Analysis Of Government Data Finds Hospitality Tops List Of Industries With Highest Rates Of Alcohol Problems
March 26, 2008
A new analysis of government data finds that 15 percent of employees in the hospitality industry suffer from serious alcohol-related problems. Excessive alcohol use costs U.S. employers billions in lost productivity and additional health care costs every year. According to a new report by Ensuring Solutions to Alcohol Problems at The George Washington University Medical Center, “Workplace Screening & Brief Intervention: What Employers Can and Should Do About Excessive Alcohol Use”, alcohol-related problems are disproportionately represented in American business, with employees in the hospitality, construction and wholesale industries significantly more likely to be dependent on or abuse alcohol. The report is available at http://www.ensuringsolutions.org/.
Alcohol problems affect all employers, with an average of nine percent of U.S. workers drinking in ways that contribute to absenteeism, higher health care costs and lost productivity. But, Ensuring Solutions researchers found that men working in the hospitality and construction are approximately 50 percent more likely to have an alcohol-related problem than women in the same industry. In wholesale trade, men are almost three times more likely to have an alcohol problem than women. In addition, more than 18 percent of young workers between the ages of 18 and 25 have an alcohol-related problem, compared to just seven percent of workers 26 and older. (See data table below)
“Most employees represented in these numbers are not dependent on alcohol,” said Eric Goplerud, PhD, director of Ensuring Solutions to Alcohol Problems and lead researcher. “But they do use alcohol in ways that lead to short-term safety problems and long-term health consequences.”
To develop a better understanding of the impact of alcohol problems in the workplace, Ensuring Solutions to Alcohol Problems, an initiative sponsored by The Pew Charitable Trusts, conducted an extensive analysis of two large government-sponsored epidemiological surveys, the National Survey on Drug Use and Health (NSDUH) and the National Comorbidity Survey. This analysis estimates the workplace impact of alcohol problems — categorized as alcohol dependence (alcoholism) and alcohol abuse — on 13 sectors of U.S. industry.
“The impact of alcohol problems in the workplace is a tremendous hidden challenge — in part because very few people with an alcohol problem are ever identified,” said Andrew Webber, president and CEO of the National Business Coalition on Health. “In the past, employers have led the way to doing more for people with chronic diseases like diabetes and heart disease. It’s time for American industry to do the same for people with alcohol problems.”
The results of the Ensuring Solutions analysis have been used to develop a Web-based calculator that employers can use to estimate the impact of alcohol problems and the potential cost savings to be gained through workplace screening and brief intervention. The calculator is available at http://www.alcoholcostcalculator.org/.
In addition to analyzing the scope of workplace alcohol problems, the report promotes the adoption of a practice known as Screening and Brief Intervention (SBI). SBI has been shown to reduce excessive alcohol use when administered to patients in a variety of settings, including hospitals and universities. Ensuring Solutions believes that if SBI were to become a widespread practice in primary care, workplace wellness programs and employee assistance, the prevalence of workplace alcohol problems would be significantly reduced.
“Alcohol problems affect every workplace, with some industries paying a tremendous price.” said Dr. Goplerud. “It’s in the interest of every employer to do something. Screening and brief intervention is a proven approach that promises to effectively reduce workplace alcohol problems.”
Table: Prevalence of Hazardous Alcohol Use by Industry Sector
Hospitality: Male - 17.4% Female - 12.6% Overall - 15.0%
Construction: Male - 15.2% Female - 10.0% Overall - 14.7%
Wholesale Trade: Male - 14.6% Female - 5.3% Overall - 11.9%
Professional: Male - 13.3% Female - 7.1% Overall - 10.6%
Retail Trade: Male - 13.4%/TD> Female - 6.2% Overall - 9.7%
Finance & Real Estate: Male - 11.2% Female -7.6% Overall - 9.2%
Manufacturing: Male - 9.5% Female - 6.5% Overall - 8.6%
Transportation/Utilities: Male - 9.1% Female - 4.8% Overall - 8.2%
Information/Communication: Male - 12.7% Female - 4.8% Overall - 8.1%
Agriculture: Male - 8.7% Female - 1.9% Overall - 7.2%
Other Services: Male - 8.9% Female - 3.8% Overall - 6.4%
Education/Social Services: Male - 9.4% Female - 4.3% Overall - 5.4%
Public Administration: Male - 6.4% Female - 4.1% Overall - 5.3%
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About Ensuring Solutions
Ensuring Solutions to Alcohol Problems develops authoritative, research-based information about alcohol-related problems for business leaders, policymakers, and other working to save lives and money by increasing access to treatment. Ensuring Solutions, based at The George Washington University Medical Center, was established by a grant from The Pew Charitable Trusts. For more information, go to http://www.ensuringsolutions.org/.
