Not All Drinks Are Created Equal: Implications for Alcohol Assessment in India

Nayak, Madhabika B.; Kerr, William C.; Greenfield, Thomas K.; Pillai, Aravind

doi:10.1093/alcalc/agn074

Cited by 31 publications

(33 citation statements)

References 33 publications

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“…We assessed serious adverse events in the per-protocol population. We estimated the primary continuous outcome (mean daily ethanol consumed in the past 14 days) by multiplying the total standard drinks 27 consumed in the past 14 days by 10 (based on the WHO definition of a standard drink as 10 g of pure ethanol 28 ). We used zero-inflated negative binomial regression 29 to estimate the intervention effect for this outcome and other positively skewed overdispersed outcomes with an excess of zeros.…”

Section: Methodsmentioning

confidence: 99%

Counselling for Alcohol Problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial

et al. 2017

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SummaryBackgroundAlthough structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psychological treatment delivered by lay counsellors to patients with harmful drinking attending routine primary health-care settings.MethodsIn this randomised controlled trial, we recruited male harmful drinkers defined by an Alcohol Use Disorders Identification Test (AUDIT) score of 12–19 who were aged 18–65 years from ten primary health centres in Goa, India. We excluded patients who needed emergency medical treatment or inpatient admission, who were unable to communicate clearly, and who were intoxicated at the time of screening. Participants were randomly allocated (1:1) by trained health assistants based at the primary health centres to enhanced usual care (EUC) alone or EUC combined with CAP, in randomly sized blocks of four to six, stratified by primary health centre, and allocation was concealed with use of sequential numbered opaque envelopes. Physicians providing EUC and those assessing outcomes were masked. Primary outcomes were remission (AUDIT score of <8) and mean daily alcohol consumed in the past 14 days, at 3 months. Secondary outcomes were the effect of drinking, disability score, days unable to work, suicide attempts, intimate partner violence, and resource use and costs of illness. Analyses were on an intention-to-treat basis. We used logistic regression analysis for remission and zero-inflated negative binomial regression analysis for alcohol consumption. We assessed serious adverse events in the per-protocol population. This trial is registered with the ISCRTN registry, number ISRCTN76465238.FindingsBetween Oct 28, 2013, and July 29, 2015, we enrolled and randomly allocated 377 participants (188 [50%] to the EUC plus CAP group and 190 [50%] to the EUC alone group [one of whom was subsequently excluded because of a protocol violation]), of whom 336 (89%) completed the 3 month primary outcome assessment (164 [87%] in the EUC plus CAP group and 172 [91%] in the EUC alone group). The proportion with remission (59 [36%] of 164 in the EUC plus CAP group vs 44 [26%] of 172 in the EUC alone group; adjusted prevalence ratio 1·50 [95% CI 1·09–2·07]; p=0·01) and the proportion abstinent in the past 14 days (68 [42%] vs 31 [18%]; adjusted odds ratio 3·00 [1·76–5·13]; p<0·0001) were significantly higher in the EUC plus CAP group than in the EUC alone group, but we noted no effect on mean daily alcohol consumed in the past 14 days among those who reported drinking in this period (37·0 g [SD 44·2] vs 31·0 g [27·8]; count ratio 1·08 [0·79–1·49]; p=0·62). We noted an effect on the percentage of days abstinent in the past 14 days (adjusted mean difference [AMD] 16·0% [8·1–24·1]; p<0·0001), but no effect on the percentage of days of heavy drinking (AMD −0·4% [–5·7 to 4·...

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Section: Methodsmentioning

confidence: 99%

Counselling for Alcohol Problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial

et al. 2017

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“…Since taxation of alcoholic brews depends on the ethanol content such discrepancies are likely to benefit the alcohol manufacturers. According to [4] variation in alcohol concentration is one of the factors that determine volume consumed. The finding that some brews marketed as herbal drinks had a high ethanol content indicates that non suspecting Kenyans are using alcohol unknowingly.…”

Section: Discussionmentioning

confidence: 99%

“…Amounts of alcohol consumed by a person depend partly on the ethanol content. Estimates of both mean volume of alcohol consumption and heavy drinking amounts are influenced by variation in alcohol concentration and quantity [4]. People from poor communities prefer cheap and potent alcohol.…”

Section: Introductionmentioning

confidence: 99%

Alcohol dependence: Does the composition of the available beverages promote it?

