title: Paradoxical increase of positive answers to the Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire during a period of decreasing alcohol consumption: results from two population-based surveys in Ile-de-France, 1991 and 2005.
abstract: OBJECTIVE
  To describe trends of responses to the Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire during a period of declining alcohol consumption, in a country with no temperance history.
  
  
  METHODS
  Two random-sample surveys, conducted in 1991 and 2005, respectively.
  
  
  METHODS
  The adult population of Ile-de-France.
  
  
  METHODS
  A total of 1183 subjects in 1991 and 5382 subjects in 2005.
  
  
  METHODS
  Responses to CAGE questions, obtained by face-to-face interviews in 1991 and by telephone in 2005.
  
  
  RESULTS
  were standardized on the 2005 population structure.
  
  
  RESULTS
  The proportion of subjects giving at least two positive answers has increased by 4.2 times; the biggest increase was observed for the Guilt question (4.8 times) and the smallest for the Eye-opener question (2.6 times). Several increases were higher for women than for men: 12.9 times versus 3.3 times for two or more positive answers, 9.8 times versus 3.8 times for the Guilt question. Increases did not vary consistently by age.
  
  
  CONCLUSIONS
  These paradoxical trends do not support the use of CAGE in general population surveys. They confirm previous reports suggesting that CAGE was sensitive to community temperance level. They might reflect the emergence of a temperance movement in France, with stronger impact among women. This movement might be responsible for the fall in alcohol consumption.
authors.affiliation: INSERM, Research Center U-897, Equipe Avenir, Prévention et prise en charge des Traumatismes/Injury Prevention and Control, Bordeaux, France. antoine.messiah@isped.u-bordeaux2.fr
authors.forename: Antoine
authors.initials: A
authors.lastname: Messiah
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Encrenaz
authors.forename: David
authors.initials: D
authors.lastname: Sapinho
authors.forename: Fabien
authors.initials: F
authors.lastname: Gilbert
authors.forename: Elodie
authors.initials: E
authors.lastname: Carmona
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess-Masféty
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000639:trends; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D003431:Cross-Cultural Comparison; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013695:Temperance / Q000639:trends