bluuebunny/crossref_metadata_2025 huggingface dataset:
Smoking prevention: towards a process approach
Authors: LEVENTHAL HOWARD , KEESHAN PATRICIA , BAKER TIMOTHY , WETTER DAVID
Published: January 2006

Current studies of smoking prevention treat the adolescent as a target of influence, they emphasize the acquisition of skills for resisting peer pressure and give too little attention to motivation for resistance. Studies consistent with this social learning framework show moderate reductions in the incidence of smoking for the short term; recent, long‐term follow‐ups show no reduction in experimental over control conditions. We propose a re‐examination of the influence framework and suggest that adolescents use smoking and dress, to project an image of self that will increase the likelihood of success in the formation of relationships in which participants share feelings and attitudes toward each other and the adult world. We also suggest that adults focus upon external, perceptible, and remote threats, e.g. smoking is seen as evil, a response to peer pressure, and a long term threat to health, and ignore discourse about proximal, subjective feelings respecting the changing sexual urges and feelings of social anxiety that accompany adolescence. The socialization of these affects is left to the peer group. It is suggested that future programs intensify their focus on motivation for resisting smoking based upon a revised view of the adolescents objectives in self definition, and combine this with the best of the current skills approaches.
Research on stress and smoking: progress and problems
Authors: POMERLEAU OVIDE F. , POMERLEAU CYNTHIA S.
Published: January 2006

Despite evidence that smoking behaviour increases in the context of stress, there has yet to be a clear‐cut demonstration that nicotine intake is similarly enhanced. Although nicotine intake has been shown to reduce reported anxiety in the context of stress, the controlling conditions (type of stressor, intensity, temporal relationships, etc.) need further exploration. Recent findings involving nicotine's effects on the hypophyseal‐adrenal axis provide a new perspective on these issues, in that increased nicotine intake during exposure to a stressor may represent, at least in part, behavioral compensation for diminished sensitivity to nicotine brought about by nicotine‐stimulated corticosteroid release. Corticosteroids may decrease central nervous system excitability in a way that could account for anxiety reduction; on the other hand, anxiety reduction may be an epiphenomenon with respect to the reinforcement of smoking behaviour. The integration of behavioural, physiological, and biochemical research exemplified by the above approach should lead to a better understanding of stress and smoking.
The application of 1980s psychology to 1990s smoking research
Authors: TIFFANY STEPHEN T.
Published: January 2006

The 1988 Surgeon General's report (US DHHS, 1988) argued that smoking should be considered an addiction because it displays the features common to all addictive disorders, which were, most importantly, highly controlled or compulsive use of a psychoactive substance. Furthermore, urges to smoke were identified as directly responsible for this pattern of drug use. Although it is commonly asserted that urges are central to the addictive process, relatively little research has been devoted to this issue and the evidence that is available provides little support for the assumption. This paper argues that the role of urges in addictive smoking should receive greater attention from smoking researchers and offers several suggestions for overcoming the methodological and theoretical limitations of previous research on smoking urges.
Smokers of the future
Authors: WARBURTON DAVID M. , REVELL ANDREW D. , THOMPSON DEWI H.
Published: January 2006

Teenagers continue to be initiated into smoking, especially young women. A predictor of smoking is the existence ofstressors in their life. The major components of smoking motivation have been found to be similar in young smokers to those found in older smokers, except for the appearance of a group who are resisting the pressures against smoking. There is no evidence that the smokers of the future will be more extreme personality types than the smokers of 10 or more years ago. Changes in demographic characteristics of smokers in the United Kingdom and the United States in favour of relatively more women and more smokers from the poorer socio‐economic groups requires investigation into whether this is attributable to different coping requirements in these groups.
Comprehensive approaches to tobacco use control
Authors: GLYNN THOMAS J.
Published: January 2006

This essay suggests approaches to two issues of importance to the future of tobacco use control research. First, there is need to identify those areas of tobacco use prevention and cessation research which have evolved to the point where additional investigation would only bring incremental gains. The reduction potential of this research should then be consolidated by applying existing, effective interventions widely and systematically. Conversely, there is need to identify those areas in which additional research is necessary. Second, the most logical way to reach agreement on those areas which are ready to move from research to applications‐of‐research is, with the co‐operation and advice of the research community, through the large funding organizations which have supported this research over the past 2 decades. It is these organizations which, once the most effective interventions are identified, are capable of supporting the centrally‐planned, consensus‐driven, comprehensive approaches to tobacco use control which will be necessary to continued success in reducing tobacco‐related morbidity and mortality in the industrialized world and to begin addressing the growing problems of tobacco use in the developing world.
Great expectations: some suggestions for applying the balanced placebo design to nicotine and smoking
Authors: SUTTON STEPHEN R.
Published: January 2006

