Alcohol use and problem drinking in South Africa: Results from a national-population-based survey 2014-2015

The aim of this study was to estimate the pattern of alcohol use among South African adults by their socio-demographic and health status indicators. We analysed data from a 2014–2015 South African national population-based survey which sampled 22 752 adults (mean age 37.1 years, SD?=?17.6, age range of 15–109 years). Results indicate 3.9% were hazardous or harmful alcohol users. In adjusted logistic regression analysis, both men and women who self-reported to use tobacco, and women to have hypertension, were at higher risk for harmful alcohol use. Age and socioeconomic status moderated harmful alcohol use among men so that those in middle age (35–49 years) and with above average household income were at lower risk for hazardous or harmful alcohol use. Socio-demographic factors appear to primarily influence risk for hazardous or harmful alcohol use among South African adults.     

Post-traumatic stress disorder and health risk behaviour among persons 15 years and older in South Africa

The aim of this study was to investigate the association between post-traumatic stress disorder (PTSD) and health risk behaviours among persons 15 years and older in South Africa. We analysed data from the South African National Health and Nutrition Examination Survey (SANHANES-1, 2012) (N = 15 201; mean age = 36.9 years, SD = 16.5; 2.1% with PSTD, 4.0% with partial PTSD). The survey included questions from validated measures of the following health risk behaviours: problem drinking, current tobacco use, physical activity, sedentary behaviour, vegetable consumption, and fast food and frequent soft drinks consumption. In adjusted logistic regression analysis, only self-reporting with PTSD was associated with problem drinking. The data did not yield significant association between PTSD status and any of the other health risk behaviours (tobacco use, low physical activity, and fast food consumption).     

Ethnic identity and risky health behaviors in school-age Mexican-American children

The study examined the relationship between ethnic identity and risky health behaviors in 1,892 Mexican-American students (M age= 14.6, SD= 1.35; 50.3% male) in South Texas. The Ethnic Identity Scale assessed ethnic identity and questions from the Youth Risk Behavior Survey measured risky health behaviors (mixed use of alcohol and drugs, heavy drinking, driving under the influence, regular marijuana use, regular cigarette smoking, lack of regular exercise, not eating breakfast regularly, and carrying a gun or knife to school). Logistic regression tested the relationships between ethnic identity and report of risky health behaviors controlling for potential confounders (sex, free school lunch status, grade, and self-reported school grade). Adjusted odds ratio (AOR) and confidence intervals were calculated. Results indicated that being associated with Mexican-American cultural identity was significantly associated with a decreased mixed use of alcohol and drugs (AOR= .97), heavy drinking (AOR= .98), and regular marijuana use (AOR= .97). A stronger ethnic identity was protective against engaging in risky health behaviors among these Mexican-American adolescents.     

Sociodemographic factors,religiosity, academic performance,and substance use among first-year university students in South Africa

The purpose of this study was to identify the relationships among sociodemographic variables, family background, religiosity, course of study, academic performance, and substance use. The sample included 799 first-year students in the age range of 16 to 49 years (M age 20.1 yr., SD = 3.2) chosen at random from the University of the North in South Africa. A Model Core Questionnaire from the WHO on Substance use was administered. Analysis indicated that women smoked tobacco or cannabis and drank less than men, while women took more stimulants and other opiate type drugs than men. Low scores on religiosity was a predictor for past-month tobacco use alcohol use, binge drinking, cannabis use, and having a drinking or drug problem now. Being a member of a Protestant denominational church or a Roman Catholic was a predictor for past-month tobacco and alcohol use. A family history of drinking or drug problems and being a social science or humanities student were predictive for a current alcohol or drug problem. Economic status, education of parents. living arrangement. and rural-urban differences were not associated with substance use. Findings have implications for prevention programmes.     

Alcohol Use in Three Different Inner Cities in South Africa: AUDIT-C and CAGE

The aim of the present study was to describe the frequency of risky drinking among a general urban population survey (n=1379) in South Africa with the help of (Alcohol Use Disorders Identification Test) AUDIT-C scores, CAGE (Cut down, Annoyed, Guilty, Eye-opener) scores and compare the scores with calculated risky drinking in terms of weekly alcohol consumption or heavy episodic drinking. Results indicate 44.4% for men and 25.4% for women as hazardous or harmful drinkers and using the CAGE 44.7% (55% among men and 35.5% among women). AUDIT-C and CAGE cases were more likely to be women than men and were also more likely among Coloureds and Whites than Black Africans and Indians or Asians. This study showed a greater sensitivity of AUDIT to CAGE.     

