National Alcohol Surveys: Advancing Epidemiologic Analyses of 21st Century Drinking

摘要：全国酒精调查：21世纪饮酒的流行病学分析进展 危险的酒精使用仍然是世界上最常见的可预防的发病和死亡原因之一。 它体现了主要的种族/民族和其他差异。重复进行的国家代表性调查 时间提供了一种手段，以推进调查方法，监测酒精使用的总体趋势和分组， 及时调查与饮酒有关的健康问题。酒精研究小组及其中心 进行了一系列的国家酒精调查（NAS）四十年，并建议在这个项目中进行 2023-2024年的第15版NAS（称为N15）。通过实施N15，我们将作出回应， 通过采用多模式、自适应的调查设计，应对现代调查研究的挑战。这将 包括一个完全基于网络调查，使用基于地址的抽样以及概率和非概率网络小组。 此外，这将是第一个包括使用干血斑（DBS）收集生物样本的NAS。包括 该系列中的附加NAS将扩展可用于构建酒精最近变化的趋势数据 消费模式，这也是至关重要的年龄段队列模型，以了解组成部分， 这些趋势。利用2000-2020年的NAS系列数据，我们建议评估种族/民族和社会经济 酒精使用和酒精问题之间的差异，以及酒精使用模式和 使用因果推理方法的问题，包括基于酒精税估计的工具变量， 其他政策措施。这种方法还没有被应用到研究酒精相关的差异， 问题利用扩大的趋势数据，我们建议检查总趋势和饮料- 具体的酒精量，酒精使用障碍，以及从1979年开始酒精与大麻和其他药物的共同使用 或1984年，取决于措施的可用性，到2024年，年龄-时期-队列分解。酒精和 毒品共同使用，特别是大麻，特别是考虑到娱乐性大麻使用的合法化， 许多国家和正在发生的阿片类药物危机。心理困扰（PD）是阿片类药物危机的可能驱动因素， “绝望之死”最近的NAS版本包括PD的测量，这是一个常见的问题， 吸毒是一个已知的风险因素。然而，人们对个人和环境层面的调节因素了解较少 以及这种关系的生物调节剂。收集DBS样本将使炎症研究成为可能， 酒精使用和PD之间关系的生物介质，这可以为未来的研究提供信息， 预防干预。此外，更好地了解酒精之间关系的调节剂 使用和PD，从个人到社区水平的特点，可以帮助优先考虑群体接受 预防干预。总之，本项目提出的数据收集和分析可以促进 方法问题和实质性研究问题，以便更好地了解和处理 21世纪世纪饮酒及其趋势、相关因素和后果

ABSTRACT: National Alcohol Surveys: Advancing Epidemiologic Analyses of 21st Century Drinking Hazardous alcohol use remains one of the most common preventable causes of morbidity and mortality in the US and it manifests major racial/ethnic and other disparities. Nationally representative surveys repeated over time provide a means to advance survey methods, monitor trends in alcohol use overall and in sub-groups, and investigate timely health topics related to alcohol use. The Alcohol Research Group and its Center have conducted a series of National Alcohol Surveys (NAS) for forty years, and are proposing in this Project to conduct the 15th edition of the NAS in 2023-2024 (termed N15). Through the implementation of the N15 we will respond to challenges to modern-day survey research by employing a multi-mode, adaptive survey design. This will include a fully web-based survey using address-based sampling, and probability and non-probability web panels. Further, this will be the first NAS to include biosample collection using dried blood spots (DBS). Including an additional NAS in the series will expand the trend data available for framing recent changes in alcohol consumption patterns, which is also essential for age-period-cohort models for understanding components of these trends. With NAS series data from 2000-2020 we propose to evaluate racial/ethnic and socioeconomic disparities in alcohol use and alcohol problems, and risk relationships between alcohol use patterns and problems using causal inference methods including instrumental variables based on alcohol tax estimates and other policy measures. Such methods have yet to be applied to the study of disparities in alcohol-related problems. Capitalizing on the expanded trends data, we propose to examine trends for total and beverage- specific alcohol volume, alcohol use disorder, and co-use of alcohol with marijuana and other drugs from 1979 or 1984, dependent on the availability of measures, to 2024 with age-period-cohort decompositions. Alcohol and drug co-use, particularly cannabis, is especially timely given the legalization of recreational marijuana use in many states and the ongoing opioid crisis. Psychological distress (PD) is a likely driver of the opioid crisis and “deaths of despair”. Recent NAS editions have included measures of PD, a common problem for which alcohol use is a known risk factor. However, less well understood are the individual- and environmental-level moderators and biological mediators of this relationship. Collecting DBS samples will enable the study of inflammation as a biological mediator of the relationship between alcohol use and PD, which could inform future research and prevention interventions. Further, a better understanding of the moderators of the relationship between alcohol use and PD, from individual- to community-level characteristics, could help to prioritize groups to receive prevention interventions. In summary, this project proposes data collection and analyses that can advance both methodological issues and substantive research questions with the aim of better understanding and addressing 21st century drinking and its trends, correlates and consequences.