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New this Month - April 2006

Below are citations/abstracts of recently published articles and publications that have been authored and/or co-authored by Pacific Institute staff.

Berkeley

Meng-Jinn Chen & Joel Grube

Austin, E. W., Chen, M.-J., & Grube, J. W. (2006). How does alcohol advertising influence underage drinking? The role of desirability, identification and skepticism. Journal of Adolescent Health, 38(4), 376-384.

Abstract: PURPOSE: To investigate, using an information processing model, how persuasive media messages for alcohol use lead to concurring beliefs and behaviors among youths. METHODS: Data were collected in 2000-2001 using computer-assisted, self-administered interviews with youths aged 9-17 years (n = 652). RESULTS: Latent variable structural equations models showed that skepticism was negatively associated with positive affect toward alcohol portrayals and positively with the desire to emulate characters portrayed in alcohol advertisements. These, in turn, predicted expectancies and liking of/desire for beer toys and brands, which predicted alcohol use. Parental guidance decreased alcohol use directly and indirectly by lessening influences of positive affect toward advertising. CONCLUSIONS: Media alcohol portrayals influence children's drinking through a progressive decision-making process, with its influence underestimated by typical exposure-and-effects analyses.: PURPOSE: To investigate, using an information processing model, how persuasive media messages for alcohol use lead to concurring beliefs and behaviors among youths. METHODS: Data were collected in 2000-2001 using computer-assisted, self-administered interviews with youths aged 9-17 years (n = 652). RESULTS: Latent variable structural equations models showed that skepticism was negatively associated with positive affect toward alcohol portrayals and positively with the desire to emulate characters portrayed in alcohol advertisements. These, in turn, predicted expectancies and liking of/desire for beer toys and brands, which predicted alcohol use. Parental guidance decreased alcohol use directly and indirectly by lessening influences of positive affect toward advertising. CONCLUSIONS: Media alcohol portrayals influence children's drinking through a progressive decision-making process, with its influence underestimated by typical exposure-and-effects analyses.

Carol Cunradi

Cunradi, C. B., Ragland, D. R., Greiner, B., Klein, M., & Fisher, J. M. (2005). Attributable risk of alcohol and other drugs for crashes in the transit industry. Injury Prevention, 11(6), 378-382.

Abstract: OBJECTIVE: To estimate the impact of employee alcohol and drug use on crashes in the transit industry from 1995-2000. DESIGN: Secondary analysis of federally mandated post crash and random alcohol and drug testing results. SETTING: The US transit industry. SUBJECTS: Transit industry employees. MAIN OUTCOME MEASURES: Relative risk (RR), population attributable risk (PAR), and population attributable risk percentage (PAR%). RESULTS: For alcohol testing, the estimated PAR% ranged from 0.02% (1999) to 0.03% (1995). For drug testing, the estimated PAR% ranged from 0.38% (1998) to 0.67% (1997). Based on these calculations, the estimated number of crashes per 1000 crashes attributable to alcohol was less than one during 1995-2000, and the number attributable to drugs ranged from about four to about six. The number of crashes attributable to either alcohol or drugs did not vary greatly from 1995-2000. Estimated rates of crashes attributable to alcohol or drugs were substantially lower in 1995, the first year of testing, than had been projected based on previous estimates, and did not show substantial change from 1995-2000. CONCLUSIONS: Approaches to transit safety based on reducing employee use of alcohol and other drugs have modest potential for reducing number of fatalities, injuries, and crashes.: OBJECTIVE: To estimate the impact of employee alcohol and drug use on crashes in the transit industry from 1995-2000. DESIGN: Secondary analysis of federally mandated post crash and random alcohol and drug testing results. SETTING: The US transit industry. SUBJECTS: Transit industry employees. MAIN OUTCOME MEASURES: Relative risk (RR), population attributable risk (PAR), and population attributable risk percentage (PAR%). RESULTS: For alcohol testing, the estimated PAR% ranged from 0.02% (1999) to 0.03% (1995). For drug testing, the estimated PAR% ranged from 0.38% (1998) to 0.67% (1997). Based on these calculations, the estimated number of crashes per 1000 crashes attributable to alcohol was less than one during 1995-2000, and the number attributable to drugs ranged from about four to about six. The number of crashes attributable to either alcohol or drugs did not vary greatly from 1995-2000. Estimated rates of crashes attributable to alcohol or drugs were substantially lower in 1995, the first year of testing, than had been projected based on previous estimates, and did not show substantial change from 1995-2000. CONCLUSIONS: Approaches to transit safety based on reducing employee use of alcohol and other drugs have modest potential for reducing number of fatalities, injuries, and crashes.

