title: Alcohol use disorders and perceived drinking norms: ethnic differences in Israeli adults.
abstract: OBJECTIVE
  Individuals' perceptions of drinking acceptability in their society (perceived injunctive drinking norms) are widely assumed to explain ethnic group differences in drinking and alcohol use disorders (AUDs), but this has never been formally tested. Immigrants to Israel from the former Soviet Union (FSU) are more likely to drink and report AUD symptoms than other Israelis. We tested perceived drinking norms as a mediator of differences between FSU immigrants and other Israelis in drinking and AUDs.
  
  
  METHODS
  Adult household residents (N = 1,349) selected from the Israeli population register were assessed with a structured interview measuring drinking, AUD symptoms, and perceived drinking norms. Regression analyses were used to produce odds ratios (OR) and risk ratios (RR) and 95% confidence intervals (CI) to test differences between FSU immigrants and other Israelis on binary and graded outcomes. Mediation of FSU effects by perceived drinking norms was tested with bootstrapping procedures.
  
  
  RESULTS
  FSU immigrants were more likely than other Israelis to be current drinkers (OR = 2.39, CI [1.61, 3.55]), have higher maximum number of drinks per day (RR = 1.88, CI [1.64, 2.16]), have any AUD (OR = 1.75, CI [1.16, 2.64]), score higher on a continuous measure of AUD (RR = 1.44, CI [1.12, 1.84]), and perceive more permissive drinking norms (p < .0001). For all four drinking variables, the FSU group effect was at least partially mediated by perceived drinking norms.
  
  
  CONCLUSIONS
  This is the first demonstration that drinking norms mediate ethnic differences in AUDs. This work contributes to understanding ethnic group differences in drinking and AUDs, potentially informing etiologic research and public policy aimed at reducing alcohol-related harm.
authors.affiliation: New York State Psychiatric Institute, New York, New York, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York. dsh2@columbia.edu
authors.forename: Dvora
authors.initials: D
authors.lastname: Shmulewitz
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Keyes
authors.forename: Efrat
authors.initials: E
authors.lastname: Aharonovich
authors.forename: Christina
authors.initials: C
authors.lastname: Aivadyan
authors.forename: Eliana
authors.initials: E
authors.lastname: Greenstein
authors.forename: Baruch
authors.initials: B
authors.lastname: Spivak
authors.forename: Abraham
authors.initials: A
authors.lastname: Weizman
authors.forename: Amos
authors.initials: A
authors.lastname: Frisch
authors.forename: Deborah
authors.initials: D
authors.lastname: Hasin
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D054242:Emigrants and Immigrants / Q000523:psychology; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012927:Social Control, Informal; D014586:USSR / Q000208:ethnology