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Prevalence of alcohol use disorders and associated factors: a population-based study using AUDIT in southern Brazil

ADDICTION, Issue 6 2003
Raúl A. Mendoza-Sassi
ABSTRACT Aims To assess the prevalence of potential alcohol use disorders and associated factors using the Alcohol Use Disorders Identification Test (AUDIT). Design Cross-sectional study. Setting A town in southern Brazil. Participants A representative sample of 1260 people aged 15 and over. Measurements Demographic, socioeconomic, smoking habit and mental health data were collected. Logistic regression was used in the multivariate analysis, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Findings Overall prevalence of alcohol use disorder was 7.9%, with 14.5% prevalence among men and 2.4% among women. The risk of alcohol misuse increased across social class (P linear trend = 0.03) and compared with the highest classes (A and B), groups C through E had ORs of 1.48, 1.51 and 2.36, respectively. Males had an OR of 6.89 (CI 3.61,13.16) compared with women. A linear trend was found (P = 0.001) between smoking categories, and smokers (OR 3.27; CI 1.91,5.58) and ex-smokers (OR 1.30; CI 0.56,2.98) were at higher risk than non-smokers. Those with minor psychiatric disorders had a 2.48 OR (CI 1.35,4.56) of presenting a positive test. Conclusions The AUDIT detected a high prevalence of potential alcohol use disorders in the population sampled. Those identified are potential targets for preventive measures implemented through health policies. [source]

Active and passive maternal smoking during pregnancy and the risks of low birthweight and preterm birth: the Generation R Study

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2008
Vincent W. V. Jaddoe
Summary The objective of this study was to examine the associations between active and passive smoking in different periods of pregnancy and changing smoking habits during pregnancy, with low birthweight and preterm birth. The study was embedded in the Generation R Study, a population-based prospective cohort study from early fetal life onwards in Rotterdam, The Netherlands. Active and passive smoking were assessed by questionnaires in early, mid- and late pregnancy. Analyses were based on 7098 pregnant women and their children. Active smoking until pregnancy was ascertained and was not associated with low birthweight and preterm birth. Continued active smoking after pregnancy was also recorded and was associated with low birthweight (adjusted odds ratio 1.75 [95% CI 1.20, 2.56]) and preterm birth (adjusted odds ratio 1.36 [95% CI 1.04, 1.78]). The strongest associations were found for active maternal smoking in late pregnancy. Passive maternal smoking in late pregnancy was associated with continuously measured birthweight (P for trend <0.001). For all active smoking categories in early pregnancy, quitting smoking was associated with a higher birthweight than continuing to smoke. Tendencies towards smaller non-significant beneficial effects on mean birthweight were found for reducing the number of cigarettes without quitting completely. This study shows that active and passive smoking in late pregnancy are associated with adverse effects on weight and gestational age at birth. Smoking in early pregnancy only, seems not to affect fetal growth adversely. Health care strategies for pregnant women should be aimed at quitting smoking completely rather than reducing the number of cigarettes. [source]