About The George Washington University Medical Center
The George Washington University Medical Center is an internationally recognized interdisciplinary academic health center that has consistently provided high-quality medical care in the Washington, DC metropolitan area for 176 years. The Medical Center comprises the School of Medicine and Health Sciences, the 11th oldest medical school in the country; the School of Public Health and Health Services, the only such school in the nation’s capital; GW Hospital, jointly owned and operated by a partnership between The George Washington University and a subsidiary of Universal Health Services, Inc.; and the GW Medical Faculty Associates, an independent faculty practice plan. For more information on GWUMC, visit http://www.gwumc.edu/
Source: Susan Laine
George Washington University Medical Center
Acting Surgeon General Kicks Off 1,600 Town Hall Meetings Throughout The Nation To Address The Underage Drinking Problem
March 25, 2008
In response to the Surgeon General’s Call to Action to prevent and reduce underage drinking, more than 1,600 town hall meetings will take place all across the country in March and April 2008. These meetings are designed to raise awareness about new information on the public health risk that this problem poses as well as the steps that communities and individuals can take to combat and prevent it.
Event:National Kick-off: Town Hall Meeting to Address Underage Drinking Problem
Who: Acting Surgeon General Rear Admiral Steven K. Galson, M.D., M.P.H.
First Lady of Wyoming, Nancy Freudenthal
The Honorable John Barrasso, U.S. Senator
When: March 24, 2008, 6:30 pm
Where: CentralWyomingCollege
ArtsCenter
2660 Peck Avenue
Riverton, Wyoming 82501
Acting Surgeon General Rear Admiral Steven K. Galson, M.D., M.P.H., will join with the First Lady of Wyoming, Nancy Freudenthal, to kick off this nationwide effort at a Town Hall meeting in Wyoming on March 24, 2008. Special guest is the Honorable John Barrasso, who will speak on the topic. The meetings will provide greater insight into the nature and scope of the problem and steps for preventing it through reduced demand, availability and access. Parents and other concerned citizens will be given knowledge and tools to connect with today’s youth about the dangers of underage drinking.
The Substance Abuse and Mental Health Services Administration (SAMHSA) is sponsoring these meetings in collaboration with the Federal Interagency Coordinating Committee on the Prevention of Underage Drinking and state and local organizations.
Reporters and members of the public seeking information on Town Hall Meeting being held in their area can go to here.
SAMHSA is a public health agency within the Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation’s substance abuse prevention, addictions treatment, and mental health services delivery system.
http://www.samhsa.gov
Doctors Should Ask About Cocaine Use When Younger Patients Present With Chest Pains
March 19, 2008
In a bid to improve management of patients who present with chest pain and other heart attack symptoms, the American Heart Association (AHA) has issued a scientific statement recommending doctors ask about cocaine use when they examine younger patients with chest pains and who have no obvious risk factors for heart disease.
The statement is published as a paper in an early online issue of Circulation, the journal of the AHA, and is authored by Dr James McCord, chair of the statement writing committee and cardiology director of the chest pain unit for the Henry Ford Medical System in Detroit, Michigan, and colleagues.
McCord explained that if doctors suspect a heart attack, then they should rule out cocaine use early on because cocaine exposure changes what is safe and what is not. The statement emphasizes in particular that:
- Clot-busters and beta-blockers are dangerous for patients who have been exposed to cocaine.
- Bare metal stents rather than drug-eluting stents should be used in long-term cocaine users.
- Most cocaine-associated chest pain is not a heart attack.
- Patients who have been exposed to cocaine should be placed under observation for 9 to 12 hours.
Assessment of cocaine use is particularly important for younger patients, said McCord. 37 per cent of all cocaine-related visits to emergency departments are by people aged between 35 and 44 years, he added.
Research shows that chest pain that is associated with cocaine use tends to appear within three hours of taking the drug, but the chemical residue stays in the body for a minimum of 18 hours and can continue to present problems, said McCord. Also, doctors have more difficulty diagnosing heart attacks using electrocardiographs of younger patients, he explained.
