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Thomas K Greenfield

Publications and source records attributed to Thomas K Greenfield.

At least 19 recordsLinked to original sources
PubMed2007

A comparative multi-level analysis of contextual drinking in American and Canadian adults.

AIM: To investigate the effects of demographic factors and drinking location on contextual drinking in a comparison of US and Canadian adults. DESIGN: Multi-level techniques were used to model the two-level hierarchical structure of drinking contexts (level 1) nested within individuals (level 2). PARTICIPANTS: Two random samples of current drinkers aged 18 years or older were drawn from Canada's Alcohol and Other Drugs Survey (CADS, 1994) and the 1995 National Alcohol Survey (NAS 9). The US sample included 2304 respondents (level 2) who reported a total of 5956 drinking contexts (level 1); in Canada, 5394 respondents reported 13 235 drinking contexts. MEASUREMENTS: Participants reported usual alcohol intake in up to four drinking locations. Demographic data included age, gender, education level, income and marital status. FINDINGS: Significant variation in usual alcohol intake was observed between drinking locations in both the US and Canada. The full multi-level models explained 25% of the variance at the contextual level and 25% and 22% at the individual level in the US and Canada. Contextual drinking was determined by a complex relationship between demographic characteristics and drinking locations. Some interactions between locations and demographic variables were observed for both the US and Canada, whereas others were observed only in the US sample. CONCLUSIONS: There is a need, from a population health perspective, for a multi-level approach in epidemiology and prevention that considers drinking setting as a relevant level for analysis and intervention.

Adult↗
PubMed2007

Ethnic disparities in clinical severity and services for alcohol problems: results from the National Alcohol Survey.

BACKGROUND: This study reports lifetime estimates of the extent of unmet need for alcohol services across the 3 largest ethnic groups in America, and examines factors that may contribute to ethnic differences in service use. Prior studies report mixed findings as to the existence of ethnic disparities in alcohol services, with some suggesting that minorities are over-represented in treatment settings. METHODS: Drawing on the most recent National Alcohol Surveys, we compare rates and factors associated with the lifetime service use for alcohol problems among Whites, Blacks, and Hispanics who meet lifetime criteria for alcohol abuse or dependence. RESULTS: While bivariate analyses revealed few ethnic differences in service use, there were significant differences by ethnicity in multivariate models that included alcohol problem severity and its interactions with ethnicity. At higher levels of problem severity, both Hispanics and Blacks were less likely to have utilized services than comparable Whites. Hispanics, on the whole, reported higher-severity alcohol problems than Whites. Yet, they were less likely to have received specialty treatment and multiple types of alcohol services, and were more likely to cite economic and logistical barriers as reasons for not obtaining care. CONCLUSIONS: Future efforts to study ethnic disparities in alcohol services should utilize analytic approaches that address potential confounding between ethnicity and other factors in service use, such as alcohol problem severity. Our findings suggest that Hispanics and Blacks with higher-severity alcohol problems may utilize services at lower rates than comparable Whites, and that, particularly for Hispanics, this may in part be attributable to financial and logistical barriers to care.

Adolescent↗
PubMed2006

Age-period-cohort influences on trends in past year marijuana use in the US from the 1984, 1990, 1995 and 2000 National Alcohol Surveys.

BACKGROUND: Previous studies have described trends in marijuana use in the US and examined age-period-cohort (APC) effects finding increased lifetime use among cohorts born after 1945. However, no studies have utilized data on current consumption in multiple cross-sectional surveys to estimate these factors. METHODS: Age-period-cohort models including demographic factors are estimated using logistic regressions in four US National Alcohol Surveys (NAS) conducted between 1984 and 2000. Trends in past year marijuana use are also evaluated. RESULTS: Marijuana use declined over the study period from 10% to 7.2% of the population. Declines were mainly seen among men, resulting in a degree of gender convergence, particularly for those aged 18-25. Significant effects of age, period and cohort were found, with steep declines in use by age from the early 20s to the 40s. All male cohorts born after 1945 and female cohorts born between 1945 and 1960 showed elevated prevalence compared to earlier cohorts. CONCLUSIONS: Trend results from the NAS differ from those in other surveys and indicate decreased prevalence of past year marijuana use and gender convergence. APC results confirm past findings of age effects and cohort differences between those born before and after 1945. Marijuana use presents many measurement difficulties and future research to understand differences across surveys is needed.

