Tolerance
Who Pays the Bar Tab? Beer Consumption and Economic Growth in the United States
Resul Cesur & Inas Rashad Kelly
Economic Inquiry, forthcoming
Abstract:
Few studies explore the linkages between health behaviors and macroeconomic outcomes. This study uses 1971–2007 state-level data from the United States to estimate the impact of beer consumption on economic growth. We document that beer consumption has negative effects on economic growth measures once the endogeneity of beer consumption is addressed. Our estimates are robust to a range of specification checks. These findings run parallel to a large body of literature documenting substantial social and economic costs stemming from alcohol use.
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Katherine Keyes et al.
Drug and Alcohol Dependence, forthcoming
Background: Civilian populations now comprise the majority of casualties in modern warfare, but effects of war exposure on alcohol disorders in the general population are largely unexplored. Accumulating literature indicates that adverse experiences early in life sensitize individuals to increased alcohol problems after adult stressful experiences. However, child and adult stressful experiences can be correlated, limiting interpretation. We examine risk for alcohol disorders among Israelis after the 2006 Lebanon War, a fateful event outside the control of civilian individuals and uncorrelated with childhood experiences. Further, we test whether those with a history of maltreatment are at greater risk for an alcohol use disorder after war exposure compared to those without such a history.
Methods: Adult household residents selected from the Israeli population register were assessed with a psychiatric structured interview; the analyzed sample included 1,306 respondents. War measures included self-reported days in an exposed region.
Results: Among those with a history of maltreatment, those in a war-exposed region for 30+ days had 5.3 times the odds of subsequent alcohol disorders compared to those exposed 0 days (95% C.I. 1.01-27.76), controlled for relevant confounders; the odds ratio for those without this history was 0.5 (95% C.I. 0.25-1.01); test for interaction: X2 = 5.28, df = 1, P = 0.02.
Conclusions: Experiencing a fateful stressor outside the control of study participants, civilian exposure to the 2006 Lebanon War, is associated with a heightened risk of alcohol disorders among those with early adverse childhood experiences. Results suggest that early life experiences may sensitize individuals to adverse health responses later in life.
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Do Public Smoking Bans Have an Impact on Active Smoking? Evidence from the UK
Andrew Jones et al.
Health Economics, forthcoming
Abstract:
The literature on the effects of public smoking bans on smoking behaviour presents conflicting results and there is limited evidence on their impact on active smoking. This paper evaluates the impact of smoking bans on active smoking using data from the British Household Panel Survey and exploiting the policy experiment provided by the differential timing of the introduction of the bans in Scotland and England. We assess the short-term impact of the smoking bans by employing a series of flexible difference-in-differences fixed effects panel data models. We find that the introduction of the public smoking bans in England and Scotland had limited short-run effects on both smoking prevalence and the total level of smoking. Although we identify significant differences in trends in smoking consumption across the survey period by population sub-groups, we find insufficient evidence to conclude that these were affected by the introduction of the smoking bans. These results challenge those found in the public health literature but are in line with the most recent strand of economic literature indicating that there is no firm evidence on the effects of smoking bans on smoking.
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Patrick Quinn & Paige Harden
Journal of Abnormal Psychology, forthcoming
Abstract:
Drunk driving, a major contributor to alcohol-related mortality, has been linked to a variety of other alcohol-related (e.g., Alcohol Dependence, early age at first drink) and non-alcohol-related externalizing behaviors. In a sample of 517 same-sex twin pairs from the National Longitudinal Study of Adolescent Health, we examined 3 conceptualizations of the etiology of drunk driving in relation to other externalizing behaviors. A series of behavioral-genetic models found consistent evidence for drunk driving as a manifestation of genetic vulnerabilities toward a spectrum of alcohol-related and non-alcohol-related externalizing behaviors. Most notably, multidimensional scaling analyses produced a genetic “map” with drunk driving located near its center, supporting the strength of drunk driving’s genetic relations with a broad range of externalizing behaviors. In contrast, nonshared environmental associations with drunk driving were weaker and more diffuse. Drunk driving may be a manifestation of genetic vulnerabilities toward a broad externalizing spectrum.
