Short CommunicationRisky drinking and its detection among medical students
Highlights
► Half of male and quarter of female medical students are risky alcohol drinkers. ► During the first study year drinking increases among half of the students. ► After the first study year female risky drinkers decrease but men increase drinking. ► AUDIT-3 is an effective drinking screen among male but not for female students.
Introduction
Physicians' own health habits can significantly influence the amount and quality of work with patients suffering from alcohol or drug related disorders (Brotons et al., 2005, Frank, 2004, Frank et al., 2000). Also, health habits during the medical studies can affect students' attitudes to counselling (Frank, Galuska, Elon, & Wright, 2004). However, the licensed medical personnel including medical students generally thinks that it is the doctor's duty to intervene/confront the patients' alcohol problem (Aalto et al., 2001, Cape et al., 2006).
Studies among medical students show that about 90% drinks alcohol (Akvardar et al., 2004, Pickard et al., 2000, Thakore et al., 2009). Both the number of drinkers and the drinking amount have increased during the past three decades (Boland et al., 2002). However, medical students drink alcohol less in comparison with other academic students (Kunttu & Huttunen, 2008). Compared with students in dentistry, medical students tend to drink alcohol less frequently during all phases of their studies (Newbury-Birch, Lowry, & Kamali, 2002). In a German study it was observed that risky alcohol drinking is more frequent among medical students than in a matched age group of 18 to 29 year old individuals in general population, the difference being more robust in male than female subgroup (Voigt et al., 2009). Another German study showed that more than half of medical students using alcohol occasionally drank in binges and almost one third of them at least twice a week (Keller, Maddock, Laforge, Velicer, & Basler, 2007).
Based on interviews the prevalence or risky alcohol drinking among medical students has been estimated at about 30% (Ashton and Kamali, 1995, Granville-Chapman et al., 2001, Voigt et al., 2009). Using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire (Saunders, Aasland, Babor, de la Fuente, & Grant, 1993) the prevalence has varied between 18 to 52% (Granville-Chapman et al., 2001, Shah et al., 2009). The short version of the AUDIT (AUDIT-C) which comprises the three AUDIT questions on drinking quantities is as sensitive as the whole AUDIT to detect risky drinking according to findings in various studies (Meneses-Gaya et al., 2010). Using the AUDIT-C the prevalence of risky alcohol drinking among university students was 68% (Kypri et al., 2009). No prevalence data is available using the AUDIT-C screening instrument among medical students.
The aim of this study was to explore the prevalence of risky alcohol drinking detected by the AUDIT-C and the predictive factors associated with it among medical students. Further, the aim was to evaluate the feasibility of the structured binge drinking question (AUDIT-3) in detecting risky drinking among them.
Section snippets
Subjects and methods
The study was approved by the Dean of the University and the Study Director. All the students in the faculty were presented with the anonymous survey questionnaire at the compulsory exam of cumulative medical knowledge in April 2007. The study sample consisted of replies of 465 students yielding to 94% reply rate.
Basic demographic data, information on alcohol use (including the AUDIT-C questionnaire), smoking and experimenting with illicit drugs were collected (Meriläinen, Heinälä, & Seppä, 2010
Results
The mean AUDIT-C score (range 0–12) for women (n = 292) was 3.3 (range 0–10) and 5.5 (range 0–12) for men (n = 173). Risky alcohol drinkers accounted for 155 (33%), in subsample of women (AUDIT-C ≥ 5) 71/292 (24%) and men (AUDIT-C ≥ 6) 84/173 (49%).
The drinking patterns of risky drinkers during the first study year were almost identical in both genders, but consequently women significantly decreased and men increased their drinking. Significantly more men than women had thought of reducing drinking (
Discussion
Risky drinking among medical students was common, especially among men. Men increased more significantly their alcohol drinking after the first study year than women and more male than female risky alcohol drinkers had thought of reducing drinking. Among men the AUDIT-3 was almost as reliable as AUDIT-C in detecting risky alcohol use.
This study captured a representative sample of students in the faculty. The weakness of it is that the AUDIT-C was used as the golden standard. Because of this we
Role of funding sources
This study was supported by the University of Tampere, Finland, which had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit it for publication.
Contributors
Kaija Seppä, Anna-Stiina Svidkovski and Pekka Heinälä designed the survey and wrote the protocol. Jaakko Ketoja did the literature searches and the statistical analyses and wrote the first draft of the manuscript. All authors have contributed to the final version and have approved it.
Conflict of interest
All authors have no conflict of interest in relation to this research.
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