SIMAH Publications

This study provides a review of the dose-response relationships between alcohol use and multiple diseases and injuries which are causally linked to alcohol use. The impact of multiple factors on the dose-response relationship is also described, with a focus on sex, socioeconomic status, and other behavioral risk factors.

https://doi.org/10.3390/nu13082652

Authors: Jürgen Rehm, Pol Rovira, Laura Llamosas-Falcón, Kevin D. Shield

Publication: Nutrients, July 2021

The findings of this study show that alcohol use is a clear risk factor for the incidence of and poor treatment outcomes from HIV, TB, and pneumonia. Emerging evidence suggests that heavy and chronic alcohol use is associated with an increased risk of acquisition of COVID-19 and more severe disease once infected.

https://doi.org/10.3390/nu13103317

Authors: Neo K. Morojele, Sheela V. Shenoi, Paul A. Shuper, Ronald Scott Braithwaite, Jürgen Rehm

Publication: Nutrients, Sept. 2021

The findings of this study show that individuals along the entire continuum of SES are exposed to increased alcohol-attributable mortality risk. Differences in the dose-response relationship can guide priorities in targeting public health initiatives.

https://doi.org/10.1186/s12916-021-02132-z

Authors: Charlotte Probst, Shannon Lange, Carolin Kilian, Celine Saul, Jürgen Rehm

Publication: BMC Medicine, Nov. 2021

Socio-economic inequalities in alcohol-attributable mortality make an important contribution to socio-economic health inequalities overall. A comprehensive approach to reducing socio-economic inequalities in alcohol-related health requires combining the implementation of evidence-based, cost-effective alcohol control policies with broader policy measures that act upon the structural, economic and social root causes of socioeconomic inequalities.

https://doi.org/10.1111/add.15466

Authors: Charlotte Probst, Carolin Kilian

Publication: Addiction, March 2021

This study developed a new computational model which uses psychological theory to model alcohol use. This model will aid future work to estimate changes in alcohol consumption following population-level interventions.

https://doi.org/10.1016/j.addbeh.2021.107094

Authors: Charlotte Buckley, Matt Field, Tuong Manh Vu, Alan Brennan, Thomas K Greenfield, Petra S Meier, Alexandra Nielsen, Charlotte Probst, Paul A Shuper, Robin C Purshouse

Publication: Addictive Behaviors, Jan. 2022

The findings of this study show that alcohol use disorders increased the risk for incident depressive disorders, but not the converse. Low socioeconomic status was an independent risk factor for both alcohol use and depressive disorders.

https://doi.org/10.1016/j.jad.2021.12.132

Authors: Aurélie M Lasserre, Sameer Imtiaz, Michael Roerecke, Markus Heilig, Charlotte Probst, Jürgen Rehm
Publication: Journal of Affective Disorders, March 2022

The findings of this study show that heavy alcohol use/alcohol use disorders were associated with elevated odds of past-year suicidal thoughts and attempted suicide for both men and women. A linear increase in the risk relationships over time was not found.

https://doi.org/10.1007/s00127-022-02225-x

Authors: Shannon Lange, Huan Jiang, Courtney Bagge, Charlotte Probst, Alexander Tran, Jürgen Rehm

Publication: Social Psychiatry and Psychiatric Epidemiology, Jan. 2022

The findings from this study show that suicide mortality rates among midle-aged men and women in the United States have increased between 1990 and 2019. In contrast, during the same period in Lithuania there was a downward trend in mortality rates.

https://doi.org/10.1186/s12888-022-03766-w

Authors: Shannon Lange, Jürgen Rehm, Alexander Tran, Courtney L. Bagge, Domantas Jasilionis, Mark S. Kaplan, Olga Meščeriakova-Veliulienė, Mindaugas Štelemėkas, Charlotte Probst

Publication: BMC Psychiatry, Feb. 2022

The findings of this study show that 66% (men) and 80% (women) of the deaths associated with low socioeconomic status were explained by lifestyle risk factors (alcohol use, smoking, physical inactivity and obesity). Notably, this result was driven by the greater exposure and clustering of unhealthy lifestyle factors among groups with low socioeconomic status, as opposed to an increased vulnerability to unhealthy lifestyle factors among groups with low socioeconomic status.

https://doi.org/10.1001/jamahealthforum.2022.0401

Authors: Klajdi Puka, Charlotte Buckley, Nina Mulia, Aurélie M Lasserre, Jürgen Rehm, Charlotte Probst

Publication: JAMA Health Forum, April 2022

The findings of this study quantify the temporal trend of the sex- and age-group-specific proportion of suicides that were alcohol-involved in the United States. Between 2003 and 2018, alcohol use preceding death by suicide increased among women compared with men.

