bluuebunny/crossref_metadata_2025 huggingface dataset:
Alcohol and drug abuse in Nepal
Authors: SHRESTHA NIRAKAR MAN
Published: January 2006

Alcohol use has been in Nepal since time immemorial. Social tolerance to alcohol use is quite high and so far alcohol has not been taken seriously either by the Government or by any social organization. Production, sale, and consumption of alcohol is ever on the increase and it could be taken as the number one problem drug in the country. Cannabis and opium use has been in Nepal for centuries and in the past they did not pose much of a problem. Drug use began to be seen as a problem since only the mid‐1960s and early‐1970s with the influx of large numbers of hippies. Presently, the drug scene in Nepal is dominated by heroin and it has affected youths, mainly in the urban areas. A number of measures, both on supply reduction and demand reduction, have been taken by the Government together with non‐Governmental organizations. However, the number of drug users is on the increase. Relapse rate following detoxification treatment is quite high. After‐care and rehabilitative measures are lacking. Many drug users become involved in high‐risk behaviours in spite of their knowledge of the dangers. Therefore, it calls for the change in our strategies which must be based on the thorough understanding of human nature and its behaviour.
Effect of alcoholism treatment on cirrhosis mortality: a 20‐year multivariate time series analysis
Authors: HOLDER HAROLD D. , PARKER ROBERT NASH
Published: January 2006

Substantial empirical evidence suggests that alcohol consumption is an important cause of cirrhosis mortality levels. However, recent research has failed to find the expected positive relationship between consumption and cirrhosis mortality, in both the United States and Canada, when data from the mid‐1970s through the late 1980s are analysed. Although recent studies have investigated a number of possible explanations, this study examines the hypothesis that an increase in the provision of treatment for alcoholism resulted in a disjuncture in the established relationship between consumption and cirrhosis deaths. This hypothesis if evaluated with a multivariate time series model in which the relationship between consumption and cirrhosis mortality is estimated with controls for treatment and the unemployment rate, using data from the US state of North Carolina. The results indicate that with treatment controlled, changes in cirrhosis mortality are independent of consumption. Further, treatment has a significant short‐term lagged effect on cirrhosis mortality, suggesting that the impact of treatment on chronic alcohol abusers may be one of delaying the consequences of such abuse.
Predictors of smoking behaviour: an application of Ajzen's theory of planned behaviour
Authors: GODIN GASTON , VALOIS PIERRE , LEPAGE LINDA , DESHARNAIS RAYMOND
Published: January 2006

The aim of the present paper was to verify the basic assumptions underlying the theory of planned behaviour for the prediction of cigarette smoking intentions and behaviour among adults of the general population (study 1) and a group of pregnant women (study 2). Each study was developed based upon Ajzen's theory of planned behaviour. In both studies, baseline data was collected at home with trained interviewers and with the use of paper and pencil questionnaires. The self‐report on behaviour was obtained 6 months (study 1) and between 8 and 9 months (study 2) after baseline data collection. In study 1, for smokers, perceived behavioural control, attitudes and subjective norm were explaining intention, whereas perceived behavioural control and habit were the most important predictors of behaviour, fn study 2, smoker's intentions was mainly under the influence of perceived behavioural control and attitude, whereas behaviour was predicted by perceived behavioural control only. The present studies suggest that promotional programmes should help smokers to know and develop their will‐power regarding non‐smoking of cigarettes and should be informed of the effort required in order to modify smoking behaviour.
The incidence of illicit drug use in the United States, 1962–1989
Authors: GFROERER JOSEPH , BRODSKY MARC
Published: January 2006

The Data Note Series is edited by Bridget Grant of the US National Institute on Alcohol Abuse and Alcoholism

Epidemiological descriptions of drug abuse in the US in the Ian three decades have generally not included data on the patterns and trends in the incidence of illicit drug use (i.e. new users). In this paper, estimates of illicit drug use incidence are presented, based on retrospective data from the National Household Survey on Drug Abuse. Incidence of marijuana use began increasing in the 1960s and reached a peak in 1973, after which a continuing decline was seen. Cocaine use incidence began to increase in the late 1960s and reached a peak in 1982, then declined.
Depressed affect as a predictor of increased desire for alcohol in current drinkers of alcohol
Authors: GREELEY JANET , SWIFT WENDY , HEATHER NICK
Published: January 2006

Male drinkers (n = 45) were asked to rate their desire for a drink of alcohol when presented with the sight, smell and taste of their preferred alcoholic beverage and of a lemon cordial drink. The subjects’level of depressed affect on that day and their average daily consumption of alcohol over the last 30 days were measured prior to exposure to these cues. Both level of depressed affect and log of mean daily alcohol consumption predicted increased desire for alcohol when alcohol cues were present, accounting for 40% of the variance in desire. When presented with the lemon cordial cues only 14% of the variance in desire for alcohol was explained by these variables. Also, Spearman's rank order correlations were calculated between heavy drinkers’(n = 19) ratings of self‐efficacy to resist drinking and desire for alcohol in the presence of the alcohol cues. There were significant negative correlations between desire for alcohol and self‐efficacy ratings on the‘urges and temptations’and‘positive social situations’subscales of the Situational Confidence Questionnaire‐39. Several alternative accounts of these findings are discussed.
Reversibility of alcohol‐induced immune depression
Authors: TØNNESEN HANNE , KAISER ANNA H. H. , NIELSEN BEATRICE B. , PEDERSEN ANNE E.
Published: January 2006