There are a number of methodological problems with the traditional placebo‐controlled design used to investigate the effects of nicotine in human subjects. For example, the experimental instructions may create a ‘guessing set’ in the participants such that they search for possible clues to try to identify which condition they are in. If they guess correctly, the internal validity of the design may be threatened. Furthermore, by attempting to control for the effect of subjects' expectancies, the traditional placebo design precludes any estimate of expectancy effects. Continued use of this methodology in the smoking field is likely to lead to an overemphasis on pharmacological factors in smoking and a corresponding underemphasis on cognitive factors and nicotine‐expectancy interactions. These problems can be overcome by the use of the balanced placebo design which orthogonally manipulates instructions (Told Nicotine versus Told Placebo) and nicotine (Received Nicotine versus Received Placebo). The balanced placebo design offers a powerful methodology for studying many aspects of smoking behaviour and nicotine effects, and three examples are given to illustrate its potential in this field: nicotine titration, nicotine and performance, and priming effects in smoking relapse.
The cue‐responsivity phenomenon in dependent drinkers: ‘personality’ vulnerability and anxiety as intervening variables
Authors: MCCUSKER C. G. , BROWN K.
Published: January 2006

The cue‐responsivity phenomenon to alcohol‐associated stimuli in dependent drinkers was examined. In accordance with previous research, significant differences on both physiological and subjective cue‐responsivity variables, between dependent and non‐dependent drinkers were found. The unique contribution of this paper is two‐fold. Firstly, evidence is presented which suggests that the Eysenckian personality traits of introversion and neuroticism are more predictive of cue‐responsivity variance in the dependent drinkers than either severity of dependence or number of years' drinking. Secondly, within this dependent group, the relationship between cue‐responsivity and ‘craving’ was seen to be less straightforward than traditionally thought. Specifically, it suggested that it was the extent to which autonomic cue‐responsivity elicited increases in self‐reported anxiety, which predicted most of the variance on the ‘craving’ variable. Taken together, these results raise the interesting possibility that a personality disposition akin to trait anxiety, and the degree to which cue exposure elicits state anxiety, mediated the relationship between cue‐responsivity and ‘craving’ in dependent drinkers.
Should opiate addicts be involved in controlling their own detoxification? A comparison of fixed versus negotiable schedules
Authors: DAWE SHARON , GRIFFITHS PAUL , GOSSOP MICHAEL , STRANG JOHN
Published: January 2006

This study compares the responses of opiate addicts at a London drug treatment centre to two outpatient methadone‐based detoxification programmes. These involved either a fixed (non‐negotiable) dose reduction schedule or a flexible, negotiable withdrawal schedule. In the negotiable condition, subjects were less likely to complete the detoxification programme and the mean reduction in dose achieved by the subjects in the negotiable condition was less than that in the fixed group. There was no difference between groups in programme retention at 6 weeks though subjects who remained in treatment in the negotiable group tended to extend their detoxification period beyond this point. The overall response of subjects in both groups was unsatisfactory. Only 13% of the subjects initially allocated to detoxification or 28% of those who actually started detoxification completed treatment; urine screening showed that heroin abuse was a continuing problem during treatment. The implications of these results for detoxification and drug treatment services are discussed.
Follow‐up after a six‐month maintenance period on naltrexone versus placebo in heroin addicts
Authors: SAN L. , POMAROL G. , PERI J. M. , OLLE J. M. , CAMI J.
Published: January 2006

Naltrexone and placebo as adjuvant treatment of opioid dependence were compared in a double‐blind, controlled clinical trial in 50 heroin addicts. The overall efficacy was assessed by the degree of treatment acceptance, percentage of relapse in heroin consumption, presence of side effects, and overall retention on naltrexone. A total of 50 patients of both sexes, aged from 18 to 30 years, who fulfilled DSM‐III‐R criteria for opioid dependence were included in the study. All patients completed detoxification with clonidine on an in‐patient basis for 2 weeks and subsequently, on an out‐patient basis, received oral naltrexone (350 mg per week) for a month. At the beginning of the second month patients were randomly allocated to treatment with naltrexone (28 patients) or placebo (22 patients) until a 6‐month treatment period in a double‐blind fashion had been completed. During the study period (1 year) all patients followed the same therapeutic schedule. Patients in both groups were comparable in terms of socio‐demographic data and toxicological history. The efficacy of naltrexone was not superior to that of placebo as there were no significant differences in acceptance of treatment, retention rates, opioid and other drug consumption, drug compliance or side effects.
A meta‐analysis of double‐blind placebo‐controlled trials of clonidine for smoking cessation
Authors: COVEY LIRIO S. , GLASSMAN ALEXANDER H.
Published: January 2006

Combined data from nine double‐blind placebo‐controlled trials (total n=813), showed a smoking quit rate with clonidine that was significantly greater than with placebo. Further analysis suggested a potentiating influence of individual behavior therapy, and it appeared that clonidine may be more helpful for female than male smokers. Future trials are needed to determine long‐term efficacy, and to clarify the effects of gender, other subject characteristics and various treatment conditions on the usefulness of clonidine as a smoking cessation aid.
Evaluation of patients treated for pathological gambling in a combined alcohol, substance abuse and pathological gambling treatment unit using the Addiction Severity Index
Authors: LESIEUR HENRY R. , BLUME SHEILA B.
Published: January 2006

