We are testing a new beta website for gov.scot go to new site

The Scottish Health Survey 2013: Volume 1: Main Report

Listen

3 Alcohol

Linsay Gray and Alistair H Leyland

SUMMARY

Daily alcohol consumption

  • In 2013, men drank an average of 5.2 units on their heaviest drinking day in the previous week; the figure for women was 2.8 units.
  • While average unit consumption on the heaviest drinking day in the last week has declined over the years (from 6.5 and 3.6 units for men and women in 2003 to 5.2 units and 2.8 units respectively in 2013), consumption did not change significantly between 2012 and 2013.

Weekly alcohol consumption

  • In 2013, one in five women (20%) reported that they did not drink alcohol, a significant increase on previous years (17% in 2012, and 13% in 2003). Twelve percent of men, in 2013, did not drink.
  • Adults in Scotland consumed an average of 10.1 units of alcohol per week (13.7 units for men and 6.8 units for women) in 2013.
  • Average weekly unit consumption has declined over the years for both men (from 19.8 in 2003 to 13.7 units in 2013) and women (from 9.0 in 2003 to 6.8 units in 2013). The decline in unit consumption between 2012 and 2013 was significant for men (15.2 units to 13.7 units) but not for women.
  • Men consumed alcohol on an average of 2.8 days per week in 2013 (a decline from 3.3 days in 2003); for women the equivalent was 2.4 days per week, a decline from 2.7 days in 2003.
  • The percentage of adults drinking on more than five days in the previous week declined between 2003 and 2013 (from 20% to 12% for men and from 13% to 9% for women).
  • While older drinkers consumed alcohol with greater frequency than younger drinkers, the quantity consumed in each session, and in total, was lower for older drinkers. Over a third of those aged 75 and over described themselves as a non-drinker, with women of this age nearly twice as likely as men to report this (45% and 24%, respectively).

Adherence to government guidelines on alcohol consumption

  • The percentage of men exceeding the recommended limit of 3-4 units in any one day fell from 45% in 2003 to 40% in 2013. Over the same period, the percentage of women exceeding their recommended limit of 2-3 units on their heaviest drinking day fell by 7 percentage points (from 37% to 30% in 2012 and 31% in 2013).
  • A person is defined as drinking at hazardous or harmful levels if they are a man consuming more than 21 units per week or a woman drinking in excess of 14 units per week. In 2013, just over a fifth of men (22%) and 16% of women drank at hazardous or harmful levels.
  • Hazardous or harmful drinking has declined among both men and women since 2003 (from 33% to 22% in men and from 23% to 16% in women) but did not change significantly between 2012 and 2013.
  • While men and women with the highest household incomes were most likely to drink at hazardous or harmful levels (27% and 25%, respectively), average weekly unit consumption among hazardous or harmful drinkers was highest among those with the lowest incomes (58.1 units and 35.1 units for male and female hazardous/harmful drinkers in lowest income quintile, respectively).
  • Forty-five percent of men and 35% of women drank outwith the government guidelines for weekly and/or daily drinking, a decrease from 53% and 42% respectively in 2003.
  • The percentage of adults drinking outwith government guidelines has fallen significantly over the years. While there has been little change in the percentage of adults adhering to the weekly and/or drinking guidelines (44% in 2013), there has been an increase in the proportion of adults describing themselves as an ex-drinker (5% in 2003 and 9% in 2013).

Alcohol Use Disorder Identification Test (AUDIT)

  • An AUDIT score of 8 or more indicates a person is drinking at hazardous or harmful levels or has possible alcohol dependence. Men were twice as likely as women to have a score of 8 or more in 2012/2013 (25% compared with 12% of women).

