-->PONE-D-25-45788-->-->Predictors of binge drinking among adults in Autonomous Province of Vojvodina, Serbia: data from behavioral risk-factors surveillance system-->-->PLOS ONE

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Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

-->Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. -->

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Partly

Reviewer #4: Partly

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-->2. Has the statistical analysis been performed appropriately and rigorously? -->

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: No

Reviewer #4: Yes

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-->3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: No

Reviewer #4: No

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-->4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.-->

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: No

Reviewer #4: No

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-->5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)-->

Reviewer #1: All comments are uploaded as a word document. Here is a short summary:

Overall, this is a well-conceived and relevant study addressing an important public health issue. The manuscript is methodologically sound and provides valuable insights into binge drinking patterns in Vojvodina. To further strengthen the manuscript, improvements are recommended in language flow, section transitions, and methodological clarity. Enhancing consistency in academic language, tightening redundancies, and expanding contextual discussion will significantly improve the manuscript’s readability and impact.

Reviewer #2: This is an interesting paper exploring some of the demographic associations with binge drinking. The results are fairly consistent with what has been observed in other countries, though with some interesting differences. The authors focus just on some demographic features as if these should be consistent across cultures. But what about social and cultural factors that might influence drinking behaviour and account for differences in observed rates of binge or other drinking? Also, what about the impact of subcultures on drinking habits? Sports oriented subcultures may have different norms than academically inclined, or religiously oriented subcultures. These may cross the usual demographic boundaries.

I wondered why alcohol use in a general sense was included as a demographic (explanatory factor). Would it not have been useful to know to what degree the demographic factors identified with binge drinking hold for drinking in general? Do we really know how specific these factors are to binge drinking? Could they be non-specific?

Overall, the paper is well written. I found a few typographical errors that should be corrected.

In the introduction, line 51, it is better to say 4 or more drinks for women, 5 or more drinks for men.

Line 94 is a bit ambiguous – better to say adults who used healthcare in one or more of 44 healthcare centers

In the definition of binge drinker, they describe two conditions – binging or non-consumption. Does that mean that they eliminated from the study any non-binge but still drinkers? In that case, what do they know about how their risk variables affect non-binge drinking patterns? Might they also be risk factors for drinking generally? How do we know that they are specific to binge drinking?

Oh, I see alcohol use is an explanatory variable. Still, if it an explanatory variable, how do we see effect on it?

Lines 221, 224, does ‘twice a time’ simply mean ‘two times’ or ‘twice’?

Line 258 ‘criteriums’ should be ‘criteria’

Reviewer #3: Summary: Tomašević et al. investigated risk factors for binge drinking in adult population of Autonomous Province of Vojvodina, Serbia. They included demographics and health behaviors as potential predictors, and the analysis was stratified by sex. Their findings suggested that younger age and current smokers were associated with increased likelihood of binge drinking in both sexes. Other significant variables were never married, low socioeconomic status, and former smokers in females, and physically inactive males.

The comments below are grouped by topics/themes.

1. Need further clarification:

a. Was the BRFSS instrument translated to the primary language(s) spoken in APV prior to administration? If yes, please include this information.

b. Please elaborate on what the BRFSS instrument consists of (e.g., number of items, score range).

c. On the sample size section (line 116), it is stated that “persons with mental impairment” was one of the exclusion criteria. Does this mean any mental health conditions or serious mental illness?

d. On the outcome variable section (line 147), binge drinkers were coded as 1, and non-consumptions were coded as 0. What about those who consumed alcohol in the past 30 days but did not binge? Were they excluded from the study?

2. Statistical analysis:

a. Please report the number and percentage of incomplete/missing/excluded data and the type of missing data, especially if the rate of missingness is substantial.

b. Please check for potential multicollinearity between employment status and socioeconomic status. If they are highly correlated, then consider dropping one of them in the analysis.

c. On the statistical analysis section (line 171), it is stated that p <0.05 was statistically significant. Since there are two separate models (males and females), please consider controlling the rate of false positives (e.g., Benjamini-Hochberg, Bonferroni) or providing reasons to keep the choice of p <0.05.

d. Need to report additional metric, such as goodness-of-fit and/or model performance/discrimination

e. On the abstract (line 27), former smokers in females were a significant predictor. However, the 95% confidence interval includes 1.0. The authors might consider reporting more precise CI values (e.g., two to three decimal places) to avoid confusion.

3. Writing:

a. The authors should revise the language to improve readability.

b. Please check for punctuation.

c. The authors should consider using either ‘sex’ or ‘gender’ consistently throughout the paper.

Reviewer #4: The manuscript addresses an important public health issue and makes valuable use of a large, population-based dataset collected in Vojvodina, Serbia. To further improve the clarity and accuracy of the manuscript, I recommend the following revisions:

I recommend that the authors conduct a thorough language edit of the manuscript to address grammatical errors, inconsistencies, and issues with clarity. Please ensure consistent formatting throughout, including uniform font type and size, and consistent use of punctuation. Additionally, several acronyms are either defined after their first use or not defined at all. Please review and correct all acronym usage.

The term material status appears to be used interchangeably with socioeconomic status throughout the manuscript. However, these concepts are not equivalent. From the Methods section, the authors describe material status as the variable used, yet in other parts of the manuscript the term socioeconomic status is used instead. Material status generally reflects material living conditions or deprivation, while socioeconomic status encompasses broader dimensions such as income, education, and occupation, these terms should not be treated as interchangeable. If the authors intended material status to serve as an indicator of socioeconomic status, then explicit justification of this study design choice and a clear description of how material status was explained and asked during the data collection phase with participants should be provided. If this is not the case, the two terms should not be used interchangeably, as they represent different constructs. Please clarify which construct was actually measured/collected in the study. Please ensure consistent terminology across all sections, and revise to accurately reflect the study design/results.

In the Discussion section, the sentence “which is consistent with results from Peru, Italy, Spain, and Ontario (18, 27, 36, 37)” treats Ontario as if it were a country. Please double check the geographic context (e.g., province in Canada) for clarity. This appears more than once throughout the Discussion section.

Finally, in accordance with the PLOS Data Policy, is the data collected in this study publicly available, either as supplementary material or in an online repository? Please provide the appropriate access information if possible.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes: Yumiko Wiranto

Reviewer #4: Yes: Julie Tian

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Attachments

Attachment

Submitted filename: Review Comments Binge Drinking Study.docx

Predictors of binge drinking among adults in Autonomous Province of Vojvodina, Serbia: data from the population-based behavioral risk-factors surveillance system

PONE-D-25-45788R1

Dear Dr. Radić,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Vincenzo De Luca

Academic Editor

PLOS One

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

-->Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.-->

Reviewer #2: All comments have been addressed

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-->2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. -->

Reviewer #2: Yes

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-->3. Has the statistical analysis been performed appropriately and rigorously? -->

Reviewer #2: Yes

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-->4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

Reviewer #2: Yes

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-->5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.-->

Reviewer #2: Yes

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-->6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)-->

Reviewer #2: (No Response)

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-->7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.-->

Reviewer #2: No

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