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Background: Alcohol misuse is a serious problem among university students in Colombia as well as in other Latin American countries. Studies show consistently that this population presents the highest rates of alcohol use. Despite such a situation, there is a lack of preventive programs for university students in this region of the world. The purpose of this paper is to present the protocol to evaluate a preventive strategy called IBEM-U, based on Motivational Interviewing and the I-Change Model. Method: This protocol shows how the evaluation of the effectiveness of the IBEM-U program will be carried out. A randomized control trial with a within-subjects design with one follow-up at six months after the post-test will be implemented. The comparison group will receive an alternative program similar in length but focusing on another issue. Around 1000 participants over 18 years of age, from at least six different universities around the country, will be recruited. Results: It is expected that the program will be effective in reducing past month alcohol consumption up to 15% in the experimental group as the main outcome. Secondary and tertiary outcomes include decreasing heavy episodic drinking and increasing knowledge, awareness, risk perception, attitude, self-efficacy, intention, and action planning, regarding heavy episodic drinking. Conclusion: IBEM-U can be considered a highly appropriate approach for reducing alcohol misuse among university students. The main reasons for these results are the self-imposed goals based on long-term purposes, that could be seriously affected by the ingestion of high amounts of alcohol.

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BACKGROUND: To estimate the prevalence of changes in the frequency of self-reported heavy episodic drinking (HED) among drinkers in Latin America and Caribbean countries on alcohol consumption during the COVID-19 pandemic, and to assess self-reported factors associated with the increased frequency of HED. METHODS: Data from 12,328 adults who responded to the cross-sectional survey conducted in 33 countries of Latin America and the Caribbean by Pan American Health Organization were used. Logistic regression analyses were performed to estimate the effect of the sociodemographic characteristics, quarantine practices, and anxiety symptoms on the increase in frequency of HED among the 2019 drinkers. RESULTS: 65 % of drinkers in 2019 self-reported HED during the COVID-19 pandemic with 13.8 % of the drinkers reporting an increase in HED compared to a 33.38 % decrease in HED. Multivariable analysis indicated that male gender (aOR 1.29, 95 %CI 1.13; 1.49), higher income (aOR 1.64, 95 %CI 1.35; 1.99) and higher level of quarantine practices (aOR 1.10, 95 %CI 1.04; 1.16) were positively associated with increased frequency of HED; unemployment (aOR 0.78, 95 %CI 0.64; 0.96), student status (aOR 0.53, 95 %CI 0.43; 0.64) and living with children (aOR 0.91, 95 %CI 0.84; 0.99) were negatively associated with increased frequency of HED. A gradient of association was found between generalized anxiety disorder and an increase in HED frequency during the pandemic. CONCLUSION: Along with other measures to decrease the spread of COVID-19, it is important to include measures to reduce alcohol consumption and address mental health conditions in the national response to the pandemic.

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Thise study aimed to assess the prevalence and correlates of heavy episodic drinking (HED) among adults in Ecuador. In the national, cross-sectional 2018 Ecuador STEPwise approach to Surveillance (STEPS) survey, 4638 persons (median age = 39 years, range 18-69 years) responded to a questionnaire and physical measures. Logistic regression was used to assess the determinants of HED. Results indicate that 24.1% had past-month HED, 36.7% among men, and 12.0% of women; among past-12-month drinkers, 40.6% had past-month HED. In adjusted logistic regression analysis, male sex (adjusted odds ratio = AOR: 3.03, 95% confidence interval = CI: 2.44-3.77), past smoking (AOR: 1.42, 95% CI: 1.12-1.81), and current smoking (AOR: 2.94, 95% CI: 2.25-3.86) were positively associated with HED, and being aged 50-69 years (AOR: 0.52, 95% CI: 0.39-0.68) was negatively associated with HED. In sex-stratified analyses among men, being African Ecuadorean or Mulato (AOR: 1.74, 95% CI: 1.07-2.84) and high physical activity (AOR: 1.43, 95% CI: 1.02-2.01) were positively associated with HED, and among women, being Montubia (AOR: 0.38, 95% CI: 0.16-0.90) was negatively associated with HED and obesity (AOR: 1.58, 95% CI: 1.05, 2.38) was positively associated with HED. Almost one in four participants engaged in HED, and several sociodemographic and health indicators were identified associated with HED.