Cocaine-associated emergency department visits went up by 47 per cent between 1999 and 2002, said the authors, which means that the number of cocaine users that doctors are likely to come across as a result of such admissions will probably increase.
A common method for diagnosing and treating heart attacks is to take the patient into the catheterization lab (the “cath lab”), which has the equipment that allows the doctor to insert a thin tube or catheter into a heart artery and then use imaging techniques to see where the blockage might be, and then inflate a small balloon to open the the artery.
Where a cath lab is not available, a doctor may give a patient who appears to have had a heart attack a clot busting drug instead. However, if the patient is a recent cocaine user there is an added risk of bleeding into the brain because of the higher blood pressure induced by the cocaine. So this procedure should only be used if the doctor is absolutely certain the patient has indeed had a heart attack, said the authors.
Beta-blockers are used to reduce blood pressure without causing narrowing of the arteries. But in patients who have recently been using cocaine and who present with chest pain, beta-blockers may actually produce the opposite effect: they could increase blood pressure and make the arteries already narrowed by cocaine even narrower. This has been shown to have potential fatal consequences in studies using animals, said McCord.
Drug eluting or bare metal stents are used to restore blood flow to the heart where there is no arterial blockage. Studies have shown that long term cocaine users fitted with stents have a tendency to lapses in taking the regular medication needed to stop drug-eluting stents becoming blocked, and that is why the statement recommends such patients be fitted with bare metal ones only.
Cocaine can worsen the effects of a heart attack, said the authors, because it increases the heart’s need for oxygen, elevating heart rate, blood pressure and contraction power at each beat. But at the same time the drug also constricts blood vessels and makes it harder for the heart to get the oxygen it needs. This increases risk of clotting and manifests as angina, which is felt as chest pain.
The statement draws attention to other conditions that can develop alongside chest pain and heart attacks with cocaine users, and it is important that these are also looked for as they can be crucial to the treatment that is followed. For instance, one condition that can accompany cocaine use is aortic dissection (a tear in a blood vessel that can be fatal), another is bleeding into the lung (”crack lung”).
Other symptoms that patients who use cocaine also report having alongside chest pains are shortness of breath, palpitations, feelings of anxiety, nausea, dizziness and sweating profusely. These are very similar to heart attack.
“Management of Cocaine-Associated Chest Pain and Myocardial Infarction. A Scientific Statement From the American Heart Association Acute Cardiac Care Committee of the Council on Clinical Cardiology.
James McCord, Hani Jneid, Judd E. Hollander, James A. de Lemos, Bojan Cercek, Priscilla Hsue, W. Brian Gibler, E. Magnus Ohman, Barbara Drew, George Philippides, and L. Kristin Newby.
Circulation, Published before print on March 17, 2008.
DOI:10.1161/CIRCULATIONAHA.107.188950
Click here for the full text of the article (PDF).
Sources: American Heart Association press statement.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
ADP Launches New Campaign To Reduce Meth Use In California
March 18, 2008
The California Department of Alcohol and Drug Programs (ADP) unveiled a new media campaign to fight methamphetamine use in the gay, bisexual, and other men who have sex with men (G/B/MSM) communities.
“Methamphetamine use is a problem in California and we are committed to doing all we can to address it,” said Renee Zito, Director of ADP. “We believe that targeting messages about meth use in the communities it affects can improve the lives of Californians.”
The $11 million “Me Not Meth” campaign includes television, outdoor and print advertisements designed to curb methamphetamine use by highlighting personal losses.
The campaign is being launched as research and data suggest that methamphetamine use and abuse has significant negative public health effects among gay men, bisexual men and men who have sex with men. A survey by the Centers for Disease Control and Prevention found that methamphetamine use was more common in men infected with HIV. The odds for becoming infected with HIV double or triple for MSM who use methamphetamine compared to those who do not.
Outdoor advertising began this week and television ads will begin airing on March 17 and will continue for 12 weeks. The advertisements were developed by GMMB and Better World Advertising, and the television spot was directed by award-winning director Joel Schumacher.
