Suchergebnisse

<i>Background/Aims:</i> Cannabis use is a growing challenge for public health, calling for adequate instruments to identify problematic consumption patterns. The Cannabis Use Disorders Identification Test (CUDIT) is a 10-item questionnaire used for screening cannabis abuse and dependency. The present study evaluated that screening instrument. <i>Methods:</i> In a representative population sample of 5,025 Swiss adolescents and young adults, 593 current cannabis users replied to the CUDIT. Internal consistency was examined by means of Cronbach's alpha and confirmatory factor analysis. In addition, the CUDIT was compared to accepted concepts of problematic cannabis use (e.g. using cannabis and driving). ROC analyses were used to test the CUDIT's discriminative ability and to determine an appropriate cut-off. <i>Results:</i> Two items ('injuries' and 'hours being stoned') had loadings below 0.5 on the unidimensional construct and correlated lower than 0.4 with the total CUDIT score. All concepts of problematic cannabis use were related to CUDIT scores. An ideal cut-off between six and eight points was found. <i>Conclusions:</i> Although the CUDIT seems to be a promising instrument to identify problematic cannabis use, there is a need to revise some of its items.

<i>Aim:</i> To determine the extent drinking patterns (at the individual and country level) are associated with alcohol-related consequences over and above the total alcohol the person consumes. <i>Methods:</i> Hierarchical linear models were estimated based on general population surveys conducted in 18 countries participating in the GENACIS project. <i>Results:</i> In general, the positive association between drinking pattern scores and alcohol-related consequences was found at both the individual and country levels, independent of volume of drinking. In addition, a significant interaction effect indicated that the more detrimental the country's drinking pattern, the less steep the association between the volume of drinking and its consequences. <i>Conclusion:</i> Drinking patterns have an independent impact on consequences over and above the relationship between volume and consequences.

More than 7,000 assaults were reported to the magistrates of Portsmouth, England, between 1700 and 1781. Time-series analyses were run to see (1) what effects, if any, war had on levels of aggression and (2) whether overall levels of aggression decreased over time. Aggression was measured in two ways: (1) the extent to which assailants ganged up on adversaries and (2) levels of violence in individual confrontations (whether a weapon was used, and if so, what type; whether assailants refrained from using a weapon; and whether they stopped short of physical violence and instead merely insulted or threatened their enemies). Neither measure showed a significant variation over time. The participation of women in brawls decreased, but the aggressiveness of those who continued to brawl actually increased. Complaints about insults and threats declined, while complaints of a more serious nature showed a modest increase, reflecting, among other things, the emergence of new definitions of actionable behavior.

The "gin epidemic" of 1720 to 1751 in England was the first time that government intervened in a systematic fashion to regulate and control sales of alcohol. The epidemic therefore provides an opportunity to gauge the effects of multiple legislative interventions over time. Toward that end, we employed time series analysis in conjunction with qualitative methodologies to test the interplay of multiple independent variables, including real wages and taxes, on the consumption of distilled spirits from 1700 through 1771. The results showed that each of the 3 major gin acts was successful in the short term only, consistent with the state's limited resources for enforcement at the local level, and that in each instance consumption actually increased shortly thereafter. This was true even of the Gin Act of 1751, which, contrary to the assumptions of contemporaries and many historians, succeeded by accident rather than by design. The results also suggest that the epidemic followed the inverse U-shaped trajectory of more recent drug scares and that consumption declined only after the more deleterious effects of distilled spirits had been experienced by large numbers of people.

<i>Background:</i> Alcohol consumption has been causally related to the incidence of coronary heart disease, but the role of alcohol before the event has not been explored in depth. This study tested the hypothesis that heavy drinking (binge drinking) increases the risk of subsequent acute myocardial infarctions (AMI), whereas light to moderate drinking occasions decrease the risk. <i>Methods:</i> Case-crossover design of 250 incident AMI cases in Switzerland, with main hypotheses tested by conditional logistic regression. <i>Results:</i> Alcohol consumption 12 h before the event significantly increased the risk of AMI (OR 3.1; 95% CI 1.4–6.9). Separately, the effects of moderate and binge drinking before the event on AMI were of similar size but did not reach significance. In addition, AMI patients showed more binge drinking than comparable control subjects from the Swiss general population. <i>Conclusions:</i> We found no evidence that alcohol consumption before the event had protective effects on AMI. Instead, alcohol consumption increased the risk.

Alcohol consumption is associated with elevated risks of disease and injury, and the best indicator of the level of consumption in a country is total alcohol per capita (APC) consumption among adults which comprises recorded consumption and unrecorded consumption. While recorded consumption can be assessed with small measurement bias via taxation or other governmental records, unrecorded consumption is more difficult to assess. The objectives of this study were to estimate the country-specific proportion and volume of unrecorded APC in 2015, to identify main sources of unrecorded alcohol and to assess to what extent experts perceive unrecorded alcohol as a public health, social, and financial problem. Estimates of unrecorded APC were based on a multilevel fractional response regression model using data from World Health Organization's (WHO) STEPwise approach to surveillance surveys (16 countries, 66 188 participants), estimates from the routine WHO reporting on key indicators of alcohol use (189 countries), and a nominal group expert assessment (42 countries, 129 experts). Expert assessments also included data on the sources of unrecorded alcohol and the perception of unrecorded alcohol as a public health, social, and financial problem. The volume of global unrecorded APC was 1.6 L pure alcohol, representing 25% of the total APC. The volume of unrecorded APC was highest in Europe (2.1 L per capita), while the proportion of unrecorded APC was highest in the WHO Eastern Mediterranean region (57% of the total alcohol). In countries with available data, homemade alcohol was identified as a major source of unrecorded alcohol. The majority of experts considered unrecorded alcohol to be a public health (62%), social (60%), and financial problem (54%). High volumes of unrecorded alcohol are consumed globally; however, the volumes consumed and the sources of the unrecorded alcohol exhibit large geographical variation.