Seventy‐two pathological gambling patients were followed‐up after treatment in a combined alcohol, substance abuse and compulsive gambling treatment program. The Addiction Severity Index (modified for use with pathological gamblers) was used to evaluate the effectiveness of treatment. Patients reduced their intake of alcohol, other drugs and their gambling as well as improved in legal, family/social, and psychological functioning. There was a trend for improvement in medical condition and no net change in employment functioning. The study supports the idea that combined treatment is an effective way of dealing with patients whose gambling problems are discovered when they enter treatment for another addiction, as well as for patients whose initial complaints include pathological gambling, with or without additional problems.
Locus of control of behaviour: is high externality associated with substance misuse?
Authors: HAYNES PHILIP , AYLIFFE GLENDA
Published: January 2006

Personal control and responsibility are key themes in the therapeutic use of ‘motivational interviewing’. This popular method of counselling has suggested that clients need to believe they have a significant degree of control over their behaviour if they are to make progress. Using a well validated psychological test on locus of control of behaviour, our research sought to establish whether active misusers really believed that had less personal control than non‐misusers. To establish this a sample of misusers was tested and compared with three diverse, comparable groups. Possible confounding factors such as age, sex and class were controlled for. T tests established a significant difference between the active misusers and the other sampled groups. Further, a regression analysis of variance, calculated to explain the differing external scores offered no reasonable explanation as far as age, sex and class were concerned. Alternatively, self diagnosed substance misuse accounted for 23% of the variation in scores. We concluded, therefore, that high externality scores are a good indicator of active misusing behaviour and that beliefs about personal control are important to address, if one is to increase the chances of a positive client outcome.
A comparison of the diets of non‐smokers and smokers
Authors: WHICHELOW MARGARET J. , ERZINCLIOGLU SHARON W. , COX B. D.
Published: January 2006

Dietary data, mostly in the form of the frequency of consumption of foods, from the 9003 respondents in the Health and Lifestyle Survey were used to compare lifetime non‐smokers with light, heavy and ex‐smokers, taking account of age and social class. Non‐smokers, of both sexes, were significantly more likely than smokers to consume, frequently, fresh fruit in summer and winter, fruit juice, cooked and canned fruit, salads in summer and winter, breakfast cereals, cakes, biscuits, puddings, pasta, poultry, light desserts and preserves. They were also more likely to choose ‘brown’ bread, semi‐ or skimmed milk, low fat or polyunsaturated spread and to eat breakfast. Smokers were likely to consume chips and processed meats frequently, to drink more alcohol, more cups of tea and coffee and take sugar in these beverages. The differences from the non‐smokers were more marked in the heavy smokers. Ex‐smokers only differed from non‐smokers in consuming more alcohol, tea and coffee, and nuts, in consuming cakes and soft drinks less frequently and in being more likely to choose skimmed or semi‐skimmed milk. The results extend previous findings, and suggest that the eating patterns of non‐smokers are more in line with current dietary recommendations than those of light smokers or, more particularly, heavy smokers.
Like parent like child? Associations between drinking and smoking behaviour of parents and their children
Authors: GREEN GILL , MACINTYRE SALLY , WEST PATRICK , ECOB RUSSELL
Published: January 2006

This paper examines the association between the smoking and drinking behaviours of parents and their adolescent children, and the effect of gender and social class upon this association. It is based on data collected from a cohort of young people and their parents, resident in the west of Scotland. Both social class and parental smoking behaviour were independently associated with young people's smoking, with young people from lower social class households or whose parents smoked being most likely to smoke. Social class and gender were independently associated with young people's drinking, with males and young people from non‐manual households being most likely to drink. Parental drinking behaviour was associated positively with young people's drinking only in non‐manual classes and among daughters. We conclude that it is important to take social class and gender into account since it may influence whether or not there is an association between the behaviour of young people and that of their parents, and it may influence young people's behaviour in addition to influences from parental behaviour.
Predisposing effects of cigarette advertising on children's intentions to smoke when older
Authors: AITKEN P. P. , EADIE D. R. , HASTINGS G. B. , HAYWOOD A. J.
Published: January 2006

