Thomas Greenfield - Profile on Academia.edu (original) (raw)

Papers by Thomas Greenfield

Alcohol and Alcoholism, Oct 30, 2018

Liquor privatization was the specific focus of our study, which was the subject of Dr Braillon's ... more Liquor privatization was the specific focus of our study, which was the subject of Dr Braillon's letter; this complex policy change involved liberalization of retail availability and wholesale practices but also an effective increase in taxation. Tax rates in Washington are complicated as they include both fees and taxes based on both price and spirits volume implemented at different points in the distribution process. Dr Braillon's figures on tax rates appear to come from the Tax Foundation website, where estimates from the Distilled Spirts Council of the USA are presented. The 35.22pergallonfigureisfrom2013,afterprivatizationhadoccurred,andestimatesfromthesamesourcefor2011showanestimatedtaxrateof35.22 per gallon figure is from 2013, after privatization had occurred, and estimates from the same source for 2011 show an estimated tax rate of 35.22pergallonfigureisfrom2013,afterprivatizationhadoccurred,andestimatesfromthesamesourcefor2011showanestimatedtaxrateof26.70 under the government control system. As noted in our paper , we have also demonstrated that liquor prices increased from 2012 to 2014 by 15.5% for an index of 750 ml containers and 5.5% for an index of 1.75 L containers, reflecting increased spirits taxes . The letter's 2017 tax estimate of 31.48mayrepresentthereductioninthewholesalefeeto531.48 may represent the reduction in the wholesale fee to 5% that occurred by 2015 and possibly variation from assumptions in the estimation formula regarding product prices for converting ad valorem to specific tax rates. Regardless, it is clear that tax rates increased with privatization, and Washington continues to levy the highest spirits taxes of any US state. Therefore, although liquor availability did greatly increase, it is not accurate to describe the Washington liquor privatization as only a liberalization. Liquor-related income is also somewhat complicated in Washington as this includes both taxes that did not change across privatization and other sources that did change. First, an ad valorem tax on dollar sales and a specific tax on spirits volume were applied at consistent rates across privatization. Second, before privatization the state received revenues from government wholesale and retail store profits, while after privatization income also includes wholesale and retail-level fees on gross dollar sales. The figures quoted by Dr Braillon do not match any reported by Washington state government sources. Revenues from the tax on liters of spirits sold, 31.48mayrepresentthereductioninthewholesalefeeto53.7708 per liter of spirits regardless of ethanol content, should have the clearest relationship with alcohol sales as the other taxes and fees are percentages of dollar sales. The liter tax revenue as reported by the Washington Department of Revenue did increase

Journal of Studies on Alcohol and Drugs, May 1, 2018

The purpose of this study was to evaluate changes in marijuana use prevalence and user characteri... more The purpose of this study was to evaluate changes in marijuana use prevalence and user characteristics across the 2012 recreational legalization in Washington State. Differences in change estimates between retrospective and contemporaneous pre-legalization measures are compared and considered in relation to potential social acceptability and illegality effects on reporting. Method: Four representative surveys of the Washington State population 18 years and older were conducted by telephone, two in 2014 and two in 2015, which are combined by year for analyses (N = 3,451). Respondents reported their current past-year use frequency and retrospective frequency of use in 2012 before the election in which legalization was passed. They also provided demographic information and details of alcohol use, including simultaneous use with marijuana. Results: A small and not statistically significant increase of 1.2 percentage points in past-year use prevalence, from 24.3% (22.3-26.5) to 25.6% (23.6-27.6), was found when combining the surveys. No statistically significant change was found in the prevalence of simultaneous use with alcohol, which decreased from 12.9% (11.3-14.7) to 12.6% (11.0-14.4). In contrast, estimates from the National Survey on Drug Use and Health (NSDUH) indicate substantially increased prevalence, from 15. 5% (13.8-17.3) in 2010-2012 to 19.1% (16.9-21.4) in 2013-2014, although this change is not statistically significant. Other fi ndings of interest from the Washington State surveys include new users after legalization tending to be older, White, and moderate drinkers who do not use marijuana simultaneously with alcohol. Conclusions: A retrospective pre-legalization measure showed only a small increase in marijuana use prevalence in contrast to larger changes found in prospectively assessed use in the NSDUH. Changes in the social acceptability and legal status of marijuana after legalization may have increased reporting of pre-legalization use compared with concurrent assessments. (J.

