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Gerhard Gmel

Publications and source records attributed to Gerhard Gmel.

At least 19 recordsLinked to original sources
PubMed2007

At-risk drinking and drug use among patients seeking care in an emergency department.

OBJECTIVE: This study reports the frequency of alcohol use and associated tobacco and drug use among emergency department (ED) patients, in order to increase physician awareness and treatment of women and men seeking care in ED settings. METHOD: All adults seen in the ED at the University Hospital in Lausanne, Switzerland, between 11 AM and 11 PM were screened by direct interview for at-risk drinking, tobacco use, drug use, and depression during an 18-month period. RESULTS: A total of 8,599 patients (4,006 women and 4,593 men) participated in the screening procedure and provided full data on the variables in our analysis. The mean age was 51.9 years for women and 45.0 years for men; 57.5% (n = 2,304) of women and 58.5% (n = 2,688) of men were being treated for trauma. Based on guidelines of the National Institute on Alcohol Abuse and Alcoholism, 13.1% (n = 523) of the women were at-risk drinkers, 57.3% (n = 2,301) were low-risk drinkers, and 29.6% (n = 1,182) were abstinent. Among men, 32.8% (n = 1,507) met criteria for at-risk drinking, 51.8% (n = 2,380) met criteria for low-risk drinking, and 15.4% (n = 706) were abstinent. Younger individuals (ages 18-30) had significantly higher rates of episodic heavy drinking episodes, whereas at-risk older patients were more likely to drink on a daily basis. A binary model found that women and men who drank at at-risk levels are more likely to use tobacco (odds ratio [OR] = 2.48, 95% confidence interval [CI]: 2.0-3.08) and illicit drugs (OR = 5.91, CI: 3.32- 10.54) compared with abstinent and low-risk drinkers. CONCLUSIONS: This study supports systematic alcohol screening of women and men seen in EDs and suggests that patterns of alcohol and drug use vary by age and gender.

Alcohol Drinking↗
PubMed2007

Drinking motives as mediators of the link between alcohol expectancies and alcohol use among adolescents.

OBJECTIVE: The purpose of this study was to test whether the link between alcohol expectancies and alcohol use (drinking frequency, usual quantity, five-plus drinking) is mediated by drinking motives. METHOD: Linear structural equation models were estimated based on a nationally representative sample of 5,616 8th, 9th, and 10th graders in Switzerland (51% female; mean [SD] age = 15.1 [1.0] years). RESULTS: In most cases, a perfect mediation occurred. Although all expectancy and motive dimensions were related to all alcohol-use measures in multivariate models, the expectancy link in multiple multivariate models was reduced to zero, whereas the motive link remained basically the same. One exception was the Tension Reduction Expectancy scale, which included aspects other than problem coping that were still related to alcohol consumption, even when coping motives were controlled for. CONCLUSIONS: Given the consistency of the results across different alcohol expectancies, drinking motives, and alcohol-use measures, the present study provides evidence to support one basic assumption of the motivational model of alcohol use: Drinking motives are the most proximate factor that precedes alcohol use. They are the gateway through which more distal influences (e.g., alcohol expectancies) are mediated.

Adaptation, Psychological↗
PubMed2006

Changes in adolescents' reasons for drinking in Switzerland and associations with alcohol use from 1994 to 2002.

PURPOSE: To determine changes in the prevalence of reasons for drinking and their associations with alcohol use among adolescents in Switzerland from 1994 to 2002. METHOD: Based on national representative samples of 3792 alcohol-using students in 8th and 9th grades in Switzerland (mean age 15.5 years, SD .7), chi-square tests were used to determine changes in reasons for drinking over time. To determine associations between reasons and alcohol use and changes in these associations over time, multiple regression models were estimated separately for the frequency of alcohol consumption and drunkenness. RESULTS: Most adolescents reported drinking to celebrate special occasions, because they wanted to try alcohol, or because they liked the taste of alcoholic drinks. From 1994 to 2002, an increase in all reasons was observed. In multiple regressions, nearly all reasons were significantly related to alcohol consumption and drunkenness. With two exceptions, no interaction with the study year was found. Furthermore, the number of reasons cited by the adolescents surveyed is important: the more reasons they indicated, the more often they drank. The highest alcohol use in 2002 was found among adolescents who indicated all or nearly all reasons, a group that did not exist in 1994. CONCLUSIONS: There appears to be a new group of adolescents who indicated a high number of different reasons for drinking, who often consumed alcohol, and who were frequently drunk. Prevention approaches should be especially targeted at this new risk group.

