Binge drinking and health-related quality of life: Do popular perceptions match reality?

doi:10.1016/j.amepre.2003.10.022

American Journal of Preventive Medicine

Volume 26, Issue 3, April 2004, Pages 230-233

https://doi.org/10.1016/j.amepre.2003.10.022 Get rights and content

Abstract

Background

Popular culture (movies, television shows, advertising) often portrays drinking to the point of intoxication as either humorous or associated with enjoyable social activities that enhance quality of life. This study examined the association between binge drinking (consuming five or more alcoholic drinks on one occasion) and health-related quality of life (HRQOL) among U.S. adults.

Methods

Data are from the Behavioral Risk Factor Surveillance System, a continuous random-digit-dial telephone survey of adults aged ≥18 years conducted in all states. This survey included questions about alcohol consumption and HRQOL.

Results

In 2001, 52% of U.S. adults were current drinkers (one or more drinks in the past 30 days). Of current drinkers, 11% were frequent binge drinkers (three or more episodes in past month) and 14% were infrequent binge drinkers (one to two episodes in past month). After adjusting for confounding factors, frequent binge drinkers were more likely than non-binge drinkers to experience ≥14 unhealthy days (physical or mental) in the past month (adjusted odds ratio [AOR]=1.39, 95% confidence interval [CI]=1.24–1.56), primarily because they had more mentally unhealthy days than non-binge drinkers (AOR=1.52, 95% CI=1.32–1.75).

Conclusions

Frequent binge drinking is associated with significantly worse HRQOL and mental distress, including stress, depression, and emotional problems. Effective interventions to prevent binge drinking should be widely adopted and may help improve quality of life.

Introduction

Binge drinking (consuming five or more drinks on one occasion)1 is responsible for a substantial proportion of the approximately 100,000 alcohol-related deaths per year in the United States.2 Adverse health and social outcomes associated with this behavior include unintentional injuries, interpersonal violence, suicides, unplanned pregnancy, emotional and legal problems, and lost productivity.3, 4, 5, 6, 7, 8, 9 Nonetheless, binge drinking is commonly portrayed in movies, television shows, and advertising as either humorous or associated with enjoyable social activities that enhance quality of life.10, 11, 12, 13, 14, 15, 16, 17, 18, 19 Films and television routinely associate alcohol with glamorous or sexually oriented activities,15, 18 and the alcohol beverage industry spends >$2 billion annually on advertising and promotion.20 The purpose of this study was to assess whether binge drinking is associated with an enhanced health-related quality of life (HRQOL) among U.S. adults.

Section snippets

Methods

The Behavioral Risk Factor Surveillance System (BRFSS) is a cross-sectional telephone survey operated by state health agencies with assistance from the Centers for Disease Control and Prevention. It represents the non-institutionalized civilian U.S. population aged ≥18 years.21, 22, 23, 24, 25 In 2001, all 50 states and the District of Columbia participated, and 203,021 persons completed the interview.

Respondents who report having at least one drink in the past 30 days were asked: “Considering

Results

Of 99,783 current drinkers, 10.7% (n =10,634) were frequent binge drinkers; 14.2% (n =14,189), infrequent binge drinkers; and 75.1% (n =74,960), non-binge drinkers. Compared with non-binge drinkers, binge drinkers were younger (mean age for frequent binge drinkers, 34.6 years; infrequent binge drinkers, 35.6 years; non-binge drinkers, 45.7 years); more likely to be male; have a high school education or less; never have been married; and to smoke (Table 1). After adjustment for age, frequent

Discussion

This study found that people who binge drink frequently (three or more times per month) are significantly more likely than non-binge drinkers to experience ≥14 unhealthy days (physical or mental) in the past month. This difference is due largely to more mentally unhealthy days (days when they experienced stress, depression, or other emotional difficulties) among frequent binge drinkers. In addition, women and older people (aged ≥55) who are infrequent binge drinkers (one to two times per month)

Acknowledgements

We are grateful to the state BRFSS coordinators for their participation in data collection for this analysis, and BRFSS Branch staff for their assistance in developing the database.

