University College London Medical School, Department of Epidemiology and Public Health, 119 Torrington Place, London WC1E 6BT,
1 Centre for Research on Drugs and Health Behaviour, Imperial College of Science, Technology and Medicine, 200 Seagrave Road, London SW6, 1RQ,
2 School of Social Sciences, University of Middlesex, Enfield, London EN3 4SF and
3 Health Education Authority, Trevelyan House, 30 Great Peter Street, London SW1P 2HW, UK
Received 21 December 1998; in revised form 22 March 1999; accepted 7 April 1999
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ABSTRACT |
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INTRODUCTION |
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This paper aims to advance knowledge of the pattern of alcohol consumption practices among young people by presenting the findings of research which set out to explore differences in drinking patterns of a sample of 1624-year-old white males in one relatively deprived electoral ward in east London. In addition to being amongst the heaviest consumers of alcohol in the population (Office for National Statistics, 1998), it was decided to focus on young men from a deprived area because they have been largely ignored in research which tends to focus on school, college, and university populations. By focusing on this group, the report describes the alcohol consumption practices of these young people, and details important differences found in their drinking behaviour across the age range. In terms of promoting appropriate health messages, an understanding of the differences in the pattern of alcohol consumption among different groups of young people, in particular an appreciation of change in drinking practices over time, is crucial if they are to be targeted effectively.
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SAMPLE AND METHODS |
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Research sample
Using the London Research Centre (1995) findings on the level of deprivation in electoral wards in England and Wales, a research location was selected to represent the behaviour and views of young men living in a relatively deprived inner city area about their drinking. The selected ward was situated in London, because it afforded convenient access for the researcher. Seventeen 1617-, 24 1821-, and 19 2224-year-olds completed the questionnaire in community settings in the chosen ward. The settings used were four public houses (17), a bench outside a sports centre (8), a bar with a liquor licence inside a leisure centre (8), the staff room of a youth club (16), a college refectory (4), and the homes of a network of friends (7). Twenty-four were students working towards General and National Vocational Qualifications (11), A levels (7) or higher qualifications (6), 17 were unskilled manual workers, seven were clerical and managerial, seven unemployed, three skilled manual, and two had professional occupations. Most of the young men were not married/cohabiting (54) and had no children (59). Thirty-seven lived with their parents; the remainder were renting privately (17), staying with friends (2), owner occupiers (2), and housing association tenants (2).
Recruitment
Because the questionnaire was part of a larger study, the sample was recruited over a 3-month period. The researcher went into the field in sessions averaging 4 h in duration at different times of the day and on all days of the week. Young men who appeared to meet the criteria of the chosen study group were approached and asked if they would like to participate in the study. This approach led to the completion of 53 questionnaires and five refusals. In addition, an indigenous 21-year-old white male was given training and asked to recruit members of his social network (7). All of these young men were aged between 21 and 24 years, were in employment, and none of those approached using this method refused to participate.
Data analysis
A number of measures were compared. The first four questions on the questionnaire aimed to examine the social context in which drinking was usually situated. Using AUDIT, the following measures were examined: (a) drinking frequency; (b) number of drinks consumed on a typical occasion; (c) frequency of binge drinking (the WHO definition of six or more drinks on one occasion was used); (d) drinking problems and consequences (AUDIT questions 410). In order to establish how many units of alcohol each respondent was drinking, an additional question was added to AUDIT asking respondents to indicate what their usual drinking measure was. By interpreting the responses bottle and glass as 1 U and pint and double as 2 U, a calculation of typical mean weekly alcohol consumption [a sum of (a) and (b) above and usual drinking measure] was made and is shown in Table 1. In order to compare the differences in hazardous and harmful alcohol consumption across the age range, two measures were used. In Table 2
, the AUDIT scores have been summarized according to the proportion of respondents with low (<8) and high (>7) scores in each age category, and Table 3
shows the low and high mean AUDIT scores of each age group.
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RESULTS |
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The majority (65%; 39) scored above the AUDIT cut-off score, which predicts hazardous and harmful alcohol consumption. Their mean AUDIT score of 11.2, was also well above the critical score and the mean weekly alcohol consumption for the whole sample was 26 U/week. In all of these measures there were differences between age groups.
Sixteen17-year-olds:
In the 1617-year-old group, the proportion of respondents in low (53%) and high (47%) AUDIT categories was roughly equal (Table 2) and their mean AUDIT score was 8 (Table 3
). On average, weekly alcohol consumption among this group was 11 U/week (Table 1
). Their drink preferences included ciders and alcopops, they tended to use Saturday as their heavy drinking day and the majority drank most of their alcohol at friends (10/17). All 1617-year-olds reported drinking between one and five drinks on typical occasions, and most drank two to four times a month or less (12/17). Two binged weekly. Their most popular drinking measures were bottles (6/17) and pints (6/17).
