It's my time to shine : young Australians reflect on past, present and imagined future alcohol consumption

Drawing on interviews about the drinking trajectories of sixty young Victorian drinkers (aged 20-24), this paper outlines patterns of change over time and explores two drinking biographies in depth. For most research participants, drinking alcohol was an enjoyable and integral part of their social lives, but its role changed as they made other transitions in their lives. Most participants considered their early twenties to be a time for heavy alcohol consumption, and most imagined that they would drink less when they were middle-aged.

The role of alcohol consumption in recovering drug users

This thesis found that alcohol consumption by illicit drig users has not been well researched. A qualitative study found alcohol was used as a substitute and believed to be related to illicit substance use. While the quantitative study generated no overall consensus, the research highlighted the need to conduct additional studies into substance abuse. The portfolio explored the relationship between maltreatment and the development of Reactive Attachment Disorder through four case studies of child clients.

Access to alcohol outlets and harmful alcohol consumption : a multi-level study in Melbourne, Australia

Aims To assess the association between access to off-premises alcohol outlets and harmful alcohol consumption.
Design, setting and participants Multi-level study of 2334 adults aged 18–75 years from 49 census collector districts (the smallest spatial unit in Australia at the time of survey) in metropolitan Melbourne.
Measurements Alcohol outlet density was defined as the number of outlets within a 1-km road network of respondents’ homes and proximity was the shortest road network distance to the closest outlet from their home. Using multi-level logistic regression we estimated the association between outlet density and proximity and four measures of harmful alcohol consumption: drinking at levels associated with short-term harm at least weekly and monthly; drinking at levels associated with long-term harm and frequency of consumption.
Findings Density of alcohol outlets was associated with increased risk of drinking alcohol at levels associated with harm. The strongest association was for short-term harm at least weekly [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.04–1.16]. When density was fitted as a categorical variable, the highest risk of drinking at levels associated with short-term harm was when there were eight or more outlets (short-term harm weekly: OR 2.36, 95% CI 1.22–4.54 and short-term harm monthly: OR 1.80, 95% CI 1.07–3.04). We found no evidence to support an association between proximity and harmful alcohol consumption.
Conclusions The number of off-premises alcohol outlets in a locality is associated with the level of harmful alcohol consumption in that area. Reducing the number of off-premises alcohol outlets could reduce levels of harmful alcohol consumption.

Association of risky alcohol consumption and accreditation in the 'Good Sports' alcohol management programme

Background Involvement in community sports clubs is often associated with high levels of risky alcohol consumption; however, developing prevention-focused interventions in these settings can be complex. We examined the association of reduced risky alcohol consumption with the implementation of the Good Sports Programme (GSP)—a programme that accredits clubs in three stages, on the basis of their implementation of alcohol-related harm reduction strategies.

Methods Using a cross section of football and cricket clubs, consumption was compared between clubs accredited at level 1, 2 or 3 of the GSP and clubs not accredited (92 clubs; 1924 individuals). Drinking above Australian guidelines for short-term risk (more than four standard drinks) on the last playing day prior to the survey and drinking at the club over the last 12 months at average levels exceeding short- and long-term risk (more than two standard drinks) guidelines were also examined.

Results Multilevel modelling indicated that higher accreditation stage (0, 1, 2, 3) was associated with a 0.79 reduction in the odds of risky consumption on the playing day; a 0.85 reduction in the odds for short-term risky drinking, and a 0.86 reduction in long-term risky drinking.

Conclusions The findings suggest that higher accreditation in the GSP is associated with reduced rates of risky alcohol use at a population level.

A cluster randomised controlled trial of a comprehensive accreditation intervention to reduce alcohol consumption at community sports clubs: study protocol

