Loneliness and Increased Hazardous Alcohol Use: Data from a Nationwide Internet Survey with 1-Year Follow-Up
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Study Population
2.1.1. Internet Survey
2.1.2. Managing the Data Quality and Generating the Study Population
2.2. Measures
2.2.1. Explanatory Variables
2.2.2. Outcome Variables
2.2.3. Demographics and Potential Health Factors Related to Alcohol Use
2.3. Statistical Analyses
2.4. Ethical Approval
3. Results
3.1. Participant Characteristics
3.2. Characteristics of Participants according to AUDIT Scores
3.3. Loneliness and Hazardous Alcohol Use Based on AUDIT Scores
3.4. Association between Loneliness and AUDIT Score Pattern Changes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
AUDIT | Alcohol Use Disorders Identification Test |
aRR | Adjusted risk ratios |
CI | Confidence interval |
COVID-19 | Coronavirus infectious disease identified in 2019 |
JASTIS | Japan Society and New Tobacco Internet Survey |
SD | Standard deviation |
WHO | World Health Organization |
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Follow-Up | Drinking Categories Based on AUDIT | ||||||||
---|---|---|---|---|---|---|---|---|---|
Non-High-Risk (0–14) | Nondrinker (0) | Low-Risk (1–7) | Medium-Risk (8–14) | High-or-Over-Risk (≧15) | High-Risk (15–19) | Probable Alcohol Dependence (20–40) | |||
N = 15,854 | N = 15,091 (95.2%) | N = 4719 (29.8%) | N = 8749 (55.2%) | N = 1623 (10.2%) | N = 763 (4.8%) | N = 404 (2.5%) | N = 359 (2.3%) | p Value * | |
Loneliness (Mean, SD) | 4.1 (±1.8) | 4.0 (±1.8) | 4.2 (±1.9) | 4.0 (±1.75) | 3.9 (±1.7) | 4.9 (±2.2) | 4.6 (±2.1) | 5.1 (±2.3) | <0.001 |
Score < 6 (%) | 12,648 (80) | 12,172 (81) | 3669 (78) | 7157 (82) | 1346 (83) | 476 (62) | 273 (68) | 203 (57) | <0.001 |
Score ≧ 6 (%) | 3206 (20) | 2919 (19) | 1050 (22) | 1592 (18) | 277 (17) | 287 (38) | 131 (32) | 156 (43) | |
Age, year (Mean, SD) | 52.8 (±15.6) | 52.9 (±15.7) | 52.5 (±16.0) | 52.9 (±15.8) | 54.6 (±14.0) | 49.4 (±13.7) | 50.3 (±14.2) | 48.4 (±13.0) | <0.001 |
20–39 years (%) | 3513 (22) | 3337 (22) | 1144 (24) | 1942 (22) | 251 (15) | 176 (23) | 96 (24) | 80 (22) | <0.001 |
40–59 years (%) | 6246 (39) | 5855 (39) | 1778 (38) | 3381 (39) | 696 (43) | 391 (51) | 189 (47) | 202 (56) | |
60 or over (%) | 6095 (38) | 5899 (39) | 1797 (38) | 3426 (39) | 676 (42) | 196 (26) | 119 (29) | 77 (21) | |
Sex (%) | <0.001 | ||||||||
Women | 7615 (48) | 7449 (49) | 2895 (61) | 4209 (48) | 345 (21) | 166 (22) | 69 (17) | 97 (27) | |
Men | 8239 (52) | 7642 (51) | 1824 (39) | 4540 (52) | 1278 (79) | 597 (78) | 335 (83) | 262 (73) | |
Education (%) | <0.001 | ||||||||
Low | 4899 (31) | 4647 (31) | 1704 (36) | 2483 (28) | 460 (28) | 252 (33) | 123 (30) | 129 (36) | |
Middle | 3342 (21) | 3244 (22) | 1168 (25) | 1827 (21) | 249 (15) | 98 (13) | 47 (12) | 51 (14) | |
High | 7613 (48) | 7200 (48) | 1847 (39) | 4439 (51) | 914 (56) | 413 (54) | 234 (58) | 179 (50) | |
Marital status (%) | 0.919 | ||||||||
Marriage | 10,121 (64) | 9631 (64) | 2792 (59) | 5687 (65) | 1152 (71) | 490 (64) | 271 (67) | 219 (61) | |
No marriage | 4085 (26) | 3893 (26) | 1327 (28) | 2237 (26) | 329 (20) | 192 (25) | 96 (24) | 96 (27) | |
Divorced/Widowed | 1648 (10) | 1567 (10) | 600 (13) | 825 (9) | 142 (9) | 81 (11) | 37 (9) | 44 (12) | |
Living arrangements (%) | 0.004 | ||||||||
