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Ecological analysis of collectivity of alcohol consumption in England: importance of average drinker
H Colhoun1, Y Ben-Shlomo, W Dong
1Department of Epidemiology and Public Health, University College London. helen@public-health.ucl.ac.uk
Objective:
To assess whether the average consumption of alcohol is associated with the prevalence of heavy drinking, problem drinking, and abstention in England.
Design:
Ecological analysis using data from a cross sectional household based survey of English adults.
Subjects:
Random sample of 32,333 adults from the English population who participated in the 1993 and 1994 health surveys for England.
Main Outcome Measures:
Association, expressed as the correlation coefficient, between the regional mean and median alcohol consumption and the regional prevalence of heavy drinking, problem drinking, and abstention.
Results:
Mean consumption of alcohol in light to moderate drinkers was strongly positively associated with the prevalence of heavy drinking (r = 0.75 in men and r = 0.62 in women for drinking more than 21 and 14 units per week respectively). A similar association was found between median consumption and prevalence of heavy drinking. Abstention was not significantly associated with mean consumption in drinkers (r = 0.08 for men and r = -0.29 for women). Both the median and mean consumption in drinkers were positively associated with the prevalence of problem drinking as defined by the CAGE questionnaire on alcohol use (r = 0.53 for men and r = 0.42 for women for the association with mean consumption).
Conclusion:
Factors that increase the average consumption of alcohol in the population may result in an increase in the prevalence of heavy drinking and related problems.