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Two-bottle choice home cage drinking is one of the most widely used paradigms to study ethanol consumption in rodents. In its simplest form, animals are provided with access to two drinking bottles, one of which contains regular tap water and the other ethanol, for 24 hr/day with daily intake measured via change in bottle weight over the 24 hr period. Consequently, this approach requires no specialized laboratory equipment. While such ease of implementation is likely the greatest contributor to its widespread adoption by preclinical alcohol researchers, the resolution of drinking data acquired using this approach is limited by the number of times the researcher measures bottle weight (e.g., once daily). However, the desire to examine drinking patterns in the context of overall intake, pharmacological interventions, and neuronal manipulations has prompted the development of home cage lickometer systems that can acquire data at the level of individual licks. Although a number of these systems have been developed recently, the open-source system, LIQ HD, has garnered significant attention in the field for its affordability and user friendliness. Although exciting, this system was designed for use in mice. Here, we review appropriate procedures for standard and lickometer-equipped two-bottle choice home cage drinking. We also introduce methods for adapting the LIQ HD system to rats including hardware modifications to accommodate larger cage size and a redesigned 3D printed bottle holder compatible with standard off-the-shelf drinking bottles. Using this approach, researchers can examine daily drinking patterns in addition to levels of intake in many rats in parallel thereby increasing the resolution of acquired data with minimal investment in additional resources. These methods provide researchers with the flexibility to use either standard bottles or a lickometer-equipped apparatus to interrogate the neurobiological mechanisms underlying alcohol drinking depending on their precise experimental needs.

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This study explores patterns of alcohol drinking within a representative New Zealand sample (2887 participants (1464 female, 1423 male)). Alcohol use and drinking patterns across the population are described. Multivariable logistic regressions document associations between alcohol use and drinking patterns and the likelihood of experiencing different health outcomes. Alcohol use, early drinking initiation, frequent drinking, and heavy episodic drinking (HED) are prevalent in New Zealand and vary in relation to gender, age, and socioeconomic characteristics. Those who reported alcohol-related problems were more likely to report poor mental health (AOR: 2.21; 95% CI: 1.42-3.46) and disability (AOR: 1.79, 95% CI: 1.06-3.00), and less likely to experience positive mental health (AOR: 0.28, 95% CI: 0.18-0.42). Those who reported HED were also less likely to experience good general health (AOR: 0.61, 95% CI: 0.47-0.81) and positive mental health (AOR: 0.67, 95% CI: 0.53-0.84). Younger age cohorts were more likely to engage in early drinking, and those who initiated regular drinking before age 18 were more likely to report HED and alcohol-related problems. Findings indicate that problem drinking and HED are not only associated with poor physical health, but also reduce the likelihood of individuals experiencing positive mental health. This provides information to enable public health practitioners to target alcohol prevention strategies at the entire population of drinkers.

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Background: Alcohol and prescription opioid use are highly prevalent among chronic pain populations. One-fifth of individuals prescribed opioids report same-day use of alcohol and opioids. Alcohol use and alcohol/opioid co-use can have deleterious pain management and health outcomes. The extent to which individuals with chronic pain are aware of these deleterious outcomes is considerably understudied.Objectives: To explore individuals' understanding of seven health- and pain-related risks of alcohol/alcohol-opioid use. An exploratory aim was to examine whether greater risk awareness was associated with alcohol/opioid use patterns.Methods: Participants included 261 adults age ≥21(36.4% women) endorsing current alcohol use, chronic musculoskeletal pain, and opioid prescription who completed an online survey via Amazon Mechanical Turk.Results: Distribution of the total number of items for which a participant endorsed awareness was as follows: zero (10.7%), one (5.0%), two (13.0%), three (13.8%), four (13.8%), five (11.5%), six (10.0%), and seven items (22.2%). Awareness of the health consequences of alcohol/alcohol-opioid use was positively associated with opioid misuse behaviors (ß = .525, ΔR2 = .251, p < .001), and higher-risk alcohol consumption (ß = .152, ΔR2 = .021, p = .011).Conclusion: Many adults with chronic pain are unaware of the health consequences of alcohol/alcohol-opioid use. Findings of positive covariation between risk awareness and higher-risk alcohol/opioid use suggest that future interventions among this population should go beyond simple risk education and utilize motivational enhancement to help change decisional balance.