Adolescent↗
PubMed2006

'I drink spirits to get drunk and block out my problems...' beverage preference, drinking motives and alcohol use in adolescence.

AIMS: To investigate among adolescents whether (i) drinking motives are related to beverage preference; (ii) beverage preference is related to alcohol use (drinking levels and risky drinking occasions); (iii) the association between beverage preference and alcohol use is moderated or mediated by drinking motives. METHOD: Data from a national representative sample of 5379 8th-10th graders in Switzerland (mean age 15.1, SD = 0.95) were analysed using multiple regression analyses. Beverage preference was based on the proportion of a specific beverage in the total amount of drinks consumed at the last drinking occasion. Drinking motives were assessed by the drinking motive questionnaire revised (DMQ-R). RESULTS: A significant positive association was found between enhancement motives and a preference for beer and spirits; the association was negative with regard to a preference for wine and alcopops. Conformity motives were positively related to a wine preference but negatively to a beer preference. Only a preference for beer and spirits was significantly associated with alcohol use in models that exclude motives. However, the association between beer preference and adolescent alcohol use was mediated by drinking motives. A preference for alcopops and spirits was moderated by motives: social drinkers who preferred alcopops drank less than those who did not prefer alcopops. Coping drinkers who preferred spirits drank more than those who preferred other alcoholic drinks. CONCLUSIONS: Drinking motives are potential explanatory factors for the association between beverage preference and alcohol use. Prevention approaches should target coping motives, particularly for adolescents who show a preference for spirits.

Adolescent↗
PubMed2006

Disentangling gender and age effects on risky single occasion drinking during adolescence.

OBJECTIVES: To determine the association between adolescent risky single occasion drinking (RSOD) and gender, age, and the relative age position of students within their class. METHOD: A cross-sectional national representative sample of 7088 from 8th to 10th graders in Switzerland (mean age 14.6; SD = 0.94) as part of the ESPAD international study was analysed using hierarchical linear modelling. RESULTS: Being male, older than the class average and a member of older classes (on average) was associated with a higher RSOD frequency. Additionally, interactions between student and class level were found. The higher the mean class age the greater the difference in RSOD between boys and girls, and the lower the impact on RSOD of the relative age position in a class. CONCLUSIONS: In early and mid-adolescence, prevention efforts should try to impede the modelling of alcohol use of older classmates, whereas in late adolescence gender-specific motives for RSOD should be taken into account.

Adolescent↗
PubMed2006

Who drinks and why? A review of socio-demographic, personality, and contextual issues behind the drinking motives in young people.

The aim was to review the empirical research carried out over the last 15 years on the characteristics of young people (10- to 25-year olds) who have specific motives for drinking. In a computer-assisted search of relevant literature, 82 studies were identified. Concerning demographic factors, a developmental trend was found - from general, undifferentiated drinking motives in late childhood and early adolescence to more gender-specific drinking motives in subsequent years. With regard to personality factors, two specific patterns can be distinguished: extraversion and sensation-seeking correlate with enhancement motives, while neuroticism and anxiety correlate most strongly with coping motives. For contextual factors, drinking motives were found to vary across countries but not among different ethnic groups in the same culture. Based on these results, preventive strategies should take into account general, undifferentiated drinking motivation in late childhood, and social and enhancement motives in adolescence, particularly among boys. Findings on personality indicate that it would be useful to focus on extraverted, sensation-seeking boys who drink for enhancement motives and neurotic, anxious girls who drink for coping motives.

Adaptation, Psychological↗
PubMed2006

Measuring alcohol consumption--should the 'graduated frequency' approach become the norm in survey research?

AIMS: To analyse whether recommendations for the graduated frequency (GF) approach to measure alcohol consumption are justified in a multi-cultural comparative study. DESIGN: Representative surveys, conducted between 1995 and 2003, of 10 countries participating in the GENACIS project (Gender, Alcohol and Culture: an International Study). MEASUREMENTS: Usual quantity, usual frequency and mean consumption per day measured with three instruments: GF, generic quantity-frequency (QF) and beverage-specific quantity-frequency (QFBS). FINDINGS: The GF did not consistently yield higher volumes and quantities across all countries compared with the generic QF, while the QFBS resulted in higher quantities and higher volumes compared with the GF (in all but one country) and the QF. Frequencies were mostly higher on the GF compared with the QF and QFBS but there was also evidence of over-reporting of frequencies with the GF. Results for the GF suggested that it was implemented improperly in at least three of the 10 countries. CONCLUSION: The GF does not appear to be appropriate for cross-cultural research. It results in over-reporting of frequencies and appears to be too complex to be administered correctly in many countries. The best measure for these purposes appeared to be the QFBS particularly because it captures more effectively the variability of different alcoholic beverages with different ethanol contents and consumption with different vessel sizes.