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Heavy episodic drinking (HED) is highly prevalent in college students. In Argentina, there is a notable lack of longitudinal studies examining drinking trajectories. The present study identified HED trajectories in Argentinean college students during the first 3 years of college (seven waves) and examined the association between risk factors for alcohol use and HED trajectories. The sample was composed of 1,240 college students [63.1% women, aged 18-25 years (M = 19.1 ± 1.7)] who completed at least three waves (the first data collection and ≥2 follow-ups). For 3 years, participants completed seven surveys that measured HED frequency, age of drinking onset, drunkenness occurrence, trait impulsivity, family history of alcohol abuse, stressful life events, and perceived peer's drinking. Latent Class Growth Analysis (LCGA) and Multinomial Logistic Regression (MLR) were used to identify the pattern and number of HED trajectories and to explore which risk factors better distinguished between the trajectories, respectively. Six HED trajectories were identified: Heavy Stable Frequency, Moderate Stable Frequency, Moderate Decreasing Frequency, Stable Infrequent, Decreasing Infrequent, and No-HED. Younger age of drinking onset, alcohol intoxication, greater perception of peer drinking frequency and higher levels of impulsivity (i.e., sensation seeking, lack of premeditation, and positive urgency) increased the probability of belonging to the trajectories with more frequent HED. These trajectories partially coincide with those identified in studies from other cultures. Unlike previous studies, we did not find a trajectory with increasing/ascending HED frequency. This may be related to contextual/cultural variables unique to Argentina, like differences in the age when the peak in alcohol consumption is reached or the legal minimum age to buy alcoholic beverages in this country, and the idiosyncratic elements that characterize college life in Argentina. This work represents a step forward in the identification of risk factors differentiating between different HED trajectories, and help understand changes in alcohol use during college, in an understudied population.

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BACKGROUND: Heavy episodic drinking (HED) can have health and social consequences. This study assesses the associations between HED and demographic, socioeconomic, motivation and effects indicators for people aged 18⁻34 years old living in four cities in different regions of the world. METHOD: Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward/back translated and face-to-face interviewing was undertaken. A total of 6235 interviews were undertaken in 2014. Separate univariable and multivariable modelling was undertaken to determine the best predictors of HED. RESULTS: HED prevalence was 9.0%. The best predictors differed for each city. The higher probability of HED in the final models included beliefs that they have reached adulthood, feeling relaxed as an effect of drinking alcohol, and forgetting problems as an effect of drinking alcohol. Lower probability of HED was associated with not being interested in alcohol as a reason for limiting alcohol, and the belief that drinking alcohol is too expensive or a waste of money. CONCLUSION: Although some indicators were common across the four cities, the variables included in the final models predominantly differed from city to city. The need for country-specific prevention and early intervention programs are warranted.

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The consequences of alcohol use are closely related to its pattern of intake. The aim of this study is to analyze the pattern of alcohol use by doctors and nurses. Associated co-factors have also been considered. We calculated a representative sample of doctors and nurses from two hospitals in Maranhão, Northeastern Brazil. The Alcohol Use Disorders Identification Test (AUDIT) was employed to assess patterns of alcohol consumption. A score ≥8 was defined as alcohol misuse, and an answer to question number 3 > 1 was indicative of heavy episodic drinking (HED). In order to identify factors associated with HED and alcohol misuse, bivariate and multiple logistic regression analyses were performed with SPSS v20.0. A sample of 510 professionals was examined and 25% of those were abstainers; among those who had drinks containing alcohol, 86% were classified as low-risk alcohol use, scoring lower than 8, while 10.6% of the whole sample was categorized as alcohol misusers, scoring more than 8. The habit of smoking (OR = 6.02; CI: 1.71-21.16), following the Catholic religion (OR = 3.55; CI: 2.47-8.58), and also gender (OR = 3.09; CI: 1.68-5.71) were independently associated with alcohol misuse. HED was found in 14.3%. Younger age (OR = 0.96; CI: 0.92-0.98), male gender (OR = 5.13; CI: 2.55-10.30), the Catholic religion (OR = 3.22; CI: 1.44-7.21), and smoking habits (OR = 5.25; CI: 1.26-21.75) were associated with HED. Therefore, physicians and nurses have a lesser prevalence of abstainers, similar rates of alcohol misuse, and greater prevalence of HED when compared to the general Brazilian adult population. More studies involving these professionals need to be carried out in other Brazilian states in order to determine whether the results can be understood as widespread throughout the country.

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Harmful alcohol use encompasses a spectrum of habits, including heavy episodic drinking (HED) which increases the risk of acute alcohol-related harms. The prevalence of HED in Saint Vincent and the Grenadines (SVG) is 5.7% among the overall population aged 15 years and older and 10.2% among drinkers. Responsible Beverage Service interventions train alcohol servers to limit levels of intoxication attained by customers and decrease acute alcohol-related harms. The objectives of this study were to determine bar tenders' and rum shopkeepers' knowledge of and attitudes toward problem drinking and willingness to participate in server training. Researchers used convenience and purposive sampling to recruit 30 participants from Barraouile, Kingstown, and Calliaqua to participate in semi-structured interviews designed to explore study objectives. Results and conclusions were derived from grounded theory analysis. Heavy episodic drinking is common but not stigmatized. Heavy drinking is considered a "problem" if the customer attains a level of disinhibition causing drunken and disruptive or injurious behavior. Bartenders and rum shopkeepers reported intervening with visibly intoxicated patrons and encouraging cessation of continued alcohol consumption. Participants cited economic incentives, prevention of alcohol-related harms, and personal morals as motivators to prevent drunkenness. Respondents acknowledged that encouraging responsible drinking was a legitimate part of their role and were favorable to server training. However, there were mixed opinions about the intervention's perceived efficacy given absent community-wide standards on preventing intoxication and limitations of existing alcohol policy. Given respondents' motivation and lack of standardized alcohol server training in SVG, mandated server training can be an effective strategy when promoted as one piece of a multi-component alcohol policy.

