Kasey G. Creswell, Brooke J. Arterberry, Megan E. Patrick
{"title":"Historical trends in young adult solitary alcohol use by age and sex from 1977 to 2022","authors":"Kasey G. Creswell, Brooke J. Arterberry, Megan E. Patrick","doi":"10.1111/acer.70103","DOIUrl":"10.1111/acer.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Solitary alcohol use among young adults is a risky drinking behavior associated with concurrent and future alcohol use disorder (AUD) and negative psychosocial outcomes. However, data on its prevalence and historical trends in the general population are limited. We examined historical trends in solitary alcohol use among US young adults (aged 19–30) by age and sex over a 46-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were from the Monitoring the Future (MTF) Panel study collected between 1977 and 2022. The sample included 12,851 participants (51.6% female) who reported past-year alcohol use and completed surveys at ages 19/20, 21/22, 23/24, 25/26, 27/28, and 29/30. Solitary alcohol use was assessed by self-report of drinking alone in the past year. Joinpoint regression analyses examined historical trends in the prevalence of solitary alcohol use by age and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately 40% of those who used alcohol in the past year reported engaging in solitary alcohol use at least once in the past year. Across all age groups, the prevalence of past-year solitary alcohol use initially decreased and then increased over time. Significant joinpoints indicated shifts in trends beginning in the mid-1990s to early 2000s, with increases more pronounced among females.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of solitary alcohol use among US young adults has increased in recent decades, to levels on par with what was observed in the late 1970s. Particular increases among females since late 1990s/early 2000s have narrowed the traditional sex gap in this risky drinking behavior. Given the association of solitary drinking with concurrent and future alcohol problems, these findings highlight the need for continued monitoring of solitary alcohol use among young adults, especially females.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"49 8","pages":"1759-1767"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriel P. A. Costa, Rebecca Suh, Julio C. Nunes, Brian Pittman, Mehmet Sofuoglu, Ismene Petrakis, Joao P. De Aquino
{"title":"Pain interference, alcohol use, and metabolic health: Insights from a nationally representative study","authors":"Gabriel P. A. Costa, Rebecca Suh, Julio C. Nunes, Brian Pittman, Mehmet Sofuoglu, Ismene Petrakis, Joao P. De Aquino","doi":"10.1111/acer.70108","DOIUrl":"10.1111/acer.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic pain, heavy alcohol use, and metabolic dysfunction frequently cooccur, yet their interrelationships remain inadequately characterized, contributing to fragmented therapeutic approaches. This study quantifies independent and interactive associations between these conditions and pain interference in a nationally representative sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional analysis of 30,442 adults (51.1% women) participating in the 2007–2012 National Health and Nutrition Examination Survey (NHANES), representing an estimated 301,890,165 US adults. Primary exposures included heavy alcohol use (defined by National Institute on Alcohol Abuse and Alcoholism criteria), metabolic dysfunction (indexed by obesity status, Triglyceride-Glucose Index [TyG], and Systemic Inflammation Index [SII]), and sleep duration. Our main outcome was pain interference, measured as days in the past 30 days during which pain disrupted usual activities. We utilized survey-weighted quasi-Poisson regression models, adjusting for age, gender, and race/ethnicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Heavy alcohol use was independently associated with 34% more days of pain interference (IRR = 1.34, 95% CI = 1.16–1.55), while obesity was associated with a 50% increase (IRR = 1.50, 95% CI = 1.35–1.67). Higher TyG (IRR = 1.19, 95% CI = 1.10–1.30) and SII (IRR = 1.01, 95% CI = 1.01–1.02) were also consistently associated with increased pain interference. The interaction between heavy alcohol use and obesity suggested additive rather than synergistic effects (IRR = 0.82, 95% CI = 0.65–1.05). Each additional hour of sleep was associated with a 14% reduction in pain interference (IRR = 0.86, 95% CI = 0.83–0.88). In a secondary analysis (<i>n</i> = 9756), higher physical activity was associated with 10% fewer days of pain interference (IRR = 0.90, 95% CI = 0.87–0.93).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Heavy alcohol use and metabolic dysfunction demonstrate independent, additive effects on pain interference, with concurrent conditions corresponding to maximal days of pain interference. Sleep duration and physical activity emerge as potentially modifiable protective factors. These findings support the implementation of integrated therapeutic approaches targeting multiple pathophysiological domains to optimize clinical outcomes in this complex patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"49 8","pages":"1768-1777"},"PeriodicalIF":2.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Biomedical and behavioral research on alcohol and youth: Celebrating the alcohol research career achievements of Dr. Linda Patia Spear.","authors":"Marisa M Silveri","doi":"10.1111/acer.70104","DOIUrl":"10.1111/acer.70104","url":null,"abstract":"","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Næsborg Schøler, Anette Søgaard Nielsen, Katie Witkiewitz, Michael Bogenschutz, Randi Bilberg, Angelina Isabella Mellentin, Kjeld Andersen