References (57)

H. Wechsler et al.
Environmental correlates of underage alcohol use and related problems of college students
Am J Prev Med
(2000)
E.M. Andresen et al.
Performance of health-related quality-of-life instruments in a spinal cord injured population
Arch Phys Med Rehabil
(1999)
J.E. Hathaway et al.
Health status and health care use of Massachusetts women reporting partner abuse
Am J Prev Med
(2000)
J.R. Vest et al.
Multistate analysis of factors associated with intimate partner violence
Am J Prev Med
(2002)
E.S. Ford et al.
Self-reported asthma and health-related quality of lifefindings from the Behavioral Risk Factor Surveillance System
Chest
(2003)
C.H. Denny et al.
Physician advice about smoking and drinkingare U.S. adults being informed?
Am J Prev Med
(2003)
T. Naimi et al.
Definitions of binge drinking
JAMA
(2003)
J.M. McGinnis et al.
Actual causes of death in the United States
JAMA
(1993)
National Institute on Alcohol Abuse and Alcoholism. Tenth special report to the US Congress on alcohol and health....
U.S. Department of Health and Human Services. Healthy people 2010. Vol. 1, 2nd ed. Washington DC: U.S. Government...

H. Wechsler et al.

Health and behavioral consequences of binge drinking in collegea national survey of students at 140 campuses

JAMA

(1994)

H. Wechsler et al.

Trends in college binge drinking during a period of increased prevention effortsfindings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

J Am Coll Health

(2002)

M.J. Schofield et al.

Sexually transmitted infections and use of sexual health services among young Australian womenwomen's health Australia study

Int J STD AIDS

(2000)

R. Wiscott et al.

Binge drinking in later lifecomparing young–old and old–old social drinkers

Psychol Addict Behav

(2002)

H. Wechsler et al.

Dying to drink: confronting binge drinking on college campuses

(2002)

Cohen JB. Reconceptualizing alcohol advertising effects: a consumer psychology perspective. In: Martin SE, ed. The...

N. Signorielli

Mass media images and impact on health. A sourcebook

(1993)

M.D. Slater et al.

Male adolescents' reactions to TV beer advertisementsthe effects of sports content and programming context

J Stud Alcohol

(1996)

P.A. Madden et al.

The frequency and nature of alcohol and tobacco advertising in televised sports, 1990 through 1992

Am J Public Health

(1994)

R.H. DuRant et al.

Tobacco and alcohol use behaviors portrayed in music videosa content analysis

Am J Public Health

(1997)

M.E. Lender et al.

Drinking in America

(1987)

National Center on Addiction and Substance Abuse at Columbia University. Teen tipplers: America's underage drinking...

T.S. Naimi et al.

Binge drinking among US adults

JAMA

(2003)

Kilbourne J. Deadly persuasion: advertising and addiction. In: Program and abstracts of the Alcohol Policy Conference...

Nelson DE, Holtzman D, Waller M, Leutzinger CL, Condon K. Objectives and design of the Behavioral Risk Factor...

J.S. Waksberg

Methods for random digit dialing

J Am Stat Assoc

(1978)

Iachan R, Schulman J, Powell-Griner E, Nelson DE, Mariolis P, Stanwyck C. Pooling state telephone survey health data...

Cited by (126)