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BACKGROUND AND AIMS: Previously identified national drinking patterns in Europe lack comparability and might be no longer be valid due to changes in economic conditions and policy frameworks. We aimed to identify the most recent alcohol drinking patterns in Europe based on comparable alcohol exposure indicators using a data-driven approach, as well as identifying temporal changes and establishing empirical links between these patterns and indicators of alcohol-related harm. DESIGN: Data from the World Health Organization's monitoring system on alcohol exposure indicators were used. Repeated cross-sectional hierarchical cluster analyses were applied. Differences in alcohol-attributable harm between clusters of countries were analyzed via linear regression. SETTING: European Union countries, plus Iceland, Norway and Ukraine, for 2000, 2010, 2015 and 2019. PARTICIPANTS/CASES: Observations consisted of annual country data, at four different time points for alcohol exposure. Harm indicators were only included for 2019. MEASUREMENTS: Alcohol exposure indicators included alcohol per capita consumption (APC), beverage-specific consumption and prevalence of drinking status indicators (lifetime abstainers, current drinkers, former drinkers and heavy episodic drinking). Alcohol-attributable harm was measured using age-standardized alcohol-attributable Disability-Adjusted Life Years (DALYs) lost and deaths per 100 000 people. FINDINGS: The same six clusters were identified in 2019, 2015 and 2010, mainly characterized by type of alcoholic beverage and prevalence drinking status indicators, with geographical interpretation. Two-thirds of the countries remained in the same cluster over time, with one additional cluster identified in 2000, characterized by low APC. The most recent drinking patterns were shown to be significantly associated with alcohol-attributable deaths and DALY rates. Compared with wine-drinking countries, the mortality rate per 100 000 people was significantly higher in Eastern Europe with high spirits and 'other' beverage consumption [ ß ^ = 90, 95% confidence interval (CI) = 55-126], and in Eastern Europe with high lifetime abstainers and high spirits consumption ( ß ^ = 42, 95% CI = 4-78). CONCLUSIONS: European drinking patterns appear to be clustered by level of beverage-specific consumption, with heavy episodic drinkers, current drinkers and lifetime abstainers being distinguishing factors between clusters. Despite the overall stability of the clusters over time, some countries shifted between drinking patterns from 2000 to 2019. Overall, patterns of drinking in the European Union seem to be stable and partly determined by geographical proximity.

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The timing, rate, and quantity of gestational alcohol consumption, collectively referred to here as Maternal Drinking Patterns (MDPs), are of known importance to fetal developmental outcomes. However, few studies have directly evaluated the impact of MDPs on offspring behavior. To do so, we used specialized equipment to record the precise amount and timing of alcohol consumption in pregnant dams, and then characterized MDPs using Principle Component Analysis (PCA). We next tested offspring on behaviors we have previously identified as impacted by prenatal alcohol exposure, and evaluated them where possible in the context of MDPs. Male alcohol exposed mice exhibited longer latencies to fall on the rotarod compared to their controls, which we attribute to a delayed decrease in body weight-gain. This effect was mediated by MDPs within the first 15 min of alcohol access (i.e. alcohol frontloading), where the highest performing male offspring came from dams exhibiting the highest rate of alcohol frontloading. Female alcohol exposed mice displayed reduced locomotor activity in the open field compared to controls, which was mediated by MDPs encompassing the entire drinking session. Surprisingly, total gestational alcohol exposure alone was not associated with any behavioral outcomes. Finally, we observed allodynia in alcohol exposed mice that developed more quickly in males compared to females, and which was not observed in controls. To our knowledge, this report represents the highest resolution assessment of alcohol drinking throughout gestation in mice, and one of few to have identified relationships between specific alcohol MDPs and neurobehavioral outcomes in offspring.