Adult↗
PubMed2006

Measuring confrontation during recovery from addiction.

The effect of confrontation on recovery from addiction continues to be a topic of considerable debate. Although many residential treatment programs view some form of confrontation as an integral part of recovery, a number of studies have found confrontation from professional treatment staff to be counterproductive. One of the problems inherent in the current debates about confrontation is the lack of a comprehensive measure of confrontation that assesses different dimensions. This study describes the development of the "Alcohol and Drug Confrontation Subscale" (ADCS), a 72-item instrument designed to measure the quantity and frequency of confrontation that individuals receive about drug or alcohol use-related problems. Confrontation is defined as an individual being told "bad things" might happen to them if they do not make changes to address a drug or alcohol use-related problem or make changes to maintain sobriety. The instrument also measures the respondents' perceptions about their relationships with confronters (three-item alpha = .79) and perceptions about the confrontational statements (three-item alpha = .63). The sample included 108 individuals entering three sober living housing organizations in Northern California between 2003 and 2005. They indicated that receiving confrontational statements about alcohol or drug use-related problems was common, especially from spouses/significant others (56% of those with significant others) and family members (60%). Participants who reported receiving more confrontation reported having more positive views about their relationships with confronters and about confrontational statements than those who received less confrontation. Additional studies are necessary to establish validity, generalize results to more diverse populations, and assess confrontation at different time points during recovery.

Adolescent↗
PubMed2006

How many drinks does it take you to feel drunk? Trends and predictors for subjective drunkenness.

AIMS: To describe and model the sources of the variation and trends in the meaning of subjective drunkenness. DESIGN: Trend analyses of three cross-sectional surveys. SETTING: US general population. PARTICIPANTS: Those who report being drunk in the past year among those in the 1979, 1995 and 2000 National Alcohol Surveys. MEASUREMENTS: Number of drinks reported to feel drunk (dependent variable), past-year alcohol consumption measures, beverage preference, state drunk driving blood alcohol concentration (BAC) limit and demographics. FINDINGS: The mean reported number of drinks to feel drunk declined significantly between each survey and was significantly lower for women. Considerable variation was also found within surveys and was explained partially by available variables. Volume of alcohol and heavy drinking occasions were associated positively with the number of drinks to feel drunk. Higher educational attainment was associated negatively as was being a wine drinker, of older age, of African American ethnicity and of becoming drunk more frequently than once per month. Living in a state with a per se BAC limit of 0.08% was associated negatively in models for men. CONCLUSIONS: A substantial shift downward in the meaning of drunkenness occurred in the US between 1979 and 2000. This may be explained partly by the increase in educational attainment, the ageing of the population, the decline in per capita alcohol consumption and changes in alcohol policy towards lower BAC limits for drunk driving along with greater penalties, enforcement and awareness.

Accidents, Traffic↗
PubMed2006

The alcohol content of wine consumed in the US and per capita consumption: new estimates reveal different trends.

BACKGROUND: To estimate the mean percentage alcohol content by volume (%ABV) for wine sold in the US and in each state for the years 1962 to 2002, and to apply these to per capita wine sales for the years 1970 to 2002. METHOD: Estimates of wine-type mean %ABV are calculated using brand-level sales and %ABV from one state and are extrapolated to other states and to the US using wine-type sales. RESULTS: The mean %ABV is found to vary substantially over time and across states, with US means ranging from 16.2% in 1962 to a low of 10.5% in 1991. By 2002, the US mean %ABV had risen to nearly 11.5%. Application of %ABV estimates to the per capita consumption of wine indicated significant differences from previous estimates with lower alcohol intake from wine found for all years after 1980 and 6 year-to-year changes in opposite directions. CONCLUSIONS: Empirically based estimates of the alcohol content of wine sold in the US show changes over time and differences between states that have significance for epidemiologic monitoring and modeling of the determinants and consequences of alcohol use and for improving comparisons with per capita beer and spirits consumption series.

