Determinants of risky substance use and risky gambling

Abstract

First paragraph: That certain behaviour in a particular situation entails high risks is a perception that does not require human consciousness; indeed, perceiving or failing to perceive risk has been through the eons a sure means of Darwinian selection. A mouse that sees the shadow of an owl will take action ( or freeze to evade notice) because of the immediate risk. Throughout human history, people have taken risks into account in how they behave. The risks have sometimes been tangible, as in the risk of injury in falling off a cliff, and sometimes intangible and a matter of belief, as in the risk of eternal damnation for doing something sinful. Often the calculation of risk combines elements that are tangible and measurable, and elements that are a matter of morals or conviction. Positivist research in the field of substance use and gambling behaviour is driven to measure the inherent risk of such behaviours. This quantification uses statistical methods to estimate the probability of outcomes for a specific variable. For example, we can calculate 'relative risk: which is the ratio of the probability of an event occurring (e.g. developing liver cirrhosis or having a car crash) in an exposed group (e.g. heavy drinkers) to the probability of the event occurring in a comparison, nonexposed group (e.g. non- or moderate drinkers). However, the exact level of consumption at which use become risky or harmful has been modified over time, in response to changing knowledge and societal perspectives. For example, in the context of alcohol brief interventions (a short, structured conversation about alcohol consumption that seeks in a non-confrontational way to motivate and support an individual to think about and/or plan a change in their drinking behaviour) the definition of risky drinking was set by the WHO at an average of more than 20 (women) or 40 (men) grams of alcohol per day (Heather, 2006), even if more recent publications tend to lower such limits to around 12 and 25 grams (Schi.itze et al., 2011).  Additional co-authors: Rosie Lees, Gert-Jan Meerkerk, Laura Schmidt, Dike van de Mheen, and Reinout Wiers.