Adult↗
PubMed2006

Is alcopop consumption in Switzerland associated with riskier drinking patterns and more alcohol-related problems?

OBJECTIVES: To examine (a) whether consumers of alcopops compared to consumers of other alcoholic beverages but not alcopops have riskier drinking patterns and more alcohol-related consequences (e.g. truancy, scuffles, problems with parents) and (b) whether the amount of alcopops consumed is associated independently with risky drinking patterns and alcohol-related consequences over and above those associated with the amount of other alcoholic beverages consumed. SAMPLE: As part of the ESPAD international study, a cross-sectional national representative sample of 5,444 drinkers aged 13-16 years was interviewed by means of an anonymous, self-report questionnaire administered in a classroom setting. RESULTS: Earlier initiation of consumption, more frequent risky single occasion drinking (RSOD), and a higher likelihood of negative consequences for consumers than for non-consumers of alcopops were due mainly to higher overall consumption. Other alcoholic beverages had similar effects, and whether the same amount of alcohol was consumed as alcopops or as any conventional alcoholic beverage made no difference. CONCLUSIONS: Alcopops in Switzerland do not seem to be linked to specific riskier drinking patterns or consequences per se. Like all alcoholic beverages, they add to the problems caused by drinking and seem to be consumed in addition to conventional alcoholic beverages without replacing them. As the alcohol industry will continue to launch new beverages, prevention targeting alcohol consumption in general might be more effective than focusing on new beverages only.

Adolescent↗
PubMed2006

The economic impact of a smoke-free bylaw on restaurant and bar sales in Ottawa, Canada.

AIMS: On 1 August 2001, the City of Ottawa (Canada's Capital) implemented a smoke-free bylaw that completely prohibited smoking in work-places and public places, including restaurants and bars, with no exemption for separately ventilated smoking rooms. This paper evaluates the effects of this bylaw on restaurant and bar sales. DATA AND MEASURES: We used retail sales tax data from March 1998 to June 2002 to construct two outcome measures: the ratio of licensed restaurant and bar sales to total retail sales and the ratio of unlicensed restaurant sales to total retail sales. Restaurant and bar sales were subtracted from total retail sales in the denominator of these measures. DESIGN AND ANALYSIS: We employed an interrupted time-series design. Autoregressive integrated moving average (ARIMA) intervention analysis was used to test for three possible impacts that the bylaw might have on the sales of restaurants and bars. We repeated the analysis using regression with autoregressive moving average (ARMA) errors method to triangulate our results. FINDINGS: Outcome measures showed declining trends at baseline before the bylaw went into effect. Results from ARIMA intervention and regression analyses did not support the hypotheses that the smoke-free bylaw had an impact that resulted in (1) abrupt permanent, (2) gradual permanent or (3) abrupt temporary changes in restaurant and bar sales. CONCLUSIONS: While a large body of research has found no significant adverse impact of smoke-free legislation on restaurant and bar sales in the United States, Australia and elsewhere, our study confirms these results in a northern region with a bilingual population, which has important implications for impending policy in Europe and other areas.

Beverages↗
PubMed2006

Alcohol-attributable injuries in admissions to a swiss emergency room--an analysis of the link between volume of drinking, drinking patterns, and preattendance drinking.