Alcohol abusers have suppressed cellular immune function. The aim of the study was to investigate the time of sobriety required to normalize immune function. Delayed hypersensitivity was investigated during disulfiram controlled abstinence in ten heavy alcoholics and in seven moderate drinkers without liver diseases. For comparison a control group of eight previous drinkers was tested. The skin test responses were modest initially with a median area of response of 12 mm2 (range 0–31) in the heavy alcoholics and 3 mm2 (0–15) in the moderate drinkers, ft improved significantly in both groups after two weeks of sobriety. The responses stabilized after 8 weeks at 74 mm2 (54–102) in the heavy alcoholics and after 9 weeks at 63 mm2 (42–76) in the moderate drinking group. The control group had skin lest responses of 70 mm2 (46–87), not different from the responses of the alcohol groups after two months of abstinence. The results suggest that while 2 weeks of abstinence from alcohol will improve the depressed cellular immunity, 2 months of sobriety is necessary to normalize it.
Increased desire to smoke during acute stress
Authors: PERKINS KENNETH A. , GROBE JAMES E.
Published: January 2006

Conditions which promote smoking urges, or desire to smoke, are believed to be important in maintaining smoking behaviour, yet little controlled research has examined acute situational factors which increase desire to smoke. In this study, 16 male and 16 female smokers either smoked or sham‐smoked with an unlit cigarette after brief abstinence during two sessions, one involving a stressful computer task and the other a non‐stress task. Desire to smoke was greater during the stress vs. non‐stress task for sham‐smokers (p < 0.01). Furthermore, although smoking desire decreased markedly after smoking in the smoking smokers (p < 0.001), even this group tended to report greater desire to smoke during stress (p < 0.10). There were no differences between males and females. These findings indicate that exposure to stressors increases desire to smoke, and suggest that such situations may be influential in maintaining smoking behaviour in smokers not attempting to quit.
The effects of methadone on immune function among injecting drug users: a review
Authors: McLACHLAN COLIN , CROFTS NICK , WODAK ALEX , CROWE SUZANNE
Published: January 2006

Methadone maintenance therapy is advocated as a major preventive strategy for the spread of the human immunodeficiency virus (HIV) and other blood‐borne infectious agents among injecting drug users (IDUs) because of its effects in decreasing the frequency of injecting and presumably sharing of equipment. As an opioid agonist, methadone may share the direct and indirect immunoregulatory effects of other opioids, and thus affect susceptibility to, and the natural history of, HIV infection. Available evidence pertaining to methadone and immune function is reviewed. The long‐term immunosuppression observed in heroin injectors on present (incomplete) evidence appears to be caused by factors associated with a drug‐using lifestyle rather than by a direct action of heroin. Although data are conflicting, it is most likely that methadone does not significantly impair immune function and is safe for HIV‐infected IDUs, possibly even allowing some improvement of immune function to occur. The increasing reliance placed on methadone maintenance to control the epidemic of HIV infection in IDUs requires that remaining uncertainties regarding methadone and immune function are clarified urgently.
A longitudinal study of reasons for smoking in adolescence
Authors: McGEE ROB , STANTON WARREN R.
Published: January 2006

This longitudinal study examined factors related to smoking at age 13 and to persistence of smoking from ages 13 to 15 years in a sample (n =719) of New Zealand adolescents. History of smoking at 9 and 11 years predicted smoking at 13 (odds ratio = 2.8), persistence of smoking from age 13 to 15 (OR = 2.4) and smoking at 15 among those not smoking at age 13 (OR = 2.4). While there were no significant sex differences in pre‐adolescent and early adolescent smoking, by age 15 more girls than boys reported smoking. A concern with the immediate negative effects of smoking (taste, smell, feeling ill and feeling silly) as a reason for not smoking at age 13 was inversely related to smoking at age 15 (OR = 0.4). Reasons for smoking at age 13 were not associated with later smoking. Family disadvantage and use of alcohol and other drugs were also associated with later adolescent smoking.
Adverse consequences of lysergic acid diethylamide
Authors: ABRAHAM HENRY DAVID , ALDRIDGE ANDREW M.
Published: January 2006

The continued endemic use of hallucinogenic drugs, and of LSD in particular, raises concern regarding their short and long term adverse consequences. The epidemiology of LSD abuse is reviewed suggesting an increase in LSD use among the young as the prevalence rates for other substances continues to fall. Evidence supports the association of LSD use with panic reactions, prolonged schizoaffective psychoses and post–hallucinogen perceptual disorder, the latter being present continually for as long as 5 years. Evidence does not support claims of genetic disorders arising from hallucinogens. In light of the foregoing, current data confirm earlier findings of long lasting psychopathology arising in vulnerable individuals from the use of LSD. A hypothetical long term molecular mechanism of adverse effects is proposed.
Measurement of the severity of amphetamine dependence
Authors: CHURCHILL ANDREW C. , BURGESS PHILIP M. , PEAD JOHN , GILL TONY
Published: January 2006