With the launch of the campaign, ADP also announced the results of a statewide survey of Californians’ perceptions of methamphetamine use and abuse. The survey showed that:
— 71 percent of G/B/MSM surveyed say that they have been asked to try methamphetamine
— More than half of G/B/MSM surveyed (55 percent) reported using methamphetamine in their lifetime
— 54 percent of G/B/MSM respondents have a close friend who uses methamphetamine
“Sadly, the study findings do not surprise me,” said Cathy Reback, Ph.D., research sociologist at the Friends Research Institute, Inc., and the UCLA Integrated Substance Abuse Programs. “I have been working in the field of research and treatment with a focus on providing resources for gay and bisexual men for the past 13 years. Methamphetamine use, particularly the association between methamphetamine use and HIV infection, is a serious public health concern in California.”
The benchmark survey data was collected via telephone among a geographically stratified representative sample (1,215) of households in the state of California and an online survey of 549 recruited gay and bisexual men.
The media campaign was tested extensively among the target audience through formative message testing focus groups, quantitative advertisement testing, and one-on-one interviews. Research found that a personal appeal from someone who has lost important things in his life is the most persuasive way to engage the G/B/MSM community.
The campaign is part of the California Methamphetamine Initiative (CMI), which is designed to reduce the use and abuse of methamphetamine in the state. The CMI includes a public information and education campaign, educational materials such as a tool kit and DVD, as well as funding for prevention programs. Working closely with other state organizations, the CMI was designed to complement existing anti-methamphetamine efforts in California.
Funding for the first year of the methamphetamine campaign was authorized in fiscal year 2007-07.
Both the survey results and the advertisements can be viewed in full at http://www.menotmeth.org.
The California Department of Alcohol and Drug Programs
http://www.menotmeth.org
Harder To Curb Teen Drinking In Inner City Areas Compared To Rural Areas
March 18, 2008
Efforts to keep middle schoolers from consuming alcohol are more effective in rural areas than inner city ones, according to a study carried out by researchers at the University of Florida.
A three-year, three-pronged prevention program did little to keep Chicago middle schoolers from drinking or using drugs, despite its prior success in rural Minnesota, where the program reduced alcohol use 20 to 30 percent, UF and University of Minnesota researchers recently reported in the online edition of the journal Addiction.
“The intervention found to be effective in rural areas was not effective here, which really surprised us,” said Kelli A. Komro, Ph.D., a UF associate professor of epidemiology in the UF College of Medicine and the study’s lead author. “This is an important finding to realize this program was not enough. The bottom line is this: Low-income children in urban areas need more, long-term intensive efforts.”
Adolescents who drink by age 15 - about half of teens - are more likely to struggle in school, abuse alcohol later in life, smoke cigarettes and use other drugs than those who don’t. Even worse, exposure to alcohol at a young age may damage the developing brain, according to a 2007 U.S. Surgeon General report.
“Almost any problem kids might have, alcohol increases that risk,” Komro said.
By targeting middle-school-age children, the UF and University of Minnesota team hoped to reduce these risks. The researchers studied 5,812 sixth-, seventh- and eighth-graders from mostly low-income communities in Chicago, randomly dividing the neighborhoods into two groups: those who would participate in the prevention program and those who would not.
The program, a tweaked version of what Komro and her colleagues developed for their Minnesota study, included three preventive approaches to relay the message that drinking is not acceptable in school, at home and in the community.
In participating schools, an alcohol prevention curriculum was used in the classroom. Students led these sessions because the prevention messages are more accepted when they come from peers rather than teachers, Komro said. The family component included homework assignments that parents and children could complete together, organized events for families, and educational postcards with helpful hints that were sent to parents. For the community aspect of the program, researchers hired organizers to work with community volunteers to change the risks and problems with teen drinking in their neighborhoods.
But at the end of the study, year-end surveys showed no difference in alcohol use among the teens who took part in the project and those who did not. At least 70 percent of the schools in the neighborhoods that did not use the program had some form of drug and alcohol prevention program in the schools. It’s unlikely these programs skewed the results of the study though, Komro said. UF’s prevention program was larger and more comprehensive than the other school-based programs and researchers would have detected a difference among the students had it worked.
One particular problem surfaced during the community component of the project. The organizers struggled to rally some community members around the cause, often having to explain why they should be concerned about adolescent alcohol use. That gave researchers some insight into why the program did not work there.
“People in these areas are concerned with housing, they’re concerned with gangs and other drug use,” Komro said. “There was a whole upfront effort where we had to educate people about how alcohol was related to those other issues, and that it was an important issue to think about with their young people.
“We know from other studies in low-income, urban neighborhoods, there is a higher concentration of alcohol outlets, compared to suburban or rural areas. There were a lot of alcohol ads around these schools and a greater density of pro-alcohol messages these children are exposed to. You mix that with the poverty level and it’s just a high-risk environment.”