Six hundred and forty Glasgow children, initially aged between 11 and 14 years, were interviewed twice, with approximately one year between interviews. Children whose intentions to smoke when older became more positive between the two interviews tended to be more aware of cigarette advertising at the time of the first interview (compared with children whose intentions to smoke were negative at both interviews). Children whose intentions to smoke became more negative between the interviews tended to be less appreciative of cigarette advertisements at the time of the first interview (compared with children whose intentions to smoke were positive at both interviews). Since both groups differed from their respective contrast groups before their declared intentions changed, these findings support the view that cigarette advertising has predisposing as well as reinforcing effects on children's attitudes and behaviour with respect to smoking.
Assessment and management of opioid withdrawal symptoms in buprenorphine‐dependent subjects
Authors: SAN Luis , CAMÍ JORDI , FERNÁNDEZ TERESA , OLLÉ JOSÉ M. , PERI JOSÉ M. , TORRENS MARTA
Published: January 2006

The spontaneous physical dependence of buprenorphine was assessed in opioid addicts who switched from heroin to sublingual or intravenous buprenorphine. Twenty‐two patients were randomly assigned to double‐blind administration of methadone (n = 11) or placebo (n=11) for 13 days after abrupt withdrawal of buprenorphine. Methadone was administered according to four pre‐established dosing schedules depending on the previous amount of daily consumed buprenorphine. No methadone‐treated patient required modification of the therapeutic regimen, whereas eight of eleven placebo‐treated patients needed treatment with methadone. Buprenorphine withdrawal syndrome was of opioid type, began somewhat more slowly, and showed a peak until day 5. The occurrence, time‐course and characteristics of buprenorphine withdrawal syndrome make it necessary to reconsider the abuse potential of this analgesic.
Alcohol and attempted suicide
Authors: MERRILL JOHN , MILKER GABRIELLE , OWENS JOHN , VALE ALLISTER
Published: January 2006

This study investigates the prevalence of excessive drinking and alcohol‐related problems amongst suicide attempts. It also compares the characteristics of attempted suicide by alcohol consumption group. Drinking histories were taken on 250 consecutive attempted suicides admitted to the West Midlands Poisons Unit. Fifity‐one per cent of the men and 31% of the women drank more than the weekly limits recommended by the Health Education Council. Of the men, 22.5% drank more than 50 units of alcohol a week and 9.5% of the women drank more than 35 units of alcohol a week. Alcohol‐related problems (social problems, alcohol dependence or physical illness) were present in 34% of men and 15.5% of women. These results show a greater incidence of alcohol misuse than previous studies on attempted suicide. This is probably because detailed alcohol histories were taken on all patients. Alcohol misuse is best treated before major alcohol‐related problems develop. Those responsible for assessing cases of attempted suicide should be adept at detecting alcohol misuse and instituting appropriate management.
The first and second decades of AIDS among injecting drug users
Authors: JARLAIS DON C. DES
Published: January 2006

This paper examines findings and trends from the first decade of research on AIDS among injecting drug users as a basis for projecting into the next decade. One of the most disturbing aspects of AIDS and HIV infection among injecting drug users which emerged in the first decade is the globalization of the problem. Further geographic spread can be expected, particularly in developing countries. Rapid spread of HIV among drug injectors has occurred in many different cities, with a lack of AIDS awareness and mechanisms for efficient mixing of the at‐risk population appearing to be important contributing factors. Drug injectors have modified their behavior in response to a wide variety of AIDS prevention programs. No single type of prevention program should be viewed as a panacea, and a comprehensive system of programs will undoubtedly be needed. Changing sexual risk behavior has proven to be considerably more difficult than changing drug injection risk behavior, and is an area in need of much more research.
AIDS, drugs and history
Authors: BERRIDGE VIRGINIA
Published: January 2006

This paper analyses the relationship of history to two current and inter‐related policy issues, AIDS and drugs. AIDS, in particular in its early years, was a disease surrounded by history; and historians and others actively brought the ‘lesson of history’ into the public debates. Cholera and the Black Death provided historical examples of reactions to past epidemic disease; and the record of voluntarism in Britain in the area of sexually transmitted diseases was used to justify a non‐punitive response to AIDS. As the perception of AIDS has changed from epidemic to chronic disease, as reactions to the disease have become ‘normalized’, so the type of historical input has also altered. The lesson of history' approach has appeared less relevant, or has changed focus to encompass chronic—TB, multiple sclerosis—rather than epidemic disease. The concept of AIDS itself as an historic event, of the ‘contemporary history’ of AIDS has also come to the fore. The paper contrasts the relationship of AIDS and history with the ahistorical reaction to the particular impact of AIDS on drug policy. The policy reaction to illicit drugs has been historically conscious, in particular in the 1960's. But little of this historical perspective filtered into the reaction to AIDS on drug policy. Drugs, unlike AIDS, was not an open policy arena. The paper argues that overall drug policy objectives were already clear and it suited no policy interest to call on the historical record. The achievement of established policy objectives was better achieved by an emphasis on the newness of development, a response to potentially epidemic and unusual circumstances.
Epidemiology, HIV and drugs: mathematical models and data
Authors: BLOWER SALLY , MEDLEY GRAHAM
Published: January 2006

