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Biomedical subjects

Robin Room

Publications and source records attributed to Robin Room.

At least 37 records · Page 2Linked to original sources
PubMed2004

Smoking and drinking as complementary behaviours.

Parallels and contrasts between tobacco smoking and alcohol drinking are considered, in terms of harms, cultural positioning, and a dependence, which is social as well as physical and psychological. Evidence is briefly reviewed of two kinds of conjunction: of being a smoker and being a drinker, and of the smoking event and the drinking event. The complementary relation between smoking and drinking, it is argued, can be understood at physiological, psychological and social levels. Implications for prevention, intervention and policy are discussed, including the need for international agreement on alcohol as well as tobacco control.

Alcohol Drinking↗
PubMed2004

Kettil Bruun Society for Social and Epidemiological Research on Alcohol.

The Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS) was established in 1987 and is an independent organization open to all scientists working on problems related to social and epidemiological research on alcohol. The aim of the Society is to promote social and epidemiological research which fosters a comparative understanding of the social aspects of alcohol use and alcohol problems. In line with this the Society also aims at promoting a spirit of international collaboration. The Kettil Bruun Society is based on individual membership and, by 2003, has 197 fully paid-up members, representing 34 different countries over five continents. The main activities include an annual meeting as well as thematic meetings. In these meetings, discussions are emphasized by having precirculated papers and assigned discussants. The KBS also serves as a basis for organizing international collaborative projects. Project meetings or work-shops are often organized around the annual meetings, and the projects tend to run over several years. The Society's primary influence is through the mutual influence of its members on each others' thinking, the work of the projects that KBS sponsors and the influence its members have collectively on the development of the field.

Alcohol Drinking↗
PubMed2004

Effects of alcohol controls: Nordic research traditions.

Drawing on a recent review of studies of the impact of alcohol control changes in the Nordic countries (particularly Finland, Norway and Sweden), this paper reviews the development of research traditions of such studies in the Nordic countries. From the Nordic experience, there is evidence of variation in the effects of policy changes by demographic segment, by type of problem and by drinking pattern and amount. Policy changes have often had their greatest effect on heavier drinkers. Big reductions in alcohol taxes in Denmark in 2003 and Finland in 2004 offer a new chance to study whose drinking changes how much, and in what contexts, in a collaborative study comparing northern Sweden with Finland, Denmark and southern Sweden.

Alcoholism↗
PubMed2003

The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview.

AIMS: As part of a larger study to estimate the global burden of disease attributable to alcohol: to quantify the relationships between average volume of alcohol consumption, patterns of drinking and disease and injury outcomes, and to combine exposure and risk estimates to determine regional and global alcohol-attributable fractions (AAFs) for major disease and injury categories. DESIGN, METHODS, SETTING: Systematic literature reviews were used to select diseases related to alcohol consumption. Meta-analyses of the relationship between alcohol consumption and disease and multi-level analyses of aggregate data to fill alcohol-disease relationships not currently covered by individual-level data were used to determine the risk relationships between alcohol and disease. AAFs were estimated as a function of prevalence of exposure and relative risk, or from combining the aggregate multi-level analyses with prevalence data. FINDINGS: Average volume of alcohol consumption was found to increase risk for the following major chronic diseases: mouth and oropharyngeal cancer; oesophageal cancer; liver cancer; breast cancer; unipolar major depression; epilepsy; alcohol use disorders; hypertensive disease; hemorrhagic stroke; and cirrhosis of the liver. Coronary heart disease (CHD), unintentional and intentional injuries were found to depend on patterns of drinking in addition to average volume of alcohol consumption. Most effects of alcohol on disease were detrimental, but for certain patterns of drinking, a beneficial influence on CHD, stroke and diabetes mellitus was observed. CONCLUSIONS: Alcohol is related to many major disease outcomes, mainly in a detrimental fashion. While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury. The influence of patterns of drinking may be underestimated because pattern measures have not been included in many epidemiologic studies. Generalizability of the results is limited by methodological problems of the underlying studies used in the present analyses. Future studies need to address these methodological issues in order to obtain more accurate risk estimates.

Acute Disease↗
PubMed2003

The global distribution of average volume of alcohol consumption and patterns of drinking.