American Journal of Public Health, 2000

Objectives. Given the decline in alcohol use in the United States since the 1980s, the purpose of... more Objectives. Given the decline in alcohol use in the United States since the 1980s, the purpose of this study was to assess shifts in self-reported social consequences of alcohol use (and 5 consequences subscales) and dependence symptoms from 1984 to 1995. Methods. This study used data from 3 national alcohol surveys based on household probability samples of current drinkers (adults) in 1984, 1990, and 1995; sample sizes were 1503, 1338, and 1417, respectively. Results. Overall, few changes in prevalence of social consequences or dependence symptoms were found. Significantly lower prevalence rates of 2 consequences subscales (accidents/legal problems and work problems) were reported between 1984 and 1990, but prevalence rates did not change for any of the scales from 1990 to 1995. Conclusions. This stability in alcohol-related outcomes despite reductions in alcohol consumption may be a result of cultural shifts in which problem amplification occurs in "drier" historical periods. Furthermore, rates of alcoholrelated problems may be approaching their lowest limit and may not be readily influenced by any additional decreases in alcohol consumption. (

Self-selection bias poses a major threat to the validity of 7 earch findings in naturalistic, qua... more Self-selection bias poses a major threat to the validity of 7 earch findings in naturalistic, quasi-experimental, or single-group oLsigns. A new method of addressing self-selection bias in naturalistic evaluations of prevention programs was implemented. The study, involving voluntary exposure to multicomponent interventions, was developed and applied to an evaluation of an alcohol abuse prevention program in which student participation in hall-based programs was conditioned by choice of where to live. A longitudinal mail survey of students in 1978 (N=274) and 1980 (N197) assessed the impact of the alcohol abuse prevention program implemented in the intervening years. The effects of three interventions wert compared: (1) alcohol education; (2) structured drinking environments; and (3) living group self-regulation activities. Choice of living environments and other variables were controlled. Outcome measures included alcohol consumption and alcohol-related problems. Results generally showed a lack of program impact. Aggregate levels of both drinking and problems differed substantially across living groups, and a strong selection rule was found predicting the probabilities of being in each living group. Problem drinkers did not avoid program exposure even though programs were offered in the living groups. The findings suggest that after correcting for possible self-selection bias, differences in alcohol consumption and problems must be accounted for primarily by sorting between living groups rather than by living group climate or other environmental factors. (JAC)

JMIR Research Protocols, Jan 10, 2020

Alcohol and Alcoholism, Jun 23, 2015

Aims: In June, 2012 the state of Washington ended a wholesale and retail monopoly on liquor sales... more Aims: In June, 2012 the state of Washington ended a wholesale and retail monopoly on liquor sales resulting in about five times as many stores selling liquor. Three-tier restrictions were also removed on liquor, while beer and wine availability did not increase. Substantial taxes at both the wholesale and retail levels were implemented and it was expected that prices would rise. Methods: To evaluate price changes after privatization we developed an index of about 68 brands that were popular in Washington during early 2012. Data on final liquor prices (including all taxes) in Washington were obtained through store visits and on-line sources between November 2013 and March of 2014. Primary analyses were conducted on five or six brand indexes to allow the inclusion of most stores. Results: Washington liquor prices rose by an average of 15.5% for the 750 ml size and by 4.7% for the 1.75 l size, while only small changes were seen in the bordering states of Oregon and Idaho. Prices were found to vary greatly by store type. Liquor Superstores had generally the lowest prices while drugstore, grocery and especially smaller Liquor Store prices were found to be substantially higher. Our findings indicate that liquor prices in Washington increased substantially after privatization and as compared to price changes in bordering states, with a much larger increase seen for the 750 ml size and with wide variation across store types. However, persistent drinkers looking for low prices will be able to find them in certain stores.