Prior experience with flavored alcohol increases preference for flavored alcohol but flavor does not influence binge-like drinking behavior in mice
2023, Physiology and Behavior
Binge drinking can lead to various negative consequences and in non-experimental settings, alcohol usually contains flavoring, which may promote increased binge drinking. Preclinical models of binge-like drinking have been well established, however, the influence of flavor on alcohol preference and binge-like drinking has not been fully explored.
Male and female C57BL/6 J mice were tested via two-bottle choice with alcohol flavored with different concentrations of unsweetened Cherry flavor Kool-Aid and water. Next, mice were tested for preference for flavored alcohol over plain alcohol. Consumption of flavored alcohol versus water was examined over 48 h. Binge-like drinking with flavored alcohol was validated via drinking in the dark (DID). A separate cohort of mice underwent chronic DID for 6 weeks with either flavored or plain alcohol. After chronic DID, mice were then tested for preference for flavored versus plain alcohol and then alcohol consumption despite adverse effects was examined using the quinine adulteration test.
The 0.1% Kool-Aid concentration was chosen to use for further testing based on intake. Mice preferred Kool-Aid flavored alcohol over plain alcohol after the concentration test, but mice with no prior exposure to plain or flavored alcohol preferred plain over flavored alcohol. Throughout all initial testing, female mice showed increased alcohol intake compared to male mice. Both male and female mice showed binge-like drinking of flavored alcohol, with females having higher intake and blood alcohol levels. Kool-Aid flavor did not increase alcohol intake during chronic binge-like drinking. Previous exposure to flavored alcohol during DID increased the preference for flavored alcohol over plain alcohol but did not influence alcohol consumption despite adverse effects.
The present study indicates that prior experience with flavored alcohol increases preference and intake, suggesting an effect of learned safety from neophobia. However, flavor does not impact binge-like alcohol consumption or alcohol drinking despite negative consequences. Additionally, the current study shows that female mice will consume more flavored alcohol than males, similar to findings from other alcohol studies.
Binge drinking is associated with higher cortisol and lower hippocampal and prefrontal gray matter volume: Prospective association with future alcohol intake
2023, Neurobiology of Stress
Cortisol is a significant driver of the biological stress response that is potently activated by acute alcohol intake and increased with binge drinking. Binge drinking is associated with negative social and health consequences and risk of developing alcohol use disorder (AUD). Both cortisol levels and AUD are also associated with changes in hippocampal and prefrontal regions. However, no previous research has assessed structural gray matter volume (GMV) and cortisol concurrently to examine BD effects on hippocampal and prefrontal GMV and cortisol, and their prospective relationship to future alcohol intake.
Individuals who reported binge drinking (BD: N = 55) and demographically matched non-binge moderate drinkers (MD: N = 58) were enrolled and scanned using high-resolution structural MRI. Whole brain voxel-based morphometry was used to quantify regional GMV. In a second phase, 65% of the sample volunteered to participate in prospective daily assessment of alcohol intake for 30 days post-scanning.
Relative to MD, BD showed significantly higher cortisol and smaller GMV in regions including hippocampus, dorsal lateral prefrontal cortex (dlPFC), prefrontal and supplementary motor, primary sensory and posterior parietal cortex (FWE, p < 0.05). GMV in bilateral dlPFC and motor cortices were negatively associated with cortisol levels, and smaller GMV in multiple PFC regions was associated with more subsequent drinking days in BD.
These findings indicate neuroendocrine and structural dysregulation associated with BD relative to MD. Notably, BD-associated lower GMV regions were those involved in stress, memory and cognitive control, with lower GMV in cognitive control and motor regions also predicting higher levels of future alcohol intake in BD.
Understanding and treating suboptimal health status through tourism engagement: An exploratory study of Chinese domestic tourists
2022, Journal of King Saud University - Science
Suboptimal health status (SHS) is a global public health concern of worldwide academic interest. The topic is popular in the medical sciences, including public health; however, other disciplines have paid little attention to this condition despite aging societies. This study introduced SHS into the tourism literature, a logical connection given the established positive correlation between well-being and tourism engagement. Lifestyle factors are crucial to SHS. Accordingly, this study examines tourists’ sociodemographic characteristics, tourism-related attributes, and lifestyle behaviors to compare individuals with SHS to those with optimal health status.
Chinese tourists in Shandong Province, China who had visited Mount Tai within 6 months of study recruitment (October to December 2021) completed a pen-and-pencil survey to answer questions for this cross-sectional research study. In total, 360 surveys were eligible for analysis following initial screening.
The self-report SHS status survey, SHSQ-25, was used to determine the portion of study participants exhibiting symptoms of SHS. The descriptive analysis indicated that 36.4 % (n = 131) of the sample (N = 360) presented with SHS. Three lifestyle behavior factors (i.e., work stress, sleep length, and drinking length), five SHS domains (i.e., fatigue, cardiovascular system, immune system, digestive system, and mental status), and two tourism-related attributes (i.e., international travel frequency and travel expenditure) were integrated using canonical correlation analysis to determine relationships among these three domains.
Results from this study demonstrated the meaningful relationships among lifestyle behaviors, tourism-related attributes, and SHS. Previous work has implied that tourism participation may enhance individuals’ health status and well-being; however, conclusions from this study are contradictory to those findings. For travelers with SHS to fully benefit from tourism, more information is needed to develop suitable marketing strategies and tourism products. This study provides a starting point to direct future research to further explore motivations of and strategies to benefit tourists with SHS.
Changes in alcohol use as a function of psychological distress and social support following COVID-19 related University closings
2020, Addictive Behaviors
Amidst the coronavirus pandemic, universities across the country abruptly closed campuses and transitioned to remote learning. The effects of these unprecedented closures are unknown. The current study examined reported alcohol consumption during the week prior to and after campus closure at a public university in Northeast Ohio. Analysis of data from 1,958 students, who endorsed using alcohol in the past 30 days, demonstrates that alcohol consumption (amount and frequency) increased as time progressed. Those with more symptoms of depression and anxiety reported greater increases in alcohol consumption (assessed via retrospective timeline follow-back) compared to students with fewer symptoms. Furthermore, students with greater perceived social support reported less alcohol consumption. Together, these findings highlight the need for universities to offer services and programs to students that will minimize risk factors and maximize protective factors in order to reduce or prevent alcohol abuse during the coronavirus pandemic.
Prevalence of binge drinking and its association with mental health conditions and quality of life in Singapore
2020, Addictive Behaviors
Although heavy alcohol consumption has been linked to a myriad of adverse health problems, there is a paucity of population-based studies in Asian countries. The aims of this study were to determine the past-year prevalence of binge drinking in Singapore and its associations with socio-demographic factors, mental health conditions and quality of life.
Data from the Singapore Mental Health Study 2016 (N = 6126) on binge drinking were included in the analysis. Multiple logistic regressions were used to assess the adjusted odds ratio (OR_adj) between binge drinking and relevant socio-demographic variables, and mental health conditions.
In the sample, 13.7% of respondents reported past-year binge drinking, 17.6% of males and 9.8% of females were binge drinkers. Most of them were infrequent binge drinkers (7.3% binge drink less than monthly). Moderate associations between binge drinking and mood and anxiety disorders (OR_adj = 1.8–4.4), were noted, while associations with alcohol use disorders were much stronger (OR_adj = 5.3–9.7). Associations between binge drinking and anxiety disorders were observed exclusively in females (OR_adj = 2.3–3.3). Binge drinkers reported a lower quality of life compared to their non-binging counterparts; binge-drinking males seemed to be more affected.
The prevalence of binge drinking is low in Singapore compared to global estimates; most binge drinkers in Singapore were infrequent binge drinkers. However, binge drinking was found to be associated with a myriad of mental health conditions, and a decline in quality of life was noted among binge drinkers.
Alcohol use and binge drinking among men who have sex with men in China: Prevalence and correlates
2019, Drug and Alcohol Dependence
Both alcohol use/misuse and HIV incidence are increasing among men who have sex with men (MSM) in China. Little is known about predictors of alcohol use/misuse.
An online nationwide sample (n = 1100) of MSM from mainland China was recruited between 2014 and 2015. The study objective was to examine the prevalence of a history of alcohol use and frequency of binge drinking in the previous 6 months in this population and assess their relationship with psychological and public health issues.
Nearly 62.1% of respondents reported a history of alcohol use; 30.7% were current infrequent binge drinkers; and 13.6% were current frequent binge drinkers. Adjusted logistic models showed that MSM who reported a history of alcohol use were more likely to report drug use in the previous 6 months (AOR = 1.67); higher levels of internalized homophobia (AOR = 1.49); and partial or full disclosure of their sexual orientation (AOR = 1.46). MSM engaging in current frequent binge drinking were more likely to report female sexual partners (AOR = 2.04) and drug use (AOR = 1.61) in the previous 6 months; higher levels of sexual sensation seeking (AOR = 1.68); and higher levels of homosexual stigma (AOR = 1.69). MSM who reported being unsure of their HIV status were less likely to be current frequent binge drinkers (AOR = 0.46).
A high prevalence of a history of alcohol use and binge drinking exists among Chinese MSM. Strategies that target alcohol use/misuse in this population are needed.