The utility of mathematical models in understanding the dynamics of HIV transmission among injecting drug users (IDUs) and their non‐IDU sex partners is discussed. We emphasize the need for collaborative relationships between modellers and drug‐use researchers, and we stress that models should be based on data in both their formulation and development stages. We outline some of the possible data requirements of transmission models and we highlight the need for the collection of appropriate quantitative data, so that modellers can estimate specific parameters for their models. We believe that discussion of the needs and utility of mathematical modelling will lead to mutually beneficial collaborations between theoreticians and drug‐use researchers. These collaborations may aid in the Design and the evaluation of effective behavioural or medical intervention strategies.
Measurement of HIV risk behaviors among intravenous drug users
Authors: SAMUELS JACK F. , VLAHOV DAVID , ANTHONY JAMES C. , CHAISSON RICHARD E.
Published: January 2006

This paper reviews issues related to the measurement of drug use and other behaviors in studies of human immunodeficiency virus (HIV) infection in intravenous drug users. These issues include: (1) choice of variables, (2) study design, (3) time frame of measurement, (4) categories of measurement, (5) interviewer effects, and (6) validity of measurement. Difficulties and approaches for measuring drug use and other intimate behaviors in intravenous drug users are discussed. Attempts to come to terms with these measurement issues in the context of HIV infection in intravenous drug users should lead to the Junker development of methods for use in the general context of drug abuse research.
A new target for behavioural research—amphetamine misuse
Authors: KLEE HILARY
Published: January 2006

Despite the increase in social research into drug misuse that has occurred in the wake of the AIDS pandemic, the focus of the research has tended to be overly restricted in terms of the populations studied. Younger, non‐opiate, non‐agency samples are more representative of national patterns of illicit drug use but have been relatively neglected in favour of older, opiate users receiving treatment from drug agencies. Amphetamine misuse illustrates the dangers of such sampling bias. In comparing the HIV‐related risk behaviour of amphetamine injectors with that of heroin injectors, the data suggest that amphetamine misuse is associated with patterns of behaviour that have serious implications for the transmission of HIV infection.
The validity of self‐reported drug use
Authors: SKOG OLE‐JØRGEN
Published: January 2006

Response errors in self‐reported drug questionnaires are evaluated, with particular reference to incidence and prevalence estimates. A simple model of response errors is defined, and some analytical results are obtained from this model. By assuming independence of response errors at different points in time, estimates for response errors are obtained from panel data. The results suggest that while the frequency of false negatives may be larger than the frequency of false positives, the latter error may nevertheless produce large errors in prevalence estimates, particularly if the prevalence rate is small.
Sex and the risk of HIV infection: the role of alcohol
Authors: McEWAN ROBERT T. , McCALLUM ALISON , BHOPAL RAJINDER S. , MADHOK RAJAN
Published: January 2006

To investigate sexual behaviour under the influence of alcohol and the relationship between drinking habits and unsafe sex we carried out a postal and interview survey of 2174 students in the North East of England. Drinking habits were classified as non, light, medium and heavy, and cross‐tabulated against sexual and other risk taking behaviour. Response rates of 74% and 77% were obtained in the postal and interview surveys respectively. In the postal survey, heavier drinkers were more likely to have unsafe sex such as casual sex without a condom, and sex with someone know to have many partners. Respondents associated alcohol with sexual risk taking; because of drinking too much, in the last year, 19% had not taken contraceptive precautions during sex. The interview survey largely confirmed postal survey results. There are three possible explanations of the association between drinking habits and unsafe sex: alcohol might disinhibit safer sex; young risk‐takers may also drink more; or, drinking might be associated with unsafe sex by coincidence because sexual encounters often begin in licensed premises. Drinking habits should therefore be a priority issue for future HIV/AIDS related research, policy debate, and health education endeavour.
Engaging patients with alcohol problems in treatment: the first consultation
Authors: THOM BETSY , BROWN CHERYL , DRUMMOND COLIN , EDWARDS GRIFFITH , MULLAN MICHAEL , TAYLOR COLIN
Published: January 2006

This paper considers the impact of the first consultation at a specialist alcohol clinic on patients' perceptions of their drink problem and on their expectations of help from three sources: an alcohol clinic, general practitioners and Alcoholics Anonymous. AT intake, mates had higher expectations than females of help from the alcohol clinic while people in manual occupations and those in the ‘less heavy’ drinking category had higher expectations of general practitioner help than other patients. Change was found to occur during the first clinic consultation so that by the end of the session patients had raised their rating of problem seventy and their expectations of help from the three sources examined. Overall, patient perceptions of the clinic assessment session were positive. The study highlights the importance of obtaining a full understanding of the process of engagement in treatment and indicates the potential of a clinical assessment to effect change in patient attitudes.
The use of services for alcohol problems: general practitioner and specialist alcohol clinic
Authors: THOM BETSY , BROWN CHERYL , DRUMMOND COLIN , EDWARDS GRIFFITH , MULLAN MICHAEL
Published: January 2006