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Karin Verweij et al.
Drug and Alcohol Dependence, December 2013, Pages 580–586
Background: Several studies have shown that early cannabis use is correlated with poor educational performance including high school drop-out. The predominant explanation for this relationship is that cannabis use causes disengagement from education. Another explanation is that the association between early cannabis use and educational attainment is not causal, but the result of overlapping risk factors that increase the likelihood of both early cannabis use and disengagement from education. These confounding factors could be of genetic and/or environmental origin.
Methods: Here we use data from a large community-based sample of adult twins (N = 3337) who completed a comprehensive semi-structured telephone interview. We first apply the classical twin-design to determine whether genetic and/or environmental influences underlie the relationship between early-onset cannabis use (prior to age 18) and early school leaving. Next, with a co-twin control design we investigate whether the relationship between the two variables is more likely due to direct causality or overlapping risk factors.
Results: We find a significant phenotypic correlation between early-onset cannabis use and early school leaving (r = 0.26), which could be explained by familial influences (of genetic and/or shared environmental origin). The pattern of odds ratios found in the co-twin control design is not consistent with direct causation, but rather suggests that the association is due to shared environmental factors influencing both variables.
Conclusion: Our findings suggest that the relationship between early-onset cannabis use and school leaving is due to shared environmental risk factors influencing both the risk of early-onset cannabis use and early school leaving.
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An Economic Theory of Workaholics and Alcoholics
Aaron Finkle & Dongsoo Shin
Economic Inquiry, forthcoming
Abstract:
This paper considers the role of alcohol in agency problems in order to provide an economic rationale for alcoholics and workaholics. In our model, alcohol reduces productivity, but also can make imbibers blurt private information. We show that in the optimal contract, low-productivity workers are compelled to over-indulge in alcohol, while high-productivity workers overproduce output. Thus, workers are made into “alcoholics” and “workaholics” depending on their productivity. We conclude that excessive drinking (working) may be the result, not the cause, of low (high) productivity of workers.
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An Application of Unconditional Quantile Regression to Cigarette Taxes
Johanna Catherine Maclean, Douglas Webber & Joachim Marti
Journal of Policy Analysis and Management, forthcoming
Abstract:
This study investigates heterogeneous response to state cigarette tax increases using unconditional quantile regression (UQR). We make two contributions to the empirical policy analysis literature. First, we argue that UQR provides more policy-relevant information than conventional quantile regression in most empirical state policy analyses. Second, we document cigarette tax elasticity across a sample of adult smokers in the Current Population Survey Tobacco Use Supplements between 1992 and 2011. Our ordinary least squares regression show an imprecise negative relationship between taxes and cigarettes smoked in the past 30 days, while UQR reveals a U-shaped relationship: Only moderate smokers reduce their smoking following a cigarette tax increase, and the magnitude of the effect is small. A $1.00 (135 percent) increase in the cigarette tax leads to a 3.5 percent reduction in the number of cigarettes smoked in the past 30 days among the most responsive smokers (implied tax elasticity = −0.03).
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The use of caffeinated alcoholic beverages among underage drinkers: Results of a national survey
Kalé Kponee, Michael Siegel & David Jernigan
Addictive Behaviors, forthcoming
Objective: The mixing of alcoholic beverages with caffeine has been identified as a public health problem among college students; however, little is known about the consumption of such drinks among younger adolescents. We estimated the prevalence of caffeinated alcoholic beverage (CAB) use among a wide age range of underage drinkers, examined differences in traditional (i.e. self-mixed alcoholic beverages with soda, coffee and tea) and non-traditional CAB use (pre-mixed caffeinated alcoholic beverages or self-mixed alcoholic beverages with energy drinks or energy shots) among underage drinkers by age and other demographic characteristics, and examined differences in hazardous drinking behavior between CAB and non-CAB users.
