Transition probabilities for four states of alcohol use in adolescence and young adulthood: what factors matter when?
Transition probabilities for four states of alcohol use in adolescence and young adulthood: what factors matter when?
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DOI：
10.1111/add.12985
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发表时间：
2015-08-01
期刊：
影响因子：
6
通讯作者：
Rehm, Juergen
中科院分区：
文献类型：
--
作者：
Probst, Charlotte;Moyo, Daniel;Rehm, Juergen
背景与目的Risky单次饮酒(RSOD)是一种健康威胁，特别是在较年轻的年龄。这项研究旨在量化戒酒、饮酒、经常饮酒和频繁饮酒之间的转移概率(TPS)，并了解TPS与关键人口统计学因素的关系。设计队列研究(基线，两次随访)。以德国慕尼黑及周边地区的青少年和青壮年人群为研究对象，采用马尔可夫模型来估计年度TPS和年龄、性别和社会经济状况(SES)的危险比(HRs)。参与者1995年基线年龄为14-25岁的3021人，在1998/1999(n=2548)和2003-2005(n=2210)进行了跟踪调查。在标准化访谈中评估了酒精使用、RSOD状况、年龄、性别和SES(主观经济状况)。较高的年龄[1年增加的危险比(HR)=0.87，95%可信区间(CI)=0.84~0.91]、女性(HR=0.30，95%CI=0.21~0.42)和高SES(HR=0.64，95%CI=0.43~0.97)与从使用到RSOD进展的低风险相关。虽然年龄主要与戒酒和饮酒之间的转变有关，但性别与RSOD和频繁的RSD相关的转变更相关。结论德国青少年和年轻人在戒酒、饮酒、危险单次饮酒和频繁危险单次饮酒的饮酒状态下趋于稳定。女性不太可能过渡到风险更高的状态，更有可能从频繁的高风险单次饮酒过渡回来，年龄越高，过渡风险越低，社会经济地位越高的参与者从饮酒过渡到高风险单次饮酒的可能性就越小。
Background and AimsRisky single-occasion drinking (RSOD) is a health threat, particularly at younger ages. The study aimed to quantify transition probabilities (TPs) between abstinence, use of alcohol, RSOD and frequent RSOD, and to understand how TPs are associated with key demographic factors.DesignCohort study (baseline, two follow-ups). A Markov model was fitted to estimate annual TPs and hazard ratios (HRs) for age, sex and socio-economic status (SES).SettingAdolescent and young adult general population of Munich (Germany) and surrounding areas.ParticipantsA total of 3021 people aged 14-25years at baseline in 1995 followed-up in 1998/1999 (n=2548) and 2003-2005 (n=2210).MeasurementsAlcohol use, RSOD status, age, sex and SES (subjective financial situation) were assessed in a standardized interview.FindingsThe highest TPs (>65%) were found for staying in the same drinking state. Higher age [hazard ratio (HR) for 1-year increase=0.87, 95% confidence interval (CI)=0.84-0.91], being female (HR=0.30, 95% CI=0.21-0.42), and a high SES (HR=0.64, 95% CI=0.43-0.97) were associated with a lower hazard to progress from use to RSOD. While age was associated predominantly with transitions between abstinence and alcohol use, sex was more relevant for transitions associated with RSOD and frequent RSOD.ConclusionsGerman adolescents and young adults tend to be stable in the drinking states of abstinence, use of alcohol, risky single-occasion drinking and frequent risky single-occasion drinking. Females are less likely to transition to riskier states and more likely to transition back from frequent risky single-occasion drinking, higher age is associated with lower hazard of transitioning and participants of higher socio-economic status are less likely to transition from use of alcohol' to risky single-occasion drinking'.