Alcohol consumption is known to increase during Christmas time and excessive alcohol consumption has been proven to be associated with gastrointestinal bleeding and certain vitamin deficiencies. While food fortification is well known and practiced in most countries, food or beverages fortified with medicine has never been practiced on a wider scale, just as alcohol rarely is fortified. In this article it is speculated how alcohol fortified with proton pump inhibitor and vitamin B would effect alcohol-related morbidity.
Low-risk drinking guidelines have been developed independently in a number of jurisdictions resulting in different sets of advice with different definitions of 'low risk'. This paper discusses some of the fundamental issues addressed by an expert advisory panel during the course of developing national guidelines for Canadians and summarises key sets of evidence that were influential.
The underlying reasoning and connection between the evidence and the guidelines is discussed in relation to: (i) how to minimise risk of long-term illnesses; (ii) how to minimise risk of short-term harms, for example injury; and (iii) alcohol use during pregnancy. Both absolute and relative risks were considered in the development of the guidelines.
Meta-analyses of all-cause mortality were used to identify upper limits for usual drinking levels where potential benefits and risks were balanced for the average person in comparison with lifetime abstainers (10 standard drinks per week for women, 15 for men). Emergency room studies and situational risk factors were considered for advice on reducing short-term: (i) when not to drink at all; (ii) how to reduce intoxication; and (iii) upper limits for occasional daily consumption by adults aged 25 to 64 years (3 standard drinks for women, 4 for men). Shortcomings in the research data were highlighted.
It was estimated that total compliance with these guidelines at a national level would result in substantially reduced per capita alcohol consumption and approximately 4600 fewer deaths per year.
Comment In: Drug Alcohol Rev. 2012 Mar;31(2):153-522220756
OBJECTIVES: The purpose of this study was to estimate retrospectively the costs of health care resources used in the Malmö Preventive Project, Sweden and estimate the costs of in-patient care that were avoided because of early intervention. SETTING AND SUBJECTS: A large-scale community intervention programme was conducted from 1974 to 1992 in Malmö, Sweden with the aim of reducing morbidity and mortality of cardiovascular diseases (CVD), alcohol related illnesses, and breast cancer. Between 1974 and 1992, 33 336 male and female subjects were screened for hypertension, hyperlipidaemia, type-2 diabetes and alcohol abuse. Intervention programmes that included life-style modifications, follow-up visits with physicians and nurses and drug therapy were offered to about 25% of screened subjects. METHODS: Recruitment costs were generated through out the screening period. Intervention costs were estimated for 5 years after screening. Excess in-patient care costs were estimated by subtracting hospital consumption for an unscreened, matched cohort from that of the screened cohort over follow-up periods of 13-19 years. Intervention and excess in-patient care costs were estimated until 1996. RESULTS: The net expenditures for recruitment and intervention was SEK253 million and saved costs for in-patient care of SEK143 millions (1998 prices). Considering the opportunity cost of the resources used in the study, the net cost rises to about SEK200 millions. CONCLUSIONS: The results suggest that only part of the intervention costs were offset by reduction in future morbidity health care costs. This is in line with results from prospective analyses of other primary prevention programmes.
In order to strengthen local alcohol prevention work in Sweden the Swedish government has for the past almost 15 years commissioned the Public Health Agency of Sweden to initiate a series of community-based alcohol prevention projects. The latest of these, labeled local development with ambitions (LUMA), included 25 municipalities in Sweden.
Aim of this study is to examine if LUMA municipalities that received financial support, with requirements, increased local alcohol prevention and if alcohol consumption and harm declined.
Twenty-five Swedish municipalities that received financial support aiming to strengthen local alcohol preventing activities (intervention group) were compared to municipalities that did not receive such support (control group, N = 224), before, during, and after the intervention period. Two composite measures of policy and activity were created and used. The composite activity measure includes seven activity indicators and the composite policy measure includes six policy indicators. Harm measures have been selected based on several recommended indicators for monitoring alcohol, tobacco, and other drugs in Sweden. A fixed effects model was used to analyze data.
The results reveal that prevention activities increased and several alcohol-related harm indicators were reduced in intervention municipalities (LUMA) compared with in control municipalities.
It seems as if financial support, combined with specific requirements and support from the regional and national level, can stimulate local alcohol prevention activities and have a significant effect on alcohol consumption and alcohol-related harm. Similar evaluations in other countries would be of great value for assessing the generalizability of findings.