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OBJECTIVE: To investigate drinking patterns and gender differences in alcohol-related problems in a Brazilian population, with an emphasis on the frequency of heavy drinking. METHODS: A cross-sectional study was conducted with a probability adult household sample (n = 1,464) in the city of São Paulo, Brazil. Alcohol intake and ICD-10 psychopathology diagnoses were assessed with the Composite International Diagnostic Interview 1.1. The analyses focused on the prevalence and determinants of 12-month nonheavy drinking, heavy episodic drinking (4-5 drinks per occasion), and heavy and frequent drinking (heavy drinking at least 3 times/week), as well as associated alcohol-related problems according to drinking patterns and gender. RESULTS: Nearly 22% (32.4% women, 8.7% men) of the subjects were lifetime abstainers, 60.3% were non-heavy drinkers, and 17.5% reported heavy drinking in a 12-month period (26.3% men, 10.9% women). Subjects with the highest frequency of heavy drinking reported the most problems. Among subjects who did not engage in heavy drinking, men reported more problems than did women. A gender convergence in the amount of problems was observed when considering heavy drinking patterns. Heavy and frequent drinkers were twice as likely as abstainers to present lifetime depressive disorders. Lifetime nicotine dependence was associated with all drinking patterns. Heavy and frequent drinking was not restricted to young ages. CONCLUSIONS: Heavy and frequent episodic drinking was strongly associated with problems in a community sample from the largest city in Latin America. Prevention policies should target this drinking pattern, independent of age or gender. These findings warrant continued research on risky drinking behavior, particularly among persistent heavy drinkers at the non-dependent level.

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CONTEXTO: O beber pesado episódico (BPE) tem sido fortemente associado a danos e a uma carga social consideráveis. OBJETIVOS: Este estudo tem como finalidade avaliar o panorama brasileiro a partir de aspectos sociodemográficos, fatores individuais e sociais relacionados ao beber pesado. MÉTODOS: A busca de artigos científicos foi realizada com base em um programa de computador nos principais bancos de dados científicos. RESULTADOS: Os homens beberam pesado mais freqüentemente que as mulheres. O beber pesado episódico foi mais prevalente em adolescentes e adultos jovens, e a prevalência tende a diminuir com o aumento da idade. As condições socioeconômicas parecem ter um efeito sobre o beber pesado. O início precoce do beber pesado esteve associado com história de dependência do álcool na vida adulta. O beber pesado episódico esteve associado ao uso concomitante de outras substâncias psicoativas. Os fatores de risco para BPE incluíram atividades sociais e disponibilidade de dinheiro. A pressão dos pares mostrou influenciar mais do que o suporte parental especialmente no final de adolescência. O BP também variou de acordo com a cultura, com mais episódios de BP no Sul em comparação com o Norte do País. CONCLUSÕES: Uma variedade de aspectos sociodemográficos e individuais associados ao beber pesado foi identificada. Porém, o conhecimento nessa área ainda é muito limitado. Mais pesquisas no Brasil são urgentemente necessárias visto que os resultados provenientes de outras culturas não podem ser generalizados.

BACKGROUND: Heavy episodic drinking has been shown to be closely associated with considerable damage to and burden on society. OBJECTIVES: This review aims to give an overview of the Brazilian reality based on socio-demographic aspects, considering individual and social factors related to heavy drinking. METHODS: A computer-assisted search of relevant articles was conducted in the foremost scientific databases. RESULTS: Males tended to heavy drinking more frequently than females. Heavy episodic drinking was most prevalent among adolescents and young adults, though this prevalence tended to level off as they age. Socioeconomic conditions appear to have an effect on heavy drinking. The early onset of heavy drinking has been associated with a history of alcohol dependency in the adult phase. Heavy episodic drinking coincided with other psychoactive substance usage. Motives for heavy drinking included both social activities as well as the availability of money. Peer pressure was one of the strongest influencing factors in binge drinking and seemed to outweigh parental influence, particularly from late adolescence onward. Heavy drinking also varied according to both the predominant adult and adolescent drinking culture, with more binge drinking in the southern areas of Brazil as compared with the northern and central regions. CONCLUSIONS: A myriad of socio-demographical, individual, and social characteristics associated with heavy drinking have been identified. However, knowledge in these areas remain limited, as most research has been conducted on specific groups and situations, in particular, that of North American college students. More research in Brazil is urgently needed, as results from other cultural contexts should not be generalized.

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