{"title":"Relief craving severity moderates nonpharmacological treatment outcomes in treatment-seeking older adults with alcohol use disorder","authors":"Peter Næsborg Schøler, Anette Søgaard Nielsen, Katie Witkiewitz, Michael Bogenschutz, Randi Bilberg, Angelina Isabella Mellentin, Kjeld Andersen","doi":"10.1111/acer.70097","DOIUrl":"10.1111/acer.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Craving alcohol for reward (positive reinforcement) and relief (negative reinforcement) has been proposed as useful phenotypes for precision medicine approaches to alcohol use disorder (AUD) treatment. This study examined reward and relief craving in nonpharmacological treatments, Motivational Enhancement Therapy (MET) versus MET + Community Reinforcement Approach (CRA), among older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Secondary analyses of data from The Elderly Study (<i>N</i> = 693; mean age 64.0 years; male 59.7%), a single-blinded, multisite, randomized controlled trial of two nonpharmacological treatments in an elderly population (60+ years) diagnosed with DSM-5 AUD. Latent profile analysis (LPA) was used to identify craving profiles based on The Alcohol Abstinence Self-Efficacy Scale (AASE) temptation subscale scores. The classification performance of clinical cutoff scores on the AASE scale was tested against the LPA solution. Associations between cutoff-based craving groups and treatment success (binary variable representing change in alcohol consumption and quality of life across profiles pre-/posttreatment) were analyzed using logistic regression, stratified on MET versus MET + CRA. Differences in alcohol consumption and quality of life scores pre-/posttreatment were analyzed using the Wilcoxon signed-rank test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four reward-relief craving profiles were identified but were more distinguished by variation in relief craving (low relief, medium-low relief, medium-high relief, and high relief). Compared to the low relief craving group, the medium-high relief craving group had lower odds for treatment success when receiving MET: adjusted Odds Ratio (aOR) 0.42 (95% CI 0.21–0.84), and the high relief craving group had lower odds for treatment success when receiving MET + CRA: aOR 0.38 (95% CI 0.15–0.94). Alcohol consumption was reduced, and psychological quality of life was improved at follow-up across all relief craving groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified reward and relief drinking craving among older adults with AUD. Results indicate that considering relief craving when offering nonpharmacological treatment to older adults suffering from AUD may be clinically relevant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"49 8","pages":"1803-1817"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acer.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Articles of Public Interest","authors":"","doi":"10.1111/acer.70096","DOIUrl":"https://doi.org/10.1111/acer.70096","url":null,"abstract":"","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"49 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Kautz-Turnbull, M. Rockhold, E. Speybroeck, J. Myers, C. L. M. Petrenko
{"title":"Preventing exclusionary discipline and adverse life experiences in FASD: Teachers' ability to recognize students with FASD in the classroom and develop and implement preventative strategies to support learning and behavior","authors":"C. Kautz-Turnbull, M. Rockhold, E. Speybroeck, J. Myers, C. L. M. Petrenko","doi":"10.1111/acer.70100","DOIUrl":"10.1111/acer.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>People with fetal alcohol spectrum disorders (FASD) experience significant behavioral and academic challenges and high rates of exclusionary discipline practices (EDP). This study investigated teachers' perspectives on barriers and facilitators to recognizing students with FASD in the classroom, and how teachers develop and use preventative strategies to support students with FASD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Qualitative interviews were conducted with 23 teachers with experience educating students with FASD. Data analysis used a phenomenological approach and content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Teachers identified barriers to recognition of students with FASD, including lack of diagnosis, stigma and discrimination, variability and inconsistency in skills, and compensatory strategies. Experienced teachers could recognize students with FASD and effectively supported students by tailoring existing strategies to the student's profile, building a positive relationship with the student, reframing their understanding of the student's behavior, and collaborating with others.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results indicate experienced teachers' potential to reduce adverse outcomes and EDP for students with FASD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"49 8","pages":"1828-1838"},"PeriodicalIF":2.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Upregulation of E3 ligase UBR2 in acetaldehyde-treated C2C12 myotubes and its potential involvement in fast-twitch muscle atrophy in alcohol-fed rats","authors":"Kaori Shintani-Ishida, Hiroshi Ikegaya","doi":"10.1111/acer.70102","DOIUrl":"10.1111/acer.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic alcohol intake induces atrophy of type II (anaerobic, fast-twitch) muscle fibers in preference to type I (aerobic, slow-twitch) muscle fibers. However, the molecular mechanism underlying the preferential atrophy of type II muscle fibers remains unclear. The ubiquitin-proteasome system (UPS) mediates the degradation of myofibrillar proteins in skeletal muscle loss. This study investigated whether E3 ubiquitin ligases, including UBR2 and MuRF1, are involved in ethanol-induced type II muscle fiber-specific atrophy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a chronic alcohol intake rat model, 4- to 5-week-old male Wistar rats were fed the Lieber-DeCarli liquid diet for 8 weeks. Muscle specimens were collected from the extensor digitorum longus (EDL) and soleus muscles of both legs. In an in vitro model, myotubes differentiated from murine C2C12 myoblasts were treated with culture medium containing 100 mM ethanol or 1 mM acetaldehyde for 6 h.