AIMS: To make quantitative estimates on a global basis of exposure of disease-relevant dimensions of alcohol consumption, i.e. average volume of alcohol consumption and patterns of drinking. DESIGN: Secondary data analysis. MEASUREMENTS: Level of average volume of drinking was estimated by a triangulation of data on per capita consumption and from general population surveys. Patterns of drinking were measured by an index composed of several indicators for heavy drinking occasions, an indicator of drinking with meals and an indicator of public drinking. Average volume of consumption was assessed by sex and age within each country, and patterns of drinking only by country; estimates for the global subregions were derived from the population-weighted average of the countries. For more than 90% of the world population, per capita consumption was known, and for more than 80% of the world population, survey data were available. FINDINGS: On the country level, average volume of alcohol consumption and patterns of drinking were independent. There was marked variation between WHO subregions on both dimensions. Average volume of drinking was highest in established market economies in Western Europe and the former Socialist economies in the Eastern part of Europe and in North America, and lowest in the Eastern Mediterranean region and parts of Southeast Asia including India. Patterns were most detrimental in the former Socialist economies in the Eastern part of Europe, in Middle and South America and parts of Africa. Patterns were least detrimental in Western Europe and in developed countries in the Western Pacific region (e.g., Japan). CONCLUSIONS: Although exposure to alcohol varies considerably between regions, the overall exposure by volume is quite high and patterns are relatively detrimental. The predictions for the future are not favorable, both with respect to average volume and to patterns of drinking.

Alcohol Drinking↗
PubMed2003

Alcohol as a risk factor for global burden of disease.

AIM: To make quantitative estimates of the burden of disease attributable to alcohol in the year 2000 on a global basis. DESIGN: Secondary data analysis. MEASUREMENTS: Two dimensions of alcohol exposure were included: average volume of alcohol consumption and patterns of drinking. There were also two main outcome measures: mortality, i.e. the number of deaths, and disability-adjusted life years (DALYs), i.e. the number of years of life lost to premature mortality or to disability. All estimates were prepared separately by sex, age group and WHO region. FINDINGS: Alcohol causes a considerable disease burden: 3.2% of the global deaths and 4.0% of the global DALYs in the year 2000 could be attributed to this exposure. There were marked differences by sex and region for both outcomes. In addition, there were differences by disease category and type of outcome; in particular, unintentional injuries contributed most to alcohol-attributable mortality burden while neuropsychiatric diseases contributed most to alcohol-attributable disease burden. DISCUSSION/CONCLUSIONS: The underlying assumptions are discussed and reasons are given as to why the estimates should still be considered conservative despite the considerable burden attributable to alcohol globally.

Alcohol Drinking↗
PubMed2003

Drinking and its burden in a global perspective: policy considerations and options.

AIMS: To identify the policy implications of the magnitude and characteristics of alcohol consumption and problems, viewed globally, and to summarize conclusions on the effectiveness of the strategies available to policymakers concerned with reducing rates of alcohol problems. DESIGN/METHODS/SETTING: This summative article draws on the findings of the articles preceding it and of reviews of the literature. FINDINGS AND CONCLUSIONS: Overall volume of consumption is the major factor in the prevalence of harms from drinking. Since consumption and associated problems tend to increase with economic development, policymakers in developing economies should be especially aware of the need to develop policies to minimize overall increases in alcohol consumption. Unrecorded consumption is also an important consideration for policy in many parts of the world, and poses difficulties for alcohol control policies. Drinking pattern is also an important contributing factor toward alcohol-related harm. Although some drinking patterns have been shown to produce beneficial health effects, because the net effect of alcohol on coronary disease is negative in most parts of the world, policies that promote abstinence or lower drinking overall may be the safest options. Moreover, sporadic intoxication is common in many parts of the world, and policies are unlikely to change this drinking pattern at least in the short to medium term. At the same time, because injuries comprise a large proportion of the burden of alcohol, it is appropriate to enhance these policies with targeted harm reduction strategies such as drinking and driving countermeasures and interventions focused on reducing alcohol-related violence in specific high-risk settings. Alcohol consumption is a major factor for the global burden of disease and should be considered a public health priority globally, regionally, and nationally for the vast majority of countries in the world. The need for alcohol policy is even stronger when it is taken into consideration that the burden of alcohol estimated in the WHO Global Burden of Disease project includes primarily health problems related to drinking. From the limited evidence available, however, social problems related to drinking seem to impose at least as much burden. Moreover, the burden for both social and health harms fall not only on the drinker, but also on others. There is a broad literature on policy interventions to reduce alcohol problems. Effective strategies include controls over distribution and sale, taxation, drinking-driving countermeasures, brief interventions by health workers or counselors, and selected harm reduction measures. There is a need to develop the growing literature on comparative evaluations of cost-effectiveness of such strategies. In addition, international agreements are needed to support the effectiveness of national strategies.

Alcohol Drinking↗