Measurement of alcohol consumption: issues and challenges

In both the clinical and research settings, nurses assess patterns of alcohol consumption to screen for risk of adverse events or to determine the health consequences of drinking. The purposes of this critical review are to explore issues and controversies surrounding the measurement of alcohol consumption and to critique the existing literature relevant to the research and clinical arenas. An electronic literature search was completed to identify research articles addressing human studies from 1995 through 2004 related to alcohol consumption. Key words included alcohol drinking (subheadings blood, metabolism, psychology, and urine), standard drink, problem drinking, heavy drinking, and ethanol analysis (subheadings blood, urine, and chemistry). The results were in two primary content areas: self-reported alcohol consumption and assessment of consumption by using biological markers. Self-reported alcohol consumption can be quantified in a variety of ways, such as ounces of ethanol per day, standard drinks per day, drinking occurrences per month, heavy drinking occasions per month, and frequency of perceived drunkenness. The choice of measure depends on setting (clinical vs. research), the role of the variable under study, the capabilities and demographics of the study population, the study design, and the resources available to collect alcohol consumption data. A variety of biologic instruments are used to assess alcohol consumption, each with sensitivities and specificities that vary by age, gender, and possibly by ethnicity/race. Previous work has focused on the white, male, alcohol-dependent population and non-alcohol-dependent male controls. Some urgency exists to expand the biometrics of alcohol use to minority and older populations as well as to women across the life span.