Jonathan K Noel, Julia A Dilley, Jessie Milne, Sybil Masse, Sean J Haley
{"title":"Youth digital alcohol marketing surveillance: assessing content on 2 social media platforms across 20 alcohol brands.","authors":"Jonathan K Noel, Julia A Dilley, Jessie Milne, Sybil Masse, Sean J Haley","doi":"10.1093/alcalc/agag022","DOIUrl":"https://doi.org/10.1093/alcalc/agag022","url":null,"abstract":"<p><strong>Aims: </strong>Alcohol advertising is causally linked to early alcohol initiation and other harms. We characterized the content of social media alcohol advertising, and documented compliance with alcohol industry guidelines intended to prevent risks to minors and other populations vulnerable to alcohol harms.</p><p><strong>Methods: </strong>In January and February 2024, 816 ads were gathered from Instagram, YouTube, and their respective ad libraries (Meta and Alphabet). Ads were selected for 20 alcohol brands representing the 5 top-selling brands within each of 4 major alcohol product categories: beer, spirits, seltzers, and ready-to-drink cocktails. Multiple team members reviewed each ad and documented features, themes, compliance with industry guidelines, and responses to the ads using a standard protocol based on prior research.</p><p><strong>Results: </strong>After removal of 148 exact duplicates, a sample of 309 ads were coded from the remaining 668 ads collected (46% of the sample). A total of 59% contained video. Common content included corporate branding (89%) and product display (68%). A total of 33% of ads, half of video ads (53%), and up to two-thirds (66%) of ads on one social media platform were non-compliant with industry guidelines. Ad views ranged from 13 to 37 million. Median user engagement (likes, shares, comments) was 79.5 per ad (range 0-168 240). User engagement was significantly higher for non-compliant ads vs. compliant ads (P = .007), although there was no difference in views (P = .263).</p><p><strong>Conclusions: </strong>Findings suggest a need for updating guidelines and stronger independent surveillance to monitor digital ad content to prevent messaging that may increase alcohol risks, especially for young people and other vulnerable populations.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Madison O Walsh, Matthew G Myers, Xiaoyu Liang, Kipling M Bohnert
{"title":"The social context of drinking and its association with days of heavy episodic drinking in the past month among a nationally representative sample of adolescents and young adults in the United States, 2021-23.","authors":"Madison O Walsh, Matthew G Myers, Xiaoyu Liang, Kipling M Bohnert","doi":"10.1093/alcalc/agag016","DOIUrl":"10.1093/alcalc/agag016","url":null,"abstract":"<p><strong>Introduction: </strong>Prior research links solitary drinking under the age of 21 years, the legal drinking age in the USA, with adverse health later in life. This study examines associations between the social context of drinking (i.e. drinking alone vs with others) and the frequency of heavy episodic drinking (HED) days in the past 30 days among 12-20-year-olds in the USA.</p><p><strong>Materials and methods: </strong>We aggregated National Survey on Drug Use and Health data from 2021 to 2023 for all individuals aged 12-20 years who drank alcohol in the past month (unweighted n = 6 261). The focal independent variable of interest was the social context of drinking in the past month, and the primary outcome was the categorical frequency of HED days in the past month. Weighted multinomial logistic regression was used to estimate associations, adjusting for sociodemographic factors.</p><p><strong>Results: </strong>Drinking alone, compared to drinking with others, was associated with a higher likelihood of HED on 20-30 days in the past month compared to 0 days in the adjusted model [relative risk ratio: 5.48, 95% confidence interval: 2.45, 12.25].</p><p><strong>Conclusions: </strong>Among this nationally representative sample of adolescents and young adults under the legal drinking age in the USA who drank alcohol in the past month, we found that drinking alone compared to drinking with others was associated with the highest frequency of HED days in the past month. This association was not observed across lower HED day frequency categories. Tailored interventions targeting individuals in this age range who drink alone may be necessary to help reduce high-frequency HED.