Tina Lam

Demographic and substance use factors associated with non-violent alcohol-related injuries among patrons of Australian night-time entertainment districts

This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries.

A comparative study of blood alcohol concentrations in Australian night-time entertainment districts

INTRODUCTION AND AIMS There is little research describing how intoxication levels change throughout the night in entertainment districts. This research aims to describe levels of alcohol intoxication across multiple Australian metropolitan and regional nightlife districts. DESIGN AND METHODS This study was conducted in the night-time entertainment districts of three metropolitan cities (Sydney, Melbourne and Perth) and two regional cities (Wollongong and Geelong) in Australia. Data collection occurred approximately fortnightly in each city on a Friday or Saturday night between 8 pm and 5 am. Brief structured interviews (3-10 min) and breathalyser tests were undertaken in busy thoroughfares over six months. RESULTS Of the 7037 individuals approached to participate in the study, 6998 [61.8% male, mean age 24.89 years (standard deviation 6.37; range 18-73)] agreed to be interviewed. There was a linear increase in blood alcohol concentration (BAC) levels throughout the night. Post hoc testing revealed significantly more highly intoxicated participants (i.e. BAC above 0.10 mg of alcohol per 100 mL of blood) after midnight (P < 0.05). The overall mean BAC was 0.06 mg/100 mL. Men were more intoxicated than women earlier in the night, but gender differences disappeared by 3 am. There was no age differences in intoxication earlier in the night, but after midnight, patrons over the age of 21 showed increasing BAC levels. DISCUSSION AND CONCLUSIONS There is a consistent trend across the cities of high to very high levels of intoxication later in the night, with trends after midnight being significantly different to those before.

Characteristics of individuals presenting to treatment for primary alcohol problems versus other drug problems in the Australian patient pathways study

BackgroundPeople seeking treatment for substance use disorders often have additional health and social issues. Although individuals presenting with alcohol as the primary drug of concern (PDOC) account for nearly half of all treatment episodes to the Australian alcohol and other drug (AOD) service system, previous treatment cohort studies have focused only on the profile of Australian heroin or methamphetamine users. While studies overseas indicate that clients seeking treatment primarily for their drinking are less likely to experience social and economic marginalisation than those seeking treatment primarily for illicit or pharmaceutical drug use, very little research has directly compared individuals presenting with alcohol as the PDOC to those primarily presenting with other drugs as their PDOC.MethodsSeven hundred and ninety-six participants were recruited at entry to specialist AOD treatment in Victoria and Western Australia, and completed measures of demographic and social factors, substance use, quality of life, service use, and criminal justice involvement. We compared those with alcohol as their PDOC to those with other drugs as their PDOC using Pearson chi-square and Mann–Whitney U tests.ResultsRates of social disadvantage, poor quality of life, high severity of substance dependence, and past-year AOD, mental health, acute health, and social service use were high in all groups. However, participants with alcohol as the PDOC were older; more likely to have an educational qualification; less likely to report criminal justice involvement, housing/homelessness service use, tobacco smoking, or problems with multiple substances; and reported better environmental quality of life; but were more likely to have used ambulance services, than those with other drugs as their PDOC.ConclusionsWhile those seeking treatment primarily for alcohol problems appear less likely to suffer some forms of social and economic disadvantage or to use multiple substances than those with a primary drug problem, they experience similarly high levels of substance dependence severity and mental health and AOD service use. These findings reinforce the need for AOD services to integrate or coordinate care with programs that address the many complexities clients frequently present with, while also acknowledging differences between those seeking treatment for alcohol versus other drug problems.

Substance use outcomes following treatment: Findings from the Australian Patient Pathways Study:

Background and Aims: Our understanding of patient pathways through specialist Alcohol and Other Drug treatment and broader health/welfare systems in Australia remains limited. This study examines how treatment outcomes are influenced by continuity in specialist Alcohol and Other Drug treatment, engagement with community services and mutual aid, and explores differences between clients who present with a primary alcohol problem relative to those presenting with a primary drug issue. Method: In a prospective, multi-site treatment outcome study, 796 clients from 21 Alcohol and Other Drug services in Victoria and Western Australia completed a baseline interview between January 2012 and January 2013. A total of 555 (70%) completed a follow-up assessment of subsequent service use and Alcohol and Other Drug use outcomes 12-months later. Results: Just over half of the participants (52.0%) showed reliable reductions in use of, or abstinence from, their primary drug of concern. This was highest among clients with meth/amphetamine (66%) as their primary drug of concern and lowest among clients with alcohol as their primary drug of concern (47%), with 31% achieving abstinence from all drugs of concern. Continuity of specialist Alcohol and Other Drug care was associated with higher rates of abstinence than fragmented Alcohol and Other Drug care. Different predictors of treatment success emerged for clients with a primary drug problem as compared to those with a primary alcohol problem; mutual aid attendance (odds ratio = 2.5) and community service engagement (odds ratio = 2.0) for clients with alcohol as the primary drug of concern, and completion of the index treatment (odds ratio = 2.8) and continuity in Alcohol and Other Drug care (odds ratio = 1.8) when drugs were the primary drugs of concern. Conclusion: This is the first multi-site Australian study to include treatment outcomes for alcohol and cannabis users, who represent 70% of treatment seekers in Alcohol and Other Drug services. Results suggest a substantial proportion of clients respond positively to treatment, but that clients with alcohol as their primary drug problem may require different treatment pathways, compared to those with illicit drug issues, to maximise outcomes.