Living with someone | 12,849 (81) | 12,261 (81) | 3788 (80) | 7155 (82) | 1318 (81) | 588 (77) | 322 (80) | 26,674) | |
Living alone | 3005 (19) | 2830 (19) | 931 (20) | 1594 (18) | 305 (19) | 175 (23) | 82 (20) | 93 (26) | |
Job (%) | <0.001 | ||||||||
Regular job | 6823 (43) | 6308 (42) | 1573 (33) | 3793 (43) | 942 (58) | 515 (68) | 279 (69) | 236 (66) | |
Non-regular employee | 2964 (19) | 2856 (19) | 953 (20) | 1658 (19) | 245 (15) | 108 (14) | 52 (13) | 56 (16) | |
No main income job as students/retiree/ housework | 3798 (24) | 3753 (25) | 1412 (30) | 2146 (25) | 195 (12) | 45 (6) | 23 (6) | 22 (6) | |
Unemployed | 2269 (14) | 2174 (14) | 781 (17) | 1152 (13) | 241 (15) | 95 (12) | 50 (12) | 45 (13) | |
Income (%) | <0.001 | ||||||||
Under 2 million yen | 2537 (16) | 2417 (16) | 960 (20) | 1229 (14) | 228 (14) | 120 (16) | 61 (15) | 59 (16) | |
2–4 million yen | 5769 (36) | 5491 (36) | 1634 (35) | 3283 (38) | 574 (35) | 278 (36) | 153 (38) | 125 (35) | |
4–6 million yen | 2550 (16) | 2403 (16) | 588 (12) | 1501 (17) | 314 (19) | 147 (19) | 72 (18) | 75 (21) | |
6–10 million yen | 1650 (10) | 1532 (10) | 322 (7) | 976 (11) | 234 (14) | 118 (15) | 71 (18) | 47 (13) | |
10 million or more | 367 (2) | 334 (2) | 77 (2) | 191 (2) | 66 (4) | 33 (4) | 21 (5) | 12 (3) | |
Don’t know/want to answer | 2981 (19) | 2914 (19) | 1138 (24) | 1569 (18) | 207 (13) | 67 (9) | 26 (6) | 41 (11) | |
Current smoker (%) | <0.001 | ||||||||
No | 12,763 (81) | 12,305 (82) | 4093 (87) | 7109 (81) | 1103 (68) | 458 (60) | 237 (59) | 221 (62) | |
Yes | 3091 (20) | 2786 (18) | 626 (13) | 1640 (19) | 520 (32) | 305 (40) | 167 (41) | 138 (38) | |
Psychological Distress (Mean, SD) | 4.6 (±5.6) | 4.5 (±5.5) | 4.8 (±5.8) | 4.3 (±5.3) | 4.4 (±5.5) | 7.3 (±6.6) | 6.6 (±5.9) | 8.1 (±7.2) | <0.001 |
K6 < 13 (%) | 14,268 (90) | 13,669 (91) | 4214 (89) | 7992 (91) | 1463 (90) | 599 (79) | 334 (83) | 265 (74) | <0.001 |
K6 ≧ 13 (%) | 1586 (10) | 1422 (9) | 505 (11) | 757 (9) | 160 (10) | 164 (21) | 70 (17) | 94 (26) |
Non-High-Risk at Baseline N = 15,091 | ||
---|---|---|
Non-High-Risk to Non-High-Risk (0–14) to (0–14) | Non-High-Risk to High-or-Over (0–14) to (15≧) | |
N = 14,742 | N = 349 | |
N (%) | N (%) | |
Loneliness (Mean, SD) | 4.0 (±1.8) | 4.4 (±1.9) |
Score < 6 | 11,918 (81) | 254 (73) |
Score ≧ 6 | 2824 (19) | 95 (27) |
Age, year (Mean, SD) | 53.0 (±15.7) | 49.9 (±14.5) |
20–39 years | 3246 (22) | 91 (26) |
40–59 years | 5695 (39) | 160 (46) |
60–79 years | 5801 (39) | 98 (28) |
Sex | ||
Women | 7382 (50) | 67 (19) |
Men | 7360 (50) | 282 (81) |
Education | ||
Low | 4561 (31) | 86 (25) |
Middle | 3173 (22) | 71 (20) |
High | 7008 (48) | 192 (55) |
Marital status | ||
Marriage | 9398 (64) | 233 (67) |
No marriage | 3810 (26) | 83 (24) |
Divorced/Widowed | 1534 (10) | 33 (9) |
Living arrangements | ||
Living with someone | 11,987 (81) | 274 (79) |
Living alone | 2755 (19) | 75 (21) |
Job | ||
Regular job | 6093 (41) | 215 (62) |
Non-regular employee | 2800 (19) | 56 (16) |
No main income job, students/retiree/housework | 3716 (25) | 37 (11) |
Unemployed | 2133 (14) | 41 (12) |
Income | ||
Under 2 million yen | 2366 (16) | 51 (15) |
2–4 million yen | 5354 (36) | 137 (39) |
4–6 million yen | 2342 (16) | 61 (17) |
6–10 million yen | 1477 (10) | 55 (16) |
10 million or more | 327 (2) | 7 (2) |
Don’t know/want to answer | 2876 (20) | 38 (11) |
Current smoker | ||