American Journal of Community Psychology, Jul 15, 2008

This experiment compared the effectiveness of an unlocked, mental health consumer-managed, crisis... more This experiment compared the effectiveness of an unlocked, mental health consumer-managed, crisis residential program (CRP) to a locked, inpatient psychiatric facility (LIPF) for adults civilly committed for severe psychiatric problems. Following screening and informed consent, participants (n=393) were randomized to the CRP or the LIPF and interviewed at baseline and at 30-day, 6-month, and 1-year post admission. Outcomes were costs, level of functioning, psychiatric symptoms, selfesteem, enrichment, and service satisfaction. Treatment outcomes were compared using hierarchical linear models. Participants in the CRP experienced significantly greater improvement on interviewerrated and self-reported psychopathology than did participants in the LIPF condition; service satisfaction was dramatically higher in the CRP condition. CRP-style facilities are a viable alternative to psychiatric hospitalization for many individuals facing civil commitment. Serious mental illness; consumer-managed services; recovery; mutual help; randomized trial Consumer-managed programs have a long history in the psychiatric services field, beginning around the middle of the 20 th century with organizations such as Recovery Incorporated and Fountain House . In more recent decades, such programs have received increased visibility and support through the efforts of governmental (e.g., The Community Support Program of the Center for Mental Health Services) and community-based organizations (e.g., The National Empowerment Center). In the U.S. today, mental health consumers operate or play a major role in a wide range of programs including self-help groups, drop-in centers, clubhouses, independent living centers, advocacy organizations, case management services, employment agencies, supported housing, and information and referral lines (

PLOS global public health, Jan 25, 2023

Sugar sweetened beverage (SSB) taxes are a promising strategy to decrease SSB consumption, and th... more Sugar sweetened beverage (SSB) taxes are a promising strategy to decrease SSB consumption, and their inequitable health impacts, while raising revenue to meet social objectives. In 2016, San Francisco passed a one cent per ounce tax on SSBs. This study compared SSB consumption in San Francisco to that in San Jose ´, before and after tax implementation in 2018. A longitudinal panel of adults (n = 1,443) was surveyed from zip codes in San Francisco and San Jose ´, CA with higher densities of Black and Latino residents, racial/ethnic groups with higher SSB consumption in California. SSB consumption was measured at baseline (11/17-1/18), one-(11/18-1/19), and two-years (11/19-1/20) after the SSB tax was implemented in January 2018. Average daily SSB consumption (in ounces) was ascertained using the BevQ-15 instrument and modeled as both continuous and binary (high consumption: �6 oz (178 ml) versus low consumption: <6 oz) daily beverage intake measures. Weighted generalized linear models (GLMs) estimated difference-in-differences of SSB consumption between cities by including variables for year, city, and their interaction, adjusting for demographics and sampling source. In San Francisco, average SSB consumption in the sample declined by 34.1% (-3.68 oz, p = 0.004) from baseline to 2 years post-tax, versus San Jose ẃhich declined 16.5% by 2 years post-tax (-1.29 oz, p = 0.157), a non-significant differencein-differences (-17.6%, adjusted AMR = 0.79, p = 0.224). The probability of high SSB intake in San Francisco declined significantly more than in San Jose ´from baseline to 2-years posttax (AOR[interaction] = 0.49, p = 0.031). The difference-in-differences of odds of high consumption, examining the interaction between cities, time and poverty, was far greater (AOR [city*year 2*federal poverty level] = 0.12, p = 0.010) among those living below 200% of the federal poverty level 2-years post-tax.

Journal of Womens Health, May 1, 2018

Background: Data on individual and cultural factors contributing to drinking can inform screening... more Background: Data on individual and cultural factors contributing to drinking can inform screening and brief intervention in clinical practice. Our aims were to examine 10-year trends in women's reasons for abstaining/ limiting drinking and to document changes in associations with drinking status for population subgroups defined by race/ethnicity and age. Materials and Methods: Using repeated cross-sectional data from White, Black and Hispanic women in the 2000 and 2010 United States National Alcohol Surveys (combined N = 5501), population-weighted multiple linear and multinomial logistic regression models assessed changes in three reasons for abstaining or limiting drinking (health concerns, religious prohibition, and upsetting family or friends) and drinking status (past-year abstainer, low-risk drinker, or at-risk drinker), and their associations over time. Results: Adjusting for key demographics, reasons for limiting alcohol consumption declined in importance over time, with reductions in both health concerns and religious prohibition particularly noteworthy for older women of all three racial/ethnic backgrounds. Despite these reductions in importance, both health concerns and religious prohibition were most consistently associated with increased abstinence relative to low-risk drinking; these reasons were not strongly associated with at-risk drinking, however. Conclusions: It is essential for healthcare providers and others to disseminate accurate information about the risks of drinking to counter cultural shifts that suggest greater acceptance of moderate-to-heavy drinking by women aged 40 and older.

