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Background: Alcohol is the most used substance among adolescents in Nigeria. While risk factors for alcohol use among adolescents are well documented in Europe and the US, they have received less attention in the literature on African countries. This study aimed to investigate the factors associated with alcohol experimentation and drunkenness episodes in a national sample of Nigerian adolescents. Methods: A total sample of 4,078 secondary-school students participated in the survey during the school year 2015-2016. The survey involved 32 secondary schools of six geopolitical zones (South-South, South-West, South-East, North-Center, North-West, and North-East) and two metropolitan cities (Abuja and Lagos) of Nigeria. Sociodemographic characteristics, parental alcohol use and permissiveness, friends' alcohol use, risk perceptions and beliefs were investigated as correlates of alcohol experimentation and drunkenness episodes through multilevel, mixed-effect logistic regression models. Results: The prevalence of alcohol experimentation was 34.0%, while the prevalence of drunkenness episodes was 13.4%. Results showed that male gender, family structure different from both parents' families, parental and friends' alcohol use, parental permissiveness to drink, low risk perceptions on drinking alcohol, and positive beliefs on consequences of alcohol use were associated with an increased probability of alcohol experimentation and drunkenness episodes. Family affluence and one-parent family structure were related to an increased probability of alcohol experimentation but not of drunkenness episodes. Conclusions: The majority of risk factors analyzed in this study generalize across drinking-behavior outcomes. Since the young population is dominant in Nigeria, alcohol use could become a big public health problem in the near future. High investment in adolescents' well-being by addressing the factors that contribute to drinking behavior might help to reduce the burden of the problem. Evidence-based prevention curriculum addressing knowledge, risk perceptions, beliefs on consequences of alcohol use, and parental behaviors should be implemented as widely and early as possible.

Background School-based programs are the most convenient interventions to tackle substance use among youth. “Unplugged” is a Social Influence universal school curriculum developed and tested in the “EU-Dap” project. In 2015, Nigeria implemented a large-scale project to promote healthy lifestyles in schools, families and communities. Within the project, the effectiveness of “Unplugged” was evaluated through a cluster randomized controlled trial. Methods The program was adapted to the Nigerian context, assembling suggestions from monitoring forms and interviews, and performing fidelity checks on content and method. Thirty-two secondary schools were extracted from a list provided by the Federal Ministry of Education, and randomly allocated to intervention and control arms. A self-completed anonymous questionnaire was used for baseline and follow-up surveys. The analysis sample finally included 2685 pupils (mean age 14.2 years). Multilevel models were run to estimate program effects on prevalence of self-reported cigarettes, alcohol, and marijuana use. Mediation analysis was performed to identify possible mediators of program effect on alcohol use. Results Unplugged significantly reduced the prevalence of recent alcohol use in intervention vs control pupils. The effect on prevalence of cigarette and marijuana use was not statistically significant. The program prevented progress and encouraged regress across stages of intensity of alcohol use. Negative beliefs, risk perceptions, and class climate mediated the effect of Unplugged on alcohol use. Conclusions Unplugged was effective in preventing alcohol use improving beliefs, class climate and risk perceptions among Nigerian students. The implementation of the program at a larger scale in the country should be supported.

OBJECTIVE This study aims to ascertain and compare the prevalence and correlates of alcohol-related harms to children cross-nationally. METHOD National and regional sample surveys of randomly selected households included 7,848 carers (4,223 women) from eight countries (Australia, Chile, Ireland, Lao People's Democratic Republic [PDR], Nigeria, Sri Lanka, Thailand, and Vietnam). Country response rates ranged from 35% to 99%. Face-to-face or telephone surveys asking about harm from others' drinking to children ages 0-17 years were conducted, including four specific harms: that because of others' drinking in the past year children had been (a) physically hurt, (b) verbally abused, (c) exposed to domestic violence, or (d) left unsupervised. RESULTS The prevalence of alcohol-related harms to children varied from a low of 4% in Lao PDR to 14% in Vietnam. Alcohol-related harms to children were reported by a substantial minority of families in most countries, with only Lao PDR and Nigeria reporting significantly lower levels of harm. Alcohol-related harms to children were dispersed sociodemographically and were concentrated in families with heavy drinkers. CONCLUSIONS Family-level drinking patterns were consistently identified as correlates of harm to children because of others' drinking, whereas sociodemographic factors showed few obvious correlations.

Callinan, S., Laslett, A., Rekve, D., Room, R., Waleewong, O., Benegal, V., Casswell, S., Florenzano, R., Hanh, H., Hanh, V., Hettige, S., Huckle, T., Ibanga, A., Obot, I., Rao, G., Siengsounthone, L., Rankin, G., & Thamarangsi, T. (2016). Alcohol’s harm to others: An international collaborative project. The International Journal Of Alcohol And Drug Research, 5 (2), 25-32. doi: http://dx.doi.org/10.7895/ijadr.v5i2.218 Aims: This paper outlines the methods of a collaborative population survey project measuring the range and magnitude of alcohol’s harm to others internationally. Setting: Seven countries participating in the World Health Organization (WHO) and ThaiHealth Promotion Foundation (ThaiHealth) research project titled “The Harm to Others from Drinking,” along with two other countries with similar studies, will form the core of a database which will incorporate data from other countries in the future. Measures: The WHO-ThaiHealth research project developed two comparable versions of a survey instrument, both measuring harm from others’ drinking to the respondent and the respondent’s children. Design: Surveys were administered via face-to-face methods in seven countries, while similar surveys were administered via computer-assisted telephone interviews in two additional countries. Responses from all surveys will be compiled in an international database for the purpose of international comparisons. Discussion: Harms from the alcohol consumption of others are intertwined with the cultural norms where consumption occurs. The development of this database will make it possible to look beyond reports and analyses at national levels, and illuminate the relationships between consumption, harms, and culture. Conclusions: This database will facilitate work describing the prevalence, patterning, and predictors of personal reports of harm from others’ drinking cross-nationally.