Methods: We used an existing internet panel maintained by Knowledge Networks, Inc. to assess the use of pre-mixed and self-mixed CABs in the past 30 days among a national sample of 1,031 youth drinkers ages 13-20. We conducted logistic regression analyses to estimate the relationship between traditional and non-traditional CAB use and risky drinking behavior as well as adverse outcomes of drinking, while controlling for age, gender, race/ethnicity, income, and general risk-taking (seat belt use).
Results: The overall prevalence of CAB use in the sample of underage drinkers was 52.4% (95% confidence interval [CI], 47.4%-57.4%). CAB prevalence was 48.4% among 13-15 year-old drinkers, 45.3% among 16-18 year-old drinkers, and 58.4% among 19-20 year-old drinkers. After controlling for other variables, we found a continuum of risk with non-traditional CAB use most significantly associated with binge drinking (odds ratio [OR] = 6.3), fighting (OR = 4.4), and alcohol-related injuries (OR = 5.6)
Conclusions: The problem of caffeinated alcoholic beverage use is not restricted to college-aged youth. The prevalence of CAB use among underage drinkers is higher than previously thought and begins in early adolescence. Adolescents who consume CABs, and particularly non-traditional CABs, are at increased risk of adverse outcomes.
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The Multitude of Alehouses: The Effects of Alcohol Outlet Density on Highway Safety
Meng-Chi Tang
B.E. Journal of Economic Analysis & Policy, October 2013, Pages 1023–1050
Abstract:
This article reports the use of detailed panel data on alcoholic beverage outlet licensing in Texas to determine the effects of alcohol outlet density on highway safety. After controlling for county heterogeneity, county and year fixed effects, and county-specific time trends, this study shows that alcohol outlet density decreases expected alcohol-related traffic accidents and arrests for driving under the influence (DUI). The negative correlation can be explained according to the reduced travel distance between alcohol outlets and home, but this distance effect does not appear when the number of off-premise alcohol outlets increases. The empirical results of this study show that the off-premise alcohol outlet density is negatively related to the number of expected accidents and DUI arrests. These results indicate that on-premise consumption decreases according to the number of available off-premise outlets. The results also indicate that this effect originates mainly from the off-premise outlets that sell alcoholic products with a relatively low alcohol content.
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Daniel Snipes et al.
Addictive Behaviors, forthcoming
Abstract:
Much research has documented negative associations with the consumption of alcohol mixed with energy drinks (AmED). To date, few research studies have examined the relation between AmED and sexual victimization. Furthermore, research on sexual victimization among men is less studied. The present study employed a sample of 253 men and 545 women to examine the differential associations between AmED consumption and sexual victimization as a function of gender. Results from this study suggest that AmED consumption is robustly associated with being sexually victimized among men, but not women. These results were robust while controlling for demographic factors and other substance use. Results add to the literature on sexual victimization by potentially identifying a new high-risk drinking behavior among males who have been sexually victimized.
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How Bad Could It Be? Alcohol Dampens Stress Responses to Threat of Uncertain Intensity
Daniel Bradford, Benjamin Shapiro & John Curtin
Psychological Science, forthcoming
Abstract:
Stress response dampening is an important motive for alcohol use. However, stress reduction via alcohol (alcohol SRD) is observed inconsistently in the laboratory, and this has raised questions about the precise mechanisms and boundary conditions for these effects. Emerging evidence indicates that alcohol SRD may be observed selectively during uncertain but not certain threats. In a final sample of 89 participants, we measured stress response via potentiation of defensive startle reflex in response to threat of shock in blocks with certain (low and high) and uncertain shock intensity. Our alcohol-administration procedure produced blood alcohol concentrations (BACs) across a broad range (0.00%–0.12%) across participants. Increasing BACs were associated with linearly decreasing startle potentiation and self-reported anxiety. This SRD effect was greater during uncertain than certain threat. More broadly, these results suggest that distinct mechanisms are involved in response to threats of uncertain intensity and threats of certain intensity.