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing prevalence estimation by addressing inconsistent reporting: insights from a cross-national, data-adjusted replication study.","authors":"Romain Brisson","doi":"10.1093/alcalc/agag013","DOIUrl":"https://doi.org/10.1093/alcalc/agag013","url":null,"abstract":"<p><strong>Aims: </strong>Evidence on adolescent alcohol use in low- and middle-income countries (LMICs) is scarce and, like research in high-income countries, generally overlooks inconsistent reporting. Based on a data-adjusted replication of a study in 57 LMICs, this work assessed the effect of inconsistent reporting on prevalence estimates.</p><p><strong>Methods: </strong>To standardize the operationalization of inconsistent reporting, I examined the 37 datasets that contained the exact same set of items. Inconsistencies were identified based on logical contradictions. Prevalence estimates of past 30-day alcohol use and sources of alcohol acquisition were computed using unadjusted data (i.e., including all reporters) and adjusted data (i.e., excluding inconsistent reporters).</p><p><strong>Results: </strong>Inconsistent reporting was common (M = 9.6%; range: 3.7%-23.6%). Excluding inconsistent reporters had a modest average effect on past 30-day alcohol use (mean relative change: -8.9%), but substantial heterogeneity was observed. In eight datasets, prevalence decreased by at least 15%, reaching -29.4% in Ghana. Effects were, on average, larger in younger students and males. Excluding inconsistent reporters occasionally strengthened or reversed age- and sex-related patterns. Results pertaining to alcohol acquisition were similarly heterogeneous, with multiple changes <-30% or >30%, sporadic elimination of a specific acquisition source, and occasional reordering of source hierarchies.</p><p><strong>Conclusions: </strong>As in high-income countries, inconsistent reporting of alcohol use is common among adolescents in LMICs and can substantially affect prevalence estimates. Effects are heterogeneous and hardly predictable, emphasizing the importance of incorporating consistency checks to improve the validity of research guiding public health decisions.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aino Salonsalmi, Eero Lahelma, Ossi Rahkonen, Anni Karjala, Anne Kouvonen, Tea Lallukka
{"title":"Associations between life course socioeconomic circumstances and drinking patterns among young and early midlife Finnish public sector employees.","authors":"Aino Salonsalmi, Eero Lahelma, Ossi Rahkonen, Anni Karjala, Anne Kouvonen, Tea Lallukka","doi":"10.1093/alcalc/agag023","DOIUrl":"https://doi.org/10.1093/alcalc/agag023","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to examine associations between childhood and adulthood socioeconomic circumstances with drinking patterns.</p><p><strong>Methods: </strong>Data on socioeconomic circumstances and drinking patterns were derived from a survey among young and early midlife employees of the City of Helsinki in 2017 (n = 5875, 79% women). Logistic regression analysis was used to calculate odds ratios (ORs) and their 95% confidence intervals (CIs) for frequent, binge, and problem drinking (CAGE=Cutting down, Annoyance by criticism, Guilty feeling, Eye-openers). Childhood and adulthood socioeconomic circumstances were included. The models were adjusted for age and gender, and additionally for marital status and having underage children.</p><p><strong>Results: </strong>The mean alcohol units per week varied only little by socioeconomic circumstances although men with low material circumstances (6.3 units per week if low household wealth) drank somewhat more than their counterparts with better material circumstances (5.1 units per week if high household wealth). Binge drinking was more common among individuals with low socioeconomic circumstances, but frequent drinking among individuals with high socioeconomic circumstances. Differences in problem drinking varied by socioeconomic indicator. Adjusting for marital status and underage children attenuated the associations especially for binge and problem drinking. No socioeconomic measure was paramount although for binge and problem drinking household income and further material circumstances showed the strongest associations.