Alcohol-related facial flushing is a sign of compromised alcohol metabolism and increased risk of certain cancers. This project examined how facial flushing might be used to reduce alcohol use to lower cancer risks.
Interviews with Chinese university students identified gender, friendship, and drinking purpose as important variables related to whether someone would encourage a person who flushes when drinking alcohol to stop or reduce their drinking.
A questionnaire was developed that incorporated these variables into 24 drinking scenarios in which someone flushed while drinking. Students responded whether Facial flushing alcohol consumption would a encourage the flusher to stop or drink less; b do nothing while wishing they could; or c do nothing because there was no need.
Analysis of survey responses from university students showed a three-way interaction of the variables and implied that the probability students will intervene when a drinker flushes was highest when the flusher was a female, a close friend, and the drinking purpose
Facial flushing alcohol consumption for fun and lowest if the flusher was a male, the friendship was general, and the drinking purpose was risky.
The results provide important details about the social factors affecting how other people respond to a person who flushes when drinking alcohol.
This information is useful "Facial flushing alcohol consumption" those considering ways to reduce and prevent
Facial flushing alcohol consumption cancers through education and information programs. Alcohol ethanol has been identified as a causative agent for aerodigestive tract cancers [ 12 ].
Aerodigestive cancers include cancers of the respiratory tract and the upper part of the digestive tract lips, mouth, tongue, nose, throat, vocal cords, and part Facial flushing alcohol consumption the esophagus and trachea [ 3 ]. Not all alcohol drinkers are equally at risk.
The variability of risk of developing cancer from exposure to alcohol results from individual drinking patterns, drinking in combination with other behaviors like smoking, drinking in combination with environmental exposures, and an inherited deficiency in alcohol metabolism. Flushing is important because it is perhaps the only clearly visible physiological sign of heightened cancer risk associated with alcohol use.
Being visible, facial flushing invites reactions from other people that can moderate the degree of risk. Alcohol ethanol metabolism proceeds in two stages.
In the first stage, alcohol is metabolized by the enzyme alcohol dehydrogenase ADH into acetaldehyde. Acetaldehyde is carcinogenic and toxic, and, in some people, stimulates a histamine reaction visible as a red flush on the face and neck. In the second stage, the aldehyde dehydrogenase ALDH isozymes metabolize acetaldehyde into relatively harmless acetic acid that is expelled from the body mostly in the urine.
Genetic code for ALDH consists of 19 genes in 11 families [ 4 ]. One group, ALDH2, is mainly responsible for acetaldehyde metabolism.
Lachenmeier and Salaspuro described a causal relationship between acetaldehyde exposure and upper aerodigestive cancers and suggest the carcinogenicity of acetaldehyde may be higher than previously estimated [ 6 ]. One ALDH gene Facial flushing alcohol consumption inherited from each parent. In addition to flushing, these individuals also sometimes experience tachycardia, headache, heart palpitation, shortness of breath, hyperventilation, low blood pressure, vertigo, nausea, and vomiting [ 8 ] when they drink alcohol.
Such uncomfortable physiological responses to alcohol have been suggested as a reason Asian populations consume less alcohol and have fewer alcohol-dependent persons [ 9 ]. However, despite the associated discomforts, these individuals often drink through their discomfort and develop some level of tolerance for alcohol.
A study by Parrish et al. Observers of flushing drinkers suggest they continue drinking as a result of social pressures and traditions [ 510111213 ].
It is the individuals who flush and keep on drinking who have significantly increased risks for upper aerodigestive cancers. Data from alcoholics in Japan [ 14 ] suggest that the number of individual heterozygotes who drink alcohol is increasing: If the same trend observed in Japan is occurring in China, combined with evidence that the number of drinkers and the per-capita alcohol use are increasing in China [ 161718 ], then there is an increasing risk of upper aerodigestive cancers.
Currently in China, among men esophageal cancer one of the cancers grouped under aerodigestive cancers is the fourth leading cause of cancer deaths; among women, it is the eighth [ 19 ]. It is estimated that Facial flushing alcohol consumption of Chinese, Japanese, Korean, and other Asian people have the genetic predisposition to flush [ 3 ]. A reduction in alcohol consumption among ALDH2-deficient humans could lead to reductions in the occurrence of aerodigestive cancers.
A reduction in alcohol consumption ALDH-deficient individuals can be achieved if the individuals who flush change their drinking behavior and if those who encourage those individuals to drink more change theirs. To develop the questionnaire, we initially conducted semi-structured personal interviews with students to identify what students thought were the factors influencing their reaction to a fellow student flushing.
In all, 24 Chinese university students participated in the interviews. Data from the interviews identified three factors that were used for questionnaire development. In contrast, at risky drinking occasions, some drinkers come for the purpose of getting drunk or getting others drunk.
These three factors were used to develop the questionnaire for this study. Because of the contextual nature of reactions reported by students, the questionnaire was designed with a scenario format.
Six drinking scenarios were developed as described in Table 1. Three of the drinking scenarios described occasions where the students came together expecting a considerable amount of drinking and the likelihood of getting drunk themselves or getting someone else drunk: For each of these six scenarios, there were separate questions about reactions to a male flusher and a female flusher.
For each of the scenarios, the participants were given three responses: Each scenario included four possible types of flushers: A total of students from universities in Southwestern, Central, and Northeastern China completed the survey. Data from The description of the sample is provided in Table 2. A generalized logit mixed model was estimated in Mplus Version Facial flushing alcohol consumption. The scenarios had three possible reactions to facial flushing.
Generalized modeling was necessary to account for the nominal natural of the outcome, whereas mixed modeling was necessary to account for the dependency among observations due to the nesting of Facial flushing alcohol consumption within students.
