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Health Education Population Survey (HEPS): Update from 2004 Survey - Final Report

6. Alcohol

Alcohol is a major cause of liver cirrhosis and a risk factor for high blood pressure, several types of cancer and a number of other health problems. Excessive or inappropriate use of alcohol also increases the risk of accidents and crime, and is associated with a variety of social problems. The 2002 Scottish Executive Plan for Action on Alcohol Problems recognises this explicitly in its key priorities: reducing binge drinking and reducing harmful drinking by children and young people. Health education activities have been mainly focussed on young people, with HEBS Think About It campaign targeting 12-17 year olds and the Scottish Executive campaign targeting 16-25 year olds. Other health education work in Scotland has focused on raising awareness of alcohol problems in the workplace.

The current sensible drinking guidelines consist of daily benchmarks. However, because awareness of this is low, knowledge of recommended drinking limits is perhaps more realistically assessed in relation to the better-established weekly limits. The maximum recommended limits for alcohol consumption as set out in Towards a Healthier Scotland (The Scottish Office, 1999) are 14 units for women and 21 units for men per week. For the purposes of the survey, respondents were classified as ‘drinkers’ if they had consumed any alcohol in the past year.

6.1 Reported behaviour

Respondents classified as ‘drinkers’ were asked if they had drunk any alcohol in the past week and how much they had consumed of each type of alcohol. In relation to sensible drinking behaviour, 14% of respondents were classified as exceeding the recommended weekly limits described above, and this has remained fairly stable over time (Figure 6.1).

Figure 6.1 Time trends in exceeding recommended alcohol limits (1996-2004)

Base: all respondents (2004:1784)

Men were more likely to exceed the limits for their sex than women. In 2004, however, the proportion of men exceeding the weekly limits seems to have fallen from one in four to one in five. This is the result of a drop in the levels of consumption reported by young men, aged 16-34. A similar pattern was reported in 1998, but this drop was not sustained. Data from future years will help confirm whether this is the start of a genuine change in behaviour, or a fluctuation in one year’s data.

A second measure of excessive drinking is “binge drinking”. A binge drinking session is defined in HEPS as exceeding 16 units for men, or 10 units for women on one occasion. In 2004, 9% of respondents reported four or more binge drinking sessions in the past month, again higher for men (13%) than women (6%). There has been no change over time in this behaviour.

6.2 Knowledge and motivation

Respondents who had had an alcoholic drink in the past year (drinkers) were asked how many units of alcohol they thought was the recommended weekly limit for their own sex. This question was only asked in March 1996 and March 1997, and was then put to all respondents in 2001-2004. From 2001 onwards, respondents were able to give daily or weekly limits. For those giving daily limits, weekly limits were derived by multiplying their response by seven.

There has been no significant increase in awareness since 1997 (Table 6.2). One in four drinkers was aware of the recommended limits for their sex. There has been some fluctuation over time by sex, and in 2004 women were, for the first time, more likely than men to be aware of their recommended limit.

Table 6.2 Knowledge of recommended weekly limits for own sex

Most drinkers were happy with their levels of alcohol consumption with 77% not contemplating reducing them. One in five (18%) had tried to reduce their drinking and a further 5% would like to.

Figure 6.3 Time trends in motivation to cut down alcohol consumption (1996-2004)

Base: all drinkers (2004:1542), and all exceeding weekly limits (2004: 232)

At 23% the proportion of drinkers motivated to cut down is no longer significantly higher than the baseline figure in 1996 and has reversed the apparently increasing trend seen over the past few years. The same pattern was apparent for those who had exceeded the limits (Figure 6.3).

Main points

• Men were more likely to exceed the recommended weekly limits and to binge drink than women. In 2004, however, the proportion of men exceeding the recommended limit appears to have fallen from a quarter to a fifth.
• There was a significant increase in knowledge levels regarding the recommended weekly limits between 1996 and 1997, but these levels are still relatively low and have shown no further significant increases. Women were more likely than men to be aware of the recommended limits for the first time in 2004.
• A slight decrease in motivation to cut down alcohol consumption in 2004 (23%) means that levels of motivation are not significantly higher than they were in 1996, reversing the apparent increase in motivation recorded over the past few years.