The contexts of heavy drinking: A systematic review of the combinations of context-related factors associated with heavy drinking occasions

Abstract

Background The amount of alcohol consumed during an occasion can be influenced by physical and social attributes of the setting, characteristics and state of individuals, and the interactions of these components. This systematic review identifies and describes the specific combinations and sequences of context-related factors that are associated with heavy drinking occasions. Materials and methods We conducted a systematic literature search of MEDLINE, Embase and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Eligible articles were event-level and event-based studies that quantitatively analysed associations of sequences or combinations of context-related factors with event-level alcohol consumption. We extracted information on study design, sample, variables, effect estimates and analytical methods. We compiled a list of combinations and sequences associated with heavier drinking (i.e., ‘risky contexts’) and with lighter drinking (‘protective contexts’). The review protocol was registered with PROSPERO (registration number: CRD42018089500). Results We screened 1902 retrieved records and identified a final sample of 65 eligible studies. Daily mood, day of week, location and drinking group characteristics are important drivers of whether an individual engages in a heavy drinking occasion. The direction and magnitude of some associations differed by gender, age, personality and motives, such that in particular social or physical contexts, some people may feel compelled to drink more while others are compelled to drink less. Very few sequences of factors were reported as being associated with event-level alcohol consumption. Conclusions Contexts or factors are experienced in specific sequences that shape the broader drinking context and influence drinking behaviours and consequences but are under-studied. Event-level studies such as those using ecological momentary assessment can harness new technologies for data collection and analysis to improve understandings of why people engage in heavy drinking. Continued event-level research will facilitate public health interventions and policies that reduce heavy drinking and alcohol-related harms.

Longer time spent at home during COVID-19 pandemic is associated with binge drinking among US adults

“…Multivariable logistic regression models evaluated the associations between COVID-19-related stressors (independent variables) and binge drinking ([0] = non-binge drinkers and [1] = binge drinkers) separately, while adjusting for sociodemographics. In addition, multivariable multinomial regression models were used to assess the associations between COVID-19-related stressors (independent variables) and change in alcohol consumption (dependent variable; [1] = Drinking more alcohol; [2] = drinking less alcohol; [3] = drinking about the same [referent]) among binge drinkers. Multinomial logistic regression models were implemented because the dependent variable had more than two categories; a multinomial logistic regression calculates a ratio of odds of each subcategory to the identified referent group (i.e., drinking about the same) (28).…”

“…Binge drinking is a common but preventable alcohol use behavior defined as having five or more drinks for men or four or more drinks for women in the span of two hours (1,2). A recent systematic review showed that recent and short-term stress is associated with increased heavy alcohol use in men and women (3), while previous research has indicated that life stressors, including work-and family-related stress, can increase the risk of binge drinking among adults (4)(5)(6). Among samples of individuals in high-stress situations with sudden environment changes (e.g., college students or members of the armed forces), binge drinking is commonly associated with increased stress levels and has been attributed to decrements in psychological health (7)(8)(9).…”

Drinking contexts and their association with acute alcohol‐related harm: A systematic review of event‐level studies on adults' drinking occasions

“…A further limitation is that the diverse study designs used by this literature have different advantages and disadvantages, and this may have impacted on findings. For instance, studies using ecological momentary assessment or daily diary approaches can account for inter‐ and intra‐individual variation as they collect data about multiple occasions while studies asking participants to recall specific events are less able to do so. However, study quality was generally good and most papers relying on retrospective reports of specific events used case–control or case‐crossover designs.…”

Understanding Heavy Drinking at Night through Smartphone Sensing and Active Human Engagement

“…A large body of epidemiological research shows that different characteristics of the drinking context are associated with increased drinking at the event level [58,59]. These characteristics include motives or intentions for drinking, the time of day when drinking occurs, the type and number of people involved, the venue (e.g.…”

“…However, while drinking is a dynamic behavior, i.e., drinks can be consumed in different locations throughout the extended drinking occasion, most studies have focused on single drinking settings and overlooked the influence of sequences of drinking episodes (e.g. pub crawl, or drinking before going out) [58].…”