A 10-year national trend study of alcohol consumption, 1984-1995: is the period of declining drinking over? (original) (raw)
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Longitudinal trajectories of heavy drinking in adults in the United States of America
Addiction, 2006
Aims To estimate age, period, cohort and other demographic influences on heavy alcohol consumption and trajectories of heavy drinking in American adults. Design Prospective cohort of 14 127 participants, aged 25-74 years at baseline. Generalized estimating equations to model longitudinal change in the probability of heavy drinking and its association with demographic factors. Setting National, population-based sample of non-institutionalized civilians. Measurements Heavy alcohol consumption (usual number of drinks per occasion ≥ five for men; ≥ four for women) at baseline (1971-74) and three follow-ups until 1992. Findings Heavy alcohol consumption declined with increasing age (age effect) and tracked national average consumption (period effect). There was no cohort effect. Higher probability of heavy drinking was associated with male gender (relative risk: RR = 2.4), being not married (RR = 1.4), having less than high school education (RR = 1.7), having annual income below the median (RR = 1.5), not living in the Southeast (RR = 1.7), and smoking (RR = 3.4). Getting married and quitting smoking during the study were each associated with reduction in heavy drinking (RR = 0.55 and 0.61, respectively). Slower age-related decline in the probability of heavy drinking was seen in men (P < 0.0001), married individuals (P = 0.03), and smokers (P = 0.05). Conclusions Demographic predictors of trends in heavy drinking are different from those for trends in average alcohol consumption. The likelihood of heavy drinking declined more slowly with increasing age in men and smokers, suggesting that the negative health effects of alcohol in older ages may be greatest in these groups.
Longitudinal Patterns and Predictors of Alcohol Consumption in the United States
American Journal of Public Health, 2005
Objectives. We examined demographic predictors of longitudinal patterns in alcohol consumption. Methods. We used mixed-effects models to describe individual alcohol consumption and change in consumption with age, as well as the associations between consumption and birth year, national alcohol consumption, and demographic factors, among 14 105 adults from the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study. Results. Alcohol consumption declined with increasing age, and individual consumption mirrored national consumption. Higher consumption was associated with male gender, being White, being married, having a higher educational level, having a higher income, being employed, and being a smoker. Faster agerelated decline in consumption was associated with earlier cohorts, being male, being married, having a lower educational level, and being a smoker. Conclusions. Compared with alcohol consumption among earlier cohorts, that among recent cohorts declined more slowly with increasing age, suggesting that negative health effects of alcohol could increase in the future.
2020
Background: Excessive alcohol use is the third leading cause of mortality in the United States, where alcohol use consistently increased over the last decades. This trend is currently maintained, despite regulatory policies aimed to counteract it. While the increased health risks resulting from alcohol use are evident, some open questions regarding alcohol use and its consequences in the US population remain. Objectives: The current work aims to evaluate the relation between alcohol consumption trends over a period of 15 y with all-cause and cause-specific mortality. In addition, we evaluate the adequacy of the current alcohol recommended limits according to the 2015-2020 US Dietary Guidelines for Americans (USDGA). Methods: This was a prospective population-based study defined by the NHANES conducted over the period 1999-2014 linked to US mortality registry in 2015. Results: The sample, composed of 34,672 participants, was observed for a median period of 7.8 y, totaling 282,855 person-years. In the present sample, 4,303 deaths were observed. Alcohol use increased during the period 1999-2014. Alcohol use above the current US recommendations was associated with increased all-cause and causespecific mortality risk, ranging from 39% to 126%. A proportion of these deaths, ranging from 19% to 26%, could be theoretically prevented if US citizens followed current guidelines, and 13% of allcause deaths in men could be avoided if the current US guidelines for women (1 standard drink/d) were applied to them. Conclusions: The present study provides evidence in support of limiting alcohol intake in adherence to the USDGA recommendations.