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Protracted impairment of impulse control under an acute dose of alcohol: A time course analysis
Melissa Miller & Mark Fillmore
Addictive Behaviors, forthcoming
Abstract:
Alcohol is well-known for impairing impulse control as well as its disruptive effects on other aspects of behavioral functioning, such as motor control. Time-course analyses during a single dose show rapid development of acute tolerance to impairment of motor coordination, reaction time, and levels of subjective intoxication, but no acute tolerance to impairment of the ability to inhibit responses. Evidence for a possible lag in tolerance development to the impairing effects of alcohol on inhibitory control suggests that, as drinkers’ blood alcohol concentration (BAC) declines, they might exhibit prolonged impulsivity despite having an unimpaired ability to initiate action. The present study extended the time-course analysis to examine the recovery of inhibitory control under a dose of alcohol as drinkers’ BAC descended from a peak of 80 mg/100 ml to a zero level. Twenty-four healthy adults were tested following 0.65 g/kg alcohol and a placebo in a counterbalanced order. They performed a cued go/no-go task that measured response inhibition. They also performed tasks that assessed reaction time, motor coordination, and completed ratings of their subjective levels of intoxication. Alcohol initially impaired inhibitory control, response time, and motor coordination and increased subjective ratings of intoxication. However, acute tolerance to the impairing effects of alcohol was observed for measures of response time, motor coordination, and ratings of intoxication and these measures returned to sober (i.e., placebo) levels by the time BAC fell to near zero. By contrast, impairment of inhibitory control showed no acute tolerance and remained impaired even when drinkers’ BAC returned to near zero. Taken together, these results indicate that the disinhibiting effects of alcohol are present even when the impairing effects of alcohol on other aspects of behavior have diminished under the dose. These findings could provide a greater understanding of impulsive behaviors during the descending limb of intoxication.
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Biomarker Evidence of Tobacco Smoke Exposure in Children Participating in Lead Screening
Anne Joseph et al.
American Journal of Public Health, December 2013, Pages e54-e59
Objectives: We assessed tobacco smoke exposure (TSE), defined according to detection of cotinine, in dried blood spots collected from children for lead screening.
Methods: Dried blood spots collected from a national sample of 1541 Black and White children and submitted to a commercial laboratory for lead analysis were analyzed for cotinine. We used an anonymous administrative data set including information on children's characteristics to conduct univariate and multivariate analyses.
Results: Cotinine was detected in 61% of dried blood spots; 17% of samples had cotinine levels above 3 nanograms per gram. Median cotinine levels were significantly higher among Black than White children (0.66 ng/g vs 0.30 ng/g) and among Medicaid recipients (0.94 ng/g vs < 0.3 ng/g). In multivariate analyses, significant increases in cotinine levels were associated with Black (vs White) race, older age, Medicaid coverage, higher state smoking rate, and higher average winter temperature. Detectable cotinine levels were significantly associated with higher lead levels.
Conclusions: TSE is highly prevalent among children undergoing lead screening, and exposure levels are greater among Black children and children on Medicaid. TSE may contribute to lead exposure. Concurrent lead screening and biological screening for TSE may be a feasible approach to increasing childhood TSE detection.
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Lydia Shrier et al.
Addictive Behaviors, forthcoming
Abstract:
We evaluated the feasibility, acceptability, and potential efficacy of MOMENT, an intervention to reduce youth marijuana use that combines brief motivational enhancement therapy with mobile self-monitoring and responsive messaging. At baseline, primary care patients ages 15-24 who used marijuana frequently (at least 3 times per week) completed a recall assessment, then 1 week of mobile momentary and daily reports on use-related factors. For the intervention, youth participated in two motivational enhancement therapy sessions, during which they identified their top-3 social and emotional triggers for use and discussed healthy ways to manage them. They then completed two weeks of mobile reports. Upon reporting a top-3 trigger for use, desire to use, or recent use, they received a message supporting self-efficacy and prompting consideration of coping strategies. Generalized estimating equations examined changes in momentary-, daily-, and individual-level measures on 3-month recall and mobile assessments. Twenty-seven youth (M = 19.2 years, 70% female) enrolled; there were 377-677 momentary and 50-106 daily reports per study phase. Participants reported reading the messages and finding them motivating, being comfortable with participation, and not experiencing the study as burdensome. Although proportion of momentary reports of being in a top-3 trigger context did not change (36% - 43%), marijuana desire in a top-3 trigger context and marijuana use after top-3 trigger exposure decreased over the study (p < .0001 and p = .03, respectively). Daily- and individual-level measures showed similar, non-significant, improvements. The MOMENT intervention appears feasible, well-accepted, and potentially efficacious for youth who use marijuana frequently.