A Severity of Amphetamine Dependence Questionnaire (SAmDQ) was administered to 101 subjects attending an Australian drug dependency treatment centre. The SAmDQ was adapted from the Severity of Opiate and Alcohol Dependence Questionnaires (SODQ & SADQ). The structural characteristics of the SAmDQ were examined and compared with previous findings reported on samples of opiate addicts with the SODQ. A high degree of consistency was found between the results obtained with the SAmDQ and previous findings with the SODQ. The relationship between the SAmDQ and the Severity of Dependence Scale (SDS) was also examined. The findings suggest that further development of amphetamine dependence measurement is required.
Consumption of buprenorphine and other drugs among heroin addicts under ambulatory treatment: results from cross–sectional studies in 1988 and 1990
Authors: SAN LUIS , TORRENS MARTA , CASTILLO CLAUDIO , PORTA MIQUEL , DE LA TORRE RAFEL
Published: January 2006

We assessed the prevalence of consumption of buprenorphine and other drugs among heroin addicts under ambulatory treatment in two cross‐sectional studies conducted in 1988 (188 subjects) and in 1990 (197 subjects). Patients were enrolled in one of three different programmes: methadone maintenance programme (MMP), antagonist maintenance programme (AMP) and drug‐free programme (DFP). Information given by participants was compared with results of urine screening for drugs. Urine samples were tested using enzyme immunoassay for the detection of heroin, cocaine, dextropropoxyphetie, cannabis and benzodiazopnies, and radioimmunoassay for buprenorphine. Sixty‐six percent of patients in 1988 and 71% of patients in 1990 reported having consumed buprenorphine at some time during their history of drug dependence (period prevalence) and 5.9% and 6.1%, respectively, tested positive to the drug (point prevalence). In over 70% of these patients consumption was by the intravenous route. Consumption of cannabis, cocaine and benzodiazepines was also very high in the study population. Overall, patients in the DFP group consumed the largest number of the drugs tested, while those in the AMP group consumed the smallest number. Abuse of buprenorphine could be more widespread than previously reported.
Alcohol consumption in the European Community: uniformity and diversity in drinking patterns
Authors: HUPKENS CHRISTIANNE L. H. , KNIBBE RONALD A. , DROP MARIA J.
Published: January 2006

Within the European Community (EC) drinking patterns in the southern countries can be characterised by daily consumption of wine at meals, and in the northern countries by less frequent consumption of beer outside meats. Yet, as in past decades in the southern countries beer consumption and in the northern countries mine consumption strongly increased, the question is whether the distinction in drinking patterns still applies. This paper (1) describes for each country of the EC total alcohol consumption, (2) examines the frequency and the context of consumption of the new beverage type and (3) analyses whether subpopulations, defined by sex, age and educational level, differ m the adoption of the new beverage type. In all countries wine is consumed more often at meals compared to beer. Older people consume beer in greater numbers and more frequently than younger people, who consume beer in greater numbers. People of higher educational level consume the new beverage type mare often compared to people of lower educational level, who consume the traditional beverage type more frequently. Finally, males and females differ less in the frequency of consumption of the new beverage type than in the frequency of the traditional beverage type.
Public discourse on the benefits of moderation: implications for alcohol policy development
Authors: Casswell Sally
Published: January 2006

There is increasingly widespread acceptance of a protective effect of alcohol against coronary heart disease and a consequent delay of mortality among the elderly. This information has been widely disseminated in the popular media and by industry related sectors. The policy arguments based on the epidemiological data are that moderate alcohol use is beneficial, therefore policy should not impact on moderate drinkers, only on heavy drinkers. This fits well with the arguments of those opposed to population public health measures such as taxation, controls on availability, and enforcement of drink‐driving laws like random breath testing. However, there is a growing consensus among public health researchers that population measures are most effective at reducing alcohol‐related harm. Concern has been expressed that the current public discourse on benefits of moderation will influence individuals to drink more. Of equal, or even greater, concern is the likelihood that this public discourse will decrease the chances that effective population focused policies will be implemented.
Should the controlled provision of heroin be a treatment option? Australian feasibility considerations
Authors: HAMMER GABRIELE
Published: January 2006

A proposal for a trial to provide heroin to dependent users in a controlled manner is currently being considered in the Australian Capital Territory. The political background to this proposal is outlined, as is the current ‘drug scene’. A Stage 1 examination found that a trial of controlled provision of heroin is feasible in principle and recommended a further stage (Stage 2) of feasibility investigations to explore the practicalities. The results of the Stage 1 investigations and the proposals for Stage 2 are incorporated into discussion about three important issues: the feasibility research process, the therapeutic relationship, and social control. These considerations have wider applicability, both for treatment services for illegal drug users generally and for informing drug policy debates. Much can be learnt from the feasibility considerations, whether or not a trial of the controlled provision of heroin eventuates in Australia.
Socially desirable responding and self‐reported HIV infection risk behaviors among intravenous drug users
Authors: LATKIN CARL A. , VLAHOV DAVID , ANTHONY JAMES C.
Published: January 2006

