Clarifying the Relation between Alcohol Demand and Alcohol-Related Relative Reinforcement and Driving after Drinking in a Canadian Community Sample.

Objective: Previous studies examining associations between elevated behavioural economic alcohol demand and rates of driving after drinking (DAD) have primarily focused on university students in the United States. It is unclear whether similar associations exist in community adults and in other locations. Furthermore, the role of proportionate alcohol reinforcement (e.g., reinforcement derived from alcohol vs. non-alcohol related activities) has not been investigated in relation to DAD. The goal of this study was to investigate cognitive and behavioural economic factors related to DAD in a large community sample of Canadian adults. Methods: Participants (N = 926) were extracted from the "Population Assessment for Tomorrow's Health" (PATH) registry, a sample of adults from the Hamilton, ON community. Primary assessments included a hypothetical alcohol purchase task assessing alcohol demand, the adolescent reinforcement survey schedule to assess proportionate alcohol reinforcement, a driving behaviours questionnaire assessing driving-related cognitions and DAD frequency. Results: In separate hierarchical regression models predicting DAD frequency and lifetime DAD quantity (adjusting for age, sex, income, and drinking quantity), individuals with elevated alcohol demand and alcohol related reinforcement showed greater engagement in DAD. Importantly, relative reinforcement accounted for unique variance beyond alcohol demand. Conclusions: These results extend the established relationship between alcohol demand and DAD to a large sample of Canadian adults. Furthermore, this study is the first to establish a unique association between alcohol-related reinforcement and DAD. These results suggest that alcohol related reinforcement may be a useful target for alcohol-impaired driving interventions.