View all citing articles on Scopus

^☆: The full text of this article is available via AJPM online at www.ajpm-online.net.

View full text

Brief reportBinge drinking and health-related quality of life: Do popular perceptions match reality?☆

Abstract

Background

Methods

Results

Conclusions

Introduction

Section snippets

Methods

Results

Discussion

Acknowledgements

Am J Prev Med

Arch Phys Med Rehabil

Am J Prev Med

Am J Prev Med

Chest

Am J Prev Med

Definitions of binge drinking

JAMA

Actual causes of death in the United States

JAMA

Health and behavioral consequences of binge drinking in collegea national survey of students at 140 campuses

JAMA

Trends in college binge drinking during a period of increased prevention effortsfindings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

J Am Coll Health

Sexually transmitted infections and use of sexual health services among young Australian womenwomen's health Australia study

Int J STD AIDS

Binge drinking in later lifecomparing young–old and old–old social drinkers

Psychol Addict Behav

Dying to drink: confronting binge drinking on college campuses

Mass media images and impact on health. A sourcebook

Male adolescents' reactions to TV beer advertisementsthe effects of sports content and programming context

J Stud Alcohol

The frequency and nature of alcohol and tobacco advertising in televised sports, 1990 through 1992

Am J Public Health

Tobacco and alcohol use behaviors portrayed in music videosa content analysis

Am J Public Health

Drinking in America

Binge drinking among US adults

JAMA

Methods for random digit dialing

J Am Stat Assoc

Brief report
Binge drinking and health-related quality of life: Do popular perceptions match reality?☆