Alcohol Use,Problem Drinking and Health Risk Factors Among South African Youths

The aim of this study was to assess the prevalence and associated factors of problem drinking among South African youth (18–24 years). A cross-sectional population-based household survey was conducted using a multi-stage stratified cluster sampling approach. The total sample included 3123 participants (age range 18–24 years, 45.4% women) from four of nine provinces in South Africa. Results indicate that current alcohol was relatively more common among male (40.7%) than female youths (21.3%). Similarly, hazardous or harmful drinking was more prevalent among males (24.3%) than among women (12.9%). In multivariable analyses among men and women high on sexually permissiveness had hazardous or harmful alcohol use. Lifestyle including high peer pressure, and spending more nights away in a week were associated with hazardous or harmful alcohol use.     

Prevalence and correlates of substance use among school children in six African countries

An increasing trend of noncommunicable diseases is a worldwide phenomenon, also including the developing countries. Few studies focus on adolescents' substance use in relation to mental distress and protective factors in African countries. The purpose of this study was to assess the prevalence and correlates (mental distress and protective factors) of substance use among school-going adolescents in six African countries. The sample included 20,765 students aged from 13 to 15 years from six African countries (Kenya, Namibia, Swaziland, Uganda, Zambia, Zimbabwe), chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country. The measure used was part of the Global School-Based Health Survey (GSHS) questionnaire, including various domains of health behaviour. Results indicate a prevalence of 12.6% tobacco use (past month), 6.6% risky alcohol use (two or more per day for at least 20 days or more in the past month), and 10.5% of illicit drug use (three or more times ever) in school-going adolescents in six African countries. School truancy, loneliness, sleeping problems, sadness, suicidal ideation, suicide plans, and poverty were associated with substance use (tobacco, alcohol, illicit drugs), while school attendance and parental supervision and connectedness were protective factors for substance use, and peer support protective for tobacco use. It is concluded that tobacco use, risky drinking and illicit drug use were common, clustered together and were associated with school truancy, mental distress, and lack of parental and peer support among adolescent African school children. These findings stress the need for early and integrated prevention programmes.     

Adverse developmental experiences and risky health behaviours among black South African university students

This study examined the relationship between adverse developmental experiences (ADEs) and risky health behaviours among a cross-sectional sample of black South African students (n = 393; females = 58%, M_age = 20.5 years, SD = 2.9). Binary logistic regression was used to model the association between categories of ADEs and risky health behaviours. Findings suggest individual ADEs to significantly predict risky health behaviours. The highest singular ADEs reported were being treated like a child (62%), parents being overprotective (59%), and being driven to be perfectionistic (58%). There was no indication of a general trend of ordered associations between the number of ADEs and risky health behaviours.     

Prospective analysis of early lapse to drinking and smoking among individuals in concurrent alcohol and tobacco treatment

The aims of the current study were to examine, prospectively, (a) dynamic changes in affective state, self-efficacy, and urge in the hours before initial smoking and drinking lapses among individuals in concurrent alcohol and smoking treatment, and (b) the extent to which self-efficacy, urge to use, and/or the use of one substance predicted lapse to the other substance. Ninety-six men and women recruited for a clinical trial of concurrent alcohol and tobacco treatment were eligible for inclusion. Only data from those who experienced an initial lapse to drinking (n=29) or smoking (n=32) were included. Two outpatient substance abuse clinics provided concurrent alcohol and smoking treatment on a weekly basis for three months. Ecological Momentary Assessment (EMA) methods were employed over a 28-day monitoring period to assess antecedents to first drink, and a 14-day monitoring period was examined for initial smoking lapses. Baseline and EMA measures of positive and negative affect, alcohol/smoking urge, alcohol/smoking abstinence self-efficacy, nicotine withdrawal, and quantity/frequency of alcohol and tobacco use were examined as lapse predictors. Analyses of EMA ratings controlled for the corresponding baseline measure. Smoking lapse among individuals in concurrent alcohol and tobacco treatment was foreshadowed by higher urges to smoke, lower positive mood, and lower confidence to resist smoking. Drinking lapse was preceded by lower confidence to resist smoking, but only among individuals who reported recent smoking. Concurrent alcohol and smoking treatment should focus on the enhancement of abstinence self-efficacy, positive mood, and the curbing of urges in order to offset lapse risk.     

Hazardous Alcohol Use among Persons Living with Human Immunodeficiency Virus Infection in the Eastern Cape,South Africa

The study assessed the prevalence of hazardous alcohol use among people living with HIV (PLHIV) and its correlates with socio-economic characteristics, disease variables and ART adherence in South Africa. The sample included 607 PLHIV (males =475, females =132; age range =18–61), sampled by all districts in the Eastern Cape. Participants were recruited through a health facility in the community through key informants or a support group. Results indicate that male PLHIV were more often than female PLHIV “past month” (18.9% vs. 6.1%) and hazardous alcohol drinkers (6.1% vs. 2.7%); using a cut-off score of 8 and more on the Alcohol Use Disorders Identification Test (AUDIT). Not having a disability grant for HIV/AIDS and the disability grant terminated were both related to past month alcohol use, while having the “disability grant stopped” was also related with hazardous or harmful drinking. Not having an AIDS diagnosis and not being on ART were both associated with past month alcohol use and hazardous or harmful drinking. CD4 counts and non-adherence to ART were both not significantly related with alcohol use status. Brief health provider initiated alcohol interventions for PLHIV should be promoted, with emphasis on targeting men.     