3.1 INTRODUCTION

The range of physical and mental health problems associated with the misuse of alcohol is wide. Excessive drinking is associated with increased risk of high blood pressure, chronic liver disease and cirrhosis, pancreatitis, some cancers, mental ill-health and accidents. The World Health Organization (WHO) cites alcohol as the second largest risk factor for ill-health in wealthy countries, behind tobacco use, and ahead of obesity and high blood pressure.[1]

A report published in 2009 attributed 5% of deaths in Scotland to alcohol.[2] More than 94,500 GP consultations and around 36,000 hospital discharges, each year, are for alcohol-related problems.[3],[4] Alcohol-related morbidity and mortality are not evenly distributed throughout the population and the burden is greatest among those living in the most deprived areas.[5],[6],[7]

The implications of alcohol misuse stretch beyond health and it has effects on wider outcomes including social harms, with alcohol misuse the most widely perceived social issue in Scotland.[5] A report published by Alcohol Focus Scotland in 2013 estimated that 1 in 2 people in Scotland are harmed as a result of someone else's drinking.[8] The relationship between alcohol and crime is well documented. In the 2013 Scottish Prisoner Survey, 45% of prisoners reported being drunk at the time of their offence.[9] It is also thought that alcohol is involved in 70% of assaults requiring treatment at A&E.[10]

Misuse of alcohol also has a negative impact on children with an estimated 36,000 to 51,000 children living with a parent (or guardian) whose alcohol use is potentially problematic.[11],[12] There are also economic impacts, with an estimated 1.5 million working days lost to reduced efficiency in the workplace due to the effects of alcohol, and a similar number lost due to alcohol-related absence.[13] In 2007, the total annual cost of excessive alcohol consumption was estimated to stand around £3.6 billion.[13] Recent findings from the 2013 Scottish Social Attitudes survey showed that public awareness of the harmfulness of alcohol has increased, with 60% citing it as the drug causing most problems in Scotland.[14]

3.1.1 Policy background

One of the 16 National Outcomes underpinning the Scottish Government's core purpose is for people living in Scotland to 'live longer, healthier lives'.[15] Tackling alcohol misuse is integral to ensuring that people in Scotland live longer and to reducing the significant inequalities that exist in society. The government's commitment to addressing alcohol misuse is evidenced by the inclusion of a National Performance Framework National Indicator to 'reduce alcohol related hospital admissions'.[15] Other related indicators include the reduction of premature mortality, reducing reconviction rates and crime victimisation, and reducing deaths on roads.[15]

The Scottish Government published its alcohol strategy Changing Scotland's Relationship with Alcohol: a framework for action in 2009.[16] The strategy, which was accompanied by significant new investment in prevention and treatment services, builds on the Licensing (Scotland) Act 2005, which was implemented in September 2009. More recent legislation includes the Alcohol etc. (Scotland) Act, which was implemented in October 2011 and, among other measures, included the banning of quantity discounts in off-sales, the introduction of restrictions on alcohol displays and promotions, and the introduction of the mandatory Challenge 25 age verification policy.

The Alcohol (Minimum Pricing) (Scotland) Act 2012 allows for a price to be set for a unit of alcohol, below which it cannot be sold. Its implementation date is currently uncertain due to an ongoing legal challenge led by the Scotch Whisky Association, in conjunction with some other European alcohol producers.[17] Informed by modelling carried out by the University of Sheffield,[18] Scottish Ministers have indicated their preference for a minimum unit price of 50p for at least the first two years. It is estimated that ten years after implementation of the policy, when it is considered to have reached full effectiveness, there would be at least 300 fewer alcohol-related deaths and 6,500 fewer hospital admissions each year.[19]

Evaluation of Scotland's alcohol strategy lies with NHS Health Scotland, through the Monitoring and Evaluating Scotland's Alcohol Strategy (MESAS) work programme. The third annual MESAS report, published in December 2013, concluded that there has been 'a recent and sustained decline in alcohol-related harm across most measures'.[20] It was also noted, however, that levels 'are higher than a decade ago and remain persistently higher than England & Wales'.[18]