Carol Cunradi, Genevieve Ames, & Roland Moore

Cunradi, C., Ames, G., & Moore, R. (2005). Prevalence and correlates of interpersonal violence victimization in a junior enlisted Navy cohort. Violence and Victims, 20(6), 679-694.

Abstract: This study assesses the prevalence and correlates of interpersonal violence victimization in a cohort of 493 male and 220 female junior Navy personnel who participated in a cross-sectional follow-up study on health-related behaviors. Survey data were obtained during 2000 about past-year prevalence of physical violence and sexual victimization. Chi-square tests of independence and multivariable logistic regression analyses were employed to estimate prevalence rates and to assess correlates of interpersonal violence. No gender differences were found for rates of violence victimization (16.4%) or sexual victimization (4.5%). Significant correlates of interpersonal violence victimization among males were depression and tobacco use; among females, significant correlates were depression and frequent heavy drinking. Findings suggest that large numbers of young enlisted adults serving in the military may be victims of interpersonal violence.: This study assesses the prevalence and correlates of interpersonal violence victimization in a cohort of 493 male and 220 female junior Navy personnel who participated in a cross-sectional follow-up study on health-related behaviors. Survey data were obtained during 2000 about past-year prevalence of physical violence and sexual victimization. Chi-square tests of independence and multivariable logistic regression analyses were employed to estimate prevalence rates and to assess correlates of interpersonal violence. No gender differences were found for rates of violence victimization (16.4%) or sexual victimization (4.5%). Significant correlates of interpersonal violence victimization among males were depression and tobacco use; among females, significant correlates were depression and frequent heavy drinking. Findings suggest that large numbers of young enlisted adults serving in the military may be victims of interpersonal violence.

Paul Gruenewald

Wood, D. S., & Gruenewald, P. J. (2006). Local alcohol prohibition, police presence and serious injury in isolated Alaska Native villages. Addiction, 101(3), 393-403.

Abstract: AIMS: To consider the effects of alcohol prohibition and police presence upon serious injury in isolated Alaska Native villages. DESIGN: We compared rates of injury attributed to assault, self-harm, motor vehicle collisions and 'other causes' between villages with or without local prohibition and between villages with or without local police. Negative binomial regression was used to assess the relative effects of prohibition and police presence upon serious injury rates net of potential confounders. PARTICIPANTS: A total of 132 isolated Alaska Native villages between the years 1991 through 2000. MEASUREMENTS; Serious injury was measured using Alaska Trauma Registry and Alaska Bureau of Vital Statistics death certificate records. Local option election records were used to classify cases as occurring in wet or dry villages and police deployment records were used to classify cases as occurring in villages with or without local police. Village-level statistics from the 1990 and 2000 US censuses were used in the negative binomial regression analyses. FINDINGS: Villages that prohibited alcohol had lower age-adjusted rates of serious injury resulting from assault, motor vehicle collisions and 'other causes'. Dry villages with a local police presence had a lower age-adjusted rate of serious injury caused by assault. Controlling for the relative effects of village isolation, access to alcohol markets and local demographic structures, local prohibition was associated with lower rates of assault injuries and 'other causes' injuries while local police presence was associated with lower rates of assault injuries. CONCLUSIONS: Residents of isolated Alaska Native villages are safer when they prohibit alcohol. A local police presence in dry villages provides further reduction of the incidence of assault.: AIMS: To consider the effects of alcohol prohibition and police presence upon serious injury in isolated Alaska Native villages. DESIGN: We compared rates of injury attributed to assault, self-harm, motor vehicle collisions and 'other causes' between villages with or without local prohibition and between villages with or without local police. Negative binomial regression was used to assess the relative effects of prohibition and police presence upon serious injury rates net of potential confounders. PARTICIPANTS: A total of 132 isolated Alaska Native villages between the years 1991 through 2000. MEASUREMENTS; Serious injury was measured using Alaska Trauma Registry and Alaska Bureau of Vital Statistics death certificate records. Local option election records were used to classify cases as occurring in wet or dry villages and police deployment records were used to classify cases as occurring in villages with or without local police. Village-level statistics from the 1990 and 2000 US censuses were used in the negative binomial regression analyses. FINDINGS: Villages that prohibited alcohol had lower age-adjusted rates of serious injury resulting from assault, motor vehicle collisions and 'other causes'. Dry villages with a local police presence had a lower age-adjusted rate of serious injury caused by assault. Controlling for the relative effects of village isolation, access to alcohol markets and local demographic structures, local prohibition was associated with lower rates of assault injuries and 'other causes' injuries while local police presence was associated with lower rates of assault injuries. CONCLUSIONS: Residents of isolated Alaska Native villages are safer when they prohibit alcohol. A local police presence in dry villages provides further reduction of the incidence of assault.