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AIMS: The aim of the present study was to assess the relationship between adolescent IQ and midlife alcohol use and to explore possible mediators of this relationship. METHODS: Study data were from 6300 men and women who participated in the Wisconsin Longitudinal Study of high-school students graduating in 1957. IQ scores were collected during the participants' junior year of high school. In 2004, participants reported the number of alcoholic beverages consumed (past 30 days) and the number of binge-drinking episodes. A multinomial logistic regression was conducted to determine the relationship between adolescent IQ and future drinking pattern (abstainer, moderate drinker, or heavy drinker), and Poisson regression was used to examine the number of binge-drinking episodes. Two mediators-income and education-were also explored. RESULTS: Every one-point increase in IQ score was associated with a 1.6% increase in the likelihood of reporting moderate or heavy drinking as compared to abstinence. Those with higher IQ scores also had significantly fewer binge-drinking episodes. Household income, but not education, partially mediated the relationship between IQ and drinking pattern. CONCLUSIONS: The present study suggests that higher adolescent IQ may predict a higher likelihood of moderate or heavy drinking in midlife, but fewer binge-drinking episodes. The study also suggests that this relationship is mediated by other psychosocial factors, specifically income, prompting future exploration of mediators in subsequent studies.

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Alcohol consumption, associated with various cancers, mental disorders, and aggressive behavior, leads to three million deaths globally each year. In Brazil, the alcohol per capita consumption among drinkers aged 15 and over is 41.7 g of pure alcohol/day (~1 L beer/day), which falls into the risky consumption category and exceeds the global average by almost 30%. An effective way to mitigate alcohol-related harm is to increase its retail price. This study assesses the costs of consuming leading brands of beer and sugarcane spirit cachaça (Brazil's most popular alcoholic beverages) against the expenditure on staple foods. Data on food and alcoholic beverage prices were collected in João Pessoa, Brazil, for 2020 and 2021. The cost per gram of pure alcohol and food were considered to establish consumption patterns of 16.8 g/day (moderate), 41.7 g/day, and 83.4 g/day (heavy), distributed in three scenarios involving the beverages alone or combined (64% beer and 36% cachaça), and a balanced 2000 kcal/day staple diet. The study finds that all heavy consumption scenarios cost less or significantly less (cachaça alone) than a 2000 kcal/day staple diet, highlighting an urgent need for fiscal policies, such as a minimum unit pricing for alcohol, to address public health concerns.

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Introduction: Much research into the links between parental problematic alcohol use and adolescent substance use has focused on clinically diagnosed parental alcohol disorders. Few prior studies have utilised validated measures of adolescents' perception of parental alcohol problems and considered the severity of these problems. This study examined the associations between the severity of perceived parental alcohol problems and adolescents' drinking patterns in a Swedish national sample. Methods: We used survey information from grade 9 and 11 students (15-18 years) from 2021 (n = 9,227). Perceived parental alcohol problems were measured by the short version of The Children of Alcoholics Screening Test (CAST-6). The outcomes were: alcohol consumption during the past 12 months, frequent heavy episodic drinking (HED), and early alcohol debut (before age 14). Sociodemographic characteristics were adjusted for. Results: Binary logistic regressions showed that the severity of perceived parental alcohol problems was associated with alcohol consumption during the past 12 months (low severity OR 1.53, p < 0.001; moderate severity OR 1.85, p < 0.001; high severity OR 2.52, p < 0.001), HED (low severity OR 1.16, n.s.; moderate severity OR 1.31, n.s.; high severity OR 1.64, p < 0.01), and early alcohol debut (low severity OR 1.57, p < 0.001; moderate severity OR 1.65, p < 0.001; high severity OR 2.20, p < 0.001). Conclusions: Adolescents with perceived parental alcohol problems are more likely to have risky drinking patterns themselves, and the likelihood becomes higher with increased severity. Effective interventions for children whose parents have drinking problems are important, and should also take the severity of the parents' drinking problem into account.

