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      Adult low-risk drinkers and abstainers are not the same

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          Abstract

          Background

          Alcohol consumption, even at low-levels, can not be guaranteed as safe or risk free. Specifically, the 2009 Australian National Health and Medical Research Council drinking guidelines recommend that adults should not drink more than two standard drinks on any day on average, and no more than four drinks on a single occasion. Nearly 40% of Australians aged 12 years and older drink alcohol but don’t exceed these recommended limits, yet adult low-risk drinkers have been largely overlooked in Australian alcohol survey research, where they are usually grouped with abstainers. This paper examines the socio-demographic profile of low-risk drinking adults (18+ years old), compared to those who abstain.

          Methods

          Data from the 2013 National Drug Strategy Household Survey were used. In the past 12 months, 4796 Australians had not consumed alcohol and 8734 had consumed alcohol at low-risk levels, accounting for both average volume and episodic drinking (hereafter low-risk).

          Results

          Multivariate logistic regression results indicated that low-risk drinkers were more likely to be older, married, Australian-born, and reside in a less disadvantaged neighbourhood compared with abstainers. There was no significant difference by sex between low-risk drinkers and abstainers.

          Conclusions

          The socio-demographic profile of low-risk drinkers differed from that of abstainers. Combining low-risk drinkers and abstainers into a single group, which is often the practice in survey research, may mask important differences. The study may support improved targeting of health promotion initiatives that encourage low-risk drinkers not to increase consumption or, in view of increasing evidence that low-risk drinking is not risk free, to move towards abstinence.

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          Most cited references29

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          The epidemiology of at-risk and binge drinking among middle-aged and elderly community adults: National Survey on Drug Use and Health.

          The purpose of this article was to estimate the prevalence, distribution, and correlates of at-risk alcohol use (especially binge drinking) among middle-aged and elderly persons in the United States and to compare at-risk alcohol use between women and men. Secondary analysis of the 2005 and 2006 National Survey on Drug Use and Health was conducted for 10,953 respondents aged 50 years and older. Among respondents, 6,717 were 50 to 64 years of age and 4,236 were > or =65 years. Social and demographic variables, alcohol use (including at-risk use), binge drinking, serious psychological distress, and self-rated health were assessed. Overall, 66% of male respondents and 55% of female respondents reported alcohol use during the past year. At-risk alcohol use and binge drinking were more frequent among respondents 50 to 64 years of age relative to respondents aged 65 years or older. In the > or =65 years old age group, 13% of men and 8% of women reported at-risk alcohol use, and more than 14% of men and 3% of women reported binge drinking. Among male subjects, binge drinking compared with no alcohol use was associated with higher income and being separated, divorced, or widowed, while being employed and nonmedical use of prescription drugs were associated with binge drinking compared with no alcohol use among women. For all respondents, binge drinking relative to no alcohol use was associated with the use of tobacco and illicit drugs. Among women who reported using alcohol, being African American and less educated were associated with binge drinking, but race/ethnicity and educational level were not associated with binge drinking in men who reported using alcohol. At-risk and binge drinking are frequently reported by middle-aged and elderly adults nationwide and are therefore of public health concern. Clinicians working with middle-aged and older adults should screen for binge drinking and coexisting use of other substances.
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            Associations between alcohol, smoking, socioeconomic status and comorbidities: evidence from the 45 and Up Study.

            Understanding how tobacco, alcohol and mental health are related is important for developing population-level policies and individual-level treatments that target comorbidities. The current study aimed to examine sociodemographic characteristics and mental health comorbidities associated with the odds of using tobacco and harmful levels of alcohol concurrently.
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              Estimating under- and over-reporting of drinking in national surveys of alcohol consumption: identification of consistent biases across four English-speaking countries.

              Questions about drinking 'yesterday' have been used to correct under-reporting of typical alcohol consumption in surveys. We use this method to explore patterns of over- and under-reporting of drinking quantity and frequency by population subgroups in four countries.
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                Author and article information

                Contributors
                J.Mugavin@latrobe.edu.au
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                10 January 2020
                10 January 2020
                2020
                : 20
                : 37
                Affiliations
                [1 ]ISNI 0000 0001 2342 0938, GRID grid.1018.8, Centre for Alcohol Policy Research, , School of Psychology and Public Health, La Trobe University, ; Bundoora, Victoria 3086 Australia
                [2 ]ISNI 0000 0001 2342 0938, GRID grid.1018.8, School of Allied Health, Human Services and Sport, , La Trobe University, ; Bundoora, Victoria 3086 Australia
                [3 ]ISNI 0000 0004 1936 9377, GRID grid.10548.38, Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, , Stockholm University, ; Stockholm, 106 91 Sweden
                Author information
                http://orcid.org/0000-0003-0537-6392
                Article
                8147
                10.1186/s12889-020-8147-5
                6954507
                31924194
                0904174d-9bc5-4ad0-8f56-97ea1c00bf1d
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 September 2019
                : 31 December 2019
                Funding
                Funded by: Discovery Early Career Research Award, Australian Research Council
                Award ID: DE180100016
                Award Recipient :
                Funded by: Australian Government Research Training Program Stipend Scholarship
                Award ID: NA
                Award Recipient :
                Funded by: Australian Rechabite Foundation Top-up Scholarship
                Award ID: NA
                Award Recipient :
                Funded by: Foundation for Alcohol Research and Education
                Award ID: NA
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Public health
                adults,low-risk drinking,abstinence,socio-demographics,cross-sectional data
                Public health
                adults, low-risk drinking, abstinence, socio-demographics, cross-sectional data

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