Alcohol Drinking↗
PubMed2006

Maximum quantity consumed and alcohol-related problems: assessing the most alcohol drunk with two measures.

PURPOSES: The maximum amount of alcohol consumed on any day is an important indicator of problem drinking. This study examined the ability of 2 maximum measures, taken individually and in combination, to predict alcohol-related consequences and dependence symptoms. METHOD: We analyzed data from 4,296 current drinkers who participated in the 2000 National Alcohol Survey (N10) and provided complete data on several alcohol measures. Items included the most they drank in any day in the past 12 months assessed by 2 questions: a standard question with a 6-level categorical response format and an open-ended (continuous) question referencing the occasion that you had the most to drink that followed items on drinking contexts. RESULTS: In a within-subjects analysis, more than two-thirds of the respondents provided consistent responses on both questions (69.9%), 12.4% respondents reported higher maximum quantities on the open-ended question partitioned into equivalent categories, and 17.7% reported a higher maximum on the initial categorical question. In multiple logistic regression analyses predicting alcohol-related consequences, the continuous open-ended maximum or the mean of the 2 maximum items were the strongest predictors, whereas for predicting alcohol dependence symptoms, the maximum of the open-ended and closed-ended maximum items was a better predictor than each measure alone. CONCLUSION: Although categorical response formats generally capture high-quantity drinking better than open-ended formats, use of a second, alternatively formatted "most drunk" question may modestly improve ability to predict survey indicators of alcohol use disorders.

Adult↗
PubMed2006

Estimates of the mean alcohol concentration of the spirits, wine, and beer sold in the United States and per capita consumption: 1950 to 2002.

BACKGROUND: Estimates of per capita consumption of alcohol in the United States require estimates of the mean alcohol content by volume (%ABV) of the beer, wine, and spirits sold to convert beverage volume to gallons of pure alcohol. METHODS: The mean %ABV of spirits is estimated for each year from 1950 to 2002 and for each state using the %ABV of major brands and sales of sprits types. The mean %ABV of beer and wine is extrapolated to cover this period based on previous estimates. These mean %ABVs are then applied to alcohol sales figures to calculate new yearly estimates of per capita consumption of beer, wine, spirits, and total alcohol for the United States population aged 15 and older. RESULTS: The mean %ABV for spirits is found to be lower than previous estimates and to vary considerably over time and across states. Resultant per capita consumption estimates indicate that more alcohol was consumed from beer and less from wine and spirits than found in previous estimates. CONCLUSIONS: Empirically based calculation of mean %ABV for beer, wine, and spirits sold in the United States results in different and presumably more accurate per capita consumption estimates than heretofore available. Utilization of the new estimates in aggregate time-series and cross-sectional models of alcohol consumption and related outcomes may improve the accuracy and precision of such models.

Alcohol Drinking↗
PubMed2005

A drink is a drink? Variation in the amount of alcohol contained in beer, wine and spirits drinks in a US methodological sample.

BACKGROUND: Empirically based estimates of the mean alcohol content of beer, wine and spirits drinks from a national sample of US drinkers are not currently available. METHODS: A sample of 310 drinkers from the 2000 National Alcohol Survey were re-contacted to participate in a telephone survey with specific questions about the drinks they consume. Subjects were instructed to prepare their usual drink of each beverage at home and to measure each alcoholic beverage and other ingredients with a provided beaker. Information on the brand or type of each beverage was used to specify the percentage of alcohol. RESULTS: The weighted mean alcohol content of respondents' drinks was 0.67 ounces overall, 0.56 ounces for beer, 0.66 ounces for wine and 0.89 ounces for spirits. Spirits and wine drink contents were particularly variable with many high-alcohol drinks observed. CONCLUSIONS: While the 0.6-ounce of alcohol drink standard appears to be a reasonable single standard, it cannot capture the substantial variation evident in this sample and it underestimates average wine and spirits ethanol content. Direct measurement or beverage-specific mean ethanol content estimates would improve the precision of survey alcohol assessment.