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INTRODUCTION: Attentional bias (AB) is an implicit selective attention toward processing disorder-significant information while neglecting other environmental cues. Considerable empirical evidence highlights the clinical implication of AB in the onset and maintenance of substance use disorder. An innovative method to explore direct measures of AB relies on the eye-movement activity using technologies like eye-tracking (ET). Despite the growing interest regarding the clinical relevance of AB in the spectrum of alcohol consumption, more research is needed to fully determine the AB patterns and its transfer from experimental to clinical applications. The current study consisted of three consecutive experiments. The first experiment aimed to design an ad-hoc visual attention task (VAT) consisting of alcohol-related and neutral images using a nonclinical sample (n = 15). The objective of the second and third experiments was to analyze whether the effect of type of image (alcohol-related vs. neutral images) on AB toward alcohol content using the VAT developed in the first experiment was different for type of drinker (light vs. heavy drinker in the second experiment [n = 30], and occasional social drinkers versus alcohol use disorder (AUD) patients in the third experiment [n = 48]). METHODS: Areas of interest (AOIs) within each type of image (neutral and alcohol-related) were designed and raw ET-based data were subsequently extracted through specific software analyses. For experiment 1, attention maps were created and processed for each image. For experiments 2 and 3, data on ET variables were gathered and subsequently analyzed through a two-way ANOVA with the aim of examining the effects of the type of image and drinker on eye-movement activity. RESULTS: There was a statistically significant interaction effect between type of image and type of drinker (light vs. heavy drinker in experiment 2, F(1, 56) = 13.578, p < 0.001, partial η2 = 0.195, and occasional social drinker versus AUD patients in the experiment 3, F(1, 92) = 35.806, p < 0.001, partial η2 = 0.280) for "first fixation" with large effect sizes, but not for "number of fixations" and "dwell time." The simple main effect of type of image on mean "first fixation" score for AUD patients was not statistically significant. CONCLUSION: The data derived from the experiments indicated the importance of AB in sub-clinical populations: heavy drinkers displayed an implicit preference for alcohol-related images compared to light drinkers. Nevertheless, AB fluctuations in patients with AUD compared to the control group were found. AUD patients displayed an early interest in alcohol images, followed by an avoidance attentional processing of alcohol-related images. The results are discussed in light of recent literature in the field.

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Aims: The Alcohol Use Disorders Identification Test (AUDIT) is one of the most widely used screening instruments worldwide. Although it was translated into many languages, not many country-specific adaptations exist, and a formal validation procedure of the Russian version has been carried out only recently. The present contribution documents the different steps taken to formally translate and adapt a Russian-specific version of the AUDIT (RUS-AUDIT). Methods: The AUDIT was translated into Russian following an established protocol, revised and adapted to the country context using an expert panel, and field-tested in an iterative approach, in line with WHO rules on instrument translation and adaptation A total of three pilot phases were carried out on 134 patients from primary healthcare (PHC) and 33 patients from specialised alcohol treatment facilities (narcology), guided by a specially established advisory board. Changes in each version were informed by the findings of the previous pilot phase and a thorough panel discussion. Results: Based on the findings of three different pilot phases, the RUS-AUDIT was developed as a paper-and-pencil interview for PHC professionals. Since various issues with representation and counting of standard drinks for the second test item arose, a special show card was developed to support the assessment. Preliminary AUDIT-C scores indicated that more than one-third of the screened women (34.2%) and about half of the screened men (50.9%) from PHC facilities have exceeded risk thresholds. Conclusions: The RUS-AUDIT was constructed as a feasible assessment tool for interviewers and patients. The large number of PHC patients who exceed the risk threshold has corroborated the need for formal validation and Russia-specific cut-off scores, considering the specific drinking patterns.