3.1.2 Measuring alcohol consumption in surveys

The alcohol consumption estimates discussed in this chapter are based on self-reported data collected during the survey interview. It is, however, important to note that surveys often obtain lower consumption estimates than those implied by alcohol sales data. The disjuncture can largely be explained by participants' under-reporting of consumption, but there is also some evidence that survey non-responders are more likely than responders to engage in risky health behaviours, including hazardous alcohol use.[21],[22],[23] The most recently available annual estimates of alcohol sales in Scotland show that 10.9 litres (21.0 units per adult per week) of pure alcohol per person aged 16 and over were sold in 2012 (the equivalent figure for England and Wales was 9.2 litres (17.6 units per adult per week)).[24] This volume is sufficient for every adult aged 16 and over in Scotland to drink 21 units, the weekly maximum consumption level recommended for men.

While self-reported survey estimates of consumption are typically lower than estimates based on sales data, surveys provide valuable information about the social patterning of individuals' alcohol consumption. Findings from the Scottish Health Survey will be used in the evaluation of the implementation of minimum pricing to help assess the impact on consumption patterns across different groups in society.

3.1.3 Reporting on alcohol consumption in the Scottish Health Survey (SHeS)

The key trends for weekly and daily alcohol consumption are updated and presented in this chapter. Levels of alcohol dependency and high risk alcohol use, as measured by the Alcohol Use Disorders Identification Test (AUDIT) are also provided. Supplementary tables on alcohol consumption are available on the survey website.[25]

3.1.4 Comparability with other UK statistics

The Health Surveys for England, Wales and Northern Ireland all provide estimates for alcohol consumption. A report published by the Government Statistical Service advises that these estimates, along with SHeS estimates are "not comparable."[26] Mean weekly alcohol consumption statistics are not available for Wales, and estimates of consumption on the heaviest drinking day are not available for Northern Ireland. While questions are similar in each of the surveys, questions on alcohol consumption are delivered through self-completion in the Welsh Health Survey, complicating comparisons. Categorisation of drinkers and non-drinkers is inconsistent across the surveys. Differences also exist in the way some alcoholic drinks are categorised.

3.2 METHODS AND DEFINITIONS

3.2.1 Methods

Questions about drinking alcohol have been included in SHeS since its inception in 1995. Questions are asked either face-to-face via the interviewer or included in the self-completion questionnaire if they are deemed too sensitive for a face-to face interview. All 16-17 year olds are asked about their consumption via the self-completion, as are some 18-19 year olds, at interviewers' discretion. The way in which alcohol consumption is estimated in the survey was changed significantly in 2008. A detailed discussion of those revisions can be found in the chapter on alcohol consumption in the 2008 report.[27]

In 2013, the SHeS questionnaire covered the following aspects of alcohol consumption:

  • usual weekly consumption,
  • daily consumption on the heaviest drinking day in the previous week, and
  • indicators of potential problem drinking (including physical dependence).

Weekly consumption

Participants (aged 16 and over) were asked preliminary questions to determine whether they drank alcohol at all. For those who reported that they drank, these were followed by further questions on how often during the past 12 months they had drunk each of six different types of alcoholic drink:

  • normal beer, lager, cider and shandy
  • strong beer, lager and cider
  • sherry and martini
  • spirits and liqueurs
  • wine
  • alcoholic soft drinks (alcopops).

From these questions, the average number of days a week the participant had drunk each type of drink was estimated. A follow-up question asked how much of each drink type they had usually drunk on each occasion. These data were converted into units of alcohol and multiplied by the amount they said they usually drank on any one day.[28]

Daily consumption

Participants were asked about drinking in the week preceding the interview, with actual consumption on the heaviest drinking day in that week then examined in more detail.[29] Details on the amounts consumed for each of the six types of drink listed in the weekly consumption section above were collected, rather than direct estimates of units consumed.