This study examined the extent to which self‐report of human immunodeficiency virus (HIV) risk behaviors might depend upon socially desirable response tendencies, and whether socially desirable responding might serve as a confounding variable in the study of risk behaviors and HIV serostatus. The subjects were 2885 intravenous drug users participating in the ALIVE study in Baltimore, Maryland. Participants completed an interview and were tested for HIV serostatus. The interview covered HIV risk behaviors, and included established scales to measure ‘self‐deception’ and ‘impression management’, two separate dimensions of socially desirable responding. Seven items for each scale were scored true/false, with a summary score used for analysis. Scores on self‐deception and impression management were inversely related to self‐reports of sharing injection equipment, injecting at shooting galleries, and injecting more than once a day. Neither self‐deception nor impression management was associated with cocaine use. Self‐reported receptive anal intercourse was associated inversely with self‐deception but not with impression management. HIV serostatus was not associated with social desirability, and statistically controlling for social desirability had a negligible impact on the magnitude of associations between risk behaviors and HIV serostatus. The results indicate that measures of social desirability may be used to ascertain sensitive areas of inquiry in interviews of intravenous drug users.
Developments in drinking behavior in the Netherlands from 1958 to 1989, a cohort analysis
Authors: NEVE RUDIE J. M. , DIEDERIKS JOSEPH P. M. , KNIBBE RONALD A. , DROP MARIA J.
Published: January 2006

Alcohol consumption in the Netherlands increased at a very fast rate from 1960 to 1975, especially among young men. The question is raised whether members of the cohort that started drinking during the 1960s show a lasting deviation from cohorts born earlier with respect to drinking behavior. Cohort analysis is used to assess the effects of aging, period and cohort membership on changes in abstinence, mean consumption and heavy drinking in the Netherlands in the last three decades. Social interaction theory (Skog, 1980) is used as an interpretative framework. Conclusions are that abstinence is related w aging, while mean consumption and heavy drinking are associated with period effects. Populations of men and women appear to change drinking behavior collectively. Results on women are more regular than those on men.
Mortality in a sample of convicted drinking drivers
Authors: MANN ROBERT E. , ANGLIN LISE , WILKINS KARL , VINGILIS EVELYN R. , MACDONALD SCOTT
Published: January 2006

Mortality rates for 639 drinking drivers were calculated. The sample consisted of all individuals convicted of a second offence in two Ontario cities (Oshawa and North Bay) between 1973 and late 1978. There were 53 deaths (51 males, 2 females) in the sample prior to the end of 1986. Among males, significant excess total mortality was observed (Standardized Mortality Ratio = 1.7); similar trends were observed among females. Age‐related excess mortality and excess mortality by cause were strikingly similar to mortality patterns observed among alcoholics.
Religiosity and attitudes towards drug use among 13–15 year olds in England
Authors: FRANCIS LESLIE J. , MULLEN KENNETH
Published: January 2006

A sample of 4753 13–15 year olds attending the third and fourth year classes of 29 secondary schools completed a questionnaire concerned with attitudes towards the use of alcohol, butane gas, glue, heroin, marijuana and tobacco, together with indices of religious affiliation, belief and practice. The data demonstrated that young adolescents' attitudes towards drug use varies considerably from one substance to another and that religiosity is a significant predictor of attitudes towards the use of each of the substances included in the survey.
The role of psychobiological states in chemical dependency: who becomes addicted?
Authors: NEISS ROB
Published: January 2006

This paper argues that recent developments in the understanding of psychobiological states may help to explain individual differences in susceptibility to addiction. It points out that the construct of arousal is deficient for this purpose and that a more fruitful approach views humans as bundles of state‐dependent selves, strongly affected by self‐efficacy and response expectancies. Coping skills, enhancement behaviors, and other state‐regulating techniques are seen as crucial to liability to chemical dependency and the social learning underlying their genesis is explored. Under this view drug experiences are held to be analogous to hypnotic inductions and psychological approaches to therapy could usefully focus on helping addicts develop a metaperspective on the succession of psychobiological states.
Self‐titration of nicotine: evidence from the Scottish Heart Health Study
Authors: WOODWARD MARK , TUNSTALL‐PEDOE HUGH
Published: January 2006