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BACKGROUND: The incidence of stroke in China is increasing, along with a clear trend in the prevalence of risk factors. Alcohol consumption is also a risk factor for stroke. Many cohort studies have explored the relationship between alcohol consumption and stroke risk. However, findings have been inconsistent. METHODS: We used cluster sampling to select 13 districts and counties (at the same level) in Chongqing, China. Then, we used stratified random sampling to distribute the number of people in each district and county. 23,308 adults aged 30-79 were recruited between October 2018 and February 2019. Follow-up was conducted through a monitoring system and questionnaires until September 2022. Information on alcohol consumption and other covariates was collected using a standardized questionnaire. Participants were asked to report their weekly frequency of drinking over the past year and weekly intake of various alcoholic beverages in general. The frequency of drinking was divided into three categories: 1-2 d/week, 3-5 d/week, and 6-7 d/week. The average daily alcohol consumption is calculated based on the amount of alcohol contained in different alcoholic beverages. It is classified as nondrinker (0 g/day), light (0 to 12 g/day), moderate (13 to 36 g/day), and high (> 36 g/day). Cox proportional hazard regression models were used to estimate the association between alcohol consumption and stroke risk. Results are shown as multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS: With an average follow-up of 3.80 years, there were 310 new stroke events. The incidence of total stroke was 368.69 per 100,000 person-years. Overall, after adjusting for covariates, moderate alcohol consumption (average daily alcohol consumption 13-36 g/d) was associated with a lower risk of total stroke (HR: 0.48; 95% CI: 0.25-0.92) compared with nondrinkers. The adjusted HR and 95% CI for total stroke and ischemic stroke for those who drank alcohol 6-7 days per week were 0.60(0.37, 0.96) and 0.53(0.30, 0.94), respectively. The risk of total stroke (HR: 0.39; 95% CI: 0.17-0.89) was reduced in a pattern of drinking 6-7 days per week but with a mean alcohol consumption of less than 36 g/d. There was no significant association between alcohol consumption and hemorrhagic stroke. CONCLUSION: This study suggests moderate alcohol consumption is associated with a lower risk of total stroke. And healthy drinking patterns should be of more significant concern.

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Adjusting for demographics and standard drinking measures, High Intensity Drinking (HID), indexed by the maximum quantity consumed in a single day in the past 12 months, may be valuable in predicting alcohol dependence other harms across high and low income societies. The data consisted of 17 surveys of adult (15,460 current drinkers; 71% of total surveyed) in Europe (3), the Americas (8), Africa (2), and Asia/Australia (4). Gender-disaggregated country analyses used Poison regression to investigate whether HID (8-11, 12-23, 24+ drinks) was incrementally influential, beyond log drinking volume and HED (Heavy Episodic Drinking, or 5+ days), in predicting drinking problems, adjusting for age and marital status. In adjusted models predicting AUDIT-5 for men, adding HID improved the overall model fit for 11 of 15 countries. For women, 12 of 14 countries with available data showed an improved fit with HID included. The results for the five Life-Area Harms were similar for men. Considering the results by gender, each country showing improvements in model fit by adding HID had larger values of the average difference between high intensity and usual consumption, implying variations in amounts consumed on any given day. The amount consumed/day often greatly exceeded HED levels. In many societies of varying income levels, as hypothesized, HID provided important added information on drinking patterns for predicting harms, beyond the standard volume and binging indicators.

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AIM: In this study, using national survey data from 2014 and 2019, we tested the hypothesis that students at schools who introduced a common alcohol policy in 2017 drank less than students at schools without a common policy. METHODS: We used survey data from 41 high schools that participated in the Danish National Youth Study in 2014 and 2019. We perceived the introduction of a common high-school alcohol policy in 2017 among local groups of high schools as a natural experiment and assessed it using difference-in-difference analyses. We assessed drinking patterns from 2014 and 2019 among students at schools with and without a common alcohol policy combined and stratified by sex in negative binominal regression and logistic regression models. Drinking patterns were measured as average weekly alcohol use, average alcohol intake at last school party, proportion of non-drinkers and frequent binge drinkers. RESULTS: Drinking patterns were similar among students in schools with and without a common alcohol policy. For example, among students at schools with a common alcohol policy, the average alcohol intake at the last school party among drinkers was 8.7 units in 2014 and 8.5 units in 2019, whereas average alcohol intake among students at schools without a common alcohol policy was 8.8 units in 2014 and 8.9 units in 2019 (p=0.413). CONCLUSIONS: No statistically significant effects were observed following the introduction of a common alcohol policy on students' drinking patterns, and alcohol consumption among high-school students was stable and remained high in 2014 and in 2019.