Level 1 responses level in this model had six fixed effects predictors: Level 2 students level in this model accounted for individual differences in the dependency of responses at Level 1 because one student may provide responses more similar to all questions than another.
The complete model is shown in Appendix A. Full information maximum likelihood with robust variance estimation was used throughout. Likelihood ratio tests LRTs were performed to evaluate the omnibus effect of each predictor on the overall outcome three response options corresponding to two degrees of freedomand Wald tests were used to determine the significance for the specific comparisons two response options corresponding to one degree of freedom.
The odds ratios were computed to facilitate interpretation. The survey data upon which the results are based can be accessed at University of Facial flushing alcohol consumption Data Repository [ 26 ].
Responsible authorities at each university approved the project and the surveys. The University of Nebraska-Lincoln Institutional Research Board approved both the qualitative and quantitative procedures prior to the study Interviews: The results from the test of the full model with all interactions is shown in Table 3. The odds of suggesting that the flusher stop or reduce drinking versus making no such suggestion were higher with respect to females, close friends, and fun drinking occasions.
The three-way interaction among these factors was significant Table 3.
Facial flushing alcohol consumption the follow-up test, holding constant the random effect, the three-way interactive logistic model implied that the probability of suggesting to a flusher to stop or reduce drinking versus not making such a suggestion was the highest when the flushing student was a Facial flushing alcohol consumption female friend in a fun drinking situation and lowest if the flusher was a general male friend in a risky drinking situation.
The odds of to suggest that the flusher stop but not actually doing so versus having no such inclination were lower with respect to female flushers and close friends and were also lower with respect to close friends of either gender in fun drinking occasions. The three-way interaction among these factors was not significant Table 3.
In the follow-up test, holding constant the type of drinking purpose and the random effect, the two-way interactive logistic model suggested that the probability that a student did not suggest that a flusher Facial flushing alcohol consumption or reduce but wanted to versus the probability that a student had no such inclination was the highest when the flushing student was a general female friend and the lowest if the flusher was a close male friend.
When holding constant gender and the random effect, the probability of wanting to make a suggestion versus having no such inclination was highest when the flushing student was a general friend in a fun drinking situation and lowest when the flusher was a close friend in a risky drinking purpose.
Alcohol-induced facial flushing is common in Asian populations and indicates in a given individual a compromised ability to metabolize alcohol and an increased risk for upper aerodigestive cancers. This study explored the effects of three social factors—gender, degree of friendship, and purpose—on the likelihood that someone would intervene.
The results from this study can benefit the development of educational programs aimed at increasing the number of people who reduce or stop drinking because they flush and who lend support to drinking companions who want to stop drinking or slow down. Our results indicated that the probability that someone would suggest to a flusher that she or he stop or reduce drinking was highest when the flusher was a female and a close friend and when the drinking situation was principally for pleasure.
Finding that the probability that people will suggest to a person who flushes that they reduce or stop drinking is highest when the person flushing is a female and a close friend and when the drinking situation is for pleasure gives rise to the most likely scenario about which to begin education to modify drinking behaviors. An educational approach making use of these findings will have to be sensitive to the Chinese cultural context of gender, friendship, and drinking purposes.
Specific implications of using each Facial flushing alcohol consumption factor for educational program development are discussed in the following sections. Earlier studies suggested that being a female flusher provided a degree of protection from pressure to drink [ 212223 ].
Study findings continue to support that the probability of intervening is higher for female flushers relative to male flushers. However, our new data suggest that the degree of protection is moderated by friendship and drinking purpose. Results suggest that, for females, being female is the main criterion others use to intervene across all situations. For males, however, intervention is heavily influenced by friendship and setting. Making a flusher aware of this, and suggesting that they seek assistance from close friends and that they avoid risky drinking situations when possible, could be advised.
For bystanders the students who said they would not intervene but think they shouldgender interactions were less pronounced. Again, there was a higher probability that students think they should intervene when the flusher was a female.
However, this was not affected by drinking purpose. The probability of a student saying they want to intervene but did not was higher for general rather than close friends for both females and males.
This is likely opposite to the probabilities for intervening because students were more likely to actually intervene with a close friend rather than standing by.
These results are not necessarily surprising, but given the almost universal acknowledgment by Chinese people that their drinking patterns are deeply culturally ingrained and would be extremely difficult to change, some education on this issue is thus suggested.
For example, drinking at an official banquet with bosses or dignitaries is a situation where status roles and rules of etiquette prevail over individual wishes.
Students believed that, while the degree of friendship could not change the rules of etiquette, it might change the degree to which a person followed the rules. The study results strongly supported the interaction of friendship with the drinking setting, as well as with the gender of the flusher. This was especially true for males more so than females.
The probabilities of intervention were much higher when the male was a close friend, whereas they were similar for females regardless of the closeness of the friendship. Similarly, bystanding being a person who does not intervene, but thinks the flusher should reduce or stop drinking was more likely for general friends of either gender.
This suggests hesitancy to speak up or take action when the flusher is only a casual acquaintance. In contrast, at risky drinking occasions, some drinkers come with the Facial flushing alcohol consumption of getting drunk or getting others drunk. In risky situations, someone who flushes might also pressure other people to drink in order to get others to share in the discomfort and to redirect attention away from themselves.
The study results thus support the importance of the drinking setting and purpose for taking action. It was always the case that students were more likely to intervene in a fun setting than in a risky setting.
This was true across both gender and friendship status.
This project examined how facial flushing might be used to reduce alcohol use to lower cancer risks. Interviews with Chinese university. Alcohol flush reaction is also sometimes referred to as Asian flush syndrome, Asian flush, or Asian glow because of the approximately 36% of.
The association between facial flushing after alcohol consumption and the risk of cancer remains controversial. The aim of this study was to.