Styles of analysis of GENACIS data: the relation between alcohol consumption and alcohol problems Robin Room AER Centre for Alcohol Policy Research, Turning Point Alcohol & Drug Centre, and School of Population Health, University of Melbourne Kate Graham Centre for Addiction and Mental Health, London, Ontario and Department of Psychology, University of Western Ontario and National Drug Research Institute, Curtin University, Western Australia Presentation at GENACIS plenary, June 1, 2008, Victoria, British Columbia
Relationships: predictors consumption problems A. Predictors: B. Consumption: C. Alcohol problems: demographics, volume, heavy chronic health, injury, social context, occasions social problems personality ... 1. B C: Relation of amount & patterns of consumption to alcohol problems 2. A C: relation of predictors to alcohol problems 3. A C controlling for B: relation of predictors to the risk of problems for a given consumption 4. B C controlling for A: context etc. intermediating relation of consumption & problems
B C Relation of amount & patterns of consumption alcohol problems
1.a. Relation of amount and pattern of consumption to problems: problem score Pia Mäkelä et al., Drinking habits in the Nordic Countries . Oslo: SIFA Report No. 2/99, 1999.
1.b. Relation of amount and pattern of consumption to problems: number of harms from drinking Room, R., Bondy, S.J. & Ferris, J. The risk of harm to oneself from drinking, Canada, 1989. Addiction 90:499 ‐ 513, 1995. (mislabeled: should be “Percent reporting each harm”)
1.c. Relation of amount and pattern of consumption to problems: different aspects of drinking specific types of problem consequences How much drinking is too much? It depends on the problem ( examples of different patterns of relationship for headache/nausea, finances and fighting ) From Graham, K. (March, 2007). Drinking and drinking problems among Canadian men . The Canadian Conference on Men’s Health: Raising the Standard, Victoria, BC .
Percent of men who had a headache or nausea after drinking usual number of drinks per occasion 100 90 80 frequency of drinking 5 or more drinks 70 100 60 90 50 80 40 70 30 60 20 50 10 40 0 30 1 to <2 2 to <3 3 to <4 4 to <5 5 to <6 6 to <7 7 or more 20 10 0 100 never 5+ <1 month 1-3 1-2 3-4 5-7 maximum number of drinks per occasion 90 days/month days/week days/week days/week 80 70 60 50 40 30 20 10 0 1 to <2 2 to <3 3 to <4 4 to <5 5 to <6 6 to <7 7 to <8 8 to <9 9 to <10 10 to <11 11 or more
Percent of men reporting harmful effects on finances from drinking 40 usual number of drinks per occasion 35 frequency of drinking 5 or more drinks 40 30 35 25 30 20 25 15 20 10 15 5 10 0 1 to <2 2 to <3 3 to <4 4 to <5 5 to <6 6 to <7 7 or more 5 0 40 never 5+ <1 month 1-3 1-2 3-4 5-7 days/month days/week days/week days/week 35 maximum number of drinks per occasion 30 25 20 15 10 5 0 2 3 4 5 6 7 8 9 0 1 e < < < < < < < < 1 1 r < < o o o o o o o o o m t t t t t t t t o o 1 2 3 4 5 6 7 8 t t r 9 0 o 1 1 1
Percent of men who had gotten into a physical fight when drinking usual number of drinks per occasion 20 frequency of drinking 5 or more drinks 20 15 15 10 10 5 5 0 1 to <2 2 to <3 3 to <4 4 to <5 5 to <6 6 to <7 7 or more 0 maximum number of drinks per occasion never 5+ <1 month 1-3 1-2 3-4 5-7 20 days/month days/week days/week days/week 15 10 5 0 1 to <2 2 to <3 3 to <4 4 to <5 5 to <6 6 to <7 7 to <8 8 to <9 9 to <10 10 to <11 11 or more
1.d. Relation of amount and pattern of consumption to problems: amount crossed with pattern Room, R., Bondy, S.J. & Ferris, J. The risk of harm to oneself from drinking, Canada, 1989. Addiction 90:499 ‐ 513, 1995.
A C Relation of nondrinking predictors alcohol problems
2.a. Relation of predictors to alcohol problems ‐‐ gender and age Graham, K., Demers, A., Bernards, S. with Dell, C., George, A., Kairouz, S., Nadeau, L., Poulin, C., Rehm, J., Wells, S. (November, 2005). Regional, gender and demographic variations in alcohol problems in Canada: Results from the GENACIS Canada Survey . Paper presented at “Issues of Substance” Canadian Centre on Substance Abuse National Conference, Markham, Ontario.
