A Causal Analysis of Young Adults’ Binge Drinking Reduction and Cessation

Round 1

Reviewer 1 Report

The article discusses the prevalence of binge drinking in the United States, which is associated with a range of negative physical and mental health outcomes, including chronic illnesses and death. The authors argue that identifying risk and protective factors for binge drinking reduction and cessation among young adults is crucial for improving their health. The article reviews the literature on multiple disadvantage model and examines whether drinking behavior is linked to various factors, such as social disorganization, social-structural factors, social integration, health and mental health, substance use, and access to treatment. The authors hypothesize that young adults' binge drinking reduction and cessation are associated negatively with social disorganization, health, and other substance uses, but positively with social structural factors, social integration, mental health, and access to treatment.

 

Bellow follows some comments and suggestions:

 

here are a few ways that the abstract could be improved

1. The abstract should provide a brief overview of the study's main findings. While the abstract mentions some of the factors that were associated with binge drinking reduction and cessation, it does not clearly state the overall results of the study.
2. The abstract could be more specific about the sample population. For example, it would be helpful to include the age range of the participants and whether they were recruited from a specific geographic region.
3. The abstract could provide more detail about the methods used in the study. For example, it does not mention how the multiple disadvantage model was operationalized or how the temporal-ordered causal analysis was conducted.
4. The abstract could be clearer about the implications of the study's findings. While the conclusion suggests that interventions should focus on health awareness, assessment of co-occurring disorders, network of nondrinking friends, and occupational skill training, it does not explain why these interventions are likely to be effective or how they could be implemented.

Overall, the abstract could benefit from a clearer and more concise summary of the study's main findings, methods, and implications.

 

 

Here are some suggested improvements to the introduction:

1. Clarify the main objective of the study: While the introduction briefly mentions that the objective is to identify risk and protective factors in binge drinking reduction and cessation among young adults, it would be helpful to state this more explicitly at the beginning of the section.
2. Provide more context on the prevalence of binge drinking: The introduction currently provides statistics on the prevalence of binge drinking in the United States, but it would be helpful to provide more context on why this is an important public health issue.
3. Summarize the key findings of previous research: The introduction cites several previous studies on factors that may be associated with binge drinking reduction and cessation, but it would be helpful to summarize the key findings of these studies in a concise and accessible way.
4. Provide a clearer rationale for the study: The introduction mentions the multiple disadvantage model and its application to understanding adults' onset drinking, but it could be helpful to explain more clearly why this model is relevant to the current study.
5. Use simpler language: The introduction currently uses somewhat technical language and long sentences, which may make it difficult for some readers to understand. Simplifying the language and breaking up longer sentences into shorter ones could improve the clarity and accessibility of the introduction.

 

The section "Materials and Methods" could be improved by adding more details about the procedures used for data collection and analysis. The authors could also clarify why the sample of binge drinkers was selected and how they were identified. Additionally, the section could benefit from a more detailed explanation of the measures used to define binge drinking and the categories used to classify respondents in terms of their drinking status over time. The authors should also provide more information about the socio-demographic characteristics of the sample, including age, gender, and ethnicity, and how these were controlled for in the data analysis. Finally, the authors could consider providing a more detailed description of the statistical models used to identify predictors of drinking reduction or cessation.

 

Overall, the discussion section provides a thorough analysis of the results and relates them to previous research in the field. However, there are a few areas where the discussion could be improved:

1. The authors could discuss the limitations of the study, such as the fact that the data is self-reported and may be subject to social desirability bias. They could also address the fact that the study only looks at young adults and may not be generalizable to other age groups.
2. The authors could provide more explanation and interpretation of some of their findings. For example, they could discuss why non-Hispanic African Americans and other non-Hispanic ethnic minorities were more likely to achieve drinking cessation than non-Hispanic whites, and what implications this has for future research and interventions.
3. The authors could discuss the practical implications of their findings for public health interventions. For example, they could explore how social disorganization, mental health, and access to treatment could be targeted in interventions aimed at reducing binge drinking and promoting drinking cessation.
4. The authors could provide suggestions for future research directions based on their findings. For example, they could suggest exploring the relationship between binge drinking and social disorganization in more depth, or investigating why education level and income have opposite effects on drinking cessation and binge drinking reduction.

Here are some suggestions to improve the conclusions section:

1. Provide a brief summary of the key findings of the study, highlighting the most important risk and protective factors for binge drinking reduction and drinking cessation among young adults.
2. Emphasize the practical implications of the findings for public health and policy. For example, you could discuss how the identified risk and protective factors can inform the development of effective interventions and campaigns to reduce binge drinking among young adults.
3. Discuss the limitations of the study and suggest areas for future research. For example, you could acknowledge that the study was limited to a specific population and geographic area and suggest that future research could examine the generalizability of the findings to other populations and settings.
4. Provide a clear and concise conclusion that summarizes the main points of the section and ties back to the broader implications of the study.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

I would like to thank the authors of the manuscript “A causal analysis of young-adult binge drinkers’ reduction and cessation” for presenting the results of their study.

