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. 2016 Jul;35(4):412-23.
doi: 10.1111/dar.12328. Epub 2015 Sep 10.

Alcohol use in the Pacific region: Results from the STEPwise approach to surveillance, Global School-Based Student Health Survey and Youth Risk Behavior Surveillance System

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Alcohol use in the Pacific region: Results from the STEPwise approach to surveillance, Global School-Based Student Health Survey and Youth Risk Behavior Surveillance System

Tara Kessaram et al. Drug Alcohol Rev. 2016 Jul.

Abstract

Introduction and aims: Alcohol use is a leading risk factor for disease and injury in Pacific Island countries and territories (PICT). This paper examines drinking patterns across 20 PICTs.

Design and methods: We synthesised published data from the STEPwise approach to surveillance or similar surveys for adults 25-64 years, and from the Global School-Based Student Health surveys and Youth Risk Behavior Surveillance System (YRBSS) for youth. We examined current and heavy drinking, and for adults also frequency of consumption. Using YRBSS, we studied trends in youth alcohol use in US-affiliated PICTs between 2001 and 2013.

Results: Alcohol consumption in adults and youth varied considerably across PICTs. In eight PICT populations, over 60% of male adults were current drinkers. Male adults consumed alcohol more frequently and engaged in heavy drinking more than female adults. Similar gender differences occurred in current and heavy drinking among youth. Across 10 PICTs, current drinking prevalence in males 13-15 years ranged from 10% to over 40%. Declines in alcohol use among grade 9-12 students were observed in YRBSS, although the magnitude differed by island and sex.

Discussion and conclusions: Alcohol consumption varies widely between PICTs. There are marked gender differences in use and abstention. There is scope in PICTs for implementation of best practice strategies to reduce alcohol-related harm. These need to be gender responsive and cognisant of concerning patterns of youth drinking. Strengthening surveillance of alcohol use and its consequences is vital to inform and monitor the impact of national and regional policies. [Kessaram T, McKenzie J, Girin N, Roth A, Vivili P, Williams G, Hoy D. Alcohol use in the Pacific region: Results from the STEPwise approach to surveillance, Global School-Based Student Health Survey and Youth Risk Behavior Surveillance System. Drug Alcohol Rev 2016;35:412-423].

Keywords: Pacific Islands; alcohol consumption; drinking behaviour; epidemiology; prevalence.

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Figures

Figure 1
Figure 1
Prevalence (with 95% confidence intervals) of current drinkers* among males students (above) and female students (below) in grades 9–12, by Pacific Island country and territory. Source: Youth Risk Behavior Surveillance System (2001 to 2013). *Current drinkers were defined as those who had at least one drink of alcohol on at least one day during the 30 days before the survey. 95% confidence intervals presented for Guam only as in American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Palau and the Republic of the Marshall Islands (RMI), the surveys were designed to include all members of the target student population (S. Kinchen, Centers for Disease Control and Prevention, personal communication July 12 2014). Results for CNMI for 2007 were obtained from: Lippe J, Brener N, Kann L. et al. Youth risk behavior surveillance—Pacific Island United States Territories, 2007. MMWR Surveillance Summaries. 2008;57(12):28–56. Total sample size for 2007 in CNMI was 2292. Results for RMI for 2009 were obtained from RMI Epidemiological Working Group, Substance Abuse Epidemiological Profile 2010, Republic of the Marshall Islands. Total sample size for 2009 was 1847. Cell sizes: Males: American Samoa: 1205 (2011); 1366 (2007). CNMI: 1014 (2005); 929 (2003). Guam: 642 (2013); 721 (2011); 725 (2007); 629 (2001). Palau: 162 (2011); 202 (2009); 299 (2007); 224 (2005); 190 (2003); 192 (2001). RMI: 523 (2007); 274 (2003). Females: American Samoa: 1366 (2011); 1592 (2007). CNMI: 1051 (2005); 952 (2003). Guam: 588 (2013); 663 (2011); 719 (2007); 683 (2001). Palau: 213 (2011); 247 (2009); 283 (2007); 288 (2005); 263 (2003); 233 (2001). RMI: 593 (2007); 339 (2003).
Figure 2
Figure 2
Prevalence (with 95% confidence intervals) of heavy drinking* among male students (above) and female students (below) in grades 9–12 by Pacific Island country and territory. Source: Youth Risk Behaviour Surveillance System (2001 to 2013). *Heavy drinking was defined as having five or more drinks of alcohol in a row within a couple of hours on at least 1 day during the 30 days before the survey. 95% confidence intervals presented for Guam only as they surveys in American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Palau and the Republic of the Marshall Islands (RMI) were designed to include all members of the target student population (S. Kinchen, Centers for Disease Control and Prevention, personal communication July 12 2014). Results for CNMI for 2007 were obtained from: Lippe J, Brener N, Kann L. et al. Youth risk behavior surveillance—Pacific Island United States Territories, 2007. MMWR Surveillance Summaries. 2008;57(12):28–56. Total sample size for 2007 in CNMI was 2292. Results for RMI for 2009 were obtained from RMI Epidemiological Working Group. Substance Abuse Epidemiological Profile 2010, Republic of the Marshall Islands. Total sample size for 2009 was 1847. Cell sizes: Males: American Samoa: 1429 (2011); 1598 (2007). CNMI: 1088 (2005); 1017 (2003). Guam: 722 (2013); 804 (2011); 831 (2007); 655 (2001). Palau 204 (2011); 229 (2009); 328 (2007); 248 (2005); 207 (2003); 219 (2001). RMI: 667 (2007); 360 (2003). Females: American Samoa: 1523 (2011); 1772 (2007). CNMI 1112 (2005); 1008 (2003). Guam: 666 (2013); 742 (2011); 793 (2007); 698 (2001). Palau: 234 (2011); 284 (2009); 347 (2007); 307 (2005); 279 (2003); 245 (2001). RMI: 693 (2007); 424 (2003).

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