Despite the overall results, there were positive findings that researchers hope to build on, Komro said. Of all the components, the family interventions had the most significant effects. And one aspect of the community project worked well: Half of the community teams went to stores that sold alcohol and asked merchants not to sell to underage kids. In those communities, the ability of young people to buy alcohol went down 64 percent.
“While the findings may not be what the investigators were hoping for, they reported them fully and openly, and this is good for the field,” said Brian Flay, Ph.D., a professor of public health and director of the Prevention Research Center at Oregon State University. “Science can advance properly only when both positive and negative findings are reported.”
The University of Florida Health Science Center - the most comprehensive academic health center in the Southeast - is dedicated to high-quality programs of education, research, patient care and public service. The Health Science Center encompasses the colleges of Dentistry, Public Health and Health Professions, Medicine, Nursing, Pharmacy and Veterinary Medicine, as well as the Veterinary Medical Teaching Hospital and an academic campus in Jacksonville offering graduate education programs in dentistry, medicine, nursing and pharmacy. Patient care activities, under the banner UF&Shands, are provided through teaching hospitals and a network of clinics in Gainesville and Jacksonville. The Health Science Center also has a statewide presence through satellite medical, dental and nursing clinics staffed by UF health professionals; and affiliations with community-based health-care facilities stretching from Hialeah and Miami to the Florida Panhandle.
www.health.ufl.edu
Australian Medical Association Supports Growing Momentum To End Alcohol Abuse Among Australians
March 14, 2008
AMA President, Dr Rosanna Capolingua, said that the AMA is encouraged by the growing momentum by the Government to end alcohol abuse in all areas of the Australian community.
Dr Capolingua said the broader terms of reference of the Senate Inquiry into alcohol abuse would assist the Government to build on the initiatives contained in its National Binge Drinking Strategy announced earlier this week.
She said that today’s agreement by Australia’s six major sporting bodies to work together to address binge drinking among young people is another important step.
“While it is vitally important that we address the binge drinking epidemic among our young people, we must also tackle the crippling social and economic effects of alcohol abuse in all sectors of the community,” Dr Capolingua said.
“The AMA supports the Government’s ‘whole of community’ approach to the problem and would like to see the National Binge Drinking Strategy complemented with strategies that cover all forms of alcohol abuse in the total population, especially among the socially and economically disadvantaged.
“The Government should ensure that taxes reflect the total volume of alcohol in products, and products such as ‘alcopops’ that are targeted specifically at the youth market should be taxed at a rate that makes the retail price a disincentive for young people.
“Labelling on alcohol products must include information about health risks and clearly show alcohol content. Alcohol advertising should not contribute to a culture that trivialises the dangers of alcohol.
“Alcohol education and rehabilitation programs must be expanded and made more accessible.
“As a community, we need to look at alcohol misuse and harm across all groups and ages, and examine ways to prevent the serious harm caused by alcohol abuse,” Dr Capolingua said.
According to the most recent estimates from the National drug Strategy, the total costs of alcohol abuse to the community are at least $7.5 billion per annum. This includes lost productivity, premature death, treatment costs, crime and violence.
A 2007 study by Alcohol Related Brain Injury Australia Services (Arbias) suggests that more than 200, 000 Australians suffer undiagnosed alcohol related brain damage, and that two million others are at risk due to the amount of alcohol they consume.
Australian Medical Association
Understanding The Neurological Underpinnings Of Risk
March 13, 2008
Researchers from EPFL and Caltech have made an important neurobiological discovery of how humans learn to predict risk. The research, appearing in the March 12 issue of the Journal of Neuroscience, will shed light on why certain kinds of risk, notably financial risk, are often underestimated, and whether abnormal behavior such as addiction (e.g. to gambling or drugs) could be caused by an erroneous evaluation of risk.
Planning entails making predictions. In an uncertain environment, however, our predictions often don’t pan out. And erroneous prediction of risk often leads to unusual behaviour: euphoria or excessive gambling when risk is underestimated, and panic attacks or depression when we predict that things are riskier than they really are. To understand these anomalous reactions to uncertain situations, we need to look to the neurobiological mechanisms that underlie how we learn to predict risk. Surprisingly little research has been done in this topic, and we do not yet know precisely how the brain is involved in our estimation of risk.