Introduction: Excessive alcohol consumption isresponsible for considerable harm from chronicdisease and injury. Within most developed countries,members of sporting clubs consume alcohol at levels above that of communities generally. Despite the potential benefits of interventions to address alcohol consumption in sporting clubs, there have been no randomised controlled trials to test the effectiveness of these interventions. The aim of this study is to examine the effectiveness of a comprehensive accreditation intervention with community football clubs (Rugby League, Rugby Union, soccer/association football and Australian Rules football) in reducing excessive alcohol consumption by club members.
Methods and analysis: The study will be conducted in New South Wales, Australia, and employ a cluster randomised controlled trial design. Half of the football clubs recruited to the trial will be randomised to receive an intervention implemented over two and a half winter sporting seasons. The intervention is based on social ecology theory and is comprehensive in nature, containing multiple elements designed to decrease the supply of alcohol to intoxicated members, cease the provision of cheap and free alcohol, increase the availability and costattractiveness of non-alcoholic and low-alcoholic beverages, remove high alcohol drinks and cease drinking games. The intervention utilises a three-tiered accreditation framework designed to motivate intervention implementation. Football clubs in the control group will receive printed materials on topics unrelated to alcohol. Outcome data will be collected pre- and postintervention through cross-sectional telephone surveys of club members. The primary outcome measure will be alcohol consumption by club members at the club, assessed using a graduated frequency index and a seven day diary.
Ethics and dissemination: The study was approved by The University of Newcastle Human Research Ethics Committee (reference: H-2008-0432). Study findings will be disseminated widely through peer-reviewed publications and conference presentations.

What is the optimal level of population alcohol consumption for chronic disease prevention in England? Modelling the impact of changes in average consumption levels

Objective To estimate the impact of achieving alternative average population alcohol consumption levels on chronic disease mortality in England.

Design A macro-simulation model was built to simultaneously estimate the number of deaths from coronary heart disease, stroke, hypertensive disease, diabetes, liver cirrhosis, epilepsy and five cancers that would be averted or delayed annually as a result of changes in alcohol consumption among English adults. Counterfactual scenarios assessed the impact on alcohol-related mortalities of changing (1) the median alcohol consumption of drinkers and (2) the percentage of non-drinkers.

Data sources Risk relationships were drawn from published meta-analyses. Age- and sex-specific distributions of alcohol consumption (grams per day) for the English population in 2006 were drawn from the General Household Survey 2006, and age-, sex- and cause-specific mortality data for 2006 were provided by the Office for National Statistics.

Results The optimum median consumption level for drinkers in the model was 5 g/day (about half a unit), which would avert or delay 4579 (2544 to 6590) deaths per year. Approximately equal numbers of deaths from cancers and liver disease would be delayed or averted (∼2800 for each), while there was a small increase in cardiovascular mortality. The model showed no benefit in terms of reduced mortality when the proportion of non-drinkers in the population was increased.

Conclusions Current government recommendations for alcohol consumption are well above the level likely to minimise chronic disease. Public health targets should aim for a reduction in population alcohol consumption in order to reduce chronic disease mortality.

A clustered randomised trial examining the effect of social marketing and community mobilisation on the age of uptake and levels of alcohol consumption by Australian adolescents

Introduction
Throughout the world, alcohol consumption is common among adolescents. Adolescent alcohol use and misuse have prognostic significance for several adverse long-term outcomes, including alcohol problems, alcohol dependence, school disengagement and illicit drug use. The aim of this study was to evaluate whether randomisation to a community mobilisation and social marketing intervention reduces the proportion of adolescents who initiate alcohol use before the Australian legal age of 18, and the frequency and amount of underage adolescent alcohol consumption.
Method and analysis
The study comprises 14 communities matched with 14 non-contiguous communities on socioeconomic status (SES), location and size. One of each pair was randomly allocated to the intervention. Baseline levels of adolescent alcohol use were estimated through school surveys initiated in 2006 (N=8500). Community mobilisation and social marketing interventions were initiated in 2011 to reduce underage alcohol supply and demand. The setting is communities in three Australian states (Victoria, Queensland and Western Australia). Students (N=2576) will complete school surveys in year 8 in 2013 (average age 12). Primary outcomes: (1) lifetime initiation and (2) monthly frequency of alcohol use. Reports of social marketing and family and community alcohol supply sources will also be assessed. Point estimates with 95% CIs will be compared for student alcohol use in intervention and control communities. Changes from 2006 to 2013 will be examined; multilevel modelling will assess whether random assignment of communities to the intervention reduced 2013 alcohol use, after accounting for community level differences. Analyses will also assess whether exposure to social marketing activities increased the intervention target of reducing alcohol supply by parents and community members.

