Abstract: Spouses tend to have similar lifestyles. We explored the degree to which spouse similarity in alcohol use, smoking, and physical exercise is caused by non-random mating or convergence. We used data collected for the Nord-Trondelag Health Study from 1984 to 1986 and prospective registry information about when and with whom people entered marriage/cohabitation between 1970 and 2000. Our sample included 19,599 married/cohabitating couples and 1,551 future couples that were to marry/cohabitate in the 14-16 years following data collection. All couples were grouped according to the duration between data collection and entering into marriage/cohabitation. Age-adjusted polychoric spouse correlations were used as the dependent variables in non-linear segmented regression analysis; the independent variable was time. The results indicate that spouse concordance in lifestyle is due to both non-random mating and convergence. Non-random mating appeared to be strongest for smoking. Convergence in alcohol use and smoking was evident during the period prior to marriage/cohabitation, whereas convergence in exercise was evident throughout life. Reduced spouse similarity in smoking with relationship duration may reflect secular trends.

Abstract: BACKGROUND: Young people's alcohol consumption is related to their parents' alcohol consumption, but little focus has been placed on whether there is a connection with parental intoxication. The purpose of the study was to investigate whether the experience of seeing their parents intoxicated is associated with young people's alcohol consumption and experimenting with drugs in their teens. MATERIAL AND METHOD: The study is prospective and based on data from 2,399 teenagers who took part in the Ung-HUNT 1 study in 1995-1997 and the Ung-HUNT 2 study in 2000-2001. Self-reported questionnaire data and analysis by means of logistic regression, stratified by gender, were used. RESULTS: Having been drunk > 10 times was associated with having seen their parents intoxicated among boys (OR 3.7; 95% CI 2.7-5.1 and girls (OR 2.0; 1.5-2.6). Drinking alcohol weekly or more frequently was associated with parental intoxication among boys (OR 2.2; 1.6-3.0), but not girls unless they had seen their parents drunk many times (OR 2.4; 1.1-5.2). Experimenting with drugs was associated with parental intoxication among both boys (OR 2.6; 1.7-3.9) and girls (OR 1.6; 1.1-2.2). INTERPRETATION: Repeated intoxication, frequent alcohol consumption and experimenting with drugs by teenagers were associated with seeing their parents intoxicated. There are other explanatory factors for which the study was unable to control, and interpretation of the results should take this into account.

Abstract: BACKGROUND: Aggregated measures are often employed when prevalence, risk factors and consequences of alcohol use in the population are monitored. In order to avoid time-dependent bias in aggregated measures, reference periods which assess alcohol use over longer time-periods or measures assessing typical alcohol use are considered superior to reference periods assessing recent or current alcohol consumption. Alcohol consumption in the population is found to vary through the months of the year, but it is not known whether monthly variations in actual alcohol use affects self-reports of long-term or typical alcohol consumption. Using data from a large, population-based study with data-collection over two years, the aim of the present study was to examine whether self-reported measures of alcohol use with different reference periods fluctuated across the months of the year. METHODS: Participants in the third wave of the Nord-Trondelag Health Survey (HUNT3) answered questions regarding alcohol use in the last 4 weeks, weekly alcohol consumption last twelve months, typical weekly binge drinking and typical number of alcoholic drinks consumed in a 14 day period. For each of the alcohol measures, monthly variations in reporting were estimated and compared to the overall average. RESULTS: Monthly variations in self-reported alcohol use were found across all alcohol measures regardless of reference period. A general tendency was found for highest level of alcohol use being reported during the summer season, however, the highest number of individuals who reported alcohol use in the last 4 weeks was found in January. Women reported substantially larger increase in weekly binge drinking during the summer months than men. CONCLUSIONS: Self-reports of alcohol use over longer time and typical alcohol use varies according to the month the respondents are assessed. Monthly variations should therefore be taken into account when designing, analyzing and interpreting data from population-based studies aimed to examine descriptive and analytical characteristics of alcohol use in the population.