BACKGROUND: An association between alcohol consumption and injury is clearly established from volume of drinking, heavy episodic drinking (HED), and consumption before injury. Little is known, however, about how their interaction raises risk of injury and what combination of factors carries the highest risk. This study explores which of 11 specified groups of drinkers (a) are at high risk and (b) contribute most to alcohol-attributable injuries. METHODS: In all, 8,736 patients, of whom 5,077 were injured, admitted to the surgical ward of the emergency department of Lausanne University Hospital between January 1, 2003, and June 30, 2004, were screened for alcohol use. Eleven groups were constructed on the basis of usual patterns of intake and preattendance drinking. Odds ratios (ORs) comparing injured and noninjured were derived, and alcohol-attributable fractions of injuries were calculated from ORs and prevalence of exposure groups. RESULTS: Risk of injury increased with volume of drinking, HED, and preattendance drinking. For both sexes, the highest risk was associated with low intake, HED, and 4 (women), 5 (men), or more drinks before injury. At the same level of preattendance drinking, high-volume drinkers were at lower risk than low-volume drinkers. In women, the group of low-risk non-HED drinkers taking fewer than 4 drinks suffered 47.5% of the alcohol-attributable injuries in contrast to only 20.4% for men. Low-volume male drinkers with HED had more alcohol-attributable injuries than that of low-volume female drinkers with HED (46.9% vs 23.2%). CONCLUSIONS: Although all groups of drinkers are at increased risk of alcohol-related injury, those who usually drink little but on occasion heavily are at particular risk. The lower risk of chronic heavy drinkers may be due to higher tolerance of alcohol. Prevention should thus target heavy-drinking occasions. Low-volume drinking women without HED and with only little preattendance drinking experienced a high proportion of injuries; such women would be well advised to drink very little or to take other special precautions in risky circumstances.

Adult↗
PubMed2006

Replication and validation of the Drinking Motive Questionnaire Revised (DMQ-R, Cooper, 1994) among adolescents in Switzerland.

This paper has two aims: (1) to replicate the four-dimensional structure of the Drinking Motive Questionnaire Revised (DMQ-R) in a national representative sample from Switzerland, and (2) to validate the relevance of distinguishing drinking motives by inspecting the relations with expected consequences, alcohol use, and alcohol-related and other problems. Confirmatory factor analysis and linear structural equation models were estimated based on answers of 5,617 8th to 10th graders (mean 15.1 years; SD = 0.95). The results confirm the four-dimensional factor structure in general and among subpopulations defined by gender, age, and linguistic region. It could also be confirmed that enhancement motives followed by coping motives were strongly related to alcohol use and heavy drinking, whereas conformity motives were negatively related. Coping motives were related to problems independent of whether they were assessed as alcohol-related or not, while enhancement motives were associated solely with alcohol-related problems. In sum, the results demonstrate the robustness of the DMQ-R and its usefulness for assessing drinking motives among European adolescents from different cultural backgrounds.

Adolescent↗
PubMed2005

The smoking epidemic in Switzerland--an empirical examination of the theory of diffusion of innovations.

OBJECTIVES: Cultural and sex differences in smoking rates among countries indicate different phases of the smoking epidemic. Their background is summarized in a four-stage model based on the Rogers Theory of Diffusion of Innovations. First, to test predictions of the Rogers theory and, second, to test whether, according to the theory, today's innovative process is smoking cessation, predicted by higher rates of cessation among the more highly educated and among men of all educational levels. METHODS: Data covered respondents older than 24 years from two Swiss Health Surveys (1997 and 2002). Logistic regression models were on lifetime smoking versus never-smoking, and on former smoking versus current smoking. RESULTS: Declining smoking rates in both sexes over time, measured by birth cohorts, indicate that the epidemic has peaked, but women of all educational levels and men of lower education still show high prevalence rates. The gap between higher-educated and lower-educated individuals is widening. CONCLUSION: Smoking prevalence is expected to decline further, particularly among women and little educated men. The incidence of tobacco-related diseases in women is predicted to exceed that of men, owing to their lower cessation rates.

Adult↗
PubMed2005

Association of alcohol consumption to mortality and person-years of life lost in Switzerland--measuring the impact of some methodological options.

OBJECTIVES: The present study is designed to estimate the health impact of alcohol consumption in terms of the number of deaths and person-years of life lost (PYLL) in Switzerland. To that end, three hypothetical situations have been compared to the current situation used as a reference. The underlying question was: how many deaths and person-years of life lost would be avoided if all individuals were: (1) non-drinkers, (2) low drinkers only or (3) both (either abstainers or low level drinkers)? METHODS: Etiological fractions of alcohol-related health consequences by age and gender were applied to the officially reported numbers of deaths to estimate the total number of deaths and PYLL. RESULTS: Depending upon the hypothetical situation, the estimated number of alcohol-related deaths varied between an overall net protective and an overall net causal effect: in situation (1), there would occur 730 additional deaths in reference to the current situation (+1.2% of the total alcohol-related mortality in Switzerland), whereas in situation (2) there would be 3460 deaths less (-5.5%). Thus, the current situation in Switzerland would be preferable compared to a society, in which no one drinks alcohol. A society, however, in which every individual drinks at low levels, would be preferable to the current situation. The corresponding figures for PYLL are 23,596 vs. 29,229 (6.4% vs. 7.9% of total PYLL). CONCLUSIONS: The hypothetical situation decisively impacts on the number of deaths attributable to alcohol. In contrast, it has much less influence on the number of alcohol-related PYLL. Thus, mortality is at least a questionable indicator of alcohol-related health outcomes. The study also indicated that more lives and PYLL were saved in the low-risk situation than in the abstinence situation. Public health policies should not concentrate on the promotion of abstinence.

