In the US and worldwide, the vast majority of studies of alcohol's harms have focused on outcomes experienced by the drinker, given that alcohol use causes significant morbidity and mortality. However, alcohol adversely affects not only individual drinkers, but also other people, including family members, friends, co- workers and strangers. With the exception of a few areas (such as drink driving and fetal alcohol effects), alcohol's harms to others (or externalities), are largely understudied, particularly in the US. Initial studies in Australia and ew Zealand suggest excessive drinking can harm families, cause child abuse or neglect, and cost people other than the drinker time, money, and peace of mind, potentially doubling the social costs directly associated with harms to drinkers themselves. There has been a complete absence of US population-wide data of alcohol's harms to others, excepting preliminary work for the present application that uses a brief scale in the National Alcohol Survey (NAS). Responding to PA-11-016 (Epidemiology & Prevention), we propose the first comprehensive investigation of harms due to others' heavy drinking, as experienced by US adults, studying types and sources of such harms, as well as impacts on health-related quality of life, mental health and time and financial burdens. To leverage the already-funded 2014-15 NAS (expected NH5,270) we plan to add 10 minutes of detailed questions for respondents reporting harm from others' drinking (expected nH1,580), as well as to field a parallel, specialized US-wide Alcohol's Harms to Others survey (NH2,250). Both surveys will include common items and scales and use the same sampling design (dual-frame landline/cell phone RDD CATI surveys, oversampling African Americans and Hispanics). This will permit pooling data for certain analyses to achieve greater power and precision. Current aims include to (1) comprehensively estimate the prevalence, sources and seriousness of alcohol's harms to others, and test hypotheses about individual differences in these; (2) test hypotheses regarding environmental influences (drinking contexts and neighborhood context, e.g., urbanity, socioeconomic disadvantage, disorder and alcohol outlet density) to gain insight about how such harms might be prevented; (3) estimate multi-level models to examine the roles of state alcohol taxes, policies on alcohol availability, and 'wet' to 'dry' drinking cultures. We will investigate the interplay of these levels of influence on the occurrence, sources and severity of the harms. In addition to the novel direction of the research (the first US adult population survey of alcohol's harms to others), an innovation is the proposed use of propensity score matching techniques to contrast outcomes (such as mental health impacts) while addressing the place-based sorting and selection effects common in contextual analysis. As part of this work, we will identify high-risk situations associated with severe harms from others' drinking that may be amenable to preventive interventions, and examine pathways of influence, with a goal of helping to inform prevention strategies and evaluate alcohol policies that may help reduce harms from other drinkers.

Public Health Relevance

This survey project would be the first to assess the types and seriousness of harms from others' drinking in the US national adult population. It will apply new metrics including detriments to quality of life, mental health, and other costs, to gauge the severity of these second-hand impacts of alcohol. By studying comprehensively, and for the first time, how relationships of victims and perpetrators, neighborhood social and economic factors, and state alcohol policies may add to or reduce risks of heavy drinkers' harms to families, friends, and strangers, the research will inform prevention planning and generate findings relevant for development of evidence- informed alcohol policies.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Study Section
Community Influences on Health Behavior (CIHB)
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Bloss, Gregory
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Public Health Institute
Research Institutes
United States
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Karriker-Jaffe, Katherine J; Li, Libo; Greenfield, Thomas K (2018) Estimating mental health impacts of alcohol's harms from other drinkers: using propensity scoring methods with national cross-sectional data from the United States. Addiction 113:1826-1839
Zemore, Sarah E; Karriker-Jaffe, Katherine J; Mulia, Nina et al. (2018) The Future of Research on Alcohol-Related Disparities Across U.S. Racial/Ethnic Groups: A Plan of Attack. J Stud Alcohol Drugs 79:7-21
Karriker-Jaffe, Katherine J; Room, Robin; Giesbrecht, Norman et al. (2018) Alcohol's Harm to Others: Opportunities and Challenges in a Public Health Framework. J Stud Alcohol Drugs 79:239-243
Room, Robin; Callinan, Sarah; Greenfield, Thomas K et al. (2018) The social location of harm from others' drinking in 10 societies. Addiction :
Stanesby, Oliver; Callinan, Sarah; Graham, Kathryn et al. (2018) Harm from Known Others' Drinking by Relationship Proximity to the Harmful Drinker and Gender: A Meta-Analysis Across 10 Countries. Alcohol Clin Exp Res 42:1693-1703
Graham, Kathryn; Bernards, Sharon; Laslett, Anne-Marie et al. (2018) Children, Parental Alcohol Consumption, and Intimate Partner Violence: A Multicountry Analysis by Perpetration Versus Victimization and Sex. J Interpers Violence :886260518804182
Tedor, Miyuki Fukushima; Quinn, Linda M; Wilsnack, Sharon C et al. (2018) Gender and Country Differences in Alcohol-Aggression Expectancy and Alcohol-Related Intimate Partner Violence. Deviant Behav 39:554-575
Callinan, S; Rankin, G; Room, R et al. (2018) Harms from a partner's drinking: an international study on adverse effects and reduced quality of life for women. Am J Drug Alcohol Abuse :1-9
Kaplan, Lauren M; Greenfield, Thomas K; Karriker-Jaffe, Katherine J (2018) Examination of associations between early life victimisation and alcohol's harm from others. Drug Alcohol Rev 37:365-374
Karriker-Jaffe, Katherine J; Greenfield, Thomas K; Kaplan, Lauren M (2017) Distress and alcohol-related harms from intimates, friends, and strangers. J Subst Use 22:434-441

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