Using functional imaging in a simple gambling task in which risk was constantly changed, the researchers discovered that an early activation of the anterior insula of the brain was associated with mistakes in predicting risk. The time course of the activation also indicated a role in rapid updating, suggesting that this area is involved in how we learn to modify our risk predictions. The finding was particularly interesting, notes lead author and EPFL professor Peter Bossaerts, because the anterior insula is the locus of where we integrate and process emotions.
“This represents an important advance in our understanding of the neurological underpinnings of risk, in analogy with an earlier discovery of a signal for forecast error in the dopaminergic system,” says Bossaerts, “and indicates that we need to update our understanding of the neural basis of reward anticipation in uncertain conditions to include risk assessment.”
Contrary to what Descartes held dear, the finding that risk prediction and processing of emotions are related suggests that emotions may be intimately involved in rational decision making — they may help us to correctly assess risk in an uncertain world.
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This release is available in French.
Source: Peter Bossaerts
Ecole Polytechnique Fédérale de Lausanne
Drinking In Middle Age And Heart Risk
March 13, 2008
The Daily Mail reports that “teetotallers may finally have a reason to enjoy the odd tipple - a new [study] shows non-drinkers who begin drinking in middle-age live longer and are less likely to develop heart disease.” The Daily Mirror also covers the story and says that researchers have found that “former non-drinkers who downed a glass or two a day had 38% less chance of heart disease after four years”.
This story is based on a study in which researchers analysed data from about 7,000 people in the US over a 10-year period. They found that people who started drinking moderately during the first six years of the study were less likely to have a heart attack or stroke during the next four years than those who remained teetotal.
However, as differences between the groups other than drinking habits may have had an affect, these results should be interpreted with caution. It is also important to point out that starting moderate drinking did not have a significant effect on overall deaths, so it is not fair to say that the moderate drinkers “lived longer”.
For people who reach middle age, have never drunk alcohol, (and have no medical reason not to) may start to drink moderate amounts with few risks and possibly benefits to health. People should keep within current recommendations, and be aware of the risks. However, starting drinking for the sole reason of reducing the risk of cardiovascular events seems premature at this stage.
Where did the story come from?
Dr Dana E. King and colleagues from the Medical University of South Carolina carried out the research. The study was funded by the National Heart, Lung and Blood Institute. The study was published in the peer-reviewed medical journal: The American Journal of Medicine.
What kind of scientific study was this?
This was an analysis of data from a prospective cohort study - the Atherosclerosis Risk In Communities study (ARIC) - that enrolled 15,792 people from four communities in the US between 1987 and 1989, and followed them up until 1998. The participants, aged between 45 and 64 years old, provided information about their health and lifestyle in annual telephone calls and three visits (once every three years) during this period.
From the ARIC participants, the researchers identified people who did not drink when they joined the study, or have a history of cardiovascular disease (heart attack, heart surgery or associated artery surgery and stroke) during the first six years of follow up. The researchers then looked at whether they starting drinking alcohol during the first six years of follow up, how much they drank, and what they drank (beer, wine, spirits). Moderate alcohol consumption was defined as 1-14 drinks a week for men and 1-7 drinks for women.
They then identified those people who had developed cardiovascular disease or died from it during the last four years of follow up, and compared the proportion of people who had started drinking to those who had remained teetotal. The researchers adjusted these analyses for factors other than drinking that might affect risk of cardiovascular disease, including “demographic, lifestyle factors, and disease histories” as recorded at the six-year follow up.
What were the results of the study?
Of the 7,359 people interviewed at six years who were teetotal at the start of the study, 6% had started drinking moderately, and 0.4% had started drinking heavily. People who had started drinking moderately were more likely to be white, male, educated to high school level or above, regular exercisers, and with no history of diabetes, high blood pressure, or high cholesterol.
Fewer people who began drinking moderately experienced a cardiovascular event (6.9%) than people that remained non-drinkers (10.7%). This was equivalent to a reduction of 38% in the odds of having an event during the four years of follow up. There was no difference in the rate of death between the groups.
What interpretations did the researchers draw from these results?
The researchers concluded that starting to drink moderate amounts of alcohol in midlife significantly reduced the risk of cardiovascular events after four years. They caution that this benefit must be weighed up against the known dangers of alcohol consumption. They suggest that further prospective studies are needed.
What does the NHS Knowledge Service make of this study?