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Online Network Influences on Emerging Adults’ Alcohol and Drug Use
Stephanie Cook et al.
Journal of Youth and Adolescence, November 2013, Pages 1674-1686
Abstract:
Researchers have reported that network characteristics are associated with substance use behavior. Considering that social interactions within online networks are increasingly common, we examined the relationship between online network characteristics and substance use in a sample of emerging adults (ages 18–24) from across the United States (N = 2,153; M = 21 years old; 47 % female; 70 % White). We used regression analyses to examine the relationship between online ego network characteristics (i.e., characteristics of individuals directly related to the focal participant plus the relationships shared among individuals within the online network) and alcohol use and substance use, respectively. Alcohol use was associated with network density (i.e., interconnectedness between individuals in a network), total number of peer ties, and a greater proportion of emotionally close ties. In sex-stratified models, density was related to alcohol use for males but not females. Drug use was associated with an increased number of peer ties, and the increased proportion of network members’ discussion and acceptance of drug use, respectively. We also found that online network density and total numbers of ties were associated with more personal drug use for males but not females. Conversely, we noted that social norms were related to increased drug use and this relationship was stronger for females than males. We discuss the implications of our findings for substance use and online network research.
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Marijuana and Self-regulation: Examining Likelihood and Intensity of Use and Problems
Robert Dvorak & Anne Day
Addictive Behaviors, forthcoming
Abstract:
It is important to understand the individual differences that contribute to greater frequency or intensity of marijuana use, or greater frequency of experiencing marijuana-related problems. The current study examined several elements of behavioral and emotional self-regulation as predictors of the likelihood and intensity of both marijuana use and marijuana-related problems. As predicted, indices of behavioral self-regulation (self-control, sensation seeking) were better predictors of marijuana use, while indices of emotional self-regulation (affect, distress tolerance, and emotional instability) better predicted marijuana-related problems. Surprisingly, urgency was not related to use but was predictive of problems, and there were no significant interactions between behavioral and emotional self-regulation in predicting either use or problems. From these findings we conclude that while behavioral dysregulation may put individuals at risk for using marijuana, or using it more frequently, it is those individuals with difficulty in emotional self-regulation that are at risk for experiencing negative consequences as a result of their marijuana use. Clinically, these data are relevant; clinicians might focus more on addressing emotional regulation in order to lessen or eliminate the consequences of marijuana use.
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Music increases alcohol consumption rate in young females
Lorenzo Stafford & Hannah Dodd
Experimental and Clinical Psychopharmacology, October 2013, Pages 408-415
Abstract:
Previous field research has shown that individuals consumed more alcohol and at a faster rate in environments paired with loud music. Theoretically, this effect has been linked to approach/avoidance accounts of how music influences arousal and mood, but no work has tested this experimentally. In the present study, female participants (n = 45) consumed an alcoholic (4% alcohol-by-volume) beverage in one of three contexts: slow tempo music, fast tempo music, or a no-music control. Results revealed that, compared with the control, the beverage was consumed fastest in the two music conditions. Interestingly, whereas arousal and negative mood declined in the control condition, this was not the case for either of the music conditions, suggesting a downregulation of alcohol effects. We additionally found evidence for music to disrupt sensory systems in that, counterintuitively, faster consumption was driven by increases in perceived alcohol strength, which, in turn, predicted lower breath alcohol level (BrAL). These findings suggest a unique interaction of music environment and psychoactive effects of alcohol itself on consumption rate. Because alcohol consumed at a faster rate induces greater intoxication, these findings have implications for applied and theoretical work.
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Mark Myers et al.
Journal of Studies on Alcohol and Drugs, November 2013, Pages 909–916
Objective: Little is known about the relationship between cigarette smoking initiation and subsequent alcohol involvement. To address this question, the present study compared alcohol use between students who initiated smoking during college and a matched sample of never-smoking students. We hypothesized greater increases in alcohol involvement among smoking initiators, mediated by exposure to cigarette use situations.