Abstract: The relationship between alcohol consumption and dementia risk is unclear. This investigation estimates the association between alcohol consumption reported in a population-based study in the mid-1980s and the risk for dementia up to 27 years later. The entire adult population in one Norwegian county was invited to the Nord-Trondelag Health Study during 1984-1986 (HUNT1): 88 % participated. The sample used in this study includes HUNT1 participants born between 1905 and 1946 who completed the questionnaire assessing alcohol consumption. A total of 40,435 individuals, of whom 1084 have developed dementia, are included in the analysis adjusted for age, sex, years of education, hypertension, obesity, smoking, and symptoms of depression. When adjusting for age and sex, and compared to reporting consumption of alcohol 1-4 times during the last 14 days (drinking infrequently), both abstaining from alcohol and reporting consumption of alcohol five or more times (drinking frequently) were statistically significantly associated with increased dementia risk with hazard ratios of 1.30 (95 % CI 1.05-1.61) and 1.45 (1.11-1.90), respectively. In the fully adjusted analysis, drinking alcohol frequently was still significantly associated with increased dementia risk with a hazard ratio of 1.40 (1.07-1.84). However, the association between dementia and abstaining from alcohol was no longer significant (1.15, 0.92-1.43). Equivalent results for Alzheimer's disease and vascular dementia indicated the same patterns of associations. When adjusting for other factors associated with dementia, frequent alcohol drinking, but not abstaining from alcohol, is associated with increased dementia risk compared to drinking alcohol infrequently.

Abstract: OBJECTIVE: The present study aimed to examine anxiety, depression, sleep and alcohol outcomes among individuals who were prescribed benzodiazepines or z-hypnotics in a Norwegian population-based sample (n = 58,967). METHODS: This 13 year historical cohort study obtained baseline measures of self-report anxiety, depression, sleep difficulties and alcohol use from the Nord-Trondelag Health Study (HUNT 2, 1995-1997). Information about outcomes was collected from the third wave (HUNT 3, 2006-2008) of the same epidemiological study. Prescription records of benzodiazepines and z-hypnotics were obtained from the Norwegian prescription database (NorPD, 2004-2008) and were linked to the HUNT 2 and HUNT 3 questionnaire data. RESULTS: Among the 58,967 respondents who were eligible for the study, 13,774 (23%) received at least one prescription of benzodiazepines or z-hypnotics in the period 2004-2008. Benzodiazepine use was associated with a higher risk of severe anxiety, depression and sleep outcomes. The assumption that benzodiazepine use is prospectively associated with a higher risk of problematic alcohol use was not supported. CONCLUSIONS: Consideration and discussion of the future place of benzodiazepines in treatment of anxiety and sleep difficulties in Norway could be warranted. Benzodiazepines may be efficient in reducing symptoms in the short term, but evidence from this long temporal follow-up study indicates limited positive influences in the long term.

Abstract: OBJECTIVE: To examine whether physical activity (PA) moderates the association between alcohol intake and all-cause mortality, cancer mortality and cardiovascular diseases (CVDs) mortality. DESIGN: Prospective study using 8 British population-based surveys, each linked to cause-specific mortality: Health Survey for England (1994, 1998, 1999, 2003, 2004 and 2006) and Scottish Health Survey (1998 and 2003). PARTICIPANTS: 36 370 men and women aged 40 years and over were included with a corresponding 5735 deaths and a mean of 353 049 person-years of follow-up. EXPOSURES: 6 sex-specific categories of alcohol intake (UK units/week) were defined: (1) never drunk; (2) ex-drinkers; (3) occasional drinkers; (4) within guidelines (<14 (women); <21 (men)); (5) hazardous (14-35 (women); 21-49 (men)) and (6) harmful (>35 (women) >49 (men)). PA was categorised as inactive (</=7 MET-hour/week), active at the lower (>7.5 MET-hour/week) and upper (>15 MET-hour/week) of recommended levels. MAIN OUTCOMES AND MEASURES: Cox proportional-hazard models were used to examine associations between alcohol consumption and all-cause, cancer and CVD mortality risk after adjusting for several confounders. Stratified analyses were performed to evaluate mortality risks within each PA stratum. RESULTS: We found a direct association between alcohol consumption and cancer mortality risk starting from drinking within guidelines (HR (95% CI) hazardous drinking: 1.40 (1.11 to 1.78)). Stratified analyses showed that the association between alcohol intake and mortality risk was attenuated (all-cause) or nearly nullified (cancer) among individuals who met the PA recommendations (HR (95% CI)). CONCLUSIONS: Meeting the current PA public health recommendations offsets some of the cancer and all-cause mortality risk associated with alcohol drinking.