Adolescent↗
PubMed2004

National and state estimates of the mean ethanol content of beer sold in the US and their impact on per capita consumption estimates: 1988 to 2001.

BACKGROUND: The average ethanol content of the beer sold in the US is a key factor in determining the per capita consumption of ethanol, the standard measure of alcohol use in aggregate-level research. To address the lack of empirically based estimates of beer ethanol content, we have calculated national estimates for the years 1988 to 2001 and state-specific estimates for 1993 to 2001. METHODS: These estimates are based on the ethanol content by volume of leading brands in each year, the national market share of each leading brand by type, and state-specific market shares of each beer type. RESULTS: The national mean ethanol content of beer was higher than the 4.5% figure typically used, ranging from 4.58% in 1993 to 4.75% in 1996. State-specific mean ethanol content estimates were also found to vary by state and over time. Application of mean ethanol content estimates to the per capita consumption of beer led to higher consumption estimates than those with the 4.5% conversion. For example, in 2000, the national estimate indicates that nearly 10 more drinks (containing 0.6 oz of ethanol) were consumed per person aged 14 years and older during that year. CONCLUSIONS: This may indicate that a larger than previously estimated share of the alcohol consumed in the US is in the form of beer. However, the results also indicate that empirically based estimates of wine and spirits mean that ethanol content may modify their consumption estimates as well.

Alcohol Drinking↗
PubMed2004

Age, period and cohort influences on beer, wine and spirits consumption trends in the US National Alcohol Surveys.

AIMS: To estimate the separate influences of age, period and cohort on the consumption of beer wine and spirits in the United States. DESIGN: Linear age-period-cohort models controlling for demographic change with extensive specification testing. Setting US general population 1979-2000. MEASUREMENTS: Monthly average of past-year consumption of beer, wine and spirits in five National Alcohol Surveys. Findings The strongest cohort effects are found for spirits; cohorts born before 1940 are found to have significantly higher consumption than those born after 1946, with especially high spirits consumption for men in the pre-1930s cohorts. Significant cohort effects are also found for beer with elevated consumption in the 1946-65 cohorts for men but in the pre-1940 cohorts for women. Significant negative effects of age are found for beer and spirits consumption, although not for wine. Significant period effects are found for men's beer and wine consumption and for women's spirits consumption. Increased educational attainment in the population over time is associated with reduced beer consumption and increased wine consumption. CONCLUSIONS: Changing cohort demographics are found to have significant effects on beverage-specific consumption, indicating the importance of controlling for these effects in the evaluation of alcohol policy effectiveness and the potential for substantial improvement in the forecasting of future beverage-specific consumption trends, alcohol dependence treatment demand and morbidity and mortality outcomes.

Adult↗
PubMed2003

Telephone versus in-person interviews for alcohol use: results of the 2000 National Alcohol Survey.

This study assesses differences in reports of alcohol use and alcohol-related harms using telephone and in-person interviews in a subsample of the 2000 National Alcohol Survey (NAS) (N = 411). Respondents were given a brief telephone interview which assessed their alcohol use and alcohol-related harms in the last 12 months followed by an in-person interview 2 months later that obtained the same data. Approximately 90% (n = 371) reported their drinking status consistently between interviews (277 current drinkers; 94 non-drinkers). Approximately 7% (n = 29) became current drinkers and 2.7% (n = 11) became non-drinkers at the second interview. The majority of respondents who changed their drinking status in either direction were low level drinkers. Using logistic regression modeling, no significant associations were found between demographic factors and consistency of reported drinking status. Further, there were no differences by mode for the two alcohol consumption measures (mean daily volume and mean number of days drank five or more drinks in the last 12 months) and alcohol-related harms in the last 12 months for current drinkers (n = 277). In conjunction with other mode studies, these findings support the use of telephone interviewing in large national surveys to obtain alcohol use and alcohol-related harms data.