https://doi.org/10.1111/add.15905

Authors: Shannon Lange, Mark S Kaplan, Alexander Tran, Jürgen Rehm

Publication: Addiction, May 2022

The findings from this study quantify the risk of dying from an alcohol-attributable cause of death for unemployed compared to employed individuals. The findings provide evidence that being unemployed is associated with an over three-fold higher risk of alcohol-attributable mortality compared with being employed.

https://doi.org/10.3390/ijerph19127354

Authors: Celine Saul, Shannon Lange, Charlotte Probst
Publication: International Journal of Environmental Research and Public Health, June 2022

The findings from this study quantify the contribution of alcohol-attributable causes of death to changes in US life expectancy between 2000 and 2018 by sex and socioeconomic status (SES). The SES gap in life expectancy increased by three years among men and five years among women, with alcohol-attributable deaths being a dominant driver of this socioeconomic divergence.

https://doi.org/10.1377/hlthaff.2021.01905

Authors: Charlotte Probst, Miriam Könen, Jürgen Rehm, Nikkil Sudharsanan

Publication: Health Affairs, Aug. 2022

The findings from this study quantify changes in the quantity and pattern of alcohol use over time at the individual level. This information is important for computer simulation techniques to inform their models.

https://doi.org/10.1111/add.16024

Authors: Klajdi Puka, Charlotte Buckley, Nina Mulia, Robin C Purshouse, Aurélie M Lasserre, William Kerr, Jürgen Rehm, Charlotte Probst

Publication:Addiction, Aug. 2022

This study evaluates the socioeconomic gradient of alcohol use in low-income and middle-income countries overall and within each country income group. The findings call for urgent alcohol control policies and interventions in low-income countries and lower-middle-income countries to reduce harmful heavy episodic drinking. Moreover, alcohol control policies need to be targeted at socially disadvantaged groups in upper-middle-income countries.
https://doi.org/10.1016/S2214-109X(22)00273-X

Authors: Yuanwei Xu, Pascal Geldsetzer, Jen Manne-Goehler, Michaela Theilmann, Maja-E Marcus, Zhaxybay Zhumadilov, Sarah Quesnel-Crooks, Omar Mwalim, Sahar Saeedi Moghaddam, Sogol Koolaji, Khem B Karki, Farshad Farzadfar, Narges Ebrahimi, Albertino Damasceno, Krishna K Aryal, Kokou Agoudavi, Rifat Atun, Till Bärnighausen, Justine Davies, Lindsay M Jaacks, Sebastian Vollmer, Charlotte Probst

Publication: The Lancet Global Health, Sept. 2022

The findings from this study quantify the dose-response relationship between alcohol consumption and the risk of liver cirrhosis for men and women. A non-linear dose-response relationship was identified for both men and women, with the risk of liver cirrhosis being higher among women.

https://doi.org/10.3389/fgstr.2022.1005729

Authors: Laura Llamosas-Falcón, Charlotte Probst, Charlotte Buckley, Huan Jiang, Aurélie M. Lasserre, Klajdi Puka, Alexander Tran, and Jürgen Rehm

Publication: Frontiers in Gastroenterology, Oct. 2020

The findings from this review show that daily drinking is associated with a significant increase in risk of liver cirrhosis compared to non-daily drinking, by about 70% for men and about 55% for women. These findings may be explained by consistent exposure to acetaldehyde and other toxins for daily drinkers. The authors conclude that there should be days of abstinence to allow the liver to recover, especially for heavier drinkers.

https://doi.org/10.1111/dar.13563

Authors: Laura Llamosas-Falcón, Alexander Tran, Huan Jiang, Jürgen Rehm

Publication: Drug and Alcohol Review, Oct. 2022

This study aimed to quantify disparities over time between educational and racial and ethnic groups in sex-specific mortality rates for opioid, alcohol, and combined alcohol and opioid poisonings in the USA. For all types of poisoning, the analysis indicates wide and increasing gaps between those with low and high education with the largest inequalities observed for opioid-involved poisonings for non-Hispanic Black and White men and women.

https://doi.org/10.1186/s12916-022-02590-z

Authors: Charlotte Buckley, Yu Ye, William C. Kerr, Nina Mulia, Klajdi Puka, Jürgen Rehm, Charlotte Probst

Publication: BMC Medicine, Oct. 2022

While nationally representative alcohol surveys are a mainstay of public health monitoring, they underestimate consumption at the population level. This paper demonstrates how to adjust individual-level survey data using aggregated alcohol per capita (APC) data for improved individual- and population-level consumption estimates.

https://doi.org/10.7895/ijadr.383

Authors: Charlotte Buckley, Alan Brennan, William C. Kerr, Charlotte Probst, Klajdi Puka, Robin C. Purshouse, Jürgen Rehm

