Studies testing the effect of physician advice on alcohol consumption in a noncontrolled environment have not specifically focused on risky drinkers. Therefore, it is possible that the estimated effect of professional health advice primarily reflected moderate drinkers' responses. We assessed whether professional health advice reduced alcohol consumption among risky and binge drinkers in a real-world setting.
Design.
Retrospective cohort analysis.
Setting.
We used 2009 Behavioral Risk Factor Surveillance System Annual Survey Data.
Subjects.
Five thousand seven hundred thirty-five adult male and nonpregnant female risky drinkers, with hypertension or borderline hypertension, who reported on whether they were advised to reduce alcohol consumption.
Measures.
Dependent variable: respondent was currently reducing alcohol use to control hypertension (1 = yes; 0 = no). Primary regressor: respondent claimed to have received advice from a health professional on reducing alcohol consumption to control hypertension (1 = yes; 0 = no).
Analysis.
The model was estimated using generalized maximum entropy.
Results.
Professional health advice increased the probability that both risky (marginal effect [ME] = .09), and binge drinkers (ME = .07) reduced their alcohol consumption.
Conclusion.
Our findings indicate that risky drinkers can effectively be targeted with consumption advice. This has important policy implications given that society bears the largest cost for this group, whereas moderate drinkers have been found to be relatively productive and healthy.
BaoYDuanNFoxSA. Is some provider advice on smoking cessation better than no advice? An instrumental variable analysis of the 2001 National Health Interview Survey. Health Serv Res.2006;41:2114–2135.
2.
IppolitoPMMathiosAD. Information, advertising and health choices—a study of the cereal market. Rand J Econ.1990;21:459–480.
3.
IppolitoPMMathiosAD. Information and advertising—the case of fat consumption in the United States. Am Econ Rev.1995;85:91–95.
4.
KenkelDS. Health behavior, health knowledge, and schooling. J Pol Econ.1991;99:287–305.
5.
LewittEMCoateDGrossmanM. The effects of government regulation on teenage smoking. J Law Econ.1981;24:545–569.
6.
SteadLFBergsonGLancasterT. Physician advice for smoking cessation. Cochrane Database Syst Rev.2008:CD000165.
7.
ViscusiWK. Do smokers underestimate risks. J Pol Econ.1990;98:1253–1269.
8.
RogersEM. Communication Strategies for Family Planning. New York, NY: Free Press; 1973.
9.
SchrammW. Communication in family planning. Stud Fam Plann. 1971;7:1–43.
10.
DranoveD. Demand inducement and the physician-patient relationship. Econ Inq.1988;26:281–298.
11.
KenkelD. Consumer health information and the demand for medical care. Rev Econ Stat.1990;72:587–595.
12.
BienTHMillerWRToniganJS. Brief interventions for alcohol problems—a review. Addiction. 1993;88:315–336.
13.
KanerEFDickinsonHOBeyerF. The effectiveness of brief alcohol interventions in primary care settings: A systematic review. Drug Alcohol Rev.2009;28:301–323.
14.
BaborTFAcudaWCampilloC. A cross-national trial of brief interventions with heavy drinkers. Am J Public Health. 1996;86:948–955.
15.
FlemingMFBarryKLManwellLB. Brief physician advice for problem alcohol drinkers—a randomized controlled trial in community-based primary care practices. JAMA. 1997;277:1039–1045.
16.
TeutschSMHarrisJ. Introduction. In: HaddixACTeutschSMCorsoPS, eds. Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation. New York, NY: Oxford Univ Press; 1996:1–10.
17.
KenkelDSTerzaJV. The effect of physician advice on alcohol consumption: Count regression with an endogenous treatment effect. J Appl Econ.2001;16:165–184.
18.
BrattiMMirandaA. Endogenous treatment effects for count data models with endogenous participation or sample selection. Health Econ.2011;20:1090–1109.
19.
HeienDM. Are higher alcohol taxes justified?Cato J.1995;15:243–258.
20.