Drinking problems and self-reported criminal behavior, arrests and convictions: 1990 US alcohol and 1989 county surveys

Addiction, Mar 1, 1995

Use of general population surveys in addition to institutional samples is critical to disentangli... more Use of general population surveys in addition to institutional samples is critical to disentangling the relationship between criminal behavior and alcohol problems or use of illicit drugs. Local area studies can be useful but generalizability of their results is seldom studied. Data from recent US national (n = 2058) and county (n = 3069) general population surveys are used to examine the role of alcohol problem and drug use history in predicting self-reported criminal behavior, arrest and conviction within a logistic regression framework. In the national and county surveys controlling for age, gender, income, marital status, employment, education, race and drug use, lifetime drinking problems significantly predicted current criminal behavior (odds ratios 1.3 and 1.5, respectively) with slightly stronger relationships noted in equivalent models predicting arrest (odds ratios 1.7 and 1.8) and conviction (odds ratios 1.7 and 1.6). Relationships between alcohol, drugs and criminal behavior/justice variables are discussed. Parallels between US and county results suggest that findings from intensive, articulated analyses of community-level population and institutional surveys may be cautiously generalized beyond their geographic locus.

British Journal of Psychiatry, Mar 1, 2010

Public opinions on alcohol policy issues: a comparison of American and Canadian surveys

Addiction, Apr 1, 1999

Aims. To study international and within country differences with regard to views by the general p... more Aims. To study international and within country differences with regard to views by the general public on alcohol policy topics, describe associations with socio‐demographic characteristics and drinking practices, and contrast opinions with variations in actual policies. Design, setting, subjects. Large‐scale cross‐sectional household surveys were conducted in Canada (n = 11 550) and the United States (n = 4004) in 1989‐90, involving representative samples of adults aged 18 and older. Measures. Eleven alcohol policy topics were examined: alcohol taxes; hours of off‐premise sale; legal drinking age; alcohol sales in corner stores; government advertising against alcohol; warning labels on alcohol products; alcohol advertising on TV; industry sponsorship of cultural or sports events; efforts to prevent service to drunken customers; prevention and education; and treatment. Findings. Even after controlling for drinking levels and respondent characteristics, policy measures that control physical or economic access to alcohol are not as strongly supported as those that provide information or focus on the heavy drinker. There was greater polarization of opinion within both countries for policy items relating to promotion of alcohol or control of physical, demographic or economic access, and virtually no polarization with regard to items such as curtailing service to drunken customers or providing information or treatment. In the jurisdiction with less restrictive measures on a particular policy, there seems to be greater public support for curtailing access to alcohol and, in some instances, more restrictive policies are associated with lower support for increasing restrictions. Conclusion. Public opinion data are an important resource in determining whether actual policies are compatible with the views of those affected by them. Disjunctions between research on the most effective policy interventions and views by the public point to special agenda for information dissemination and prevention initiatives.

Alcoholic beverage choice, risk perception and self-reported drunk driving: effects of measurement on risk analysis

Addiction, Nov 1, 1999

The present study examined effects of measurement on risk curve analysis in an application involv... more The present study examined effects of measurement on risk curve analysis in an application involving prediction of frequency and indicator measures of drunk driving with beverage-specific alcohol consumption and risk perception measures. From a 1995 in-person survey of the US adult household population (response rate = 77%) the responses of 1260 adult drivers who reported any drinking in the prior year were selected for analysis. Regression and graphical techniques were used to investigate relationships between drinking pattern, beverage choice, perception of risks of drinking before driving, and frequency of drunk driving. Self-reported drunk driving (occurrence) was measured by a question assessing driving after drinking enough to be in trouble if stopped by the police within the prior 12 months; those affirming this (n = 191) were asked how many times they did so (frequency). Alcohol consumption was assessed by beverage and in combination. Risk perception was assessed as a factor score from three correlated measures. Demographic variables included age, ethnicity, education and income. Controlling for demographics, heavy beer consumption (p < 0.01) more than heavy wine (NS) or liquor/spirits (p < 0.05) intake was strongly predictive of risk perception. A regression analysis showed a significant interaction between heavy beer consumption and perceived risk (p < 0.001) in predicting reported frequency of drunk driving, after controlling for heavy beer consumption (p < 0.05), total alcohol consumption and risk perception (both ps < 0.001). No interactions were important in equivalent models predicting dichotomous occurrence. Graphic analysis showed the shape of the risk curve is altered when frequency of drunk driving is taken into account rather than simple occurrence. Individuals' underestimation of beer's intoxicating effects, compared to other alcoholic beverage types, helps explain beer's over-representation in drinking driving violation reports. There is a need for creative public health campaigns designed to inform young men of beer's alcohol content and associated risks.

