“The Dop System of Alcohol Distribution is Dead, but It’s Legacy Lives On….”
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. General Patterns of Alcohol, Drug, and Tobacco Use
3.2. Dop Prevalence over Time by Sample and Residence
3.3. Rates of Total FASD and by Specific Diagnoses
3.4. Association Analysis: The Direct Relationship between Heavy Drinking, FASD Diagnoses, and Dop Experience
4. Discussion
4.1. The Dop System in Contemporary Western Cape Communities
4.2. Has the Dop System Been Influential in Today’s Alcohol Use Patterns?
5. Limitations and Strengths of the Study
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Community A | Community/Region B | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sample 1 [1997] (n = 86) | Sample 2 [1999] (n = 211) | Sample 3 [2002] (n = 222) | Sample 4 [2008] (n = 303) | Sample 5 [2010] (n = 466) | Test-Score | p | Sample 1 [2009] (n = 670) | Sample 2 [2011] (n = 450) | Test-Score | p | ||||||||
Current Alcohol Consumption | ||||||||||||||||||
Drank in past 12 months (% Yes) | 58.1 | 53.0 | 41.6 | 48.2 | 56.0 | χ2 = 15.532 | 0.004 | 54.3 | 66.6 | χ2 = 14.902 | <0.001 | |||||||
Drank in past 30 days (% Yes) | 58.1 | 50.9 | 28.4 | 38.5 | 41.6 | χ2 = 32.505 | <0.001 | 42.6 | 50.2 | χ2 = 6.348 | 0.012 | |||||||
Drank in the past week (% Yes) | 58.1 | 34.5 | 22.3 | 32.5 | 30.0 | χ2 = 38.301 | <0.0001 | 34.1 | 38.7 | χ2 = 2.466 | 0.116 | |||||||
Total # of drinks per week 1–Mean (SD) | 11.7 | (10.5) | 12.9 | (13.7) | 8.1 | (8.8) | 8.1 | (8.8) | 9.6 | (9.6) | F = 3.110 | 0.015 | 10.2 | (9.4) | 10.1 | (7.5) | t = 0.057 | 0.955 |
# of drinking days per week 1 | 1.9 | (0.9) | 1.9 | (1.5) | 1.9 | (1.0) | 1.8 | (1.0) | 1.8 | (1.2) | F = 0.303 | 0.876 | 1.8 | (1.1) | 1.8 | (1.0) | t = 0.534 | 0.811 |
Drinks per drinking Day1 (DDD) | 5.5 | (3.6) | 5.4 | (3.9) | 3.9 | (2.8) | 4.2 | (3.0) | 4.3 | (2.8) | F = 3.106 | 0.016 | 5.7 | (5.2) | 5.4 | (3.2) | t = 0.798 | 0.425 |
# drinks consumed on (Friday–Sunday)1 | 11.3 | (10.4) | 11.9 | (11.5) | 8.1 | (8.7) | 8.5 | (9.1) | 9.1 | (8.7) | F = 0.801 | 0.525 | 11.3 | (18.4) | 10.1 | (7.3) | t = 1.643 | 0.101 |
Beverage of choice (% Yes) 1,2 | ||||||||||||||||||
Beer | 54.0 | 78.4 | 81.6 | 71.6 | 79.1 | χ2 = 15.009 | 0.005 | 81.5 | 82.8 | χ2 = 0.106 | 0.744 | |||||||
Fortified Wine | 0.0 | 0.0 | 4.1 | 2.1 | 0.0 | χ2 = 8.955 | 0.062 | 2.2 | 4.6 | χ2 = 1.801 | 0.180 | |||||||
Spirits | 0.0 | 4.1 | 6.1 | 16.8 | 8.8 | χ2 = 15.537 | 0.004 | 9.3 | 15.5 | χ2 = 3.670 | 0.055 | |||||||
Wine | 8.0 | 36.5 | 53.1 | 29.5 | 32.4 | χ2 = 24.211 | <0.001 | 46.3 | 48.9 | χ2 = 0.266 | 0.606 | |||||||
Combination | 38.0 | 1.4 | 4.1 | 2.1 | 1.4 | χ2 = 98.292 | <0.001 | 3.5 | 3.4 | χ2 = 0.002 | 0.967 | |||||||
Past alcohol consumption | ||||||||||||||||||
Drank during pregnancy (% Yes) | 74.4 | 41.4 | 48.4 | 49.9 | 58.1 | χ2 = 35.838 | <0.001 | 57.7 | 67.5 | χ2 = 11.376 | 0.001 | |||||||