 

The study aimed to identify the risk and protective factors that affect young adults' reduction and cessation of binge drinking in the United States, using the multiple disadvantage model. The research involved extracting a sample of 942 young-adult binge drinkers from the National Longitudinal Study of Adolescent to Adult Health or Add Health.

The results of the study showed that several positive factors were associated with the likelihood of binge drinking reduction, including being non-Hispanic African American, having a higher level of educational advancement. However, there were also several negative factors associated with the likelihood of binge drinking reduction, such as being arrested for alcohol-related problems, having an increased income, and an increased number of close friends.

Moreover, the likelihood of change to non-drinking had positive associations with non-Hispanic African American, other non-Hispanic ethnic minority, age, occupational skill advancement, and improved health. It was also found that negative associations with being arrested for alcohol-related problems, increased income, educational advancement, increased number of close friends, disapproval from close friends, and drug use were factors affecting this likelihood.

Based on the study's findings, interventions that promote health awareness, assessment of co-occurring disorders, a network of nondrinking friends, and occupational skill training can be implemented.

In conclusion, the study provides valuable insights into the factors affecting young adults' binge drinking reduction and cessation. The multiple disadvantage model used in this research provides a promising framework for future investigations in this area.

 

Title: Adequate.

Abstract: “A sample of 942 young-adult binge drinkers.” Specify in brief the % of female and age mean and SD.

Introduction: Adequate. Relevant.

Methods: The measures section describes the variables considered and how they were analysed, but does not give details on the survey instruments. The authors could provide more detailed information about the grid or standardised questionnaires (survey, test, scale?) used to collect the data in the measures section, instead talking about comparisons and procedures as part of the data analysis and thus rather the results section.

Another point that is not very clear is whether this is data recorded by organisations, or whether it is data in which people are interviewed personally and report to them on their behaviour concerning e.g. alcohol use. Please specify if you can because this could be helpful in understanding the results and makes the methodological aspect more transparent.

Data analysis:  Adequate. Please specify the software used to perform analysis.

Discussion: Some points on study limitations is missing.

Figures & Tables: Table 1 does not look very well aligned, check the appropriateness of layout, alignment of rows and columns. Especially in the last section (yes) (no) the results need to be presented more uncluttered.

References: Verify if reference about “National Longitudinal Study of Adolescent to Adult Health, or Add Health, data set” is included.

I hope I have made some insightful suggestions that can enhance your study,

good luck!

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Dear Author's

I have reviewed the corrections made to your manuscript, and I am pleased to inform you that the changes are satisfactory. You have addressed the concerns and suggestions raised during the review process, and the manuscript is now improved in terms of clarity, structure, and readability. I appreciate your diligence in making the necessary revisions. 

 

A few suggestions that can be addressed further:

 

1. Improve clarity and flow by rephrasing ambiguous or repetitive phrases.
2. Present the hypotheses more clearly and concisely.
3. Break down long sentences and improve sentence structure for better readability.
4. Add more context to the sample selection process, such as discussing the rationale for choosing this particular data set and why it is representative of the population under study.

5. discussion: Ensure that explanations for the observed patterns and associations are clear and well-supported by the data.

Best Regards

Author Response

Reviewer 1

Comments round-2

Dear Author's

I have reviewed the corrections made to your manuscript, and I am pleased to inform you that the changes are satisfactory. You have addressed the concerns and suggestions raised during the review process, and the manuscript is now improved in terms of clarity, structure, and readability. I appreciate your diligence in making the necessary revisions. 

 

A few suggestions that can be addressed further:

 

1. Improve clarity and flow by rephrasing ambiguous or repetitive phrases.

In this re-revised version, we have rephrased some ambiguous or repetitive phrases. They are rephrased from “…were linked to…” into “…was linked to…” (line#44);

from “…5 drinks, if male, on the same occasion, on at least 1 day out of the past 30 days” into “…5 drinks, if male, in that time frame” (line#147); and

from “…rated respondents’ satisfaction with any spouse/partner reported at the Wave 4 interview” into “…similarly rated respondents’ satisfaction at the Wave 4 interview” (line#193).

1. Present the hypotheses more clearly and concisely.

From line#108 to line#117, we have rephrased the hypotheses as “…the reduction and cessation of binge drinking would be associated negatively with social disorganization (i.e., unsafe neighborhood, drinking-related arrest), with physical health, and with drug use. We also hypothesized these outcomes would be associated positively with social-structural factors (i.e., gender, age, race/ethnicity, income, education, occupation) and social integration (i.e., marital status, spousal relationship, close friends, spousal disapproval of binge drinking, close friends’ disapproval of binge drinking, religiosity, volunteering). Finally, we hypothesized outcomes’ positive association with mental health (i.e., depression), access to health insurance (i.e., health insurance coverage), and access to substance treatment (i.e., receipt of counseling).”