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BACKGROUND: Most clinical studies of alcohol use disorder (AUD) treatment have short follow-up periods, underestimating the full benefits of alcohol treatment. Furthermore, clinical studies only consider one treatment cycle and do not account for the need for multiple episodes to treat a chronic recurrent condition. METHODS: A validated microsimulation model of the long-term drinking patterns of people with AUD in the United States simulated 10,000 individuals resembling those from a large clinical trial. The model was used to assess the impact of (1) 1-year, 5-year, and lifetime horizon on alcohol treatment cost-effectiveness estimates and (2) no, one, two, four, and unlimited additional treatment episodes on alcohol treatment cost-effectiveness estimates. Model outcomes included healthcare costs, crime costs, labor market productivity, life expectancy, quality-adjusted life years (QALYs), alcohol-related hospitalizations, and deaths. Cost-effectiveness analyses were conducted for two perspectives: a healthcare perspective that included costs from hospitalization and AUD treatment, and a broader societal perspective that also included crime costs and productivity. RESULTS: The incremental cost per additional QALY gained for alcohol treatment compared with no treatment decreased from $55,590 after 1 year to $78 when healthcare costs and QALYs were tracked over the lifetime, that is, treatment became more cost effective. Treatment was cost saving for any time frame when the impacts on crime and labor productivity were also accounted for in a societal perspective. Access to multiple treatment episodes dominated (i.e., it was more effective and less costly) than no-treatment and one-episode scenarios. From a healthcare perspective, incremental costs per additional QALY for increasing from a maximum of two to four treatment episodes was $499 and from four to unlimited episodes was $5049. The unlimited treatment scenario dominated all others from a societal perspective. Results were robust in sensitivity analyses. CONCLUSIONS: A long-term perspective and multiple episodes of alcohol treatment improve cost-effectiveness estimates. When societal impacts are included, alcohol treatment is cost saving. Results support the value of alcohol treatment.

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BACKGROUND: Alcohol use disorder (AUD) has been described as a chronic disease given the high rates that affected individuals have in returning to drinking after a change attempt. Many studies have characterized predictors of aggregated alcohol use (e.g., percent heavy drinking days) following treatment for AUD. However, to inform future research on predicting drinking as an AUD outcome measure, a better understanding is needed of the patterns of drinking that surround a treatment episode and which clinical measures predict patterns of drinking. METHODS: We analyzed data from the Project MATCH and COMBINE studies (MATCH: n = 1726; 24.3% female, 20.0% non-White; COMBINE: n = 1383; 30.9% female, 23.2% non-White). Daily drinking was measured in the 90 days prior to treatment, 90 days (MATCH) and 120 days (COMBINE) during treatment, and 365 days following treatment. Gradient boosting machine learning methods were used to explore baseline predictors of drinking patterns. RESULTS: Drinking patterns during a prior time period were the most consistent predictors of future drinking patterns. Social network drinking, AUD severity, mental health symptoms, and constructs based on the addiction cycle (incentive salience, negative emotionality, and executive function) were associated with patterns of drinking prior to treatment. Addiction cycle constructs, AUD severity, purpose in life, social network, legal history, craving, and motivation were associated with drinking during the treatment period and following treatment. CONCLUSIONS: There is heterogeneity in drinking patterns around an AUD treatment episode. This study provides novel information about variables that may be important to measure to improve the prediction of drinking patterns during and following treatment. Future research should consider which patterns of drinking they aim to predict and which period of drinking is most important to predict. The current findings could guide the selection of predictor variables and generate hypotheses for those predictors.