AIM: To examine strategies of harm minimization employed by teenage drinkers. DESIGN, SETTING AND PARTICIPANTS: Two periods of ethnographic fieldwork were conducted in a rural Danish community of approximately 2000 inhabitants. The fieldwork included 50 days of participant observation among 13-16-year-olds (n = 93) as well as 26 semistructured interviews with small self-selected friendship groups of 15-16-year-olds (n = 32). FINDINGS: The teenagers participating in the present study were more concerned about social than health risks. The informants monitored their own level of intoxication, but in order to reduce alcohol consumption they depended upon support from their peers. The informants preferred drinking in the company of well-known and trusted peers, and during drinking episodes they supervised and intervened in each others' drinking to the extent that they deemed it necessary and possible. In regulating the social context of drinking they relied on their personal experiences more than on formalized knowledge about alcohol and harm, which they had learned from prevention campaigns and educational programmes. CONCLUSIONS: In this study we found that teenagers may help each other to minimize alcohol-related harm, and teenage peer groups should thus be considered a resource for health promotion.
INTRODUCTION: In Great Britain and in Denmark, strong efforts have been made to influence knowledge on the upper threshold of hazardous drinking. In Denmark, a campaign has been repeated every week 40 from 1990 to 2001 with information on the sensible drinking limits of 21 drinks per week for men and 14 drinks per week for women. The aim of this study was to examine the effect of this ongoing campaign on the level of knowledge of sensible drinking limits for men and women. MATERIAL AND METHODS: Every year from 1994 to 1999, random representative samples of 1,030 adult Danes were interviewed on the telephone. RESULTS: Our main finding was that the level of knowledge of sensible drinking limits for own sex increased in all subsets of the population throughout the period. However, at the end of the study period (1999), a total of 80% of highly educated young (18-25 years of age) men knew sensible drinking limits for own sex, while only 35% of uneducated older (more than 65 years old) men had knowledge on sensible drinking limits. The proportions were similar among women: Subjects admitting an intake higher than sensible for own sex, i.e. 21 and 14 drinks per week, respectively, had the highest knowledge of these drinking limits. DISCUSSION: We conclude that public health campaigns, such as the sensible drinking limit campaign, certainly has an impact on the level of awareness in the general population. Furthermore, those drinking more than 21 and 14 drinks per week, respectively, are reached by these campaigns.
Very brief alcohol interventions (approx. 5 min.) are recommended for implementation in Danish municipalities by the The Danish Health and Medicines Authority. We have investigated the evidence supporting this recommendation. A lack of clarity remains about the active components in brief interventions and the extent to which the existing evidence base can be interpreted as efficacy or effectiveness studies. This has important implications for the generalizability of the trials. There is insufficient evidence on the effectiveness of very brief alcohol interventions and implementation is premature.
This article investigates self-reported interventions by students in the alcohol, tobacco, illicit drug use, and drinking-driving of their friends. The data came from a study of 1184 students in Ontario schools in grades 7, 9, 11, and 13. We found that about a third of students intervened in friends' illegal drug use and drinking-driving but about half intervened about smoking. Students who intervened were more likely to be older and spend fewer nights at home. They were less likely to use cannabis, but had more friends using cannabis and illegal drugs. Also, they had more exposure to drug education and were more disapproving of drug use. Drug education may give students the knowledge and confidence to intervene in friends' drug use.
In a municipality in Sweden there was a concern about the high alcohol consumption among its residents. An alcohol education program was provided to all those employed by the municipality.
To investigate whether a day-long alcohol education program provided to all employed by a Swedish municipality had an effect on alcohol consumption among employees and specifically among employees with low and higher levels of consumption respectively.
A quasi-experimental evaluation using pre-test and post-test questionnaires was performed. The municipality's employees were divided in one intervention group (n: 124) and one control group (n: 139). ANOVA with repeated measures was performed on AUDIT-score and on three separate AUDIT-items: frequency of drinking, frequency of binge drinking, and typical amount consumed per drinking occasion.
No significant effect on alcohol consumption was identified for the intervention group as a whole. Stratified analyses showed the intervention had a significant effect on reducing the frequency of binge drinking among those with the highest consumption.
Compared to many other studies on alcohol education, some results on behaviour were found when performing stratified analyses. The employees with the highest alcohol consumption, although not labelled high consumers, reduced the frequency of binge drinking. It is difficult to speculate whether these results can be generalized to other working populations. The results have to be compared with more direct methods of reaching risk consumers, such as screening and brief interventions. Knowledge about alcohol and the associated risks of alcohol consumption might facilitate the willingness to seek help sooner.