Percent of all respondents scoring 8 or more on the AUDIT by gender and age group (abstainers and light infrequent=0) 100 90 80 70 Percentage 60 male 50 female 40 30 20 10 0 18 to 20 21 to 25 26 to 30 31 to 35 36 to 40 41 to 45 46 to 50 51 to 55 56 to 60 61 to 65 66 to 70 71 to 76
Had enough to drink so that you felt the effects of the alcohol for example, your speech was slurred or you had trouble walking steadily (by gender and age group) 100 90 80 70 Percentage 60 male 50 female 40 30 20 10 0 18 to 20 21 to 25 26 to 30 31 to 35 36 to 40 41 to 45 46 to 50 51 to 55 56 to 60 61 to 65 66 to 70 71 to 76
Found that you were not able to stop drinking once you had started (by gender and age group) 100 90 80 70 Percentage 60 male 50 female 40 30 20 10 0 18 to 20 21 to 25 26 to 30 31 to 35 36 to 40 41 to 45 46 to 50 51 to 55 56 to 60 61 to 65 66 to 70 71 to 76
The following persons tried to get you to cut down on your drinking –partner, child or health worker/doctor (by gender and age group) 100 90 80 70 Percentage 60 male 50 female 40 30 20 10 0 18 to 20 21 to 25 26 to 30 31 to 35 36 to 40 41 to 45 46 to 50 51 to 55 56 to 60 61 to 65 66 to 70 71 to 76
Tried to cut down or quit drinking (by gender and age group) 100 90 80 70 Percentage 60 male 50 female 40 30 20 10 0 18 to 20 21 to 25 26 to 30 31 to 35 36 to 40 41 to 45 46 to 50 51 to 55 56 to 60 61 to 65 66 to 70 71 to 76
Driven after having 2 or more drinks in the previous hour (by gender and age group) 100 90 80 70 Percentage 60 male 50 female 40 30 20 10 0 18 to 20 21 to 25 26 to 30 31 to 35 36 to 40 41 to 45 46 to 50 51 to 55 56 to 60 61 to 65 66 to 70 71 to 76
Gotten into a physical fight while drinking (by gender and age group) 100 90 80 70 Percentage 60 male 50 female 40 30 20 10 0 18 to 20 21 to 25 26 to 30 31 to 35 36 to 40 41 to 45 46 to 50 51 to 55 56 to 60 61 to 65 66 to 70 71 to 76
A │ B C Relation of different measures of consumption problems in predictor categories
2b. Relation of different measures of consumption to problems in predictor categories – example of correlations between different measures of drinking and depression for males compared to females Graham, K., Massak, A., Demers, A, & Rehm, J. (2007) Does the association between alcohol consumption and depression depend on how they are measured? Alcoholism: Clinical and Experimental Research 31: 78 ‐ 88 .
Depression and drinking : 1. Average correlation between depression and four types of alcohol measures (frequency, volume, usual and maximum quantity and heavy episodic drinking) for males and females 0.25 0.21 0.2 0.15 0.15 0.15 0.1 0.08 0.10 0.06 0.05 0 0.00 -0.04 -0.05 -0.1 Frequency Volume Quantity HED Male Female
Percent of males and females who met the criteria for a diagnosis of major depression based on the CIDI by usual quantity per drinking day for past 12 months 25 24.5 21.2 % meeting criteria for depression 20 19.4 16.6 15 13.9 12.0 10.6 10 8.1 7.4 8.2 8.1 5.1 5.0 4.9 5 4.4 5 5.9 3.9 0 lifetime former 1 2 3 4 5 6 7 or more abstainer drinker drinks Usual quantity (past year) Male Female
Percent of males and females who met the criteria for a diagnosis of major depression based on the CIDI by frequency of drinking 5 or more drinks per occasion in the past year 35 30.8 28.6 30 % meeting criteria for depression 25 20 17.5 19.4 17.1 13.9 15 12.0 8.7 10 5.0 5.9 7.7 5 7.3 6.5 4.7 4.0 3.9 0 lifetime former drinker drinker but less than once 1-3 days a 1-2 days a 3-4 days a everyday or abstainer never +5 a month month week week nearly everyday Frequency of drinking 5+ Male Female
A C controlling for B Relation of predictors to the risk of problems at a given consumption
3.a. Relation of predictors to the risk of problems for a given consumption: ratio of harm per litre/per binge Hazardous behaviour score per drinking volume and occasions drinking five or more drinks, by age and sex (ratio with males aged 40 to 44 as baseline), National Drug Strategy Household Survey, 2004 (Livingston & Room, working paper, 2008) 3 Hazardous behaviour per standard drink, male Hazardous behaviour per standard drink, female 2.5 Hazardous behaviour per risky drinking occasion, male Ratio (40-44 year old males as base) Hazardous behaviour per risky drinking occasion, female 2 1.5 1 0.5 0 12 to 15 to 18 to 20 to 25 to 30 to 35 to 40 to 45 to 50 to 55 to 60 to 65 to 70 to 75 to 8 14 17 19 24 29 34 39 44 49 54 59 64 69 74 79 Age group
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