A sample of 40 patients referred to a specialist alcohol clinic were given a full assessment by a clinician and then randomly allocated to one of two groups. The first group received continuing care from the clinic. The second group were returned to the management of their general practitioners who were offered specialist support in caring for their patients. Patients and general practitioners were followed‐up 6 months after the clinic assessment. This paper reports on the uptake of clinic and general practice services by patients and examines the possible factors associated with continuing attendance, including patient attributes, service activity, patients' self‐assessments of their drink problem and their expectations of help from services. Qualitative data is used to examine patients' perceptions and experiences of clinic and general practice‐based care for drinking problems. The findings highlight some of the difficulties reported by patients in receiving help for their problems particularly from general practitioners.
Changes in levels of alcohol consumption: United States, 1983–1988
Authors: WILLIAMS GERALD D. , DEBAKEY SAMAR F.
Published: January 2006

Using data from the 1983 and 1988 National Health Interview Surveys, this note examines changes both in the prevalence of abstention and the prevalence of heavier drinking among drinkers in the United States. Changes are examined separately by gender and according to other sociodemographic characteristics often associated with different levels of alcohol consumption. Results suggest an increase in abstention and a decrease in heavier drinking between 1983 and 1988. For women, decreases in heavier drinking were found among those 18‐44 years of age, among those employed, and among those divorced/separated or never married. For men, decreases in heavier drinking were found among those employed, among those with family income of $25000 or more, and among those married or divorced/separated. Changes both in abstention and heavier drinking were found to vary considerably by geographical region. These findings do not support results from other general population survey studies on alcohol use that suggest a stability in drinking levels, or even a slight increase in heavier drinking among men.
Recent developments in life‐event research and their relevance for the study of addictions
Authors: GORMAN DENNIS M. , BROWN GEORGE W.
Published: January 2006

The idea that stressful life events can on occasions contribute to the development of addictive disorders is fairly well‐accepted within both clinical and research communities. However, little support is available: research is sparse and investigators have generally neglected methodological refinements and innovations in the broader field of life‐event research. Some of these developments are discussed, especially as they relate to the measurement of the meaning of life events. Findings from research based on such techniques are summarised, and their relevance for the study of addictions discussed under three headings: specification of life events, vulnerability, and diagnostic specificity.
A comparison of predictors of treatment drop‐out of women seeking drug and alcohol treatment in a specialist women's and two traditional mixed‐sex treatment services
Authors: COPELAND JAN , HALL WAYNE
Published: January 2006

The problem of high levels of client drop‐out in drug and alcohol treatment is frequently reported in the literature. In the course of conducting an evaluation of a specialist women's treatment service, the inadequacy of the data on women‐specific predictors of treatment drop‐out was highlighted. Using a retrospective design, the characteristics of 160 women who left treatment less than 5 days after admission were compared to the 160 women who stayed longer than 5 days and were enrolled in the evaluation study. The findings of this study suggested that women who were employed, had a history of sexual assault (especially in adulthood), nominated alcohol as their drug of choice, were not married, older than 25 years of age and had demonstrated a sympathy with the agency's treatment philosophy were less likely to drop‐out of treatment. In addition, for lesbian women, women with a history of sexual assault in childhood, and those with dependent children, attendance at a specialist women's service reduced the incidence of treatment drop‐out.
The effect of general practitioners' advice to heavy drinking men
Authors: ANDERSON PETER , SCOTT EILEEN
Published: January 2006

The objective of the study was to determine the effectiveness of advice from general practitioners to heavy drinking men (consuming 350–1050 grammes of alcohol per week) to reduce their alcohol consumption. One hundred and fifty‐four men recruited from eight general practices were allocated randomly to treatment and control groups. Men in the treatment group received advice from their own general practitioner. At one year follow‐up, when analyzed according to intention to treat, the treatment group had reduced their consumption by an excess of 65 grammes of alcohol per week when compared with the control group (p < 0.05). General practitioners should be recommended to screen for alcohol consumption amongst their patients and to give advice to those found to be at risk because of their drinking.
The relationship between stressful working conditions and high alcohol consumption and severe alcohol problems in an urban general population
Authors: ROMELSJÖ ANDERS , HASIN DEBORAH , HILTON MIKE , BOSTRÖM GUNNEL , DIDERICHSEN FINN , HAGLUND BO , HALLQVIST JOHAN , KARLSSON GUNILLA , SVANSTRÖM LEIF
Published: January 2006