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Africa is the continent most affected by esophageal cancer in the world. Alcoholic beverages are controversially blamed, as esophageal cancer is a rare disease in several other countries ranked in the top 10 for consumption of alcoholic beverages. This study aims to conduct a comprehensive systematic review of published literature, statistically summarizing the strength of the association between drinking patterns and types, and the risk of esophageal cancer in Africa. A computerized search of reputable databases such as Medline/PubMed, EMBASE, Web of Science, and African Journals Online was performed to identify relevant studies published up to September 2023. The quality of the studies was evaluated using the Newcastle-Ottawa scale for case-control studies and the Agency for Healthcare Research and Quality tool for cross-sectional studies. A funnel plot and Egger test were utilized to assess potential publication bias. Meta-analyses were conducted using random-effects models with RevMan 5.3 and Stata software to estimate summary effects. The systematic review identified a total of 758,203 studies, primarily from Eastern and Southern Africa. The pooled samples across all studies comprised 29,026 individuals, including 11,237 individuals with cancer and 17,789 individuals without cancer. Meta-analysis revealed a significant association between alcohol consumption and the risk of esophageal cancer (odds ratio [OR] = 1.81; 95% confidence interval [CI], 1.50-2.19). Further analysis based on the frequency of alcoholic beverage consumption indicated a stronger association with daily (OR = 2.38; 95% CI, 1.81-3.13) and weekly (OR = 1.94; 95% CI, 1.32-2.84) drinkers in contrast to occasional drinkers (OR = 1.02; 95% CI, 0.81-1.29). Additionally, consumption of traditional alcoholic beverages was significantly associated with the risk of esophageal cancer in African populations (OR = 2.00; 95% CI, 1.42-2.82). However, no relationship has been established between the exclusive consumption of non-traditional drinks and the risk of esophageal cancer. In conclusion, the results of this study confirm the hypothesis that daily and weekly drinking patterns, significantly increase the risk of esophageal cancer in Africa, while occasional consumption does not show a significant association. Additionally, the consumption of traditional alcoholic beverages is notably linked to the risk of esophageal cancer in African populations.

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Drinking alcohol has a vast and diverse impact on many aspects of people's lives around the world. It is a major public health concern and is subject to numerous legal regulations and limitations. So far, little attention has been paid to if and how the volume of alcohol containers may affect drinking patterns. The widespread availability in recent years in Poland of small vodka bottles in various flavors and sizes was the rationale behind investigating whether the phenomenon may affect drinking patterns in any way. This was a 12-month cross-sectional survey study that started in January 2020. It included a total of 217 inpatients and outpatients that met the ICD-10 alcohol dependence criteria. The respondents were asked about their drinking habits and the use of small vodka bottles. It was found that respondents who regularly use small vodka bottles were much more likely to start their drinking early in the morning. The widespread availability and selection of small vodka bottles may encourage and facilitate drinking that starts early in the morning. It also makes it easier to maintain and control intoxication throughout the whole day, which could be considered another drinking pattern different from the other well-established ones, such as binge or continuous drinking. However, the design of this study makes it impossible to draw firm conclusions and further research is necessary.

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Front-loading is a drinking pattern in which alcohol intake is skewed toward the onset of reward access. This phenomenon has been reported across several different alcohol self-administration protocols in a wide variety of species, including humans. The hypothesis of the current review is that front-loading emerges in response to the rewarding effects of alcohol and can be used to measure the motivation to consume alcohol. Alternative or additional hypotheses that we consider and contrast with the main hypothesis are that: (1) front-loading is directed at overcoming behavioral and/or metabolic tolerance and (2) front-loading is driven by negative reinforcement. Evidence for each of these explanations is reviewed. We also consider how front-loading has been evaluated statistically in previous research and make recommendations for defining this intake pattern in future studies. Because front-loading may predict long-term maladaptive alcohol drinking patterns leading to the development of alcohol use disorder (AUD), several future directions are proposed to elucidate the relationship between front-loading and AUD.

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