</p><p><strong>Conclusions: </strong>There were only small differences by socioeconomic circumstances in the amount of alcohol used but individuals with low material circumstances most often showed adverse drinking patterns. Preventive measures focused on people with low material circumstances might diminish alcohol-related inequalities in health.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does staying put protect? How length of residence shapes the neighborhood cohesion-alcohol link among adults in the United States.","authors":"Muntasir Masum, Alexis R Santos","doi":"10.1093/alcalc/agag025","DOIUrl":"https://doi.org/10.1093/alcalc/agag025","url":null,"abstract":"<p><strong>Aims: </strong>Excessive alcohol consumption is the third leading cause of death in the United States, yet most neighborhood research on drinking focuses on adolescents and emerging adults. We examined how neighborhood cohesion and length of residency jointly relate to past-year binge drinking and weekly heavy drinking among US adults aged 25-65.</p><p><strong>Methods: </strong>Using 2013-2018 National Health Interview Survey data (N = 78 398), we created a four-item neighborhood cohesion index (α = 0.90) assessing trust, willingness to help, shared values, and belonging. Residency was categorized as <4 years, 4-10 years, or ≥10 years. Binge drinking (≥5 drinks on one occasion) and heavy drinking (≥15 drinks for men; ≥8 for women) were modeled using survey-weighted logistic regression.</p><p><strong>Results: </strong>Higher cohesion was positively associated with both binge (OR = 1.11, 95% CI: 1.08-1.14) and heavy drinking (OR = 1.14, 95% CI: 1.08-1.19). Compared with residents of <4 years, those living 4-10 and ≥10 years had 11% and 13% lower odds of binge drinking. Interaction terms indicated little moderation: residency did not attenuate the cohesion-drinking link, and among ≥10-year residents, the cohesion-heavy drinking association modestly strengthened (OR = 1.13, 95% CI: 1.01-1.26). Predicted probabilities were higher for men than women, but cohesion slopes were parallel across sexes.</p><p><strong>Conclusion: </strong>Stronger neighborhood cohesion does not always protect working-age adults from risky drinking and may even facilitate it in long-standing communities. Interventions should blend community-building with alcohol harm reduction to prevent social ties from unintentionally promoting excessive use.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alfred John Balston, Isabella Conti, Sandra Darko, Lathaanghi Gajendran, Shantelle Quashie, Samira Mohamed, Jacob Krzanowski, Bo Wang, John Archer
{"title":"Transient elastography in acute hospital inpatients with harmful alcohol use: a service evaluation.","authors":"Alfred John Balston, Isabella Conti, Sandra Darko, Lathaanghi Gajendran, Shantelle Quashie, Samira Mohamed, Jacob Krzanowski, Bo Wang, John Archer","doi":"10.1093/alcalc/agaf079","DOIUrl":"https://doi.org/10.1093/alcalc/agaf079","url":null,"abstract":"<p><strong>Aims: </strong>Hospital admissions are frequently alcohol related and are an opportunity for health promotion. Transient Elastography (TE), an ultrasound-based method of assessing liver health, may be beneficial when used by inpatient Alcohol Care Teams (ACTs). We evaluated the integration of TE in an inpatient ACT, the rate of liver fibrosis detection, and the engagement and drinking behaviour of those with raised liver stiffness at follow-up.</p><p><strong>Methods: </strong>A retrospective service evaluation of inpatients ≥18 years old that underwent ACT-led TE between June 2022 and December 2023 at an acute hospital. Inpatients were eligible for TE if they consumed more than 35 units of alcohol per week if female and more than 50 units per week if male. Significant liver fibrosis was defined as ≥8 kPa.</p><p><strong>Results: </strong>319 patients underwent TE of whom 119 (37%) had increased liver stiffness. Of 64 patients referred for local follow-up, 26 (41%) attended a first appointment. Self-reported alcohol consumption reduced in 17 of these 26 patients (65%), increased in two (7%) patients, did not change in two (7%) patients, and was unrecorded in five (19%) patients. No follow-up data were collected on patients with normal liver stiffness.</p><p><strong>Conclusions: </strong>Hospital admissions present an opportunity for detection of chronic liver disease that would otherwise remain undiagnosed in an at-risk population via ACT integrated TE. Of the few patients with raised liver stiffness that attended follow-up, most decreased their alcohol consumption or were abstinent. The outcomes of those with normal liver stiffness are not known.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pranay Nadella, William C Oles, Russell P Goodman, Wei Zhang, Jay Luther, Esperance Schaefer