Who drinks most of the alcohol in the US? The policy implications
Journal of Studies on Alcohol, 1999
The concentration of alcohol consumption in the U.S. among the heaviest drinkers is analyzed with data from two recent probability samples of the adult population. Method: Pooled data from four national telephone surveys (N = 7,049; 4,784 drinkers) with uniform methodology are used for the primary analysis, and data from an in-person national household survey (N = 2,058; 1,308 drinkers) are used for confu-matory analysis. Each survey systematically measured self-reported alcohol consumption during the prior year using a "graduated frequencies" approach designed to capture drinking at a series of amount-per-day levels. Results: The two studies produced very similar estimates: the top 2.5% of drinkers by volume account for 27% and 25% of the nation's total self-reported alcohol consumption in the telephone and in-person surveys, respectively; the top 5% account for 42% and 39%; and the top 20% of drinkers account for 89% and 87% in each survey, respectively. Men were overrepresented at the highest volumes, contributing about 76% of the country's total reported consumption. Similarly, young adults aged 18 to 29 are disproportionately represented in the heaviest drinking levels; constituting 27% of the population, they account for about 45% of overall adult drinking. Conclusions: The bulk of the alcohol reported drunk in the U.S. is consumed by a relatively small population of very heavy drinkers. Prevention policies implied by this concentration include strengthening of social norms discouraging heavy consumption, restricting marketing practices that target heavy drinkers, and implementing measures to reduce consumption by the heaviest drinkers. (J. Stud. Alcohol 60: 78-89, 1999) FREQUENTLY RECURRING STATISTIC that crops up in many discussions of alcohol consumption and policy is the percentage of heavy drinkers it takes to drink 50% of the alcohol drunk (and by implication sold) in the United States. As Klein and Pittman (1994) have observed, documentation of the level cited is often unclear (e.g., Haglund and Schuckit, 1982; Kinney and Leaton, 1987; Moore and Gerstein, 1981; Royce, 1981). Several detailed reports are available and will be reviewed presently, but the different methods used across a wide range of study years limit the general conclusions that can be drawn. There is a common finding that alcohol consumption tends to be concentrated among heavier drinkers, but the levels of concentration vary considerably across studies. One of the earlier estimates of the concentration of consumption (Room, 1970) looked at the issue in terms of the population proportion exhibiting defined drinking patterns and the proportion of total alcohol consumption these subgroups accounted for. Heavy drinkers, who drank five or more drinks at a time at least weekly, constituted 6% of the population (including nondrinkers) and accounted for 41%
The American Journal of Clinical Nutrition, 2020
Background: Excessive alcohol use is the third leading cause of mortality in the United States, where alcohol use consistently increased over the last decades. This trend is currently maintained, despite regulatory policies aimed to counteract it. While the increased health risks resulting from alcohol use are evident, some open questions regarding alcohol use and its consequences in the US population remain. Objectives: The current work aims to evaluate the relation between alcohol consumption trends over a period of 15 y with all-cause and cause-specific mortality. In addition, we evaluate the adequacy of the current alcohol recommended limits according to the 2015-2020 US Dietary Guidelines for Americans (USDGA). Methods: This was a prospective population-based study defined by the NHANES conducted over the period 1999-2014 linked to US mortality registry in 2015. Results: The sample, composed of 34,672 participants, was observed for a median period of 7.8 y, totaling 282,855 person-years. In the present sample, 4,303 deaths were observed. Alcohol use increased during the period 1999-2014. Alcohol use above the current US recommendations was associated with increased all-cause and causespecific mortality risk, ranging from 39% to 126%. A proportion of these deaths, ranging from 19% to 26%, could be theoretically prevented if US citizens followed current guidelines, and 13% of allcause deaths in men could be avoided if the current US guidelines for women (1 standard drink/d) were applied to them. Conclusions: The present study provides evidence in support of limiting alcohol intake in adherence to the USDGA recommendations.
Addiction, 2004
To estimate the separate influences of age, period and cohort on the consumption of beer wine and spirits in the United States. Design Linear age-period-cohort models controlling for demographic change with extensive specification testing. Setting US general population 1979-2000. Measurements Monthly average of past-year consumption of beer, wine and spirits in five National Alcohol Surveys. Findings The strongest cohort effects are found for spirits; cohorts born before 1940 are found to have significantly higher consumption than those born after 1946, with especially high spirits consumption for men in the pre-1930s cohorts. Significant cohort effects are also found for beer with elevated consumption in the 1946-65 cohorts for men but in the pre-1940 cohorts for women. Significant negative effects of age are found for beer and spirits consumption, although not for wine. Significant period effects are found for men's beer and wine consumption and for women's spirits consumption. Increased educational attainment in the population over time is associated with reduced beer consumption and increased wine consumption. Conclusions Changing cohort demographics are found to have significant effects on beverage-specific consumption, indicating the importance of controlling for these effects in the evaluation of alcohol policy effectiveness and the potential for substantial improvement in the forecasting of future beveragespecific consumption trends, alcohol dependence treatment demand and morbidity and mortality outcomes.
Addiction, 2009
Aims The decomposition of trends in alcohol volume and heavy drinking days into age, period, cohort and demographic effects offers an important perspective on the dynamics of change in alcohol use patterns in the United States. Design The present study utilizes data from six National Alcohol Surveys conducted over the 26-year period between 1979 and 2005. Setting United States. Measurements Alcohol volume and the number of days when five or more and eight or more drinks were consumed were derived from overall and beverage-specific graduated frequency questions. Results Trend analyses show that while mean values of drinking measures have continued to decline for those aged 26 and older, there has been a substantial increase in both alcohol volume and 5+ days among those aged 18-25 years. Age-period-cohort models indicate a potential positive cohort effect among those born after 1975. However, an alternative interpretation of an age-cohort interaction where drinking falls off more steeply in the late 20s than was the case in the oldest surveys cannot be ruled out. For women only, the 1956-60 birth cohort appears to drink more heavily than those born just before or after. Models also indicate the importance of income, ethnicity, education and marital status in determining these alcohol measures. Conclusions Increased heavy drinking among young adults in recent surveys presents a significant challenge for alcohol policy and may indicate a sustained increase in future US alcohol consumption.
Analysis of Alcohol Consumption in the United States: Probability and Level of Intake
Journal of food distribution research, 1994
This article examines the impact of socio-demographic factors on individual consumption of alcohol in the United States using the Heckman procedure and logit analysis. Factors considered are urbanization, race, ethnicity, region, weight, height, sex, food stamp participation, employment status, diet status, day of consumption, household size, age, and income. All the variables, with the exception of ethnicity and food stamp participation, significantly influence the decision to consume alcohol. Results also indicate that urbanization, region, sex, food stamp participation, and household size significantly affect the level of alcohol consumption.