Kuria¹,

Olando²

2012

OJPsych

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Affordability and availability of alcohol are factors that have been associated with alcohol dependence. Ethanol content in the alcoholic beverages is an important determinant in alcohol dependence. Quality control of alcoholic beverages available in the market is important in safeguarding the health of alcohol consumers. Few studies in Kenya have determined the chemical composition of alcohol used by the study participants. Objective: To determine the chemical composition of alcoholic beverages used by a group of alcohol dependent study participants. Design: The study was a clinical trial with pre and post measurements. Method: The CIDI and WHO-ASSIST were administered to 188 alcohol-dependent persons at intake and after six months. A researcher-designed socio demographic questionnaire was also administered at intake. Alcohol beverages were randomly collected from the location of the study area and their chemical composition analyzed using gas chromatography. Results: The mean AUDIT score of the participant was 28.6 for male and 26.6 for females. Three of the alcohol samples collected was illicit brews collected while 11 were licit. Four out of the eleven licit brews had ethanol levels that did not complied with the set government standards. Conclusion: Illicit brews with high ethanol content are available in the Kenyan market, while some of the manufacturers of the licit brew do not comply with government set content recommendations.

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“…For quantity of alcohol consumed, the number and volume of drinks consumed on a typical day over the last 30 days was recorded. Quantity of pure alcohol consumed on a typical day was derived from this variable by converting the number, volume and type of drinks consumed to grams of pure ethanol [17]. In accordance with the World Health Organization's Global Status Report on Alcohol and Health, heavy episodic drinking was defined as drinking at least 60 grams or more of pure alcohol on at least one occasion in the past 7 days [1].…”

Section: Main Outcome Measuresmentioning

confidence: 99%

Men’s Heavy Alcohol Use and Risk of HIV Acquisition and Transmission to Sexual Partners within Marriage in India

Saggurti¹

2014

J Alcohol Drug Depend

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Background: Heavy episodic drinking by men in India and elsewhere is associated with their sexual risk behaviors, thereby increasing the risk for HIV. This paper assesses whether heavy episodic drinking is associated with acquisition of HIV among married men and its transmission to their spouses in India.Methods: A case-control study was conducted from March-August 2010 among 595 cases (HIV positives) and 611 controls (HIV negatives) aged 18 years and above, recruited from HIV testing and treatment centers in seven districts of eastern and northern India. Logistic regression analyses were used to assess the associations between heavy episodic drinking (defined based on frequency and quantity) in the past 7 days and the following outcome variables: extramarital sex, men's HIV status and their spouse's HIV status.Results: No significant difference was observed in the HIV status of men reporting heavy episodic drinking and those reporting light drinking (41% vs. 50%, adjusted odds ratio [AOR]=0.7, 95% confidence interval [CI]=0.5-1.0, p=0.083). However, men reporting heavy episodic drinking were more likely to have had sex with a paid partner (past 12 months) than light drinkers (25% vs. 12%, AOR=3.0; 95% CI=1.9-4.7, p<0.001). A higher proportion of men who were heavy episodic drinkers reported having an HIV positive wife than light drinkers (53% vs. 42%, AOR=4.1; 95% CI=1.8-9.2, p<0.001). Conclusions:Men's heavy episodic drinking is associated with higher prevalence of HIV infection among their spouses. Prevention of heavy episodic drinking and associated men's risk behaviors may augment efforts to reduce the secondary transmission of HIV.

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Not All Drinks Are Created Equal: Implications for Alcohol Assessment in India

Cited by 31 publications

References 33 publications

Counselling for Alcohol Problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial

Counselling for Alcohol Problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial

Alcohol dependence: Does the composition of the available beverages promote it?

Men’s Heavy Alcohol Use and Risk of HIV Acquisition and Transmission to Sexual Partners within Marriage in India

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