Publication: International Journal of Alcohol and Drug Research, Dec. 2022

This study introduces The Simulation of Alcohol Control Policies for Health Equity (SIMAH) Project which employs a unique microsimulation approach to explore the contributions of alcohol use, socioeconomic status (SES), and race/ethnicity to the unequal trends in US life expectancy. The project integrates representative data from various sources into a comprehensive microsimulation model that incorporates changes in SES, alcohol use, and cause-specific mortality associated with alcohol use across different demographic groups.

https://doi.org/10.1093/aje/kwad018

Authors: Charlotte Probst, Charlotte Buckley, Aurélie M. Lasserre, William C. Kerr, Nina Mulia, Klajdi Puka, Robin C. Purshouse, Yu Ye, Jürgen Rehm

Publication: American Journal of Epidemiology, Jan. 2023

This review explores the association between alcohol use and sexually transmitted infections (STIs) excluding HIV. The findings indicate a significant association between alcohol use, particularly heavy drinking occasions, and STIs. The evidence also suggests that alcohol use contributes to risk-taking sexual behavior.

https://doi.org/10.7895/ijadr.381

Authors: Laura Llamosas Falcón, Omer S.M. Hasan, Paul A. Shuper, Jürgen Rehm

Publication: International Journal of Alcohol and Drug Research, Mar. 2023

The findings from this review indicate that doubling alcohol taxes or implementing minimun unit pricing at a rate of Int$ 0.90 per 10 grams of pure alcohol lead to a 10% reduction in alcohol consumption. Restricting alcohol sales by one day per week resulted in a 3.6% decrease in consumption. Pricing policies had a greater impact on consumption changes among low-income alcohol users.

https://doi.org/10.1016/j.eclinm.2023.101996

Authors: Carolin Kilian, Julia M. Lemp, Laura Llamosas-Falcón, Tessa Carr, Yu Ye, William C. Kerr, Nina Mulia, Klajdi Puka, Aurélie M. Lasserre, Sophie Bright, Jürgen Rehm, Charlotte Probst

Publication: eClinicalMedicine, May 2023

In this narrative mini-review, we discuss the extent to which socioeconomic differences exist in alcohol screening and brief intervention in the United States. Socioeconomic differences were evident in all stages of the alcohol screening and brief intervention cascade, however, individuals with low socioeconomic status appear to be more likely to receive and benefit from brief interventions when indicated. Accessing and affording healthcare was found to be the major obstacle to alcohol screening and brief intervention in those with low socioeconomic status.

https://doi.org/10.1016/j.addbeh.2023.107765

Authors: Carolin Kilian, Julia M. Lemp, and Charlotte Probst

Publication: Addictive Behaviours, October 2023

In this cohort study, we investigate whether racial and ethnic differences in all-cause mortality in the United States can be explained by differences in the exposure and vulnerability to harmful effects of different lifestyle factors. While alcohol, smoking, body mass index, and physical activity provide some explanation for the observed inequalities, other factors need to be studied to understand the determinants of these racial and ethnic inequalities.

https://doi.org/10.1186/s12889-023-16178-6

Authors: Klajdi Puka, Carolin Kilian, Yachen Zhu, Nina Mulia, Charlotte Buckley, Aurélie M. Lasserre, Jürgen Rehm, and Charlotte Probst

Publication: BMC Public Health, August 2023

We conducted a systematic review of 44 studies involving over 5 million participants to analyze the association between alcohol consumption and liver cirrhosis, distinguishing between different causes and outcomes. Non-linear dose-response relationships were identified, with higher alcohol consumption associated with an increased risk of both morbidity and mortality from cirrhosis. Drinking 25 g/day compared to lifetime abstention yielded a relative risk of 1.81 for morbidity and 2.65 for mortality, while 100 g/day resulted in RRs of 8.15 and 16.38, respectively. Notably, alcohol-related cirrhosis posed a higher risk than hepatitis C-related cirrhosis. These findings underscore the critical impact of alcohol on the burden of cirrhosis, particularly in terms of mortality, and provide valuable insights for accurately assessing attributable risks.

https://doi.org/10.1007/s12072-023-10584-z

Authors: Laura Llamosas-Falcón, Charlotte Probst, Charlotte Buckley, Huan Jiang, Aurélie M. Lasserre, Klajdi Puka, Alexander Tran, and Jürgen Rehm

Publication: Hepatology International, February 2024

The study aimed to assess the relationship between alcohol consumption and the risk of type 2 diabetes mellitus (T2DM), considering differences by sex and BMI. Data from 55 cohort studies involving over 2 million participants was analyzed. The results showed a J-shaped
relationship for women, indicating a maximum risk reduction of 31% with moderate alcohol intake, but no significant relationship for men. The protective effect was observed primarily in overweight and obese women.