ManningWGKeelerEBNewhouseJP. The Costs of Poor Health Habits. Cambridge, Mass: Harvard Univ Press; 1991.
21.
HolderHD. Alcoholism treatment and potential health care cost saving. Med Care. 1987;25:52–71.
22.
BoucheryEEHarwoodHJSacksJJ. Economic costs of excessive alcohol consumption in the US, 2006. Am J Prev Med.2011;41:516–524.
23.
MukamalKJChungHJennyNS. Alcohol consumption and risk of coronary heart disease in older adults: The cardiovascular health study. J Am Geriatr Soc.2006;54:30–37.
24.
DufourMC. Risks and benefits of alcohol use over the life span. Alcohol Health Res World. 1996;20:145–151.
25.
MukamalKJConigraveKMMittlemanMA. Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Engl J Med.2003;348:109–118.
26.
BarrettGF. The effect of alcohol consumption on earnings. Econ Rec.2002;78:79–96.
27.
KenkelDS. New estimates of the optimal tax on alcohol. Econ Inq.1996;34:296–319.
28.
ManningWGBlumbergLMoultonLH. The demand for alcohol—the differential response to price. J Health Econ.1995;14:123–148.
29.
GolanAJudgeGMillerD. Maximum Entropy Econometrics: Robust Estimation With Limited Data. Hoboken, NJ: John Wiley & Sons; 1996.
30.
GolanAJudgeGPerloffJM. A maximum entropy approach to recovering information from multinomial response data. J Am Stat Assoc. 1996;91:841–853.
31.
EbrahimiNSoofiESSoyerR. Multivariate maximum entropy identification, transformation, and dependence. J Multivariate Anal.2008;99:1217–1231.
32.
PerkinsHW. Parental religion and alcohol use problems as intergenerational predictors of problem drinking among college youth. J Sci Study Relig. 1987;26:340–357.
33.
GorsuchRL. Religious aspects of substance abuse and recovery. J Soc Issues. 1995;51:65–83.
34.
BloomfieldKGrittnerUKramerSGmelG. Social inequalities in alcohol consumption and alcohol-related problems in the study countries of the EU “concerted action gender, culture and alcohol problems: A multi-national study.”Alcohol Alcohol. 2006;41:I26–I36.
35.
WilsnackRWVogeltanzNDWilsnackSCHarrisTR. Gender differences in alcohol consumption and adverse drinking consequences: Cross-cultural patterns. Addiction. 2000;95:251–265.
36.
AppelLJBrandsMWDanielsSR. Dietary approaches to prevent and treat hypertension: A scientific statement from the American Heart Association. Hypertension. 2006;47:296–308.
WheltonPKHeJAppelLJ. Primary prevention of hypertension: Clinical and public health advisory from The National High Blood Pressure Education Program. JAMA. 2002;288:1882–1888.
39.
JudgeGHillRCGriffithsW. Introduction to the Theory and Practice of Econometrics. 2nd ed.Hoboken, NJ: John Wiley & Sons; 1998.
40.
GewekeJ. Contemporary Bayesian Econometrics and Statistics. Hoboken, NJ: John Wiley & Sons; 2005.
41.
AdkinsL. A Monte Carlo study of a generalized maximum entropy estimator of the binary choice model. Adv Econometrics. 1997;12:183–197.
42.
MittelhammerRCardellNS. On the Consistency and Asymptotic Normality of the Data-Constrained GME Estimator in the GLM. Pullman, Wash: Washington State Univ; 1997.
43.
CrookerJRHerrigesJA. Parametric and semi-nonparametric estimation of willingness-to-pay in the dichotomous choice contingent valuation framework. Environ Resour Econ.2004;27:451–480.
44.
CameronACTrivediPK. Microeconometrics: Methods and Applications. Cambridge, United Kingdom: Cambridge Univ Press; 2005.
45.
AltonjiJGElderTETaberCR. Selection on observed and unobserved variables: Assessing the effectiveness of Catholic schools. J Pol Econ.2005;113:151–184.