Gruenewald, P. J. (2006). Licensed premises: law & practice. Addiction, 101(3), 459-460.

Calverton

Wurst, F. M., Dresen, S., Allen, J. P., Wiesbeck, G., Graf, M., & Weinmann, W. (2006). Ethyl sulphate: A direct ethanol metabolite reflecting recent alcohol consumption. Addiction, 101(2), 204-211.

Background Ethyl sulphate (EtS), a direct ethanol metabolite, appears to offer potential as a biomarker for recent alcohol consumption. Although its window of assessment is similar to that of ethyl glucuronide (EtG), there are differences between the two markers in their pathways for formation and degradation. Aims (a) To assess the excretion of EtS compared to EtG and ethanol in drinking experiments with healthy volunteers, and (b) to elucidate the possibility of using the two metabolites for monitoring abstinence in substance use disorder patients during rehabilitation treatment. Design, setting, participants (a) Nine drinking experiments were performed by six healthy volunteers (two females, four males), with a mean age of 34.1 years (20-62), average oral intake of 0.2 g/kg ethanol (0.1-0.61), and having 74 spot urine samples. (b) Thirty-six substance abuse patients (mean age 41.9 years, 20-59; 22 males, 14 females) in a rehabilitation programme after withdrawal, producing 98 urine samples. Ethyl glucuronide and ethyl sulphate were measured using liquid chromatography tandem mass spectrometry (LC-MS/MS) using d₅-EtG and d₅-EtS, respectively, as an internal standard. Findings (a) Volunteers: EtG and EtS were detectable for up to 36 hours and reached the limits of determination in urine at 20.6 hours and 21.2 hours (median), respectively, after ethanol intake. EtG-100 (standardized to a creatinine of 100 mg/dl) reached its maximum level at 2.8 hours and EtS-100 at 2.1 hours (median) after the beginning of the experiment. Of the ethanol ingested, 0.022% was excreted as EtS in one volunteer. Eight samples were positive for EtS only and six for EtG only. Spearman's rank correlation coefficients of 0.84 ( P < 0.0001) between EtG and EtS and 0.87 ( P < 0.0001) between EtG-100 and EtS-100 were found. (b) Patients: of the 98 urine samples evaluated, 27 were positive for EtS and of these only 20 were also positive for EtG.

David Levy

Levy, D. T., Bauer, J. E., & Lee, H.-r. (2006). Simulation modeling and tobacco control: Creating more robust public health policies. American Journal of Public Health, 96(3), 494-498.

Abstract: Although previous empirical studies have shown that tobacco control policies are effective at reducing smoking rates, such studies have proven of limited effectiveness in distinguishing how the effect of policies depend on the other policies in place, the length of adjustment period, the way the policy is implemented, and the demographic groups considered. An alternative and complementary approach to purely statistical equations is simulation models. We describe the SimSmoke simulation model and how we used it to assess tobacco control policy in a specific case study. Simulation models are not only useful for policy prediction and planning but also may help to broaden our understanding of the role of different public health policies within a complex, dynamic social system.

Raamses Rider, Tara Kelley-Baker, Bob Voas, Bernie Murphy, & Jim McKnight

Rider, R., Kelley-Baker, T., Voas, R. B., Murphy, B., McKnight, A. J., & Levings, C. (2006). The impact of a novel educational curriculum for first-time DUI offenders on intermediate outcomes relevant to DUI recidivism. Accident; Analysis And Prevention, 38(3), 482-489.