Effects of tobacco use on non-adherence to antiretroviral therapy among HIV-positive patients in South Africa

This study aimed to estimate the relationship between tobacco use and non-adherence to antiretroviral therapy (ART) in a South African sample. Participants were 1 963 HIV patients who attended a primary care clinic in Pretoria (female = 68.5%; black African = 99.5%; median age = 37.0 years; tobacco users only = 8.6%, problem drinkers only = 14.9%, and tobacco users and problem drinkers = 10.5%). In adjusted logistic regression analysis, tobacco use only was not significantly associated with non-adherence to ART. Alcohol use only (OR: 1.72; CI: 1.26, 2.36) and tobacco use and problem drinking (OR: 2.31; CI: 1.60, 3.33) were highly associated with non-adherence to ART.     

Predictors of multiple concurrent and multiple sexual partnerships among male and female youth aged 18–24 in South Africa

This study aimed to determine predictors of multiple concurrent and multiple sexual partnerships among South African male and female youth. Data were from a cross-sectional population-based household survey of 3 123 youths aged 18 to 24 years from four South African provinces (males = 53.6%, blacks = 97.8%). Results from a sub-sample of being sexually active in the past 12 months (n = 1787) indicate that 5.3% (7.1% in males and 3.1% in females) youth participants had multiple concurrent sexual partners, and 38.8% (50.1% in males and 25.8% in females) had had two or more sexual partners in the past 12 months. Among females, multiple concurrent partnerships were only predicted by lower social network resources. Predictors of multiple sexual partnerships (two or more sexual partners in the past 12 months) among males included high HIV risk perception, never been tested for HIV and hazardous or harmful alcohol use. By contrast, among females, high peer pressure, lower education and ever having taken drugs predicted involvement with multiple sexual partners. Multi-level health promotion interventions are indicated for sexual behaviour change among South African youth.     

Concurrent alcohol and tobacco use among school-going adolescents in Namibia: Prevalence and risk factors

The aim of this study was to investigate the prevalence and risk factors for concurrent alcohol and tobacco use among school-going adolescents in Namibia. Data were from a sample of 4 531 Namibian middle school children (females = 53.1%; mean age = 15.8 years, SD = 1.8 years). They completed the Namibia Global School-based Student Health Survey (GSHS) in 2013. Overall, 74.4% of alcohol users in the past month were frequent tobacco users; whereas 40.5% of tobacco users in the past month were frequent alcohol users. Compared to students who were neither alcohol nor tobacco users (63.1%), concurrent alcohol and tobacco users were more likely to self-report with a lack of parent support, to have used illicit drugs, to have engaged in school truancy, to be sedentary in behaviour, to have engaged in a physical fight, and to have had two or more sexual partners. Substance use prevention and treatment programmes with adolescents should routinely address their risk for comorbid tobacco and alcohol use.     

Religion and Selected Health Behaviors Among Latinos in Texas

Though research has shown that religion provides a protective influence with respect to a number of health-related outcomes, little work has examined its influence on patterns of alcohol (especially binge drinking) and tobacco consumption among Latinos in Texas. Thus, we used a probability sample of Texas adults to test this relationship via logistic regression. Our results revealed that clear distinctions emerge on the basis of both denomination and frequency of attendance. Specifically, Protestants who regularly attend religious services are significantly more likely to be abstainers and to have never smoked, while those with no religious affiliation exhibit relatively unfavorable risk profiles. These findings persist despite a range of socio-demographic controls. Our study supports the assertion that religion may serve as an important protective influence on risky health behaviors.     

Tobacco Use Trends among Adolescents and Adults in South Africa

The purpose of this review is to synthesize the national prevalence data from eight surveys on tobacco use in South Africa over the past 13 years. Results from the national studies indicate that tobacco use among adults is on the decline in South Africa. The same applies to daily smoking and daily smokeless tobacco use among adolescents. However, onset of tobacco use and the prevalence of current smoking among adolescents seem not to have changed over the years. While exposure to tobacco smoke outside the home decreased from 56.5% in 1999 to 36.2% in 2002 among adolescents, exposure to tobacco smoke inside the home increased from 41.7% in 1999 to 73.3% in 2002. This change may be attributed to the introduction of the tobacco control act that from 2000 banned smoking in public places. The decline of overall daily smoking in South Africa may be attributed to the tobacco control strategy based on 1) rapidly increasing excise taxes on tobacco, and (2) comprehensive legislation, of which the most important features are banning all tobacco advertising and sponsorship, and prohibition of smoking in public and work places.     