Pre-Drinking Behavior of Young Heavy Drinkers

ABSTRACT Background: Pre-drinking has been linked to subsequent heavy drinking and the engagement in multiple risky behaviors. Objectives: The present study examined a group of adolescents who recently had a “big night out” to determine whether there were differences in their pre-drinking behavior based on age, gender, geographic location, and social setting. Methods: Participants (n = 351, aged 16–19) representing the heaviest 20–25% of drinkers in their age group were recruited using nonrandom sampling from metropolitan (Melbourne, Sydney, Perth) or regional (Bunbury) locations across Australia and administered a survey by a trained interviewer. Results: Almost half the sample pre-drank (n = 149), most commonly at a friends house. Those aged 18–19 were more likely to pre-drink, and did so at higher quantities compared to their younger counterparts. Males and females reported similar pre-drinking duration, quantity and amount spent on alcohol. Compared to those in cities, regional participants consumed greater quantities over longer periods of time. Two-thirds of participants consumed alcohol in excess of national guidelines during their pre-drinking session. These participants were more likely to nominate price as a motivation to pre-drink and were less likely to report that someone else provided them alcohol. Conclusions: This study sheds light on the pre-drinking habits of a population of young risky drinkers, and highlights the need for policy makers to address this form of drinking to reduce alcohol-related harm among young people.

How alcohol marketing engages users with alcohol brand content on Facebook: an Indian and Australian perspective

Abstract Little work has been conducted to understand how alcohol marketers engage users with their brands’ Facebook pages in India and Australia. We aimed to evaluate and compare (i) the types of marketing techniques alcohol marketers utilize to facilitate user engagement on their brands’ Facebook pages and (ii) the extent to which users engage with these techniques in two diverse national contexts. We identified the ten most popular alcohol brands on Facebook in India and Australia based on the number of ‘likes’ for each official brand site. Brand websites and data analytic sources were accessed to collect metrics relating to number of likes, frequency of posts made by alcohol marketers on their brand websites and the resulting comments from fans, and messages relating to responsible drinking. The identified brands accrued substantial user engagement (e.g. Budweiser beer attracted 12.8 million likes in Australia and Foster’s beer 802,807 likes in India). The strategies employed were a mix of country-specific (e.g. India: inspirational talks and livelihood skills vs. Australia: posts related to the brand’s tradition or heritage) and generic approaches (e.g. alcohol sponsorship of sport, music, and fashion, offering consumption suggestions, organizing competitions, giveaways, and use of memes). This cross-national comparison illustrates that alcohol marketing on Facebook is user-focused and flexible, works with specific national contexts, and capitalizes on the cultural meanings users invoke in their interactions with sites. The study results also demonstrate the potential for brands to engage those under the legal drinking age by delivering alcohol content on Facebook.

Correlates of verbal and physical aggression among patrons of licensed venues in Australia

INTRODUCTION AND AIMS The current study aimed to examine the association between patron demographics and substance use, and experiences of verbal and physical aggressive incidents within the last 3 months among patrons of night-time entertainment precincts (NEP) in Australia. DESIGN AND METHODS Patron interviews (n = 4216) were conducted around licensed venues in the NEPs of five Australian cities. Seven correlates of verbal and physical aggressive incidents were examined: gender, age, occupation, blood alcohol concentration, pre-drinking, energy drink use and illicit drug use in the current session. RESULTS A total of 7.5% and 8.2% of respondents reported involvement in a verbally and physically aggressive incident in the past 3 months, respectively. Multivariate logistic regression models indicated men and people <25 years old were significantly more likely to report both verbal and physical aggressive incidents. A significant occupation effect showed lower levels of both verbal and physical aggression in managers/professionals compared with non-office workers. The likelihood of being involved in a verbally aggressive incident significantly increased with energy drink consumption, while the likelihood of being involved in a physically aggressive incident significantly increased with blood alcohol concentration, energy drink consumption and illicit drug use. DISCUSSION AND CONCLUSIONS This study highlights the different correlates of verbal and physical aggression within NEPs, suggesting they should be viewed as distinct types of violence, rather than points on a continuum. Major modifiable correlates with verbal and physical aggression included intoxication, energy drink consumption, and illicit drug use, suggesting the need for further interventions and policy development to address these key issues. [Hyder S, Coomber K, Pennay A, Droste N, Curtis A, Mayshak R, Lam T, Gilmore W, Chikritzhs T, Miller PG. Correlates of verbal and physical aggression among patrons of licensed venues in Australia. Drug Alcohol Rev 2018;37:6-13].