The Preventing Alcohol-Related Convictions (PARC) program is a novel educational curriculum for first-time DUI offenders, with the ultimate goal of reducing DUI recidivism. It differs from traditional DUI education and prevention programs in that it does not suggest to DUI offenders that they must abstain from alcohol entirely or control their drinking to prevent a future DUI; rather, it teaches students to prevent a future DUI by not driving their cars to drinking events. Thus, the emphasis of the curriculum is on controlling driving rather than controlling drinking to avoid future DUI convictions. The implementation of the program is ongoing throughout the state of Florida. The current randomized study focused on intermediate outcomes relevant for DUI recidivism; specifically, individuals' readiness for change regarding drinking and driving, and their endorsement of a PARC planning and action approach (controlling driving) versus a traditional approach (controlling drinking). The current research demonstrated that the PARC program is effective in moving participants toward more readiness for change and toward a strategy of planning ahead to avoid driving to any venue in which drinking may occur. Future research will assess the ultimate effect on DUI recidivism.: The Preventing Alcohol-Related Convictions (PARC) program is a novel educational curriculum for first-time DUI offenders, with the ultimate goal of reducing DUI recidivism. It differs from traditional DUI education and prevention programs in that it does not suggest to DUI offenders that they must abstain from alcohol entirely or control their drinking to prevent a future DUI; rather, it teaches students to prevent a future DUI by not driving their cars to drinking events. Thus, the emphasis of the curriculum is on controlling driving rather than controlling drinking to avoid future DUI convictions. The implementation of the program is ongoing throughout the state of Florida. The current randomized study focused on intermediate outcomes relevant for DUI recidivism; specifically, individuals' readiness for change regarding drinking and driving, and their endorsement of a PARC planning and action approach (controlling driving) versus a traditional approach (controlling drinking). The current research demonstrated that the PARC program is effective in moving participants toward more readiness for change and toward a strategy of planning ahead to avoid driving to any venue in which drinking may occur. Future research will assess the ultimate effect on DUI recidivism.

Eduardo Romano, Bob Voas, & Scott Tippetts

Romano, E., Voas, R., & Tippetts, S. (2006). Stop sign violations: The role of race and ethnicity on fatal crashes. Journal Of Safety Research, 37(1), 1-7.

INTRODUCTION: In contrast to age, education, and gender, which have been studied more frequently, the role of race/ethnicity in shaping fatal stop sign running incidents has received relatively little attention. It has been shown that failing to follow traffic laws and regulations is a major cause of motor vehicle crashes (MVCs) in Latin America. Does this driving behavior in Latin America correspond to the Hispanic community in the United States? Are Hispanics more likely to be at-fault concerning stop sign crossing than other racial/ethnic groups in the United States? METHOD: We took advantage of a 1990-1996 Fatality Analysis Reporting System (FARS) file with additional racial/ethnic information. Our file consisted of drivers who died in a MVC that occurred in an intersection where a stop sign was in place that involved one or more drivers with at least one of them failing to obey the traffic device. Descriptive statistics and logistic regressions were applied. RESULTS: Overall, we found no direct difference between African-American, White, and Hispanic drivers regarding stop sign running. However, we found that race/ethnicity does play an indirect role on this problem through its impact on drinking and driving as well as its interaction with age and gender. CONCLUSIONS: We found a picture that is much more complex than what the initial hypothesis postulated. Race/ethnicity seems to play a role in shaping fatal stop sign running incidents, but the mechanisms by which such a role is played are complex and not fully understood. IMPACT ON INDUSTRY: The incidence and cost of fatal stop sign running crashes may be reduced if prevention policies targeting the most vulnerable groups could be developed.: INTRODUCTION: In contrast to age, education, and gender, which have been studied more frequently, the role of race/ethnicity in shaping fatal stop sign running incidents has received relatively little attention. It has been shown that failing to follow traffic laws and regulations is a major cause of motor vehicle crashes (MVCs) in Latin America. Does this driving behavior in Latin America correspond to the Hispanic community in the United States? Are Hispanics more likely to be at-fault concerning stop sign crossing than other racial/ethnic groups in the United States? METHOD: We took advantage of a 1990-1996 Fatality Analysis Reporting System (FARS) file with additional racial/ethnic information. Our file consisted of drivers who died in a MVC that occurred in an intersection where a stop sign was in place that involved one or more drivers with at least one of them failing to obey the traffic device. Descriptive statistics and logistic regressions were applied. RESULTS: Overall, we found no direct difference between African-American, White, and Hispanic drivers regarding stop sign running. However, we found that race/ethnicity does play an indirect role on this problem through its impact on drinking and driving as well as its interaction with age and gender. CONCLUSIONS: We found a picture that is much more complex than what the initial hypothesis postulated. Race/ethnicity seems to play a role in shaping fatal stop sign running incidents, but the mechanisms by which such a role is played are complex and not fully understood. IMPACT ON INDUSTRY: The incidence and cost of fatal stop sign running crashes may be reduced if prevention policies targeting the most vulnerable groups could be developed.