Alcohol consumption, obesity, and psychological distress in farming communities — an Australian study

Purpose: Alcohol consumption patterns nationally and internationally have been identified as elevated in rural and remote populations. In the general Australian population, 20.5% of adult males and 16.9% of adult females drink at short-term, high-risk levels. Farmers are more likely to drink excessively than those living in major cities. This study seeks to explore the relationships between farmers’ physical and mental health and their alcohol consumption patterns. Our hypothesis is that farmers consume alcohol at high-risk levels more often than the Australian average and that this consumption is associated with obesity and psychological distress.

Methods: Cross-sectional descriptive data were collected within Australian farming communities from 1,792 consenting adults in 97 locations across Australia. Data on anthropometric measurements, general physical attributes and biochemical assessments were used to explore the interrelationships of self-reported alcohol consumption patterns with obesity, psychological distress, and other physical health parameters.

Findings: There was a higher prevalence of short-term, high-risk alcohol consumption (56.9% in men and 27.5% in women) reported in the study compared with national data. There was also a significant positive association between the prevalence of high-risk alcohol consumption and the prevalence of obesity and abdominal adiposity in psychologically distressed participants.

Conclusions: The prevalence of short-term, high-risk alcohol consumption practices in this cohort of farming men and women is significantly higher than the Australian average. These consumption practices are coupled with a range of other measurable health issues within the farming population, such as obesity, hypertension, psychological distress, and age.

Alcohol consumption and body composition in a population-based sample of elderly Australian men

Background: Alcohol is calorie dense, and impacts activity, appetite and lipid processing. The aim of this study was to therefore investigate the association between alcohol consumption and components of body composition including bone, fat and lean tissue.

Methods: Participants were recruited from a randomly selected, population-based sample of 534 men aged 65 years and older enrolled in the Geelong Osteoporosis Study. Alcohol intake was ascertained using a food frequency questionnaire and the sample categorised as nondrinkers or alcohol users who consumed B2, 3–4 or C5 standard drinks on a usual drinking day. Bone mineral density (BMD), lean body mass and body fat mass were measured using dual energy X-ray absorptiometry; overall adiposity (%body fat), central adiposity (%truncal fat) and body mass index (BMI) were calculated. Bone quality was determined by quantitative heel ultrasound (QUS).

Results: There were 90 current non-drinkers (16.9 %), 266 (49.8 %) consumed 1–2 drinks/day, 104 (19.5 %) 3–4 drinks/day and 74 (13.8 %) C5 drinks/day. Those consuming C5 drinks/day had greater BMI (?4.8 %), fat mass index (?20.1 %), waist circumference (?5.0 %), %body fat (?15.2 %) and proportion of trunk fat (?5.3 %) and lower lean mass (-5.0 %) than non-drinkers after adjustment for demographic and lifestyle factors. Furthermore, they were more likely to be obese than non-drinkers according to criteria based on BMI (OR = 2.83, 95 %CI 1.10–7.29) or waist circumference (OR = 3.36, 95 %CI 1.32–8.54). There was an inverse relationship between alcohol consumption and QUS parameters and BMD at the mid forearm site; no differences were detected for BMD at other skeletal sites.

Conclusion: Higher alcohol intake was associated with greater total and central adiposity and reduced bone quality.

The association between an abusive father-son relationship, quantity of alcohol consumption, and male-to-male alcohol-related agression

Background:
While alcohol consumption and heavy episodic (binge) drinking are well-established predictors of male-to-male alcohol-related aggression (MMARA), the role of the father-son relationship in MMARA has yet to be explored.
Methods:
This study therefore examined whether fathering by the biological father rather than another father figure, negative fathering, and gender role modeled by the father figure were significant predictors of involvement in MMARA, once drinking frequency and quantity and heavy episodic drinking were controlled for. A total of 121 university students aged 18 to 25 years (M = 20.63, SD = 1.77 years) voluntarily completed the online questionnaire.
Results:
The only significant predictors of perpetration of MMARA were a more abusive paternal relationship and drinking quantity (number of standard drinks usually consumed when drinking).
Conclusions:
Negative father-son relationships may play a role in fostering young men's perpetration of MMARA in the barroom context. © 2013 by the Research Society on Alcoholism.