate for alcohol consumption (kappa=0.74; 95%CI: 0.60-0.88). None of the variables explored were significantly associated with levels of agreement for smoking status or alcohol consumption. CONCLUSIONS: Medical records showed good agreement with patient self-report for smoking and alcohol status and are a reliable means of identifying potentially at-risk ACCHS patients. Implications for public health: ACCHS medical records are accurate for identifying smoking and alcohol risk factors for their patients. However, strategies to increase documentation and reduce missing data in the medical records are needed.

Social network characteristics and alcohol use by ethnic origin: An ego-based network study on peer similarity, social relationships, and co-existing drinking habits among young Swedes.

The study explores how social network determinants relate to the prevalence and frequency of alcohol use among peer dyads. It is studied how similar alcohol habits co-exist among persons (egos) and their peers (alters) when socio-demographic similarity (e.g., in ethnic origin), network composition and other socio-cultural aspects were considered. Data was ego-based responses derived from a Swedish national survey with a cohort of 23-year olds. The analytical sample included 7987 ego-alter pairs, which corresponds to 2071 individuals (egos). A so-called dyadic design was applied i.e., all components of the analysis refer to ego-alter pairs (dyads). Multilevel multinomial-models were used to analyse similarity in alcohol habits in relation to ego-alter similarity in ethnic background, religious beliefs, age, sex, risk-taking, educational level, closure in network, duration, and type of relationship, as well as interactions between ethnicity and central network characteristics. Ego-alter similarity in terms of ethnic origin, age and sex was associated with ego-alter similarity in alcohol use. That both ego and alters were non-religious and were members of closed networks also had an impact on similarity in alcohol habits. It was concluded that network similarity might be an explanation for the co-existence of alcohol use among members of peer networks.

Factors associated with domestic violence in the Lahu hill tribe of northern Thailand: A cross-sectional study.

BACKGROUND: Domestic violence significantly affects physical and mental health, particularly among children, women, and the elderly. Living in certain family environments could lead to victimization by domestic violence, especially among families with a poor socioeconomic status, such as the Lahu hill tribe people in Thailand. This study aimed to estimate the prevalence of and determine the factors associated with domestic violence among Lahu children, women, and the elderly. METHODS: A cross-sectional study was conducted of participants who belonged to the Lahu hill tribe and lived in 20 selected villages in Chiang Rai Province, Thailand. A validated questionnaire was used to collect personal information and information regarding experiences related to domestic violence in the past year from children (aged 5-15 years), women (aged 16-59 years), and the elderly (aged 60 years and over). A binary logistic regression was used to detect associations between the variables. RESULTS: A total of 646 participants were recruited into the study, specifically, 98 children aged 5-15 years, 430 women aged 16-59 years, and 118 elderly people. Children who smoked (AOR = 8.70; 95%CI = 1.27-59.45) had greater odds of experiencing domestic violence than children who did not smoke. Women who had a role as a family member (AOR = 1.59; 95%CI = 1.02-2.50), used alcohol (AOR = 3.36; 95%CI = 2.27-4.99), lived in a family with financial problems (AOR = 4.01; 95%CI = 2.52-7.66), and lived with a family member who uses alcohol (AOR = 2.87; 95%CI = 2.20-5.63) had greater odds of suffering domestic violence than women who did not share these characteristics. The elderly who used alcohol (AOR = 3.25, 95%CI = 1.08-9.81), lived with a family member who uses alcohol (AOR = 3.31; 95%CI = 1.26-7.34), or lived in a family with financial problems in the past year (AOR = 2.16; 95%CI = 1.16-8.77) had greater odds of facing domestic violence than the elderly who did not have these characteristics. CONCLUSION: Family financial problems and substance use are associated with domestic violence in Lahu families in Thailand. Health interventions to reduce the use of substances, including training programs to respond to domestic violence, should be promoted for Lahu children, women, and the elderly.

Pacific peoples and alcohol: a review of the literature.

AIM: To present a review of recent research exploring alcohol use by Pacific peoples in New Zealand. The review builds on a comprehensive narrative review of research and literature on Pacific peoples and alcohol use, Pearls Unlimited (2009). METHOD: We conducted a scoping review of published and grey literature written and published between 2009 and 2019. Research was included if the study population, or a clearly identified subgroup of the study population, included one or more Pacific ethnicities and addressed alcohol use. RESULTS: There were 30 relevant articles covering a large range of aspects of alcohol consumption by Pacific youth and adults. Alcohol consumption by Pacific men has declined significantly to 60% from 70% in 2006/07. However, of those who consume alcohol, 46% meet the threshold for hazardous consumption. Alcohol consumption by Pacific youth has also declined. CONCLUSION: While there has been some notable research and in-depth exploration of alcohol use and Pacific people, persistent inequity in hazardous alcohol consumption indicates that an evaluation of the current interventions to prevent and service unmet needs of Pacific peoples are overdue.