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The muscle weight of the EDL seemed to be lesser in the ethanol group compared to the control group, and there was no difference in the muscle weight of the soleus between these groups. Cross-sectional area (CSA) of type IIA, IIB, and IIX muscle fibers in the EDL of ethanol-fed rats was smaller compared to the control rats, and CSA of type I muscle fibers in the soleus was larger in ethanol-fed rats. UBR2 protein levels seem to increase in the EDL but not in the soleus, whereas MuRF1 protein level remained unchanged in both muscles. C2C12 myotubes expressing MHC IIb, characteristics of type IIB muscle fibers, showed reduced myotube diameter after ethanol or acetaldehyde treatment. Acetaldehyde treatment increased UBR2 expression, but not MuRF1 expression, and enhanced ubiquitination. Knockdown of UBR2 using siRNA prevented acetaldehyde-induced myotube atrophy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that the E3 ligase UBR2 may play a role in alcohol-induced type II muscle-preferential atrophy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"49 8","pages":"1667-1677"},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashley N. Linden-Carmichael, Shou-Chun Chiang, Walter Dyer, Sandesh Bhandari, Stephanie T. Lanza
{"title":"Comparing subjective effects and intoxication on simultaneous alcohol and cannabis use occasions relative to alcohol- or cannabis-only occasions","authors":"Ashley N. Linden-Carmichael, Shou-Chun Chiang, Walter Dyer, Sandesh Bhandari, Stephanie T. Lanza","doi":"10.1111/acer.70101","DOIUrl":"10.1111/acer.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Simultaneous use of alcohol and cannabis—or use of both substances so effects overlap—is common among college-attending young adults and can heighten one's likelihood of experiencing substance-related harms in daily life. Limited ecological momentary assessment and daily diary work have examined the role of subjective intoxication and subjective effects when engaging in simultaneous relative to alcohol- or cannabis-only use, and studies have yielded mixed results. As such, subjective experiences serve as important internal cues for decision making; this study aimed to examine the level of subjective intoxication and effects across simultaneous, alcohol-only, and cannabis-only occasions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were 119 college students aged 18–25 who reported weekly simultaneous use at baseline. Participants enrolled in a 4-week ecological momentary assessment study with up to eight prompts per day collected on weekend days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multilevel models revealed that relative to alcohol- and cannabis-only days, simultaneous use days were not significantly associated with subjective alcohol or cannabis intoxication, respectively. Peak levels of subjective alcohol effects were, however, significantly stronger during simultaneous use occasions relative to alcohol-only use occasions. Subjective cannabis effects were not significantly different between simultaneous and cannabis-only use days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Study findings suggest that “adding” cannabis to an alcohol use occasion may bolster subjective effects such as feeling clumsy, confused, and having difficulty concentrating. Findings also highlight that subjective effects, rather than degree of impairment/intoxication, more strongly differentiates alcohol and simultaneous use occasions, and may serve as a useful momentary intervention target in future work.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"49 8","pages":"1818-1827"},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pamela J. Trangenstein, Erika M. Rosen, Christina C. Tam, Jih-Cheng Yeh, Thomas K. Greenfield, David H. Jernigan
{"title":"Risky relationships: Secondhand harms and health indicators associated with college students' relationships with heavy drinkers","authors":"Pamela J. Trangenstein, Erika M. Rosen, Christina C. Tam, Jih-Cheng Yeh, Thomas K. Greenfield, David H. Jernigan","doi":"10.1111/acer.70083","DOIUrl":"10.1111/acer.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Heavy drinking is pervasive on college campuses, yet little is known about how heavy drinkers affect college students around them. People with versus without heavy drinkers in their lives often differ systematically, complicating such analyses. This study tested whether relationships with heavy drinkers were associated with alcohol-related harms to others (AHTOs) and related health indicators among college students after using propensity score weighting to account for demographic and behavioral differences between those with and without heavy drinkers in their lives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data were from a probability-based survey of 1901 US college students, recruited in November–December 2021 (16% response rate), 271 of whom had a heavy drinker in their life. There were two sets of outcomes: (1) AHTOs (i.e., harassment, physical, sexual) and (2) health indicators (i.e., frequent mental distress and service use because of someone else's drinking). Secondary models were stratified by the heavy drinker's relationship to the participant (i.e., intimate peer, other peer, and family member). To correct for multiple testing, <i>p</i>-values < 0.002 were considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In double-robust propensity score-weighted regressions, relationships with a heavy drinker (vs. not) were associated with harassment (aOR = 3.89 [2.05, 7.38]) and sexual AHTOs (aOR = 2.98 [1.29, 6.88]). Students with a heavy drinker in their life (vs. not) had greater odds of frequent mental distress (aOR = 2.05 [1.28, 3.29]) and service use because of someone else's drinking (aOR = 7.39 [3.32, 16.47]). All relationship types were associated with harassment and service use because of someone else's drinking. Relationships with heavy drinking other peers and family members were associated with frequent mental distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Relationships with a heavy drinker are associated with college AHTOs and health indicators.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72145,"journal":{"name":"Alcohol (Hanover, York County, Pa.)","volume":"49 7","pages":"1576-1586"},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}