Relationship of cigarette smoking to the subgingival microbiota

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2001
A. D. Haffajee
Abstract Background: The relationship of cigarette smoking to the composition of the subgingival microbiota is not clear. Some studies indicated higher levels of certain species in smokers, while other studies failed to detect differences in the microbiota between subjects with different smoking histories. Thus, the purpose of the present investigation was to examine the prevalence, proportions and levels of the subgingival species in adult subjects who were current, past or never smokers. Method: 272 adult subjects ranging in age from 20,86 years with at least 20 teeth were recruited for study. Smoking history was obtained using a questionnaire. Clinical measures were taken at 6 sites per tooth at all teeth excluding third molars at a baseline visit. Subgingival plaque samples were taken from the mesial surface of all teeth excluding third molars in each subject at baseline and assayed individually for counts of 29 subgingival species using checkerboard DNA-DNA hybridization. Subjects were subset according to smoking history into never (n=124), past (n=98) and current smokers (n=50). Uni-variate and multi-variate analyses were used to seek associations between smoking category and the counts, proportions and prevalence of subgingival species. Results: Greater differences were observed for the prevalence (% of sites colonized) of the test species in the 3 smoking groups than were observed for counts or proportions of total counts. Members of the orange and red complexes including E. nodatum, F. nucleatum ss vincentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis and T. denticola were significantly more prevalent in current smokers than in the other 2 groups. The difference in prevalence between smokers and non-smokers was due to greater colonization at sites with pocket depth <4 mm. Stepwise multiple linear regression analysis indicated that combinations of the prevalence of 5 microbial species and pack years accounted for 44% of the variance for mean pocket depth (p<0.000001), while the prevalence of 3 microbial taxa along with age, pack years, current smoking and gender accounted for 31% of the variance in mean attachment level (p<0.000001). The difference in prevalence between current and never smokers of all members of the red complex and 8 of 12 members of the orange complex was significantly greater in the maxilla than in the mandible. Conclusions: The major difference between the subgingival microbiota in subjects with different smoking history was in the prevalence of species rather than counts or proportions. The greater extent of colonization in smokers appeared to be due to greater colonization at pocket depths <4 mm. Differences in colonization patterns between current and never smokers were greater in the maxilla than in the mandible. Zusammenfassung Grundlagen: Die Beziehung zwischen dem Zigarettenrauchen und der Zusammensetzung der subgingivalen Mikroflora ist nicht klar. Einige Studien verweisen auf höhere Titer von bestimmten Spezies bei Rauchern, während andere Studien keine Unterschiede in der Mikroflora zwischen Personen mit unterschiedlichem Raucher- oder Nichtraucherverhalten nachweisen konnten. Daher war der Zweck der vorliegenden Studie die Untersuchung von Prävalenz, Anteil und Titer der subgingivalen Spezies bei erwachsenen Patienten, die zur Zeit, früher oder niemals Raucher waren. Methode: Für die Studie wurden 272 erwachsene Patienten im Alter zwischen 20 und 86 Jahren und wenigstens 20 Zähnen rekrutiert. Die Anamnese des Rauchverhaltens wurde under Verwendung eines Fragebogens durchgeführt. Bei einer Eingangsuntersuchung erfolgten die klinischen Messungen an 6 Stellen pro Zahn bei allen Zähnen außer den dritten Molaren. Bei der Eingangsuntersuchung wurden, bei allen Zähnen außer den dritten Molaren, von den Mesialflächen subgingivale Plaqueproben entnommen. Für die einzelnen Flächen wurde die Anzahl von 29 subgingivalen Spezies mittels Schachbrett-DNA-DNA-Hybridisierung bestimmt. Die Patienten wurden entsprechend der Rauchervorgeschichte in folgende Gruppen eingeteilt: niemals (n=124), früher (n=98) und zur Zeit (n=50). Um Assoziationen zwischen den Rauchkategorien und der Anzahl, dem Anteil und der Prävalenz der subgingivalen Spezies herauszufinden wurden eine uni-variate und multi-variate Analyse verwendet. Ergebnisse: Es wurden größere Unterschiede zwischen den 3 Gruppen hinsichtlich der Prävalenz der Testspezies (% der Taschen die kolonisiert waren) beobachtet als bei der Anzahl oder dem Anteil an der Gesamtzahl der Keime beobachtet wurde. Die Prävalenz der Keime des orangen und roten Komplexes einschließlich. E. nodatum, F. nucleatum ss vincentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis und T. denticola war bei den aktuellen Rauchern stärker prävalent als in den anderen beiden Gruppen. Die Differenz in der Prävalenz zwischen Rauchern und Nichrauchern wurde verursacht durch eine stärkere Kolonisation in Taschen mit einer Taschentiefe <4 mm. Die schrittweise multiple lineare Regressionsanalyse zeigte, dass Kombinationen der Prävalenz von 5 mikrobiellen Spezies und der Packungsjahre für 44% der Varianz der mittleren Taschentiefe verantwortlich waren (p<0.000001), während die Prävalenz von 3 mikrobiellen Taxa zusammen mit Alter, Packungsjahre, Raucherstatus und Geschlecht für 31% der Varizna im mittleren Attachmentniveau verantwortlich waren (p<0.000001). Die Differenz in der Prävalenz zwischen den aktuellen Rauchern und den die niemals rauchten war für alle Keime der roten Komplexes und 8 von 12 Keimen des orangen Komplexes im Oberkiefer signifikant größer als im Unterkiefer. Schlussfolgerung: Der Hauptunterschied zwischen der subgingivalen Mikroflora bei Patienten mit unterschiedlicher Rauchervorgeschichte lag mehr bei der Prävalenz der Spezies als bei der Anzahl der Keime oder den Anteilen an der Gesamtflora. Das größere Maß an Kolonisation bei den Rauchern schien durch eine stärkere Kolonisation in Taschen <4 mm verursacht zu sein. Differenzen im Kolonisationsmuster zwischen aktuellen Rauchern und Nichtrauchern die niemals rauchten waren im Oberkiefer größer als im Unterkiefer. Résumé Origine, but: La relation entre l'usage de la cigarette et la composition de la microflore sous gingivale n'est pas claire. Certaines études indiquent d'importants niveaux de certaines espèces chez les fumeurs, alors que d'autres études n'arrivent pas à détecter de différences dans la micrflore entre des sujets ayant des histoires tabagiques différentes. Aussi, le propos de cette recherche est d'examiner la prévalence, les proportions et le niveau des espèces sous gingivales chez des sujets adultes fumeurs, anciens fumeurs ou non-fumeurs. Méthodes: 272 sujets adultes, âgès de 20 à 86 ans, ayant au moins 20 dents furent recrutés pour l'étude. L'histoire tabagique fut obtenue à l'aide d'un questionnaire. Des mesures cliniques furent prises sur 6 sites par dents, sur toutes les dents à l'exception des troisièmes molaires lors de la première visite. Des échantillons de plaque sous gingivale étaient prélevés sur la face mésiale de chaque dent à l'exception des troisièmes molaires chez chaque sujet lors de la première visite et individuellement testés pour le comptage de 29 espèces sousgingivales par hybridisation en damier ADN-ADN. Les sujets étaient groupés en sous ensembles en fonction de leur histoire tabagique en non-fumeurs (n=124), ancien fumeurs (n=98), et fumeurs (n=50). Des analyses monovariées et multivariées furent utilisées pour rechercher des associations entre les catégories de fumerus et les comptages, proportions et prévalences des espèces bactériennes. Résultats: De plus grandes différences étaient observées pour la prévalence (% de sites colonisés) des expèces testées dans les 3 groupes, que pour le comptage ou la proportion des comptages totaux. Les membres des complexes orange et rouge dont E. nodatum, F. nucléatum ss vicentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis, et T. denticolaétait significativement plus prévalent chez les fumeurs que dans les 2 autres groupes. La différence de prévalence entre les fumeurs et les non-fumeurs était due à une plus grande colonisation des sites dont la profondeur de poche était <4 mm. L'analyse par régression linéaire multiple stepwise indiquait que les combinaisons de la prévalence de 5 espèces microbiennes et les paquets-années comptaient pour 44% de la variance pour la moyenne de profondeur de poche (p<0.000001), alors que la prévalence de 3 taxons microbiens avec l'âge, les paquets-années, le tabagisme présent et le sexe comptaient pour 31% de la variance pour le niveau d'attache moyen (p<0.000001). La différence de prévalence entre les fumerus en activité et les non-fumeurs (jamais fumé) de tous les membres du complexe rouge et de 8 des 12 membres du complexe orange était significativement plus élevée au maxillaire qu'à la mandibule. Conclusions: La différence majeure entre les microflores sous gingivales chez les sujets ayant des histoires tabagiques différentes se trouvaient dans la prévalence des expèces plutôt que dans leurs quantité ou leurs proportions. La plus grande importance de colonisation chez les fumerus apparaît être dûe à une colonisation plus grande dans les poches <4 mm. Des différences des caractéristiques de colonisation entre les fumerus actifs et les personnes n'ayant jamais fuméétaient plus importantes au maxillaire qu'à la mandibule. [source]

