title: Prevalence of alcohol consumption, abuse and dependence in a country with high per capita consumption: findings from the German TACOS study. Transitions in Alcohol Consumption and Smoking.
abstract: BACKGROUND
  The aim of the Transitions in Alcohol Consumption and Smoking (TACOS) project is to investigate substance use and use disorders in the adult general population in a region of the under-researched north of Germany, focussing on smoking and alcohol consumption. In this study, the design and quality assurance provisions of the baseline cross-section of the longitudinal project are described. Prevalence rates of alcohol use disorders, consumption pattern, and the nature of their association are also analysed with regard to preventive strategies.
  
  
  METHODS
  A random sample of 4075 participants, aged 18 to 64 and drawn from residents registration office files, was interviewed with a DSM-IV adapted version of WHO CIDI. Fieldwork resulted in a response rate of 70.2% and an unbiased database with regard to demographic characteristics.
  
  
  RESULTS
  Low lifetime prevalence of alcohol use disorders (4.5% abuse, 3.8% dependence) and hazardous consumption (13.2% lifetime; 6.0% 12-month) was found compared to southern regions of Germany and US American data. In contrast, we found a comparatively high percentage of moderate alcohol uses. Male subjects are more affected by lifetime alcohol use disorders (abuse OR 8.3, 95% CI 5.3-13.2; dependence OR 4.3, 95% CI 2.8-6.4). The association between alcohol use disorders and alcohol consumption pattern revealed a weaker relation for alcohol abuse compared to dependence.
  
  
  CONCLUSIONS
  National and regional drinking habits and norms have to be considered as a significant source of variance, supporting the need for European epidemiological research on substance use in addition to US American activities, and emphasising the advantages of community-based preventive measures. An evaluation of public recommendations for safe limits of alcohol consumption and prevention targets referring to average consumption is indicated. There is also a need for a clear distinction between alcohol abuse and dependence.
authors.affiliation: University of Greifswald, Department of Epidemiology and Social Medicine, Research Group for Substance Abuse and Dependence, Germany. chmeyer@mail.uni-greifswald.de
authors.forename: C
authors.initials: C
authors.lastname: Meyer
authors.forename: H J
authors.initials: HJ
authors.lastname: Rumpf
authors.forename: U
authors.initials: U
authors.lastname: Hapke
authors.forename: H
authors.initials: H
authors.lastname: Dilling
authors.forename: U
authors.initials: U
authors.lastname: John
mesh_terms: D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D017678:Sex Distribution