The relationship between 15 measures of stressful working conditions and high alcohol consumption (35 g 100% ethanol per day or more for men and 25 g or more for women) was studied, using cross‐sectional data from a general population survey of 1344 males and 1494 females; the ages 25–64 years in metropolitan Stockholm in 1984. In a longitudinal component of the study, hospitalization and mortality with alcohol‐related diagnosis was assessed during 1984–90, and also the association between previous experience of unemployment and high alcohol consumption. Some of the associations, expressed as age‐adjusted odds ratios, were positive and some were negative when high alcohol consumption was the endpoint, but there was a clear variation by sex and social class. Generally the positive associations were stronger among male non‐manual employees. Among males, there was a clear association between stressful working conditions and subsequent risk of severe medical alcohol‐related problems, but the precision of the estimates was low due to low number of cases. The odds ratio was 6.18 (95% confidence interval 1.86, 20.61) for twisted working positions and 6.74 (95% confidence interval 1.67, 27.19). Previous unemployment among males was associated with increased risk for high alcohol consumption, with an odds ratio of 5.71 (95% CI 1.39, 15.97) among those who had been unemployed more than once, and 1.67 (95% CI 0.76, 3.64) among those who had been unemployed once during the previous 5 years. Those and other increased odds ratios were lower when subjects with an alcohol diagnosis at inpatient care during 1980–84 were excluded in the analyses. On the whole, our findings are not conclusive. The strong, but imprecise associations between stressful working conditions and severe alcohol problems, are however challenging, and warrants further studies, preferably with longitudinal design and repeated measurements of both working condition and alcohol habits.
Can carrots be addictive? An extraordinary form of drug dependence
Authors: ČERNÝ LUDĚK , ČERNÝ KAREL
Published: January 2006

The paper describes three cases of dependence on carotenoids with typical symptoms of irritability and nervousness accompanying their abstinence, with a long‐term dependence, and an inability to simply discontinue. Three patients (a man and two women) all being smokers, evaluated this dependence as very similar to that on tobacco. The limitation of Junker use had the same effect in both cases. The women evaluate the dependence as stronger than that on cigarettes, the man as somewhat weaker. The former patient–a woman–even relapsed, and recently found herself in danger of further relapse. This, however, she nipped in the bud. Laboratory enzyme examinations revealed a disorder in the enzymatic outfit affecting the auto‐immunity and the neurovegetative system.
Control, confront or collude: how family and society respond to excessive drinking
Authors: ORFORD JIM
Published: January 2006

Research on excessive drinking in the family context has revealed the range of ways of coping used by close relatives. Case material from ongoing research in England and Mexico is used to illustrate this point. This research is also revealing the ways in which the family, close and extended, often fail to support the coping actions of close relatives. The analogy is drawn between coping with excessive drinking in the family and coping in the work selling. In the latter context explicit alcohol policies have been developed. These often recommend combining confrontative and supportive coping, ft may be difficult for relatives, in the family setting, to adopt such a policy without support. The forms of coping identified in family research and in work policies correspond to basic and universal dimensions of interpersonal behaviour: dominance‐submissiveness and friendliness‐hostility. These forms of responding to excessive drinking may be identified beyond the micro‐social systems of family and workplace. They are evident, also, in the responses of community agents such as police and social workers, and at the level of local and national government.
Young‐adult children of alcoholic parents: protective effects of positive family functioning
Authors: HILL ELIZABETH M. , NORD JANET L. , BLOW FREDERIC C.
Published: January 2006

The occurrence of alcoholism is clustered within families, but the detrimental effect of a positive family history may vary with the degree of family impairment involved. In this study we assessed the effects of family history and family environment on alcohol misuse. From ongoing studies we recruited parents who had a child aged 18–30, 20 with a DSM‐III‐R alcohol dependence diagnosis, 20 without. The child then completed a multidimensional assessment. The young‐adult participants included 20 men and 20 women (mean age=24.8). Differences by family history were restricted to substance abuse behaviors. While a high level of alcohol problems occurred in both groups, those with an alcohol‐dependent parent were more likely to be heavy drinkers and showed more symptoms of alcohol dependence. Overall psychological adjustment did not differ between the groups, however. Alcohol misuse measures did correlate moderately with symptoms of poor emotional health. The most important correlates of alcohol misuse measures in this study were exposure to parental alcoholism, abusive punishment, and psychological symptoms, with some separation of effects in the two subgroups. Psychological symptoms had a stronger relationship with misuse in subjects with social‐drinking parents, while abuse was more associated in the group with an alcohol‐dependent parent. These results confirm the importance of environmental interactions with familial risk. A biological vulnerability from an alcohol‐dependent parent was not sufficient or necessary for the participants in this study to develop alcohol dependence as a young adult, although there was an increased risk. There appear to be strong protective effects of positive family relationships on the potential negative effects of a family history of alcoholism.
HIV, substance use and related behaviour of gay and bisexual men: an examination of the talking sex project cohort
Authors: MYERS TED , ROWE CHERYL J. , TUDIVER FRED G. , KURTZ RUTH G. , JACKSON EDWARD A. , ORR KEVIN W. , BULLOCK SANDRA L.
Published: January 2006