Tobacco and Other Drug Use | ||||||||||||||||||
Used tobacco in lifetime | 75.6 | 46.9 | 63.0 | 70.3 | 63.4 | χ2 = 49.050 | <0.001 | 70.0 | 67.6 | χ2 = 0.782 | 0.377 | |||||||
Use tobacco in past 30 days 3 | 83.1 | 83.2 | 77.0 | 91.1 | 79.7 | χ2 = 14.094 | 0.029 | 81.9 | 77.3 | χ2 = 2.347 | 0.126 | |||||||
# of cigarettes per day–Mean (SD) | 9.8 | (7.7) | 5.1 | (5.2) | 4.7 | (3.7) | 5.8 | (5.0) | 6.4 | (4.9) | F = 8.536 | <0.001 | 4.9 | (4.2) | 8.8 | (12.5) | t = -4.279 | <0.001 |
Used drugs–past year (% Yes) | -- | 0.5 | 0.4 | 0.7 | 1.9 | χ2 = 4.548 | 0.208 | 0.6 | 1.5 | χ2 = 2.623 | 0.105 | |||||||
Used drugs–pregnancy (% Yes) | -- | 0.0 | 0.9 | 0.7 | 1.5 | χ2 = 4.787 | 0.310 | 1.0 | 2.8 | χ2 = 5.33 | 0.201 |
Community A | Community B | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Sample 1 [1997] (n = 86) | Sample 2 [1999] (n = 211) | Sample 3 [2002] (n = 222) | Sample 4 [2008] (n = 303) | Sample 5 [2010] (n = 466) | χ2 | p | Sample 1 [2009] (n = 670) | Sample 2 [2011] (n = 450) | χ2 | p | |
Received Dop in Lifetime (%Yes) | -- | 5.7 | 5.9 | 2.3 | 1.1 | 17.435 | 0.001 | 11.0 | 11.8 | 0.144 | 0.704 |
Received Dop in Pregnancy (%Yes) | -- | 1.5 | 0.5 | 1.0 | 0.4 | 2.585 | 0.460 | 0.9 | 0.2 | 1.950 | 0.163 |
Received Dop at time of interview | 0.0 | 0.5 | 0.0 | 0.3 | 0.2 | 0.113 | 0.774 | 0.3 | 0.2 | 0.054 | 0.816 |
Community A | Community/Region B | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sample 1 [1997] | Sample 2 [1999] | Sample 3 [2002] | Sample 4 [2008] | Sample 5 [2010] | Sample 1 [2009] | Sample 2 [2011] | ||||||||
FASD | Controls | FASD | Controls | FASD | Controls | FASD | Controls | FASD | Controls | FASD | Controls | FASD | Controls | |
Received Dop in Lifetime (% Yes) | -- | -- | 11.5 | 2.8 * | 9.5 | 7.3 | 5.9 | 0.0 *** | 1.6 | 0.7 | 16.4 | 6.4 *** | 15.8 | 6.5 ** |
Received Dop in Pregnancy (% Yes) | -- | -- | 3.2 | 0.8 | 1.6 | 0.0 | 2.5 | 0.0 | 1.1 | 0.0 | 2.0 | 0.0** | 0.4 | 0.0 |
Received Dop at time of interview | 0.0 | 0.0 | 1.6 | 0.0 | 0.0 | 0.0 | 0.8 | 0.0 | 0.6 | 0.0 | 0.7 | 0.0 | 0.4 | 0.0 |
Current Maternal Age 20–29 | Current Maternal Age 30–39 | Current Maternal Age 40+ | p | |
---|---|---|---|---|
Received Dop in Lifetime (% Yes) | 2.8 | 6.8 | 13.7 | <0.001 |
Received Dop in Pregnancy (% Yes) | 0.5 | 0.6 | 1.4 | 0.134 |
Received Dop at time of interview (% Yes) | 0.5 | 0.1 | 0.4 | 0.300 |
Rural residence (% Yes) | 36.7 | 34.7 | 38.5 | 0.276 |
Rural | Urban | p | |||
---|---|---|---|---|---|
Drank in Lifetime (% Yes) | 91.8 | 79.5 | <0.001 | ||
Drank in past 12 months (% Yes) | 58.2 | 52.7 | |||
Drank in past 30 days (% Yes) | 49.1 | 39.7 | <0.001 | ||
Drank in the past week (% Yes) | 42.6 | 28.9 | <0.001 | ||
Total # of drinks per week 1–Mean (SD) | 12.3 | (15.9) | 8.4 | (7.9) | <0.001 |
# of drinking days per week 1–Mean (SD) | 1.9 | (1.0) | 1.8 | (1.2) | 0.108 |
Drinks per drinking day1 (DDD)–Mean (SD) | 5.9 | (4.7) | 4.4 | (2.9) | <0.001 |