{"title":"Phosphatidylethanol testing: patterns, demographic and clinical correlates, and outcomes.","authors":"Pranay Nadella, William C Oles, Russell P Goodman, Wei Zhang, Jay Luther, Esperance Schaefer","doi":"10.1093/alcalc/agag021","DOIUrl":"https://doi.org/10.1093/alcalc/agag021","url":null,"abstract":"<p><strong>Aims: </strong>Phosphatidylethanol (PEth) is a widely used biomarker for alcohol use, but interpretation may vary by demographic factors, and the clinical relevance of current cutoffs is uncertain. We examined the distribution of PEth values across a large healthcare network and the associations between PEth and demographics, lab markers, and clinical outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 4892 adults with ≥1 PEth 16:0/18:1 result from January 2022 to August 2024 within the Mass General Brigham system. Linear regression assessed associations between PEth and demographic characteristics, aspartate aminotransferase (AST), low-density lipoprotein, A1c, hospital encounters, length of stay, and self-reported alcohol use.</p><p><strong>Results: </strong>60% of patients had negative PEth (<20 ng/mL). Among positives, the median was 251 ng/mL. 18% had moderate (20-200 ng/mL) and 22% heavy (>200 ng/mL) alcohol use. PEth was directly associated with AST (P < .001) and inversely with age (P < .001), body mass index (P = .019), income (P = .010), and A1c (P = .0044). Black patients had higher PEth than White patients (P < .001). No differences by gender were observed. Higher PEth was associated with more hospital encounters (P < .001) but shorter stays (P < .001). PEth did not correlate well with self-reported alcohol intake, and 31% of patients with positive PEth reported no alcohol use.</p><p><strong>Conclusions: </strong>In a broad clinical population, PEth values were higher than previously reported. Demographic disparities and limited agreement with self-report suggest PEth may better detect unhealthy alcohol use and reveal unmet care needs.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Salis, Maristella Belfiori, Roberta Agabio, Antonella Mandas
{"title":"Alcohol-medication interactions among older people: a narrative review on age-specific evidence.","authors":"Francesco Salis, Maristella Belfiori, Roberta Agabio, Antonella Mandas","doi":"10.1093/alcalc/agag018","DOIUrl":"10.1093/alcalc/agag018","url":null,"abstract":"<p><strong>Aims: </strong>Alcohol use is relatively common in older adults, representing a challenge for geriatricians. Older people are also prone to chronically taking multiple medications. Concerns are raised about potential alcohol-medication interactions (AMIs). This review aims to summarize current evidence on AMIs in older adults.</p><p><strong>Methods: </strong>We conducted a literature search using MEDLINE up to 18 June 2025. Of 481 identified studies, 37 were considered pertinent and discussed in this review.</p><p><strong>Results: </strong>Epidemiological data reveal that slightly over 25% (from ~20% to 80%) of older adults concurrently take alcohol and potentially interact with medications. Negative effects related to potential AMIs range from excessive sedation when old people take benzodiazepines, opioids, or antipsychotics, to hypoglycemia when they take sulfonylureas. Pharmacokinetic modifications can depend on physiological age-related changes in the human body. This evidence mostly derives from studies not focused on older adults.</p><p><strong>Conclusions: </strong>Despite their clinical importance, few studies focus on AMIs in older adults. The limited awareness among both healthcare providers and patients represents a significant public health issue. Routine alcohol use screening, universally shared lists of potential AMIs, and larger longitudinal studies are necessary to further explore the theme and mitigate risks.