Eighteen21-year-olds:
Of the 1821-year-olds, 75% were located in the high AUDIT score bracket (Table 2) and their mean AUDIT score was 14.6 (Table 3
). The mean weekly alcohol consumption of this group was 45 U/week (Table 1
). In addition to premium lager, this age group's other most popular drink was spirits. Most said they drank heavily on Friday (14/24) and Saturday (15/25) and the majority reported drinking most alcohol in the pub (15/24). On typical occasions, the majority of 1821-year-olds said that they drank between five and 10 or more drinks (17/24), drinking this amount between two and four or more times a week (21/24). Half of them binged weekly or more often. Pints were the favoured drinking measure (13/24).
Twenty-two24-year-olds:
Sixty-eight per cent of 2224-year-olds scored >8 on AUDIT (Table 2). The mean AUDIT score for this age group was 9.7 (Table 3
) and their mean weekly consumption was 16 U/week (Table 1
). Again, 2224-year-olds preferred spirits as a second choice drink, most said that Friday was their heavy drinking day (14/19) and the majority drank most alcohol in the pub (17/19). Most reported drinking between one and six drinks on typical occasions (17/19) and drinking between two and four or more times a week (13/19). The majority binged monthly or less (11/19), while pints were their most popular usual drinking measure (12/19).
Drinking consequences and alcohol-related problems
For the whole sample, over one-third (38%; 23) indicated that, on at least one occasion in the last year, they had been unable to stop drinking once started. Comparisons across groups showed an upward trend with increasing age: 17% reported this consequence at 1617 years, 42% did so at 1821 years, and 53% at 2224 years. Almost half of the total sample (47%; 28) said that they had failed to do what was normally expected of them, because of their drinking. This percentage was consistent over all groups. Breakdown of the 22% (13) who reported that they had needed a first drink in the morning to get themselves going after a heavy drinking session, showed that this problem occurred more often in the 1821-year-old (33%) group, compared with 12% at 1617 years of age, and 16% at 2224 years of age. One-third of all young men (32%; 19) said that they had experienced a feeling of guilt or remorse after drinking. There were little differences between groups. Over one-half of the sample (57%; 34) claimed that, at some time during the last year, they had been unable to remember what had happened the night before due to their drinking. The highest proportion was found in the 1821-year-old group (75%), closely followed by 2224-year-olds (68%), while 17% of 1617-year-olds reported this consequence. Over one-third (37%; 22) reported either sustaining or causing injury because of drinking. Again, the highest level was found in the 1821-year-old group (58%), compared with 24% of 1617- and 21% of 2224-year-olds. Finally, 17% (10) said that a friend, doctor or health worker had been concerned about their drinking and advised them to cut down. More 1821-year-olds (21%) reported this problem than 1617- (12%), and 2224-year-olds (16%).
Compared with 1617-year-olds, the proportion of 1821-year-olds with high AUDIT scores increased from below 47 to 75%, three times that of those from the same age group recording low scores. This remains approximately the same at 2224 years old, indicating that between 18 and 24 years old, alcohol consumption among three-quarters of these young men was at a hazardous and harmful level. Comparisons of mean AUDIT scores across age groups produced a different pattern: mean high AUDIT scores increased between 1617 and 1821 years, and fell again at 2224 years. In both categories of mean AUDIT score, the 1617-year-old and 2224-year-old groups were roughly equal. In all groups, the total mean AUDIT scores were at or above the critical figure. Many of these trends are also mirrored in the levels and patterning of drinking consequences and alcohol-related problems reported by the sample.
In most of the measures of problems relating to drinking, it was the 1821-year-olds who reported the highest levels of negative consequences. These findings support the alcohol consumption trends and the levels of hazardous and harmful drinking recorded by AUDIT in the study. They also accord with previous research which found this age group to be the heaviest consumers (Plant et al., 1990; Health Education Authority/MORI, 1992
). According to the daily recommended limit and AUDIT, a large proportion of the young men were drinking at hazardous and harmful levels and, resulting from their drinking, many also experienced a range of negative consequences and problems. The data also indicate that, among this age group, consumption patterns and the context of drinking change over time.
At 16 or 17 years, drinking was at most a weekly Saturday night activity in which a mixture of lager, ciders and alcopops were most frequently drunk in mixed sex groups at friends' houses. On average, compared with the other groups, they were consuming the least alcohol and on the whole did not binge drink often. However, according to the revised recommended sensible drinking message, most were still drinking harmfully. At 1821 years, drinking was different. These young men were drinking more measures of alcohol on more occasions, they were binge drinking regularly on both Friday and Saturday nights and, as a result, they were on average consuming over twice the previous recommended weekly benchmarks and four times more alcohol than the younger age group. They also preferred to drink in the pub, rather than in private. At 22 years, alcohol consumption decreased again. While drinking pints in the pub remained popular on Friday nights, alcohol consumption among the 2224-year-old group was less frequent, the amount they drank was less than that of 1821-year-olds and the frequency of bingeing decreased from weekly or twice-weekly to a monthly pattern.
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DISCUSSION |
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Hopefully, our work will provide a useful reference point from which to conduct further research into the consumption patterns, alcohol-related consequences, and the level of harmful and hazardous drinking of other population groups in Britain. This sort of approach might prove useful in identifying and comparing differences in the population's use of alcohol which, in turn, would direct the most effective harm reduction strategies and safe drinking messages at the most effective target groups.
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ACKNOWLEDGEMENTS |
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FOOTNOTES |
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