# of drinks consumed on (Friday–Sunday) 1 | 11.6 | (12.4) | 7.6 | (7.0) | <0.001 |
Drank during pregnancy (% Yes) | 70.6 | 49.2 | <0.001 |
Community A | Community/Region B | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sample 1 | Sample 2 | Sample 3 | Sample 4 | Sample 5 | Sample 1 | Sample 2 | |||||||||||||||
Rural | Urban | p^ | Rural | Urban | p^ | Rural | Urban | p^ | Rural | Urban | p^ | Rural | Urban | P^ | Rural | Urban | p^ | Rural | Urban | p^ | |
FAS | 25.2 | 15.1 | <0.001 | 23.9 | 17.4 | <.0001 | 28.6 | 25.7 | 0.142 | 28.8 | 30.5 | 0.737 | 19.6 | 39.2 | <0.001 | 53.1 | 39.7 | <0.001 | 40.1 | 49.0 | <0.001 |
PFAS * | 1.0 | 3.0 | 0.002 | 13.0 | 18.4 | 0.001 | 4.9 | 12.8 | <0.001 | 14.8 | 30.5 | <0.001 | 19.6 | 58.0 | <0.001 | 27.3 | 31.1 | <0.001 | 25.6 | 43.5 | <0.001 |
ARND ** | 0.0 | 0.0 | -- | 3.3 | 7.6 | <0.001 | 0.0 | 0.0 | -- | 14.8 | 16.6 | 0.236 | 11.1 | 22.2 | <0.001 | 16.6 | 15.0 | <0.001 | 13.8 | 24.2 | <0.001 |
Total FASD | 26.2 | 18.1 | <.001 | 40.1 | 43.4 | 0.151 | 41.5 | 38.5 | 0.168 | 58.4 | 77.6 | <.001 | 50.3 | 119.5 | <0.001 | 97.0 | 85.7 | <0.001 | 79.4 | 116.7 | <0.001 |
β | S.E. | Sig. | Odds Ratio | 95% C.I. for Odds Ratio | ||
---|---|---|---|---|---|---|
Lower | Upper | |||||
Covariates | ||||||
Estimated average # of drinks consumed per day in pregnancy | 0.302 | 0.022 | 0.000 | 1.352 | 1.296 | 1.410 |
Age at time of pregnant with COI (in years) | 0.007 | 0.009 | 0.443 | 1.007 | 0.989 | 1.026 |
Urban or rural residence during pregnancy | −0.280 | 0.114 | 0.014 | 0.756 | 0.605 | 0.945 |
Maternal BMI | −0.048 | 0.008 | 0.000 | 0.953 | 0.938 | 0.969 |
Gravidity | 0.124 | 0.043 | 0.004 | 1.132 | 1.040 | 1.232 |
Predictor | ||||||
Ever receive Dop–in lifetime | 0.304 | 0.228 | 0.183 | 1.355 | 0.866 | 2.121 |
Constant | −0.119 | 0.313 | 0.702 | 0.887 |
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May, P.A.; Marais, A.-S.; De Vries, M.; Hasken, J.M.; Stegall, J.M.; Hedrick, D.M.; Snell, C.L.; Seedat, S.; Parry, C.D.H. “The Dop System of Alcohol Distribution is Dead, but It’s Legacy Lives On….”. Int. J. Environ. Res. Public Health 2019, 16, 3701. https://doi.org/10.3390/ijerph16193701
May PA, Marais A-S, De Vries M, Hasken JM, Stegall JM, Hedrick DM, Snell CL, Seedat S, Parry CDH. “The Dop System of Alcohol Distribution is Dead, but It’s Legacy Lives On….”. International Journal of Environmental Research and Public Health. 2019; 16(19):3701. https://doi.org/10.3390/ijerph16193701
Chicago/Turabian StyleMay, Philip A., Anna-Susan Marais, Marlene De Vries, Julie M. Hasken, Julie M. Stegall, Dixie M. Hedrick, Cudore L. Snell, Soraya Seedat, and Charles D.H. Parry. 2019. "“The Dop System of Alcohol Distribution is Dead, but It’s Legacy Lives On….”" International Journal of Environmental Research and Public Health 16, no. 19: 3701. https://doi.org/10.3390/ijerph16193701