Drinking habits are socially patterned and social networks influence individuals' drinking behaviors. Previous studies have focused primarily upon the influence from family members to drink less. Those studies that have focused upon peer influence have been largely confined to social norms among adolescent and college-age drinkers. By contrast, based in adult populations, this article examines exhortations from friends not only to reduce alcohol consumption but also to increase it. Survey data in 15 countries that participate in the Gender, Alcohol and Culture: An International Study project (GENACIS) were used to test whether there were country and gender differences concerning the influence to drink less or to drink more by friends and examine if this was affected by the drinking behavior. The findings revealed that those influenced to drink less had more heavy episodic drinking (HED) occasions than those who did not report such influence. By contrast, influence to drink more, originating mainly from same-sex friends, may be more the result of social situations that encourage all drinkers, regardless of their frequency of HED occasions. At the country level, influence to drink less for both sexes decreased with the proportion of drinkers in a country. Similarly, influence to drink less for both sexes also decreased in countries where gender roles were more egalitarian. Thus, in countries where alcohol use is more widespread and fewer differences are observed between male and female gender role expectations, fewer people were influenced to drink less. These findings have implications for social and behavioral strategies designed to reduce alcohol-related harm across a wide range of cultures.

Though affected others probably outnumber those actually misusing alcohol and drugs, the services that are available to them are marginal and do not adequately meet the needs of this growing population of concerned family members (FMs). Evidence available suggests that the 5-Step Method is effective in supporting FMs who are concerned about their relatives’ drinking or drug misuse. However, not all evidence-based treatments are being used by health care practitioners. The challenge of the 5-Step Method would thus be making it available to the FMs in need. This article looks at the development and experience of providing this intervention in a format that can be accessed on the internet by FMs. Preliminary results show that the internet is viable for the dissemination of the 5-Step intervention with the potential of reaching many affected FMs. FMs reported this online version as straight forward, easy to use and helpful. Ways in which the delivery of the programme might be improved for the increased benefi...

The final contribution to this special supplement of Drugs: Education, Prevention and Policy draws together some of the points that have been made in the other contributions regarding future directions which are needed in the further development of the 5-Step Method. These include: more detailed theoretical developments; testing the suitability of the method for particular groups of affected family members, including young people and those experiencing particularly complex problems including domestic violence; further study of different ways of delivering the intervention including those that are web based; new research with larger samples and longer follow-up; the inclusion of types of families missing from the studies so far, including reconstituted families, gay and lesbian families, and families with more than one substance misuser; and further investigations of the costs associated with the family impacts of alcohol and drug problems, as well as cost–benefit studies of the 5-Step Method. Although much remains to be done, the programme of research carried out to date in the UK, Mexico and Italy has only strengthened our commitment and passion for this area of work. We believe the evidence accumulated in support of approaches such as the 5-Step Method is already sufficiently compelling that they should be implemented without waiting for further detailed research evidence.

This article is based upon the collective findings of a number of studies conducted in a number of countries during the past 20 years. Female partners and mothers are the family members who have been most represented in the study samples, but the latter also included sizeable numbers of male partners, fathers, sisters, brothers and adult sons and daughters. Citing examples taken from the studies, the article describes some of the most prominent elements of the stressful experience of living with a relative who is drinking or taking drugs excessively, notably: the relationship with a relative becoming disagreeable and sometimes aggressive; conflict over money and possessions; the experience of uncertainty; worry about the relative; and home and family life being threatened. The reasons why family members may put up with substance misuse are described, and the ways in which family members may either withdraw and gain independence or stand up to substance misuse, as alternative ways of coping, are outlined. Examples of the strain experienced by family members are given. The kinds of social support valued by family members are explained, as is the finding that good quality social support for family members is often lacking. The article concludes by offering an integrated view highlighting the disempowered position in which family members usually find themselves and the importance of good social support for family members in their coping efforts. Although the picture is coloured by factors such as sociocultural group and the ages and genders of family members and their relatives, we believe the core experience for affected family members is a universal one.

This study set out to investigate the pressures experienced by different individuals to drink, or drink a little more than intended, by someone who drinks or drinks more than they do. A total of 2099 Nigerian adults between the ages of 18 and 65 years were randomly sampled. The frequency with which they experienced such other drinkers encouraging them to drink or drink more than intended from various sources was examined. Logistic regression was used to identify significant individual predictors of receiving pressure by sources of influence. Focus group discussions were also held to examine how these pressures are applied in various settings. Results indicated that male friends or acquaintances were the sources respondents reported influenced them the most to drink or drink more. Significant predictors of pressure varied by source but tended to include religion (5 of 6 sources) and gender (3 of 6). Results showed that pressure to drink or drink a little more was seen to come more from males than from females. It raises the need to have a better knowledge of these factors, particularly as they may relate to heavy or problematic drinking, and their implications for prevention and treatment.