This was a large study, but a number of limitations must be taken into account:
-With this type of study, the main limitation is that the differences in cardiovascular disease that were seen may be due to differences between the groups other than their drinking habits. For example, the people who started drinking were more likely to be regular exercisers, and to not have high blood pressure, diabetes, or high cholesterol. Although the authors state that their calculations took into account some factors that might influence and bias the results, it was not clear which factors these were, and these adjustments might not fully remove the effects of these factors. The authors also would not have been able to adjust for unknown factors, or unmeasured factors (such as diet) that might have had an effect. For this reason, it is best to interpret these results cautiously.
-This study did not report on people’s reasons for not drinking. The people who were teetotal may have had medical reasons for doing so, and these reasons might affect or be linked to their cardiovascular risk.
-The participants reported their alcohol consumption themselves, and this was assessed retrospectively each year. People’s reports of their drinking may not be accurate, either because they cannot remember or because they are concerned about what people will think about their responses.
-The study only had a relatively short period of follow up, and differences between groups might not be apparent over longer periods.
Starting drinking solely to reduce the risk of cardiovascular events seems premature at this stage. But people who have reached middle age and wish to start drinking for their own enjoyment and have no medical reason not to, then should do so moderately, and be aware of the risks.
Links to the headlines
Teetotallers should drink wine to cut risk of heart attacks, say scientists. Daily Mirror, March 11 2008
Teetotallers who turn to drink cut heart disease risk. Daily Mail, March 11 2008
Links to the science
Adopting Moderate Alcohol Consumption in Middle Age: Subsequent Cardiovascular Events.
King, DE, Mainous III AG, Geesey ME.
Am J Med 2008; 121: 201-206
This news comes from NHS Choices
Tax Hike On Booze Is The Right Way Forward, Say Doctors, UK
March 13, 2008
The BMA is pleased that one of the recommendations in its recent report on alcohol misuse, to increase taxation on alcohol, has been adopted by the Chancellor of Exchequer, Alistair Darling, in yesterday’s budget.
Dr Vivienne Nathanson, the BMA’s Head of Science and Ethics, said: “It is very important that tax increases on alcohol are part of a larger plan to reduce problem drinking.” She added:
“The evidence tells us that the cheaper and more accessible alcohol is the more people will drink. The government needs to tackle this issue so it’s good news that ministers have made a start today. These tax increases may be unpopular with some members of the public but we hope that they will look at the wider issue and recognise that the UK has a real problem on its hands regarding alcohol misuse. Tough action is needed. The UK is one of the heaviest alcohol consuming countries in Europe.
“Drinking in moderation is enjoyable and may be good for you. Drinking way over the recommended guidelines costs many people their health and ultimately their lives. The UK spends millions of pounds every year on treating people with alcohol problems and dealing with the crime and violence often associated with alcohol misuse.”
http://www.bma.org.uk
SAMHSA Accepting Applications For FY 2008 Sober Truth On Preventing Underage Drinking Act (STOP Act) Grants
March 12, 2008
The Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, is accepting applications for Fiscal Year 2008 for Sober Truth on Preventing Underage Drinking Act (STOP Act) grants. The purpose of this program is to prevent and reduce alcohol use among youth in communities throughout the United States.
The program was created to strengthen collaboration among communities, the Federal government, and State, local and tribal governments on the issue of alcohol use among youth. Applicants must demonstrate a long-term commitment to reducing alcohol use among youth and advance collaboration among community-based organizations. The goal is to disseminate to communities timely information regarding state-of-the-art practices and initiatives that have proven to be effective in preventing and reducing alcohol use among youth.
SAMHSA expects that $3.93 million in funding will be available to award up to 80 grants for up to 4 years. The actual award amount may vary, depending on the availability of funds. The grants will be awarded by SAMHSA’s Center for Substance Abuse Prevention.
Who Can Apply: Eligible applicants are domestic public and private nonprofit entities that are currently grantee organizations receiving or having received grant funds under the Drug-Free Communities Program.
How To Apply: Applications for No. SP-08-004 are available by calling SAMHSA’s Information Line at 1-877-SAMHSA7 [TDD: 1 800-487-4889] or by downloading the application here.Applicants are encouraged to apply online using http://www.grants.gov.
Application Due Date: April 9, 2008. Applications must be received by the due date and time to be considered for review. Please review carefully Section IV-3 of the application announcement for revised Fiscal Year 2008 submission requirements.
http://www.samhsa.gov