Journal of studies on alcohol, 2001

Objective: To assess the effect of mode of administration in alcohol surveys (telephone vs face-t... more Objective: To assess the effect of mode of administration in alcohol surveys (telephone vs face-to-face interviews), prevalence rates of self-reported harms due to alcohol were compared for two datasets with equivalent measures. Method: Two national alcohol surveys were used: the 1990 Warning Labels Survey, in which random digit dialing was used to generate a sample of 2,000 adults interviewed by telephone, and the 1990 National Alcohol Survey (face-to-face interviews), a probability sample of U.S. adults living in households (N = 2,058). Both surveys included identical items on five areas of alcoholrelated harm, yielding one composite index of any harm reported in the last 12 months that was compared between the two surveys for current drinkers. Results: After controlling for demographic characteristics and alcohol use, the telephone survey yielded significantly higher rates of

Drug and Alcohol Dependence, Dec 1, 2003

This study assesses differences in reports of alcohol use and alcohol-related harms using telepho... more This study assesses differences in reports of alcohol use and alcohol-related harms using telephone and in-person interviews in a subsample of the 2000 National Alcohol Survey (NAS) (N = 411). Respondents were given a brief telephone interview which assessed their alcohol use and alcohol-related harms in the last 12 months followed by an in-person interview 2 months later that obtained the same data. Approximately 90% (n = 371) reported their drinking status consistently between interviews (277 current drinkers; 94 non-drinkers). Approximately 7% (n = 29) became current drinkers and 2.7% (n = 11) became non-drinkers at the second interview. The majority of respondents who changed their drinking status in either direction were low level drinkers. Using logistic regression modeling, no significant associations were found between demographic factors and consistency of reported drinking status. Further, there were no differences by mode for the two alcohol consumption measures (mean daily volume and mean number of days drank five or more drinks in the last 12 months) and alcohol-related harms in the last 12 months for current drinkers (n = 277). In conjunction with other mode studies, these findings support the use of telephone interviewing in large national surveys to obtain alcohol use and alcohol-related harms data.

Preventive Medicine, Feb 1, 2017

Heavy episodic drinking is a well-established risk factor for heart disease, diabetes, certain ca... more Heavy episodic drinking is a well-established risk factor for heart disease, diabetes, certain cancers, stroke, hypertension and injuries, however, little is known about whether health problems precipitate changes in subsequent drinking patterns. Retrospective cohort analyses of heavy drinking by decade were conducted using data from the 2010 U.S. National Alcohol Survey (n=5,240). Generalized estimating equations models were used to predict any, monthly, and weekly heavy (5+) drinking occasions across decades of life following a diagnosis of hypertension, heart problems, diabetes, stroke, cancer, or serious injury. Experiencing heart problems was associated with higher odds of reduced weekly heavy drinking (adjusted odds ratio (OR adj ) = 3.5; 95% Confidence Interval (CI); 1.7-7.4). The onset of diabetes was also associated with higher odds of reducing any heavy drinking over the decade (OR adj =1.7; 95% CI; 1.1-2.6). Cancer survivors were less likely to report no heavy drinking (OR adj =0.5; 95% CI; 0.3-0.8) or no weekly heavy drinking (OR adj =0.3; 95% CI; 0.2-0.7). Hypertension, stroke and injury were not found to have any significant associations. Reduced heavy drinking was more likely to be reported by Black drinkers following heart problems and Whites following a diabetes diagnosis. Increased heavy drinking following a cancer diagnosis was significant among women and Whites. Future studies on alcohol's heath and mortality risks should take into consideration effects of health problems on drinking patterns. Additionally, study results support increased prevention efforts targeting heavy drinking among cancer survivors, especially White women, and individuals with or being treated for hypertension.