From line#327 to line#336, we have repeated the same revised hypotheses.

 

1. Break down long sentences and improve sentence structure for better readability.

In this re-revised version, we have broken down a few long sentences. They are rephrased

from “…Center for Epidemiologic Studies Depression Scale (CES-D); representing respondents’ total score on self-reports of ...” into “…Center for Epidemiologic Studies Depression Scale (CES-D). The scale yields respondents’ total score on self-reported...” (line#223 to line#225);

from “Also dichotomous (yes/no), attended drug treatment at Wave 3 measured respondent self-reports of alcohol or drug treatment received in the 12 months preceding the Wave 3 interview; attended counseling services at Wave 4 (yes/no) indicated if a respondent had been counseled for a psychological or emotional problem in the 12 months preceding the Wave 4 interview” into “Also dichotomous (yes/no), attended drug treatment at Wave 3 measured respondent self-reports of alcohol or drug treatment received in the 12 months preceding the Wave 3 interview. Attended counseling services at Wave 4 (yes/no) indicated if a respondent had been counseled for a psychological or emotional problem in the 12 months preceding the Wave 4 interview” (line#235 to line#239);

from “The final variable in the set, drug use at Wave 4 (yes/no) measured...” into “The final variable in the set, drug use at Wave 4 (yes/no), measured...” (line#239 to loine#240);

from “On the other hand, Asian Americans’ cessation of binge drinking may be explained by the rejection of binge drinking in their host culture of specific Asian subgroups; for other Asian American subgroups, their cessation of binge drinking may be explained by adjusting to the American culture of discouraging binge drinking despite the acceptance of binge drinking in their host culture” into “In contrast, cessation by Asian Americans may be explained by the rejection of binge drinking by some Asian subgroups. It could also be explained by some of these subgroups’ adjustment to their host nation’s cultural discouragement of binge drinking (however, in tandem with acceptance of drinking)” (line#353 to line#356);

from “The present study observed relatively high income as well as increasing income diminished...” into “The present study observed relatively high income, as well as increasing income, to diminish...” (line#362 to line#363); and

from ‘…unabated keep and gain “drinking friends”...’ into ‘…unabated have, and make new, “drinking friends”...’ (line#383 to line#384).

1. Add more context to the sample selection process, such as discussing the rationale for choosing this particular data set and why it is representative of the population under study.

From line#127 to line#130, we have added that “Since Add Health collected longitudinal data from a nationally representative sample, such data allows examination of change in young adults’ binge drinking behaviors over time. Furthermore, the data set collected information on neighborhoods and on individuals’ alcohol-related arrests.”

 

1. discussion: Ensure that explanations for the observed patterns and associations are clear and well-supported by the data.

We have carefully reviewed the revised Discussion and found that the explanations for the observed patterns and associations are clear and well-supported by data and cited studies. The only change in this re-revised version (line#357 to line#371) is that we have merged the discussion on education, income, and occupation together, making the discussion flow better and smoothly.

Best Regards

 

Reviewer 2 Report

I had the opportunity to review the revised version of the paper entitled "A causal analysis of young-adult binge drinkers’ reduction and cessation," and I must say that the changes made to the paper are adequate. The addition of a new model has greatly enhanced the quality of the analysis and added to the overall strength of the study.

However, I also noticed that the new model added could be improved in its aesthetic and formatting / layout aspects. The model itself is informative and provides valuable insights into the factors that contribute to the reduction and cessation of binge drinking among young adults. However, the way the model is presented could be more visually appealing and engaging for the reader.

Overall, I would highly recommend this paper to anyone interested in the field of binge drinking and its impact on young adults. The revisions made to the paper have improved its quality, and the new model added provides valuable insights into the underlying factors that contribute to the reduction and cessation of binge drinking.

Author Response

Reviewer 2

Comments-Round2

I had the opportunity to review the revised version of the paper entitled "A causal analysis of young-adult binge drinkers’ reduction and cessation," and I must say that the changes made to the paper are adequate. The addition of a new model has greatly enhanced the quality of the analysis and added to the overall strength of the study.

However, I also noticed that the new model added could be improved in its aesthetic and formatting / layout aspects. The model itself is informative and provides valuable insights into the factors that contribute to the reduction and cessation of binge drinking among young adults. However, the way the model is presented could be more visually appealing and engaging for the reader.

From line#47 to line#59, we have revised the format and layout of the Figure 1 with more details of the factors in the model framework.

Overall, I would highly recommend this paper to anyone interested in the field of binge drinking and its impact on young adults. The revisions made to the paper have improved its quality, and the new model added provides valuable insights into the underlying factors that contribute to the reduction and cessation of binge drinking.