Data from 2754 cigarette smokers who smoke no other forms of tobacco are extracted from the baseline cross‐sectional survey of the Scottish Heart Health Study. Carbon monoxide in expired‐air (CO‐E), serum thiocynate and serum cotinine measurements from these smokers are compared with the carbon monoxide (CO), nicotine and tar yields of the cigarettes which they smoke, controlling for daily cigarette consumption, the sex of the smoker and the other cigarette yields. CO‐E is found to increase positively with CO and tar yield, but inversely with nicotine yield. Thiocyanate increases positively with CO, is not significantly affected by tar, but increases inversely with nicotine. Cotinine is affected only by tar, in a positive direction for women. We conclude that smokers appear to self‐titrate their consumption of nicotine by more aggressive smoking of lower‐strength cigarettes.
Alcohol and non‐traffic unintended injuries
Authors: HINGSON RALPH , HOWLAND JONATHAN
Published: January 2006

In a review of the English language literature on alcohol and unintentional injury we identified 21 studies on falls, 36 on drownings and 32 on bums from 1947‐1986. The proportion of fatal and non‐fatal fall victims who had been drinking ranged from 21–77%, and 18–53% respectively. In three more recent studies, 35–63% of persons fatally injured in falls had been drinking. In five other studies 13–37% of persons injured in non fatal falls had been drinking. In our earlier review of drowning studies with complete ascertainment and duration of submergence specified, 27–47% of those who drowned had positive BAC's. In eight subsequent studies, alcohol was identified in 21–47% of drowning deaths. In our earlier review alcohol was involved in 9‐86% of bum deaths. In five more recent US studies, alcohol was found in 12–61 % of fatally injured burn victims. Case control studies are needed to establish whether alcohol increases the risk of trauma. Studies are also needed of interventions to reduce the proportion of these injuries where alcohol is involved.
The measurement of alcohol‐related accidents
Authors: HARFORD THOMAS C.
Published: January 2006

This paper examines some of the major ethical and research issues associated with the measurement and recording of alcohol‐related problems. Because self‐reports of the history of the amount of alcohol ingested are sometimes unreliable, the assessment of the role of alcohol in casualties often relies on a variety of methods which are both diverse and interrelated. The unique measurement problems posed by the diversity of alcohol measures are reviewed and issues in selection and recording bias of alcohol's involvement in injury are discussed. A number of fundamental ethical and moral issues related to measurement are identified.
Effects of mass media communications on health and safety habits: an overview of issues and evidence
Authors: WILDE GERALD J. S.
Published: January 2006

A review is presented of factors that have been investigated on their relevance in mass media communications that are specifically designed to alter health and safety related behaviours of the recipients. While alcohol consumption is a major concern in this paper, the evidence regarding the effective use of mass communications for the modification of other health and safety habits has also been incorporated. Specific topics include the choice of yardstick of effect, study methodology and the strength of conclusion this permits, as well as the dependency of the effect of mass communication upon its four constituent components: the source, the content of the message, the channel of communication, and the characteristics of the recipients. Reference is made to the effect of educational journalism related to the prevention of health problems and to efforts to increase the educational value of traffic accident reports in daily newspapers through the inclusion of information that is potentially helpful to accident avoidance.
Punishment as a factor in preventing alcohol‐related accidents
Authors: ROSS H. LAURENCE
Published: January 2006

As a humanitarian and economic ‘bad’, infliction of punishment requires justification in terms of compensating achievements, as well as moral appropriateness. In the context of road accidents, there is evidence that increasing the certainty and swiftness of threatened punishment may deter risky behavior, although increasing the severity of the threat seems ineffective. These effects may be generalizable to other kinds of accidents, but empirical evidence is lacking. A further possibility for the justifiable use of punishment is in its application to negligent service of alcohol.
Prevention of alcohol‐related accidents in the community
Authors: HOLDER HAROLD D.
Published: January 2006

This paper establishes a conceptual and operational basis for development of community prevention programs to reduce alcohol‐related accidents. A public health perspective of accidents is proposed as the philosophical basis for local prevention interventions in which accidents are viewed as system problems (system outputs, if you will) not simply problems caused by a few alcohol‐dependent individuals. Since there are no examples of controlled community prevention research projects (trials) which have demonstrated a reduction in community‐level alcohol‐related accidents, such controlled [rials are needed in the future. An example of one being developed by the Invention Research Center, Berkeley, CA is provided. Without such controlled trials, prevention research will be unable to demonstrate that such accidents can actually be reduced. This paper explores the applications of a public health perspective to the prevention of alcohol‐involved accidents at the community level including a conceptual model of alcohol‐involved trauma and suggested design, alternative local interventions, possible outcome measures, and phases for community prevention of alcohol‐related accidents.
Vietnam veterans' rapid recovery from heroin addiction: a fluke or normal expectation?
Authors: ROBINS LEE N.
Published: January 2006

Between 1972 and 1974, the outcomes of army enlisted men who had served in Vietnam during 1970–71 were evaluated and compared with that of a matched group. This paper reports the major findings of that study with respect to frequency of narcotic addiction in and after Vietnam, and the major risk factors for Vietnam addiction and later relapse. Extraordinary access to records facilitated drawing the sample, locating it, and verifying interview responses. The surprisingly low levels of readdiction and the rarity of addiction to narcotics alone as compared with poly‐substance dependence are findings still not entirely incorporated into public and scientific views of heroin addiction. Some defenses against that incorporation are examined.
Evaluation of syringe‐exchange for HIV prevention among injecting drug users in rural and urban areas of Wales
Authors: KEENE JAN , STIMSON GERRY V. , JONES STEVE , PARRY‐LANGDON NINA
Published: January 2006

