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Aims Alcohol policy effects on alcohol's harms due to others' drinking (AHTO) and contextual factors that may mediate such policy effects have been understudied. This study examines state binge drinking prevalence as a mediator of the relationship between state alcohol policy and socioeconomic environments and individual-level AHTO. Methods A nationally representative sample of US adults (N  = 32,401; 13,873 males, 18,528 females) from the 2000, 2005, 2010 and 2015 National Alcohol Surveys and the 2015 National Alcohol's Harm to Others Survey, administered in telephone interviews and based on random digit dialed sampling, were linked with state-level Alcohol Policy Scale (APS) scores, binge drinking prevalence and socioeconomic status (SES) data. Three 12-month AHTO measures were family/marriage difficulties, assault or vandalism and riding with drunk driver or having traffic accident. Three-level mediation analyses were conducted, controlling for gender, race, education, marital status, family problem-drinking history and state policing rate. Results The effects of the APS on reduced risks for assault/vandalism and drinking-driving harms were significantly mediated by reduced state binge drinking prevalence. The APS had no direct or indirect effect on family/marital trouble. State SES had significant indirect effects on increased risks for assault/vandalism and driving-related harm through increased state binge drinking prevalence and a direct effect on reduced family/marital problems. Conclusions A more stringent alcohol policy environment could reduce assault/vandalism and driving-related harm due to another drinker by lowering state binge drinking rates. Alcohol policies may not be effective in reducing family problems caused by another drinker more prevalent in low-SES states. [ABSTRACT FROM AUTHOR]

Co-use of multiple drugs may prolong or increase heavy drinking, even for individuals with health conditions adversely affected by it. Patterns of alcohol and drug use may vary across racial/ethnic groups, with differential implications for health. This study examines racial/ethnic differences in the associations between risky drinking and other drug use in adults with diabetes, hypertension, heart disease, or cancer. Multiple logistic regression modeling, stratified by condition, was performed using a nationally representative sample of adults drawn from the 2015 to 2019 National Survey on Drug and Health. The outcome was risky drinking (consuming more than 7/14 drinks weekly). Other drugs considered were tobacco, marijuana, illicit drugs, and non-medical prescription drugs. Covariates included age, sex, education, income, marital/cohabitation status, health insurance coverage, and self-rated health status. Each drug category was positively associated with risky drinking across all four conditions. Racial/ethnic minority adults were less likely than White adults to engage in risky drinking, with this pattern most consistent for those with hypertension. Other drug use in minority adults (i.e. tobacco and illicit drug use in Black and Hispanic adults, and marijuana and prescription drug use in Asian adults) was associated with disproportionately greater odds of risky drinking compared with White adults. This pattern was more prominent for those with a heart condition, and not found for those with cancer. Future interventions might address co-use of alcohol and other drugs in adults with chronic conditions, with special attention to racial/ethnic minority adults. [ABSTRACT FROM AUTHOR]