Chapel Hill

Campbell, J. C., Martin, S. L., Moracco, K. E., Manganello, J. A., & Macy, R. J. (2006). Survey data sets pertinent to the study of intimate partner violence and health. Trauma Violence & Abuse, 7(1), 3-18.

Abstract: Knowledge regarding intimate partner violence has evolved from a somewhat fragmentary and incomplete understanding of the topic to a more cohesive, multifaceted body of research. Despite these accomplishments, there are still many critical knowledge gaps about this important problem. In this age of fiscal restraint, using existing information to address research questions is extremely appealing. This article describes some currently available survey data sets that contain information regarding women's experiences of intimate partner violence and health, identifies a number of the strengths and limitations of these data sets, and makes recommendations concerning the types of survey data that should be gathered in the future to help move the field forward.: Knowledge regarding intimate partner violence has evolved from a somewhat fragmentary and incomplete understanding of the topic to a more cohesive, multifaceted body of research. Despite these accomplishments, there are still many critical knowledge gaps about this important problem. In this age of fiscal restraint, using existing information to address research questions is extremely appealing. This article describes some currently available survey data sets that contain information regarding women's experiences of intimate partner violence and health, identifies a number of the strengths and limitations of these data sets, and makes recommendations concerning the types of survey data that should be gathered in the future to help move the field forward.

Providence

Maisto, S. A., Zywiak, W. H., & Connors, G. J. (2006). Course of functioning 1 year following admission for treatment of alcohol use disorders. Addictive Behaviors, 31, 69-79.

Abstract: Research on alcohol treatment outcomes has the potential to advance knowledge about how treatment combines with other variables to influence post treatment course of functioning. The purpose of this study was to replicate and extend [Connors, G. J., Maisto, S. A., & Zywiak, W. H. (1996). Understanding relapse in the broader context of post-treatment functioning. Addiction, 91 (Suppl.), S173-S189] test of a multivariate model of course by testing the model''s fit to data from a larger sample and the use of stronger statistical methods. The participants were 400 men and women presenting for alcohol treatment in two cities in the US. These individuals completed a pretreatment (baseline) assessment battery at treatment initiation and then completed follow-up assessments bimonthly for a period of 1 year. The model included pretreatment, treatment (months 1-6), and post-baseline (months 1-6) factors to predict alcohol use (percent days abstinent, drinks/drinking day, and total number drinks/month, all for months 7-12). The application of structural equation modeling methods revealed that the model fit the data adequately for all three dependent variables, with the major significant findings of direct effects of treatment setting, coping skills, and the mediation of treatment effects through coping skills. Overall, the data replicated several findings from the Connors et al.'s study and point to the importance of investigating the mechanisms underlying treatment effects and the mediation of treatment effects by coping skills in future research.: Abstract: Research on alcohol treatment outcomes has the potential to advance knowledge about how treatment combines with other variables to influence post treatment course of functioning. The purpose of this study was to replicate and extend [Connors, G. J., Maisto, S. A., & Zywiak, W. H. (1996). Understanding relapse in the broader context of post-treatment functioning. Addiction, 91 (Suppl.), S173-S189] test of a multivariate model of course by testing the model's fit to data from a larger sample and the use of stronger statistical methods. The participants were 400 men and women presenting for alcohol treatment in two cities in the US. These individuals completed a pretreatment (baseline) assessment battery at treatment initiation and then completed follow-up assessments bimonthly for a period of 1 year. The model included pretreatment, treatment (months 1-6), and post-baseline (months 1-6) factors to predict alcohol use (percent days abstinent, drinks/drinking day, and total number drinks/month, all for months 7-12). The application of structural equation modeling methods revealed that the model fit the data adequately for all three dependent variables, with the major significant findings of direct effects of treatment setting, coping skills, and the mediation of treatment effects through coping skills. Overall, the data replicated several findings from the Connors et al.'s study and point to the importance of investigating the mechanisms underlying treatment effects and the mediation of treatment effects by coping skills in future research.

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