Adult↗
PubMed2003

Defining 'current drinkers' in national surveys: results of the 2000 National Alcohol Survey.

AIMS: The purpose of this study is to determine which respondents of national surveys who report low 'usual' past year drinking frequency, are unsure of their drinking frequency or refuse to answer, are misclassified either as 'current drinkers' or as 'ex-drinkers.' DESIGN AND SETTING: The data are from the 2000 National Alcohol Survey, a national household telephone probability sample of adults in all 50 US States and Washington, DC (n = 7612). PARTICIPANTS: A subsample of 1734 respondents who reported drinking 'less than once a month but at least once a year', 'less than once a year', 'refused' and 'don't knows' were also asked if they had consumed a whole drink of any alcoholic beverage in the 12 months using dates to anchor the question. MEASUREMENTS: Five alcohol measures were used to compare groups who changed or did not change their drinking status based on the followup question: volume, mean number of days 5 +, social consequences, dependence symptoms and DSM-IV. FINDINGS: The results indicate that only 4.6% of respondents (n = 349) changed their drinking status, and the percentages were equal in both directions. Women were more likely to change their drinking status and specifically become ex-drinkers based on the follow-up question. Respondents who became current drinkers drank significantly at a lower average volume than those who remained current drinkers. The prevalence rates based on the five alcohol measures were not affected by how 'current drinker' is defined. CONCLUSIONS: Adding the follow-up question is recommended for new alcohol surveys so that fewer respondents are misclassified.

Adult↗
PubMed2003

Factors associated with probation officers' use of criminal justice coercion to mandate alcohol treatment.

Alcohol problems are widespread among individuals in county criminal justice probation systems. However, it is unclear why only a small fraction of these problem drinkers receive treatment. In this study, self-administered questionnaires were mailed to 145 probation officers in nine California counties to identify factors that predicted probation officers' use of coercion to mandate alcohol treatment. The questionnaire measured characteristics of probation officers, characteristics of their caseloads, and perceptions about their departments. Principle components analysis combined some of the items into six factor-based scales. Multiple regression analyses identified two significant predictors of use of coercion into treatment: a belief that treatment was effective and a belief that one's peers in the department were using coercion frequently. Implications for increasing treatment entry of probationers with drinking problems include educating probation officers about the effectiveness of substance abuse treatment in general and about coerced treatment in particular. Probation departments are encouraged to develop management styles that facilitate shared normative beliefs about assessing and managing alcohol problems among probationers.

Adult↗
PubMed2003

The average ethanol content of beer in the U.S. and individual states: estimates for use in aggregate consumption statistics.

OBJECTIVE: The purpose of this study is to describe the variation in the ethanol content of beer and specific categories of beer, and to illustrate the importance of accurate assessment of ethanol conversion factors for the calculation of apparent ethanol consumption from beer at the state and national levels in the U.S. METHOD: Published sources of brand-level ethanol content, national brand share of beer categories and state beer category market shares are utilized to (1) estimate the mean ethanol content of each beer category in the U.S. for 1995 and 2000, (2) calculate per capita apparent consumption of ethanol from beer for 1995 and 2000 and for each state in 2000 and (3) describe trends in ethanol content for specific beer brands during the 1990s. RESULTS: The mean ethanol content of beer in the U.S. is found to increase from 4.33% (by volume) in 1995 to 4.66% in 2000. Using these estimates, per capita ethanol from beer is found to increase from 1.386 gallons in 1995 to 1.468 gallons in 2000. Use of a constant ethanol conversion, however, indicates a decrease. Application of ethanol content estimates to state-level per capita consumption for 2000 changes the relative rankings of 28 states, compared to the use of a constant 4.5% ethanol conversion. CONCLUSIONS: Improved ethanol conversion factor estimates are found to influence both time trends and the cross-sectional ranking of states, suggesting that analyses of both cross-sectional and time series aggregate ethanol consumption data that fail to consider variation in the ethanol content of beer may be biased.

Alcohol Drinking↗