A dose-response relationship between maternal smoking during late pregnancy and adult intelligence in male offspring

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2005
Erik Lykke Mortensen
Summary An association between maternal smoking during pregnancy and cognitive and behavioural development has been observed in several studies, but potential effects of maternal smoking on offspring adult intelligence have not been investigated. The objective of the present study was to investigate a potential association between maternal smoking during pregnancy and offspring intelligence in young adulthood. Adult intelligence was assessed at the mean age of 18.7 years by a military draft board intelligence test (Børge Priens Prøve) for 3044 singleton males from the Copenhagen Perinatal Cohort with information regarding maternal smoking during the third trimester coded into five categories (about 50% of the mothers were smokers). The following potential confounders were included as covariates in multivariable analyses: parental social status and education, single mother status, mother's height and age, number of pregnancies, and gestational age. In separate analyses, birthweight and length were also included as covariates. Maternal cigarette smoking during the third trimester, adjusted for the seven covariates, showed a negative association with offspring adult intelligence (P = 0.0001). The mean difference between the no-smoking and the heaviest smoking category amounted to 0.41 standard deviation, corresponding to an IQ difference of 6.2 points [95% confidence interval 0.14, 0.68]. The association remained significant when further adjusted for birthweight and length (P = 0.007). Both unadjusted and adjusted means suggested a dose-response relationship between maternal smoking during pregnancy and offspring adult intelligence. When subjects with missing data were excluded, essentially the same results were obtained in the reduced sample (n = 1829). These results suggest that smoking during pregnancy may have long-term negative consequences on offspring adult intelligence. [source]