https://doi.org/10.2337/dc23-1015

Authors: Laura Llamosas-Falcón, Jürgen Rehm, Sophie Bright, Charlotte Buckley, Tessa Carr, Carolin Kilian, Aurélie M. Lasserre, Julia M. Lemp, Yachen Zhu, and Charlotte Probst

Publication: Diabetes Care, November 2023

This commentary illustrates and discusses legislative changes that where introduced during the COVID-19 pandemic in the United States to expand alcohol home delivery and "to-go" sales, using 2020 and 2021 data from the Alcohol Policy Information System. Findings indicate that legislative changes have persisted beyond the peak of the pandemic, potentially becoming permanent. This prolonged liberalisation raises concerns about insufficient regulation, particularly regarding underage access and subsequent changes in drinking habits, suggesting a need for rigorous evaluation of public health impacts.

https://doi.org/10.1111/dar.13789

Authors: Julia M. Lemp, Carolin Kilian, and Charlotte Probst

Publication: Drug and Alcohol Review, December 2023

This study aimed to identify alcoholic beverage types more likely to be consumed by demographic subgroups with greater alcohol-related health risk than others, mainly individuals with low socioeconomic status (SES), racial/ethnic minority status, and high drinking levels. Adults with lower education and low or medium income were more likely to drink beer, liquor, and coolers, while those with a 4-year college/advanced degree and those with high income preferred wine. Excepting Asian adults, racial/ethnic minority adults were more likely
to drink beer (Hispanics) and liquor (Blacks), compared with White adults. High- or very-high-level drinkers were more likely to consume liquor and beer and less likely to consume wine (and coolers), compared with low-level drinkers.

https://doi.org/10.1111/dar.13819

Authors: Won Cook, William C. Kerr, Yachen Zhu, Sophie Bright, Charlotte Buckley, Aurélie M. Lasserre, Laura Llamosas-Falcón, Carolin Kilian, Nina Mulia, Robin Purshouse, Jürgen Rehm, and Charlotte Probst

Publication: Drug and Alcohol Review, February 2024

In this cohort study using unique, large representative mortality linked survey data covering 1997-2018 in the US, we found a stronger protective association between light to moderate drinking and IHD mortality in the high-SES group in both sexes even after adjusting for key covariables and behavioral risk factors. Other behavioral risk factors including smoking, BMI, and physical activity largely explained the harmful association with chronic heavy drinking in low-SES men.

https://doi.org/10.1001/jamanetworkopen.2023.54270

Authors: Yachen Zhu, Laura Llamosas-Falcón, William C. Kerr, Klajdi Puka, and Charlotte Probst

Publication: JAMA Network Open, February 2024

This study aimed to determine the dose-response relationships underlying the association between increasing levels of alcohol consumption and the occurrence of alcohol use disorder (AUD) incidence and mortality using 10 studies and 2 primary data sets. Exponential positive risk relationships were identified, with the risk of developing an AUD being greater than that of dying from an AUD, at an average consumption of 4 standard drinks per day when compared to current non-drinkers.

https://doi.org/10.1111/add.16456

Authors: Tess Carr, Carolin Kilian, Laura Llamosas-Falcón, Yachen Zhu, Aurélie M. Lasserre, Klajdi Puka, and Charlotte Probst

Publication: Addiction, March 2024

This study explores the impact of Sunday sales bans on alcohol consumption and mortality in different education groups in the United States. Survey data analyses suggest lower alcohol consumption when Sunday sales bans were in place, with an overall stronger effect in  those with high education. This was supported by a case study on the repeal of the Sunday sales ban in Minnesota in 2017, where alcohol-specific mortality increased after the repeal, especially among individuals with high education.

https://doi.org/10.1007/s11469-024-01267-3

Authors: Carolin Kilian, Julia M. Lemp, William C. Kerr, Nina Mulia, Jürgen Rehm, Yu Ye, and Charlotte Probst

Publication: International Journal of Mental Health and Addiction, February 2024

This study uses nationally representative data to quantify the mediating effects of healthcare access on socioeconomic disparities in all-cause mortality in the USA. It uncovers socioeconomic and temporal trends in healthcare access. Socioeconomic disparities in healthcare access contributed to increased mortality risk, with lack of insurance and unaffordable care accounting for 4-6% of mortality disparities between low- and high-education groups. The authors highlight the value of policies promoting equitable healthcare access to mitigate these disparities and improve public health outcomes.

Authors: Ishnaa Gulati, Carolin Kilian, Charlotte Buckley, Nina Mulia, Charlotte Probst

Publication: American Journal of Epidemiology