Abstract: BACKGROUND: The degree to which parental alcohol abuse is a risk factor for offspring mental distress is unclear, due to conflicting results of previous research. The inconsistencies in previous findings may be related to sample characteristics and lack of control of confounding or moderating factors. One such factor may be the gender of the abusing parent. Also, other factors, such as parental mental health, divorce, adolescent social network, school functioning or self-esteem, may impact the outcome. This study examines the impact of maternal and paternal alcohol abuse on adolescent mental distress, including potentially confounding, mediating or moderating effects of various variables. METHODS: Data from the Nord-Trondelag Health Study (HUNT), a Norwegian population based health survey, from 4012 offspring and their parents were analyzed. Parental alcohol abuse was measured by numerical consumption indicators and CAGE, whereas offspring mental distress was measured by SCL-5, an abbreviated instrument tapping symptoms of anxiety and depression. Statistical method was analysis of variance. RESULTS: Maternal alcohol abuse was related to offspring mental distress, whereas no effect could be shown of paternal alcohol abuse. Effects of maternal alcohol abuse was partly mediated by parental mental distress, offspring social network and school functioning. However, all effects were relatively small. CONCLUSIONS: The results indicate graver consequences for offspring of alcohol abusing mothers compared to offspring of alcohol abusing fathers. However, small effect sizes suggest that adolescent offspring of alcohol abusing parents in general manage quite well.

Abstract: OBJECTIVE: To assess changes in self-reported fertility from the mid-1990s to the mid-2000s. DESIGN: The study is a retrospective population-based study. SETTING: The study applied a dataset from two cross-sectional surveys conducted in the mid-1990s and some 10 years later, inviting all women in a county in Norway. POPULATION: Women aged 50-59 years enrolled in either survey constituted two cohorts. Data on 4468 women in the first survey (Cohort 1940) and 4951 women in the latter survey (Cohort 1950) were collected by structured questionnaires. MAIN OUTCOME MEASURES: Prevalence of fertility, infertility with subcategories subfertility and involuntary childlessness, as well as childlessness was estimated and compared between the surveys. Possible sociodemographic and lifestyle predictors of fertility were assessed at different points in time. RESULTS: Fertility declined over the two successive surveys; 87.8% of the women in Cohort 1940 were fertile compared with 84.2% of the women in Cohort 1950 (p = 0.000). The prevalence of infertility increased over time due to an increase in subfertility from 7.8 to 10.6% (p = 0.000). The level of education increased with time, as did at-risk alcohol consumption and smoking, and these factors were adversely associated with fertility. The proportion of childless women increased across surveys (p = 0.004) but relatively fewer women were involuntarily childless in Cohort 1950 than in Cohort 1940 (p = 0.543). CONCLUSION: Fertility, measured at 10-year intervals, declined significantly. The decline in fertility was related to changes in subfertility. Adjustments for sociodemographic and lifestyle factors did not fully explain the decline in fertility.

Abstract: BACKGROUND: Previous studies have demonstrated that high alcohol consumption is a predictor of divorce. However, there is a lack of studies with prospective data from both spouses. The effects of drinking among husbands versus wives and of concordant versus discordant drinking in couples are therefore unknown. Concordant drinking may lead to increased divorce rates because the malignant effects of heavy drinking are experienced in double doses; alternatively it may lead to marital stability due to partner compatibility. METHODS: All inhabitants in a Norwegian county were invited to participate in a health study. We identified 19,977 married couples where both spouses participated. Respondents provided information on alcohol use and mental distress. Survival analysis was applied to study the risk of divorce over the next 15 years. Demographics and mental distress were used as covariates. RESULTS: Heavy drinking among men (hazard ratio [HR] = 1.39) and women (HR = 1.41) increased the risk of future marital dissolution, even after adjusting for demography (reference group “light drinkers”). The HR for divorce was 1.51 when only the husband was a heavy drinker, while it was 3.07 when only the wife was a heavy drinker. Moreover, there were strong interaction effects: concordant abstainers (HR = 0.40) and concordant heavy drinkers (HR = 0.35) had lower risks of divorce compared to the risk expected from combining the main effects. Nevertheless, couples with 2 heavy drinkers (HR = 1.63) had higher risk of divorce than couples with 2 light drinkers. CONCLUSIONS: This study demonstrated that both the level of alcohol use and compatibility in alcohol use are important predictors of marital dissolution.