Adolescent↗
PubMed2005

Measuring alcohol consumption: a comparison of graduated frequency, quantity frequency, and weekly recall diary methods in a general population survey.

OBJECTIVE: The objective of this study is to compare self-reports of alcohol consumption obtained by graduated frequency (GF), quantity frequency (QF), and prospective weekly diary methods in a Swiss general population survey using a within-subject design. Another objective is to examine the consumption means, ranking order, and drinking classifications and to relate differences in consumption means and classification inconsistencies to social and drinking characteristics. METHOD: The data came from the first wave of a longitudinal study on changes in alcohol consumption. A subsample of 767 respondents who completed the three measures was examined. The sample design was accounted for. RESULTS: Weekly drinking diary (WDD) yielded over 50% more alcohol consumption than the QF and GF measures did. Measures on quantity and graduated frequencies did not differ significantly. There were more light drinkers found on QF and more harmful drinkers on the WDD. Classification inconsistencies between GF and the weekly drinking diary were significantly related to gender and problematic drinking.

Adolescent↗
PubMed2005

Why do young people drink? A review of drinking motives.

This article reviews evidence of adolescent and young adult drinking motives and their relation to possible consequences over the last 15 years. To this end, a computer-assisted search of relevant articles was conducted. Results revealed that most young people reported drinking for social motives, some indicated enhancement motives, and only a few reported coping motives. Social motives appear to be associated with moderate alcohol use, enhancement with heavy drinking, and coping motives with alcohol-related problems. However, an enormous heterogeneity was found in terms of how motives were measured: 10 to 40 items were grouped into between 2 and 10 dimensions and sometimes the same items occurred under different dimensions. Future studies should therefore use well-defined, theoretically based, homogenous instruments to disentangle cultural from measurement differences across surveys.

Adaptation, Psychological↗
PubMed2005

Spreading interviews over time in health surveys: do temporal variations of self-reported alcohol consumption affect measurement?

OBJECTIVE: To address systematic variations related to the day of the interview in self-reports of alcohol consumption in telephone health surveys. The investigations include temporal clustering effects, prediction of alcohol consumption and variations across days by characteristics of respondents and interviewing period, and sensitivity to variations of measurements instruments. METHOD: Data at baseline collected in Spring 1999 from 2846 participants in a longitudinal probabilistic general-population survey in Switzerland were used. The study is representative for drinkers in Switzerland. Alcohol consumption measures include a 6-month quantity frequency and a 1-week graduated frequency measure. RESULTS: Evidence for systematic variations in self-reports related to the day of interview was found on the graduated-frequency measure even after controlling for sample characteristics. Similar variations on the quantity frequency measure were found, but were no longer significant after statistical control of the sample characteristics. CONCLUSIONS: Statistical inference in alcohol survey research by telephone interviews based on graduated-frequency measures with short reference period may be plagued with errors related to clustering effects of the day of the interview. Temporal aspects of conducting the fieldwork should therefore be accounted for in statistical analysis.

Adolescent↗
PubMed2005

Moderate alcohol consumption and the gastrointestinal tract.

BACKGROUND: A high alcohol intake is significantly associated with diseases of the gastrointestinal tract, but less is known about the effects of moderate consumption, specifically moderate average volume of alcohol consumption. METHODS: A systematic computer-assisted literature review was completed in order to review current scientific knowledge surrounding this topic. RESULTS: Moderate alcohol consumption is associated with a number of gastrointestinal health risks, including liver diseases, oropharyngeal cancer, esophageal cancer and pancreatitis but may play a positive role in gastritis and cholelithiasis. CONCLUSION: Moderate alcohol consumption may play a positive or negative role in disease etiology, but the overall conclusion is that moderate alcohol intake is not a high risk factor for many of the gastrointestinal diseases associated with high levels of consumption. The etiology of alcohol diseases is also linked to patterns of drinking, so this is an important area for future research in this area.

Adult↗