This paper considers the prevention of HIV in rural and urban areas among both opiate and non‐opiate drug injectors. A 2‐year study evaluated specialist and community based syringe‐exchange provision in Wales. Numbers of clients and patterns of attendance at eight syringe‐exchange schemes were monitored together with comparative cross‐sectional studies of attenders (n = 152) and non‐attenders (n = 176) from the population of drug injectors in 1990 and 1991. A total of 1171 clients made 7553 visits in the 2‐year period, 110000 syringes were issued and 80% of needles and syringes were returned. There were feat demographic differences between attenders and non‐attenders, but large and significant differences in HIV risk behaviour; only 9% of attenders had recently shared syringes in 1990 (10% in 1991) compared to 41% of non‐attenders (39% in 1991). The catchment areas of specialised services were limited (5 miles or less) and insufficient in rural areas. Alternative community approaches to syringe distribution and exchange are examined.
Factor analysis of ICD‐10 symptom items in the 1988 National Health Interview Survey on Alcohol Dependence
Authors: MUTHÉN BENGT O. , HASIN DEBORAH , WISNICKI KATHLEEN S.
Published: January 2006

The present paper analyzes data from the 1988 National Health Interview Survey (NHIS88) of US adults. This general population survey is important in that it is the largest survey to date that collects detailed information on alcohol consumption and alcohol problems. The NHIS88 is a multi‐stage complex sample household study with a sample size of about 44 000 adults of which about 20 000 reported that they were current drinkers. Symptom items were used for classification of individuals into categories of alcohol abuse and alcohol dependence based on the DSM‐III‐R, DSM‐IV, and ICD‐10 classification. The present analyses are based on 20 items corresponding to the ICD‐10 classification, the elements of which are closely related to the Edwards–Gross alcohol dependence syndrome concepts. A single dimension corresponding to alcohol problems in general accounted for much of the correlations among these items, but additional dimensions of interest were also identified. Of the ICD‐10 elements only Impaired Control, Tolerance, and Withdrawal could be identified as separate dimensions.
The dimensionality of alcohol abuse and dependence: factor analysis of DSM‐III‐R and proposed DSM‐IV criteria in the 1988 National Health Interview Survey
Authors: MUTHÉN BENGT O. , GRANT BRIDGET , HASIN DEBORAH
Published: January 2006

Decisions on the final version of the DSM‐IV alcohol abuse and dependence criteria will be determined largely by the APA's substance abuse field trials, conducted primarily in treated, clinical samples. Among the major objectives of the field trials are to study the boundaries between abuse and dependence, and to identify specific criteria that define the abuse category. The decisions on revisions of the abuse and dependence criteria in DSM‐IV should, however, be informed by data from non‐treated or general population samples as well. The present study addresses the field trial objectives using recent data from a large general population survey, the 1988 National Health Interview Survey (NHIS88). The paper reports on factor analyses to assess the dimensions underlying the DSM‐III‐R and DSM‐IV dependence and abuse criteria as operationalized in the NHIS88. The focus of the analyses is on whether models with more than one dimension are needed and if so, the correspondence of the dimensions to criteria sets defined in the DSM‐III‐R and DSM‐IV. The analyses show that a two‐dimensional model is required. The dimensions are interpreted as abuse and dependence, but the sets of criteria that define each of the dimensions show important deviations from the criteria sets used in the DSM definitions.
Shop steward handling of alcohol‐related problems
Authors: DELANEY WILLIAM P. , AMES GENEVIEVE
Published: January 2006

Using direct observations and extensive field interviewing over a 4‐year period, this paper examines practices and beliefs of shop stewards in their effects on drinking patterns and consequences. It also includes response frequencies from a random sample survey questionnaire (n = 984) that are consistent with the qualitative analysis of steward behavior. Several themes are extracted which position steward handling of alcohol‐related cases as intervening between disciplinary measures of supervisors and consequences of work‐related drinking of union employees.
Interaction of public policy advocacy and research in the passage of New Zealand's Smoke‐free Environments Act 1990
Authors: CARR‐GREGG MICHAEL
Published: January 2006

This paper examines the public policy campaign that led up to the passage of New Zealand's Smoke‐free Environments Act 1990, arguably the toughest tobacco control legislation in the world, focusing on the critical interaction between advocacy and research. The paper argues that had it not been for the Toxic Substances Board Report and the publicity it received, it is doubtful that the Smoke‐free Environments Act would have been enacted. The tobacco industry catch cry that ad bans don't work, largely fell on deaf ears because of the Toxic Substances Board Report's findings, and the public health advocate's ability to refer to an authoritative Department of Health document.
The risk of alcohol
Authors: ANDERSON PETER , CREMONA ANNE , PATON ALEX , TURNER CHARLOTTE , WALLACE PAUL
Published: January 2006