Screening and brief intervention of alcohol problems in primary care in South Africa: A brief report

The aim of this randomised controlled trial was to provide screening and brief intervention for alcohol problems in a primary care setting in South Africa. Outpatients were screened for hazardous or harmful alcohol use and were randomised into an experimental (one brief counselling session) or control group (received an alcohol health education leaflet). The study population of hazardous or harmful drinkers (N=140) consisted of 105 male and 35 female women, with a mean age of 30.4 years (SD=6.6). Among the 128 (91.4%) primary care outpatients who also attended the 6-month follow-up session, the time effects on the AUDIT scores were significant but the intervention effect on the AUDIT score was statistically not significant. It would seem that alcohol screening and the provision of an alcohol health education leaflet may in itself cause reduction in drinking.     

The impact of depressive symptomatology on risky sexual behavior and sexual communication among African American female adolescents

Adolescents, particularly African American adolescents, are at high risk for sexually transmitted infections (STIs). The association between psychosocial factors and risky sexual behavior has been well established. However, only a small number of studies have examined the relationship between depressive symptomatology among African American female adolescents, specifically over time. The present study examined depressive symptoms as a predictor of risky sexual behavior, sexual communication, and STIs longitudinally among African American female adolescents between the ages 15 and 21. Binary generalized estimating equation models were conducted assessing the impact of depressive symptoms at baseline on risky sexual behavior and STIs over six- and 12-months follow-up. Age, intervention group, and baseline outcome measures were entered as covariates. The results indicated that high levels of depressive symptoms predicted no condom use during last sexual encounter and multiple sexual partners over six-months follow-up. Depressive symptoms also predicted having a main partner with concurrent partners, high fear of communication about condoms, and sex while high on alcohol or drugs over six- and 12-months follow-up. These findings could be used to inform HIV/STI prevention intervention programs and clinicians providing regular health care maintenance to African American female adolescents engaging in risky sexual behavior.     

Depression symptoms: Their association with socio-demographic factors and health among adults in South Africa

The aim of this study was to assess depression symptoms and socio-demographic and health correlates in a recent (2014-2015) national population-based survey of South Africa adults (n = 22 752; females =57.5%; mean age 37.1 years, SD = 17.6). The participants reported on their socio-demographic variables, health statuses, and experience of depression symptoms the previous four weeks. About 13% of the sample scored positive for depression symptoms. In adjusted logistic regression analysis, being female, older age, being long term sick or disabled, having two or more pain disorders, having been diagnosed with diabetes, and having smoked regularly were associated with high risk for depression symptoms. Being a student, having below or average household income, and having exercised three or more times a week was associated with lower risk for depression symptoms.     

Longitudinal Predictors of Alcohol‐Related Harms During the Transition to Adulthood

While a range of factors have been found to increase the likelihood of alcohol‐related harms among young people, little is known about their relative importance. This article aimed to identify the risks for alcohol‐related harms at an age when alcohol use and problems tend to peak in Australia (19–20 years). A wide range of concurrent and antecedent factors from multiple domains were examined using path analysis, including individual characteristics, family environment, and externalising and internalising problems. The sample comprised of 941 individuals from the Australian Temperament Project, a large longitudinal community‐based study. The path model controlled for current risky drinking and revealed a number of variables that were significant longitudinal predictors of alcohol‐related harms within each of the domains, including adolescent antisocial behaviour and drinking behaviour, low agreeableness, impulsivity, and paternal drinking levels. The potential for developmental prevention approaches to reduce alcohol‐related harms by targeting externalising behaviour problems, interpersonal influences, and individual characteristics is discussed.     

Alcohol use among adults in Kenya: Results from the National Non-Communicable Diseases Risk Factor survey, 2015

The aim of this study was to assess the prevalence and correlates of alcohol use among Kenyan adults. We analysed data from the Kenya cross-sectional national Non-Communicable Diseases Risk Factor survey, 2015. The survey sampled 4 469 adults (median age 38.0 years, interquartile range = 23, age range of 18–69 years). Results indicate that 6.7% were hazardous or harmful alcohol users and 12.8% past month binge-drinkers. In adjusted logistic regression analysis, being male, middle aged, belonging to the Luhya or Kalenjin ethic group, tobacco use, and having hypertension increased the odds for hazardous or harmful alcohol use. Socio-demographic and health factors appear to influence risk for hazardous or harmful alcohol use among adults in Kenya.