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Moderate-to-heavy habitual alcohol use appears to be detrimentally associated with inflammation even when accounting for diet quality in humans: findings from an observational intensive longitudinal study.","authors":"Kailyn Lowder, Jimikaye Beck Courtney","doi":"10.1093/alcalc/agag015","DOIUrl":"10.1093/alcalc/agag015","url":null,"abstract":"<p><strong>Aims: </strong>This study investigated the associations between diet quality and daily alcohol use across 21 days with inflammation in adults with overweight/obesity.</p><p><strong>Methods: </strong>This secondary analysis, from an observational intensive longitudinal study, investigated associations between alcohol use and inflammation. Adults 21-44 years old with a body mass index ≥ 25 kg/m2 (n = 91) participated in a 21-day study with daily measures of past-day alcohol use and baseline and follow-up measures of dietary intake (automated self-administered 24-hour recall, ASA-24). Healthy Eating Index (HEI)-2015 scores assessed diet quality. Follow-up blood draws assessed C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 beta (IL-1β). Models investigated associations between diet quality (HEI total score or whole grains and saturated fat) and alcohol use [average and variability in drinks per day or drinker type (nondrinker, light, moderate, or heavy drinker)] with inflammation, accounting for percentage body fat, smoking, and sex. Moderation by sex was also tested.</p><p><strong>Results: </strong>Average drinks per day and variability in drinks per day were not associated with inflammation. Moderate- and heavy-drinking females had 1.27 and 1.38 mg/l higher CRP than light-drinking females, with no differences in males. Heavy-drinking adults had 2.54 pg/ml higher TNF-α than light drinkers. Sex moderated the association between drinker type and IL-6 (b = 1.26, P = .035); however, there were no significant pairwise differences. Drinker type was not associated with IL-1β.</p><p><strong>Conclusions: </strong>These findings suggest that moderate-to-heavy alcohol use may be detrimentally associated with inflammation regardless of diet quality, suggesting that a high-quality diet may be insufficient to protect against the harmful effects of alcohol use on inflammation.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Increases in binge and heavy drinking frequencies during the COVID-19 pandemic are associated with liver fibrosis.","authors":"Peng-Sheng Ting, Molly Delk, Wei-Ting Lin, Hui-Yi Lin, Tung-Sung Tseng, Po-Hung Chen","doi":"10.1093/alcalc/agag011","DOIUrl":"10.1093/alcalc/agag011","url":null,"abstract":"<p><strong>Aims: </strong>We aim to investigate alcohol consumption patterns before and after the pandemic onset and utilize liver fibrosis measurements to identify at-risk drinking patterns.</p><p><strong>Methods: </strong>We selected 10 259 participants in the National Health and Nutrition Examination Survey across two cohorts: January 2017-March 2020 (pre-pandemic) and August 2021-August 2023 (during-pandemic). We employed the alcohol use questionnaire to identify drinking patterns, including heavy drinking and binge drinking frequencies. Vibration-controlled transient elastography was used to define stage 1 and significant liver fibrosis by liver stiffness measurement >7 to 9 and > 9 kPa, respectively. We first compared the prevalence and frequencies of binge drinking and single day heavy drinking between the two cohorts. We then calculated the odds of liver fibrosis among during-pandemic participants with various alcohol use patterns, compared to pre-pandemic participants with the same use patterns.</p><p><strong>Results: </strong>We found a higher prevalence of at-risk alcohol use in the during-pandemic cohort, including single-day heavy drinking and binge drinking at least once a month. Notably, the distributions of the frequency of single day heavy drinking and binge drinking were skewed towards a higher frequency of at-risk alcohol use in the during-pandemic group. Furthermore, the odds of significant liver fibrosis were higher among during-pandemic non-heavy/binge drinkers and heavy/binge drinkers, compared to their pre-pandemic counterparts.</p><p><strong>Conclusions: </strong>The data showed increases in heavy drinking and binge drinking in the during-pandemic cohort, which calls for urgent public health interventions to mitigate future adverse health impacts.</p>","PeriodicalId":7407,"journal":{"name":"Alcohol and alcoholism","volume":"61 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}