Alcohol marketing on YouTube: exploratory analysis of content adaptation to enhance user engagement in different national contexts

BackgroundWe know little about how social media alcohol marketing is utilized for alcohol promotion in different national contexts. There does not appear to be any academic work on online exposure to alcohol marketing via social media in India, and most of the limited research in Australia has focused on Facebook. Hence, the present study extends previous research by investigating alcohol promotion conducted on an under-researched form of social media (YouTube) in two contrasting geographic contexts. This study examines and compares the types of strategies used by marketers on Indian and Australian alcohol brands with the greatest YouTube presence, and the extent to which users engage with these strategies.MethodsThe 10 alcohol brands per country with the greatest YouTube presence were identified based on the number of ‘subscriptions’. The number of videos, views per video, and the type of content within the videos were collected for each brand. The data were analyzed using an inductive coding approach, using NVivo 10.ResultsThe targeted brands had gathered 98,881 subscriptions (Indian brands: n = 13,868; Australian brands: n = 85,013). The type of marketing strategies utilized by brands were a mix of those that differed by country (e.g. sexually suggestive content in India and posts related to the brand’s tradition or heritage in Australia) and generic approaches (e.g. encouraging time- and event-specific drinking; demonstrations of food/cocktail recipes; camaraderie; competitions and prize draws; and brand sponsorship at music, sports, and fashion events).ConclusionsThis cross-national comparison demonstrates that YouTube provides alcohol marketers with an advertising platform where they utilize tailored marketing approaches to cater to specific national contexts and develop content on the cultural meanings users invoke in their interactions with these strategies. Those exposed to alcohol marketing on YouTube are likely to include those under the legal drinking age.

Targeting at-risk samples through brief face-to-face interviews in night-time entertainment precincts

ABSTRACT Aims: This exploratory paper investigates the demographic profile of patrons who may be underrepresented in face-to-face interviews by employing a brief version of an interview. Method: Patron interviews (n = 8,664) were conducted in seven Australian cities; 63% completed the full interview and 37% completed the brief interview. Assessed correlates of interview type comprised gender, age, pre-drinking, consumption of alcohol mixed with energy drinks, illicit drug use, involvement in verbal or physical aggression, alcohol-related injuries, and blood alcohol concentration (BAC). Results: Using a brief interview increased the response rate by 34%. Multi-level logistic regression models indicated compared to those who completed the full interview, brief interview respondents were more likely to be: male, have a BAC of ≥0.05 to <0.10 or ≥0.10 g/100 ml, report pre-drinking, and report involvement in physical aggression. Respondents were also less likely to compete the brief interview with each 1 year increase in age. Conclusion: Compared to longer interviews, brief patron interviews can capture a different and more at-risk demographic group and increase the overall response rate. These findings raise questions about the representativeness of long interview samples describing young drinkers who experience aggression. The study also provides the groundwork for future validation of brief interviews.

Insomnia and regulation of sleep-wake cycle with drugs among adolescent risky drinkers

STUDY OBJECTIVES We aimed to explore symptoms of insomnia in a group of youths characterized as engaging in risky drinking, their use of drugs as sleep/ wake aids, and the relationships between alcohol and other drug use and insomnia. METHODS Face-to-face interviews were conducted with 596 Australian 14 to 19-year-olds identified as engaging in regular risky drinking. They completed the Insomnia Severity Index and were assessed for recent alcohol and other drug use, including drugs used specifically as sleep aids or to stay awake. Alcohol-related problems, emotional distress, self-control, and working outside of traditional hours were also assessed using validated scales. RESULTS More than one-third of the study participants (36%) reported moderate to very severe sleep-onset insomnia, and 39% screened positive for clinical insomnia using adolescent criteria. Three-fourths used drugs in the past 2 weeks to regulate their sleep cycle (65% used stimulants to stay awake, mainly caffeine, and 32% used a depressant to get to sleep, mainly cannabis). Regression analyses showed that after controlling for variables such as sex, emotional distress, self-control, alcohol use problems, and past 6-month illicit or non-prescribed drug use, those who used drugs specifically to get to sleep or to stay awake were 2.0 (P < .001) and 1.7 (P = .02) times more likely to report clinical insomnia, respectively. CONCLUSIONS Insomnia was commonly reported in this community sample of adolescents characterized as engaging in risky drinking. Those with symptoms of insomnia appeared to be managing their sleep-related symptoms through alcohol and other drug use, which may have further exacerbated their sleep issues.