Journal of Substance Use, Nov 16, 2016

Alcohol's harms to others (AHTO) has gained increased research and policy attention, yet little i... more Alcohol's harms to others (AHTO) has gained increased research and policy attention, yet little information is available on different social relationships involved in such harms or consequences of harms perpetrated by various types of drinkers. Using data from the 2014-15 U.S. National Alcohol Survey (N=5,922), we present analyses comparing frequency and impacts of eight pastyear harms from other drinkers. In this sample (53% female; 66% White/Caucasian, 13% Black/ African American, and 15% other race; 15% Hispanic/Latino of any race; mean age=47 years), 19% reported at least one harm in the prior 12 months, 8% reported more than one harm, 4.9% reported a family perpetrator, 3.5% a spouse perpetrator, 6.1% a friend perpetrator, and 8.1% a stranger perpetrator. Controlling for basic demographics, the number of harms in the past year and harms perpetrated by known others (but not strangers) were significantly associated with recent distress. When comparing specific harms, financial problems due to a family member's or a spouse/partner's drinking each were associated with significantly greater distress, as were feeling threatened or afraid of family members, spouses/partners or friends who had been drinking. These new data shed light on possible intervention points to reduce negative impacts of AHTO in the U.S.

Drug and Alcohol Review, Jan 19, 2010

Introduction and Aims-Interactive voice response (IVR), a computer-based interviewing technique, ... more Introduction and Aims-Interactive voice response (IVR), a computer-based interviewing technique, can increase a sense of privacy and a willingness to report personally sensitive attitudes and behaviors accurately. Previous research using the 2005 National Alcohol Survey indicates no significant differences between IVR-and personally administered responses to alcohol-related problems and indicators of alcohol dependence. It is not clear if this result holds for specific gender, ethnic, age and income subgroups that may respond differently by mode of data collection. The purpose of this study is to compare the prevalence rates of lifetime and current (last 12 months) alcohol-related problems by gender, ethnicity, age and income subgroups obtained by IVR as compared with traditional telephone interviews (CATI). Design and Methods-As part of the data collection effort for the 2005 National Alcohol Survey, subsamples of English speaking respondents were randomly assigned to an IVR group that received an IVR module on alcohol-related problems (n=450 lifetime drinkers) and a control group that were asked the alcohol-related problem items using CATI (n=432 lifetime drinkers). Results-Overall, there were few significant associations. Among lifetime drinkers, higher rates of legal problems were found for white and higher income respondents in the IVR group. For current drinkers, a higher percentage of indicators of alcohol dependence was found for Hispanic and women respondents in the CATI group. Discussion and Conclusion-Data collected by CATI interviews provide largely comparable results to IVR. Thus, the expense of incorporating IVR in alcohol surveys for alcohol-related problems is not indicated by these results.

Alcoholism: Clinical and Experimental Research, Dec 1, 2009

Background-There is inadequate recognition of alcohol misuse as a public health issue in India. I... more Background-There is inadequate recognition of alcohol misuse as a public health issue in India. Information on screening measures is critical for prevention and early intervention efforts. This study critically evaluated the full and shorter versions of the AUDIT and RAPS4-QF as screening measures for alcohol use disorders (AUDs) in a community sample of male drinkers in Goa, India. Methods-Data from male drinking respondents in a population study on alcohol use patterns and sexual risk behaviors in randomly selected rural and urban areas of North Goa are reported. Overall, 39% (n=743) of the 1899 screened men, age 18 to 49, reported consuming alcohol in the last 12 months. These current drinkers were administered the screening measures as part of detailed interviews on drinking patterns and AUD symptoms. Receiver Operating Characteristic (ROC) analysis was conducted for each combination of screening measure and criterion (alcohol dependence or any AUD). Reliability and correlations among the 4 measures were also examined. Results-All four measures performed well with area under the curves (AUCs) of at least .79. The full screeners that included both drinking patterns and problem items (the AUDIT and the RAP4-QF) performed better than their shorter versions (the AUDIT-C and the RAPS4) in detecting AUDs. Performance of the AUDIT and RAPS4-QF improved with lowered and raised thresholds, respectively, and alternate cut-off scores are suggested. Scores on the full measures were significantly correlated (.80). Reliability estimates for the AUDIT measures were higher than those for the RAPS4 measures. Conclusions-All measures were efficient at detecting AUDs. When screening for alcohol-related problems among males in the general population in India, cut-off scores for screeners may need to be adjusted. Selecting an appropriate screening measure and cut-off score necessitates careful consideration of the screening context and resources available to confirm alcohol-related diagnoses.