Method: Included in the present study were 104 Chinese American and Korean American undergraduates who at baseline (freshman year) reported never having smoked a cigarette. Subjects were drawn from 433 participants in a naturalistic longitudinal study of tobacco use who were assessed annually each year in college. Cigarette smoking status was assessed annually as part of a structured interview. Initiators and never-smokers were matched on gender, ethnicity, baseline alcohol use, parental smoking status, and behavioral undercontrol.
Results: As predicted, participants who initiated smoking during college reported significantly greater increases in the number of past-30-day total drinks consumed (p < .001) and reported greater prevalence of heavy drinking episodes (p < .05). The effect of smoking initiation on the change in the number of past-30-day drinks at the final assessment was partially mediated by exposure to smoking (p < .05). Exploratory analyses indicated that greater recent smoking significantly predicted increased alcohol consumption over and above the effect of exposure.
Conclusions: Students who initiate smoking during college appear at risk for increased alcohol involvement. Part of this risk is explained by environmental contextual factors, specifically exposure to situations involving other smokers that also may result in greater exposure to alcohol use.
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Prevalence of Marijuana Use at College Entry and Risk Factors for Initiation During Freshman Year
Cynthia Suerken et al.
Addictive Behaviors, forthcoming
Background: Marijuana is currently the most commonly used drug on college campuses. Marijuana use among college students is increasing, and many students begin using marijuana during college. The goal of this study was to investigate predictors of lifetime marijuana use at college entry and initiation during freshman year.
Methods: We used responses from the first two semesters of a longitudinal study of 3,146 students from 11 colleges in North Carolina and Virginia. Random-effects logistic regression models were constructed to identify factors that predict lifetime marijuana use at college entry and initiation during freshman year.
Results: Nearly 30% of students reported ever having used marijuana at college entry. Among students who had never used marijuana prior to college, 8.5% initiated use during freshman year. In multivariable logistic regression models, having at least $100 per month in spending money; attending church rarely or never; current use of cigarettes, alcohol, and hookah tobacco; lifetime use of other illicit drugs; and a higher propensity toward sensation seeking were associated with a higher likelihood of having used marijuana at least once at college entry. Hispanic ethnicity, living on campus, and current use of cigarettes and alcohol were associated with a higher likelihood of initiating marijuana use during freshman year.
Conclusion: These results have implications for targeting substance abuse prevention programs on college campuses.
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Amelia Arria et al.
Alcoholism, forthcoming
Background: It is well known that using false identification (ID) is a common method by which underage youth in the United States obtain alcohol. While false ID use is associated with high-risk drinking patterns, its association with alcohol use disorder (AUD), independent of other risk factors, has not been firmly established.
Methods: Participants were 1,015 college students recruited from 1 university and assessed annually during their first 4 years of college. Latent variable growth curve modeling was used to identify significant predictors of false ID use and test the hypothesis that false ID use increased the risk for AUD, by increasing the frequency and/or quantity of alcohol use. Several other hypothesized risk factors for AUD were accounted for, including demographics (sex, race, living situation, religiosity, socioeconomic status), individual characteristics (childhood conduct problems, sensation-seeking, age at first drink), high school behaviors (high school drinking frequency, drug use), family factors (parental monitoring, parental alcohol problems), perception of peer drinking norms, and other factors related to false ID use.
Results: False IDs were used by almost two-thirds (66.1%) of the sample. False ID use frequency was positively associated with baseline quantity and frequency of alcohol use, independent of all other factors tested. False ID use was not directly related to AUD risk, but indirectly predicted increases in AUD risk over time through its association with greater increases in alcohol use frequency over time. Several predictors of false ID use frequency were also identified.
Conclusions: False ID use may contribute to AUD risk by facilitating more frequent drinking. If replicated, these findings highlight the potential public health significance of policies that enforce sanctions against false ID use. Students who use false IDs represent an important target population for alcohol prevention activities.