We have reviewed 156 papers which provided sufficient information to relate individual alcohol consumption to risk for a variety of physical damage. Overall, there was evidence for a dose‐response relationship between level of alcohol consumption and risk of harm for liver cirrhosis, cancers of the oropharynx, larynx, oesophagus, rectum (beer only), liver and breast, and blood pressure and stroke. An increased risk of cardiac arrhythmias, cardiomyopathy and sudden coronary death was associated with heavy drinking. There was evidence for a protective effect of alcohol consumption against risk of coronary heart disease, which could be achieved at consumption levels of less than 10 g alcohol a day. The mortality of non‐drinkers was higher than that of moderate drinkers in some studies. Level of alcohol consumption and total mortality were dose‐related when non‐drinkers were excluded. The finding of a dose‐relationship between alcohol and harm suggested causality. It was not possible to define individual risk for all harms at a given level of alcohol consumption because of variations in methodology, but some idea of the order of magnitude of the increased risk can be obtained from calculating trends of pooled log‐odds ratios. At levels of alcohol consumption of more than 20–30 g a day, all individuals are likely to accumulate risk of harm. Current guidelines on upper limits of lower risk drinking in different countries (168–280 g of alcohol a week for men and 84–140 g a week for women) reflect levels at which the risk of total mortality is not greatly increased above one.
Research in general practice for smokers and excessive drinkers in Australia and the UK. III. Dissemination of interventions
Authors: RICHMOND ROBYN L. , ANDERSON PETER
Published: January 2006

This article reviews the main methods of dissemination of interventions to doctors for the benefit of patients who are smokers and excessive drinkers. Firstly, the modes of delivery of interventions are discussed suck as: postal delivery, face‐to‐face strategies such as an educational facilitator, courier, training workshops, reinforcement contact after training, and teaching in medical school. Secondly, vie examine GPs' delivery of interventions working in association with others such as with: the health visitor, health facilitator, practice nurse, and specialist clinic. Thirdly, we discuss the debate about the public health impact of GP interventions for smokers, which is about rates of recruitment of patients to programs and about the most effective interventions that will continue to be used by GPs. Fourthly, doctors underutilize their opportunities to identify and intervene with smokers and excessive drinkers and we explore many of the barriers to intervention. Finally, there are several new initiatives in general practice that require research including: matching GPs to specific treatments, comparing the uptake and continued use of different levels of interventions, evaluating the most effective ways of delivering interventions to GPs, and the training of doctors in the intervention methods.
Mediators and moderators of young adults'drinking
Authors: FROMME KIM , RUELA ANTHONY
Published: January 2006

Direct effects of modeling and indirect effects of social perception processes have been implicated in the acquisition and maintenance of alcohol use. Parental and peer drinking behavior (assessed from self‐reports), and student perceptions about parent and peer drinking (assessed from student estimates of their parents' and friends' alcohol use) were examined through surveys of college students, their parents, and a same‐sex best friend. Results showed that students' perceptions about their parents' drinking and parents' self‐reported quantity of alcohol consumed mere significant correlates of students' own drinking. Perceptions about their friends' alcohol use were found to mediate the strong correlation between student and friend drinking. Perceived similarity to parents, but not perceived similarity to their friend, moderated the relation between students' alcohol use and their perceptions about the alcohol use of significant others. When parents were asked to estimate the alcohol use of their sons, daughters, and the average college student, they consistently estimated lower consumption for their offspring than for the average student.
HIV risk‐taking behaviour among amphetamine users in Sydney, Australia
Authors: HANDO JULIE , HALL WAYNE
Published: January 2006

A survey was undertaken of needle‐sharing and sexually risky behaviour among 231 Australian amphetamine users, half of whom usually injected amphetamine. The prevalence of risky needle use and sexual behaviour was similar to that observed in recent Australian surveys of opioid injectors. About a third of those who had ever injected had shared needles, and the variables that best predicted frequency of sharing needles were having an injecting drug user as a partner, having experienced symptoms of dependence on amphetamines, and having sought medical treatment for an amphetamine related problem. Regular condom use with either regular or casual partners toas low; only the minority employed in the sex industry regularly used condoms. Sexual risk‐taking was not related to needle‐sharing or amphetamine use. Although Australian amphetamine and opioid users have reduced their risks of transmitting HIV, there remains a substantial minority of both types of drug injector who continue to place themselves and others at risk by sharing needles and engaging in unsafe sexual behaviour.
Substance use, risky behaviors, and victimization among a US national adolescent sample
Authors: WINDLE MICHAEL
Published: January 2006