No | 12,075 (82) | 230 (66) |
Yes | 2667 (18) | 119 (34) |
Psychological Distress (Mean, SD) | 4.4 (±5.4) | 6.0 (±6.2) |
K6 < 13 | 13,370 (91) | 299 (86) |
K6 ≧ 13 | 1372 (9) | 50 (14) |
Model 1 | Model 2 | Model 3 | Model 4 | |
---|---|---|---|---|
RR (95%CI) | aRR (95%CI) | aRR (95%CI) | aRR (95%CI) | |
Loneliness | ||||
Score < 6 | ref | ref | ref | Ref |
Score ≧ 6 | 1.56 (1.24–1.97) | 1.52 (1.18–1.96) | 1.57 (1.22–2.03) | 1.45 (1.08–1.96) |
Age | ||||
20–39 years | ref | ref | Ref | |
40–59 years | 0.97 (0.73–1.27) | 0.81 (0.61–1.07) | 0.81 (0.61–1.08) | |
60–79 years | 0.76 (0.54–1.06) | 0.57 (0.39–0.81) | 0.58 (0.40–0.83) | |
Sex | ||||
Women | ref | ref | ref | |
Men | 4.43 (3.17–6.19) | 4.26 (3.01–6.02) | 4.27 (3.02–6.04) | |
Education | ||||
Low | ref | ref | ref | |
Middle | 1.36 (0.97–1.91) | 1.39 (0.99–1.94) | 1.38 (0.99–1.94) | |
High | 1.05 (0.80–1.38) | 1.10 (0.83–1.44) | 1.09 (0.83–1.43) | |
Job | ||||
Regular job | ref | ref | ref | |
Non-regular employee | 1.06 (0.76–1.49) | 1.17 (0.83–1.66) | 1.18 (0.83–1.66) | |
No main income job as students/retiree/housework | 0.73 (0.47–1.12) | 0.81 (0.53–1.26) | 0.81 (0.52–1.26) | |
Unemployed | 0.76 (0.49–1.16) | 0.87 (0.57–1.34) | 0.87 (0.56–1.34) | |
Income | ||||
Under 2 million yen | ref | ref | ref | |
2–4 million yen | 1.06 (0.76–1.48) | 1.02 (0.73–1.42) | 1.02 (0.73–1.42) | |
4–6 million yen | 0.90 (0.60–1.33) | 0.83 (0.56–1.24) | 0.84 (0.56–1.25) | |
6–10 million yen | 1.29 (0.86–1.95) | 1.21 (0.80–1.83) | 1.21 (0.80–1.83) | |
10 million or more | 0.76 (0.34–1.69) | 0.68 (0.30–1.52) | 0.68 (0.31–1.53) | |
Marital status | ||||
Marriage | ref | ref | ||
No marriage | 0.50 (0.34–0.71) | 0.49 (0.34–0.71) | ||
Divorced/Widowed | 0.90 (0.58–1.41) | 0.90 (0.57–1.40) | ||
Living arrangement | ||||
Living with someone | ref | ref | ||
Living alone | 1.49 (1.05–2.13) | 1.50 (1.05–2.14) | ||
Smoking | ||||
Non-smoker | ref | ref | ||
Current smoker | 1.63 (1.29–2.06) | 1.62 (1.28–2.05) | ||
Psychological distress | ||||
K6 < 13 | ref | |||
K6 ≧ 13 | 1.23 (0.84–1.80) |
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Wakabayashi, M.; Sugiyama, Y.; Takada, M.; Kinjo, A.; Iso, H.; Tabuchi, T. Loneliness and Increased Hazardous Alcohol Use: Data from a Nationwide Internet Survey with 1-Year Follow-Up. Int. J. Environ. Res. Public Health 2022, 19, 12086. https://doi.org/10.3390/ijerph191912086
Wakabayashi M, Sugiyama Y, Takada M, Kinjo A, Iso H, Tabuchi T. Loneliness and Increased Hazardous Alcohol Use: Data from a Nationwide Internet Survey with 1-Year Follow-Up. International Journal of Environmental Research and Public Health. 2022; 19(19):12086. https://doi.org/10.3390/ijerph191912086
Chicago/Turabian StyleWakabayashi, Mami, Yoshifumi Sugiyama, Midori Takada, Aya Kinjo, Hiroyasu Iso, and Takahiro Tabuchi. 2022. "Loneliness and Increased Hazardous Alcohol Use: Data from a Nationwide Internet Survey with 1-Year Follow-Up" International Journal of Environmental Research and Public Health 19, no. 19: 12086. https://doi.org/10.3390/ijerph191912086
APA StyleWakabayashi, M., Sugiyama, Y., Takada, M., Kinjo, A., Iso, H., & Tabuchi, T. (2022). Loneliness and Increased Hazardous Alcohol Use: Data from a Nationwide Internet Survey with 1-Year Follow-Up. International Journal of Environmental Research and Public Health, 19(19), 12086. https://doi.org/10.3390/ijerph191912086