Expanding our understanding of long-term trends in alcohol abstention and consumption in England (2001–19) using two age–period–cohort approaches

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2024-07-22 DOI:10.1111/add.16599

Magdalena Opazo Breton, Madeleine Henney, Inge Kersbergen, Alan Brennan, John Holmes

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Abstract

Background and aims

Alcohol consumption has decreased in England in recent decades, while alcohol-specific death rates have remained relatively stable. Age–period–cohort (APC) models offer the potential for understanding these paradoxical trends. This study aimed to use an APC model approach to measure long-term trends in alcohol abstention and consumption in England from 2001 to 2019.

Design, setting and participants

The study used grouped and proxy-variable APC models of repeat cross-sectional survey data, set in England (2001–19). Participants were residents in England aged 13 years or over who took part in the Health Survey for England.

Measurements

Outcome variables were alcohol abstention and consumption in units. We created nine age groups (13–15, 16–17, 18–24, 25–34, until 65–74 and 75+, reference 45–54 years), four periods (2001–04, 2005–09, 2010–14 to 2015–19, reference 2005–09) and 18 5-year birth cohorts (1915–19 to 2000–04, reference 1960–64). We proxied age effects (systolic and diastolic blood pressure), period effects (alcohol affordability, internet usage and household alcohol expenditure) and birth cohort effects (prevalence of smoking and prevalence of overweight).

Findings

The odds of abstaining were considerably larger at young ages, 13–15 years [odds ratio (OR) = 5.38; 95% confidence interval (CI) = 4.50–6.43], were lowest during the first period, 2001–04 (OR = 0.83; 95% CI = 0.79–0.86) and had a U-shaped pattern by birth cohort. For units of alcohol, the incidence rate ratio (IRR) increased until age 18–24 years (IRR = 1.41, 95% CI = 1.34–1.48) and decreased afterwards, were highest during the first period, 2001–04 (IRR = 1.07; 95% CI = 1.05–1.08) and showed an inverted J-shape by birth cohort. Our proxy variable approach revealed that using blood pressure measures, alcohol affordability and prevalence of overweight as proxies resulted in APC effects that differed from our base-case model. However, internet usage, household expenditure on alcohol and smoking prevalence resulted in APC effects similar to our base-case model.

Conclusions

The discrepancy between decreasing alcohol consumption and increasing alcohol-related deaths observed in England from 2001 to 2019 may, in part, be explained by the halt in abstention trends since 2010 and a slight consumption decline since 2001.

Abstract Image

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利用两种年龄段队列方法，扩大我们对英格兰禁酒和饮酒长期趋势（2001-19 年）的了解。

背景和目的：近几十年来，英格兰的酒精消费量有所下降，而酒精致死率却保持相对稳定。年龄-时期-队列（APC）模型为理解这些自相矛盾的趋势提供了可能。本研究旨在使用 APC 模型方法测量 2001 年至 2019 年英格兰酒精戒断和消费的长期趋势：本研究采用分组和邻近变量 APC 模型，对英格兰（2001-19 年）的重复横截面调查数据进行分析。参与者为参加英格兰健康调查的 13 岁或以上英格兰居民：结果变量为禁酒和单位消费量。我们创建了 9 个年龄组（13-15 岁、16-17 岁、18-24 岁、25-34 岁、65-74 岁和 75 岁以上，参考 45-54 岁）、4 个时期（2001-04 年、2005-09 年、2010-14 年至 2015-19 年，参考 2005-09 年）和 18 个 5 年出生队列（1915-19 年至 2000-04 年，参考 1960-64 年）。我们对年龄效应（收缩压和舒张压）、时期效应（饮酒负担能力、互联网使用率和家庭饮酒支出）和出生队列效应（吸烟率和超重率）进行了代用：13-15岁青少年的戒酒几率要大得多[几率比（OR）=5.38；95%置信区间（CI）=4.50-6.43]，2001-04年第一阶段的戒酒几率最低（OR=0.83；95%CI=0.79-0.86），出生队列的戒酒几率呈U形模式。就酒精单位而言，发病率比（IRR）在 18-24 岁之前上升（IRR = 1.41，95% CI = 1.34-1.48），之后下降，在 2001-04 年的第一阶段最高（IRR = 1.07；95% CI = 1.05-1.08），并且按出生队列呈倒 "J "形。我们的替代变量方法显示，使用血压测量、酒精负担能力和超重流行率作为替代变量所产生的 APC 效果与我们的基础模型不同。然而，使用互联网、家庭酒精支出和吸烟率所产生的 APC 效果与我们的基础模型相似：从 2001 年到 2019 年，在英格兰观察到的酒精消费量下降与酒精相关死亡人数增加之间的差异，部分原因可能是自 2010 年以来戒酒趋势的停止以及自 2001 年以来消费量的轻微下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.