Data from the National Adolescent Student Health Survey were used to study the interrelations among substance use, risky (dangerous) behaviors, and victimization among 8th and 10th graders. Pearson correlations indicated significant associations between substance use and both higher levels of risky behaviors (e.g., hitchhiking, going on a blind date) and victimization among adolescents. Regression analyses indicated the potency of risky behaviors as a predictor of victimization for male adolescents, and a significant risky behavior by illicit drug use interaction for female adolescents. Results are discussed with regard to potential short‐ and long‐term health consequences of risky behaviors and violent victimization for psychological development in adolescence and adulthood.
Genetic and social influences on starting to smoke: a study of Dutch adolescent twins and their parents
Authors: BOOMSMA DORRET I. , KOOPMANS JUDITH R. , VAN DOORNEN LORENZ J. P. , ORLEBEKE JACOB F.
Published: January 2006

In a study of 1600 Dutch adolescent twin pairs we found that 59% of the inter‐individual variation in smoking behaviour could be attributed to shared environmental influences and 31% to genetic factors. The magnitude of the genetic and environmental effects did not differ between boys and girls. However, environmental effects shared by male twins and environmental effects shared by female twins were imperfectly correlated in twins from opposite‐sex pairs, indicating that different environmental factors influence smoking in adolescent boys and girls. In the parents of these twins, the correlation between husband and wife for‘currently smoking’(r = 0.43) was larger than for‘ever smoked’(r = 0.18). There was no evidence that smoking of parents (at present or in the past) encouraged smoking in their offspring. Resemblance between parents and offspring was significant but rather low and could be accounted for completely by their genetic relatedness. Moreover, the association between‘currently smoking’in the parents and smoking behaviour in their children was not larger than the association between‘ever smoking’in parents and smoking in their children.
Alcohol involvement in fatal traffic crashes in the United States: 1979–90
Authors: ZOBECK TERRY S. , GRANT BRIDGET F. , STINSON FREDERICK S. , BERTOLUCCI DARRYL
Published: January 2006

Trends in alcohol‐related traffic crash fatalities for the United States were examined with data from the Fatal Accident Reporting System for the years 1979–90. Alcohol‐related traffic crash fatalities have decreased 10% over the 12 years studied, from 20245m 1979 to 18 279 in 1990. Fatality rates per 100 million vehicle miles traveled, and per 100 000 population, registered vehicles and licensed drivers have decreased even more sharply. Rates of blood alcohol testing of fatally injured drivers rose substantially among the States, with the nationwide rate increasing from 44% in 1979 to 75% in 1990. Factors that may be affecting these trends are discussed.
Transitions in patterns of heroin administration: a study of heroin chasers and heroin injectors
Authors: GRIFFITHS PAUL , GOSSOP MICHAEL , POWIS BEVERLY , STRANG JOHN
Published: January 2006

A community sample of 408 heroin users was interviewed about changes in their predominant route of heroin administration. Clear preferences for specific routes of drug administration were evident. Two predominant routes of administration were found: injection (54%) and‘chasing the dragon’(44%). More than a third of the sample had changed their predominant route of administration (a‘transition’). Most commonly, only one transition was reported, from chasing to injecting. However, transition to injection was not inevitable: the majority of‘chasers’had never moved to regular injecting despite often using at high doses for many years. Modelling suggests that many chasers give up heroin without moving to injecting. The results indicate, however, a continuing risk of switching from chasing to injecting for those who continued to use. Women were less likely to move from chasing to injecting. Some heroin users had made the transition from injection to chasing; 28 (16%) of the. current chasers had previously been regular heroin injectors. This change in route is less well‐known and to our knowledge has not been previously investigated. Multiple transitions in route mere uncommon; predominant route of administration, once established appears robust. Harm reduction interventions directed towards changing the risk behaviours of heroin users should take account of the different routes of current administration and the potential for future transitions within continued drug use.
The effects of order of questions on reported alcohol consumption
Authors: HARFORD THOMAS C.
Published: January 2006

This research note draws upon the US National Longitudinal Survey (NLS) of Labor Market Experience among youths aged 17–24 to report the effects of variation in the ordering of alcohol questions upon the prevalence of heavier drinking. A secondary analysis of the NLS indicated a substantial decrease in the prevalence of heavier drinking between 1984 and 1985 which is attributed to the order of presentation of two differently styled questions regarding heavier drinking.
Comparison of six alcohol consumption measures from survey data
Authors: WYLLIE ALLAN , ZHANG JIA‐FANG , CASSWELL SALLY
Published: January 2006

Data were collected from a national sample of 1680 New Zealanders that allowed comparison of six different alcohol consumption measures. A measure based on reports of typical frequency and the amount typically consumed in 15 specified drinking locations produced the highest estimate of consumption. This measure and three others showed a particularly high degree of correlation, these being: a measure based on typical frequency and typical occasion amount; a variation of the Finnish period estimate; and a New Zealand variation of the period estimate that incorporated a typical frequency measure. The four measures just described, together with a last 7 days measure, showed generally consistent results when data were examined at the level of the total population and age, gender and socio‐economic sub‐groups. A measure based on the last two drinking occasions showed the hast consistency with the other measures. The high degree of consistency found in the present study is similar to that found in a previous Finnish study and gives confidence that different ways of obtaining information about alcohol consumption, including relatively quick methods, can lead to similar conclusions about the comparative drinking of population sub‐groups.