This paper reports on the substance use of 612 gay and bisexual men who participated in an HIV risk reduction project. Use/non‐use, level of substance use, and reported frequency of use prior to sexual activity were examined in relation to number of sexual fanners, sexual activities, HIV antibody test seeking behaviour and known HIV status. The use of substances among the study cohort appear to be higher than in a comparable heterosexual male group. An association was found between substance use, and both number of sexual partners and sexual activities. However, no significant difference was found in substance use between men participating in protected versus unprotected anal sex. Similarly, no significant difference was found in the reported frequency of substance use prior to sex by those participating in protected and unprotected anal intercourse. Greater drug use was reported among those who were known to be HIV antibody pisitive. These findings raise issues for further research. The high use of alcohol and drugs by gay and bisexual men may pose significant health risks for this group of men.
Stages of drug use: a community survey of Perth teenagers
Authors: BLAZE‐TEMPLE DEBRA , LO SING KAI
Published: January 2006

A Guttman stages of drug use model was confirmed for Australian youth in this systematic household survey of 13–17‐year‐olds in Perth (n = 1093). The same model held for both sexes and all ages although the model was more efficient for the older youth. General drug use prevalence, expansion of drug repertoire and frequency of use all increased with age. Multiple drug use was prevalent. Marijuana use was not a necessary stage for the progression to other illicit drug use as 29% of current users of other illicit drugs reported never using marijuana. The hazard rate for use of marijuana or other illicit drugs, if one was a current tobacco smoker, was high. Alcohol and tobacco were implicated as important‘gateway’ drugs though hazard rates showed tobacco to be the more important of the two. Implications of the study are that delaying or eliminating the onset of tobacco use are important goals of prevention programmes and that multiple drug use should be recognised and addressed in health education programmes for youth.
Consequences of increasing alcohol availability: the Iowa experience revisited
Authors: FITZGERALD J. L. , MULFORD H. A.
Published: January 2006

Before/after survey data were used to investigate the effect that a sudden and dramatic wine and spirits availability increase in Iowa might have had on heavy and problem drinker rates. Three state surveys representing the age 18+ non‐institutionalized population of Iowa were conducted in 1985, 1986 and 1989. Neither previous sales analyses nor this survey data analysis support the Distribution of Consumption Prevention Model prediction that increased wine and spirits availability would produce significant and lasting consumption increases and, in turn, heavy drinker and problem drinker prevalence rate increases.
Positive and negative consequences of alcohol drinking among young university students in Finland
Authors: NYSTRÖM MIKAEL
Published: January 2006

In a sample of 1663 female and 707 male Finnish university students in their first study year, the female students reported less negative and less positive consequences of alcohol drinking than their male counterparts. The female students also drank less, less frequently and less often for intoxication. However, the profile of negative and positive consequences of drinking was similar for both genders; 74.6% of the female students and 80.0% of the males had more positive than negative experiences from alcohol. Both the positive and negative consequences of drinking correlated positively to alcohol consumption and drinking for intoxication. About half of the students who had many positive consequences of drinking were not heavy drinkers and did not report many negative consequences. Depression, anxiety, stress or psychosomatic symptoms did not correlate with either with positive or negative consequences of drinking, nor with alcohol consumption. Drinking for anxiety, depression, stress or the reduction of tension appeared to be infrequent. Young Finnish university students mostly drink for the positive consequences of drinking.
Development of a short ‘readiness to change’ questionnaire for use in brief, opportunistic interventions among excessive drinkers
Authors: ROLLNICK STEPHEN , HEATHER NICK , GOLD RUTH , HALL WAYNE
Published: January 2006

Excessive drinkers (141) identified in medical settings who were not seeking help for an alcohol problem completed a questionnaire based on Prochaska and DiClemente's stages of change model. Principal components analysis revealed a clear factor structure corresponding to the ‘precontemplation’, ‘contemplation’ and ‘action’ stages of change. On this basis, a 12‐item ‘Readiness to change’ questionnaire was developed with satisfactory psychometric properties. As predicted, scale scores on adjacent stages of change showed significantly higher inter‐correlations than scores on non‐adjacent stages. Concurrent validation by comparison with subjects' choices of cartoons depicting each of the stages of change and with screening questions regarding aspects of drinking behaviour was moderate to very good. The questionnaire provides a short and convenient measure of readiness to change which may be used in conjunction with brief, opportunistic interventions with excessive drinkers.
Alcohol‐related mortality in the United States, 1979–1988
Authors: STINSON FREDERICK S. , DeBAKEY SAMAR FARHA
Published: January 2006

Using alcohol‐attributable fractions derived from studies of alcohol's involvement in various causes of death, this report presents trends in overall alcohol‐related mortality for each year from 1979 through 1988. Age‐adjusted rates show decreases in alcohol‐related mortality for both sexes and for whites and nonwhites. Decreases occur for causes of death directly attributable to alcohol and for other diseases and injuries and adverse effects indirectly attributable to alcohol. Issues surrounding the use of currently available alcohol‐attributable fractions for estimating alcohol‐related mortality are discussed.