Problem drinking

Since 2012 the AUDIT questionnaire has been used to assess problem drinking. AUDIT is widely considered to be the best screening tool for detecting problematic alcohol use. It comprises ten indicators of problem drinking, three indicators on consumption, four on use of alcohol considered harmful to oneself or others, and three on physical dependency on alcohol. Given the potentially sensitive nature of these questions, they were administered in self-completion format for all participants.

3.2.2 Calculating alcohol consumption in SHeS

The guidelines on sensible drinking are expressed in terms of units of alcohol consumed. As discussed above, detailed information on both the volume of alcohol drunk in a typical week and on the heaviest drinking day in the week preceding the survey was collected from participants. The volumes reported were not validated. In the UK, a standard unit of alcohol is 10 millilitres or around 8 grams of ethanol. In this chapter, alcohol consumption is reported in terms of units of alcohol.

Questions on the quantity of wine drunk were revised in 2008. Since then, participants reporting drinking any wine have been asked what size of glass they drank from: large (250ml), medium (175ml) and small (125ml). In addition, to help participants make more accurate judgements they are also shown a showcard depicting glasses with 125ml, 175ml and 250ml of liquid. Participants also had the option of specifying the quantity of wine drunk in bottles or fractions of a bottle; with a bottle treated as the equivalent of six small (125ml) glasses.

There are numerous challenges associated with calculating units at a population level, not least of which are the variability of alcohol strengths and the fact that these have changed over time. Table 3A below outlines how the volumes of alcohol reported on in the survey were converted into units (the 2008 report provides full information about how this process has changed over time).[25] Those who drank bottled or canned beer, lager, stout or cider were asked in detail about what they drank, and this information was used to estimate the amount in pints.

Table 3A Alcohol unit conversion factors

Type of drink

Volume reported

Unit conversion factor

Normal strength beer, lager, stout, cider, shandy (less than 6% ABV)

Half pint

1.0

Can or bottle

Amount in pints multiplied by 2.5

Small can
(size unknown)

1.5

Large can/bottle
(size unknown)

2.0

Strong beer, lager, stout, cider, shandy (6% ABV or more)

Half pint

2.0

Can or bottle

Amount in pints multiplied by 4

Small can
(size unknown)

2.0

Large can/bottle
(size unknown)

3.0

Wine

250ml glass

3.0

175ml glass

2.0

125ml glass

1.5

750ml bottle

1.5 x 6

Sherry, vermouth and other fortified wines

Glass

1.0

Spirits

Glass (single measure)

1.0

Alcopops

Small can or bottle

1.5

Large (700ml) bottle

3.5

3.2.3 Definitions

The recommended sensible drinking guidelines in the UK state that women should not regularly drink more than 2 to 3 units of alcohol per day and men should not regularly exceed 3 to 4 units per day. In addition, the Scottish Government recommends that everyone should aim to have at least two alcohol-free days per week.

It is also recommended that, over the course of a week, women and men should not exceed 14 units and 21 units, respectively. Those who drink within these levels are described as 'moderate' drinkers. Men who consume over 21 and up to 50 units per week and women who consume over 14 and up to 35 units are classed as 'hazardous' drinkers, while those who consume more than 50/35 (men/women) units a week are considered to be drinking at 'harmful' levels.[30]

Hazardous drinking can also be defined according to scores on the AUDIT questionnaire. Guidance on the tool, which is primarily intended to screen respondents for levels of alcohol dependency or high-risk use, has been published by the World Health Organization (WHO). Section 3.2.4 includes a fuller description of the tool.[31]

There is no standard definition of 'binge' drinking in the UK. To aid comparisons between other major surveys of alcohol consumption in Britain, SHeS uses the definition used by the Health Survey for England and the General Lifestyle Survey. Both these surveys define binge drinking as consuming more than 6 units on one occasion for women and more than 8 units for men.

An additional measure of people's adherence to the daily and weekly drinking advice set out above is also reported in this chapter. The two key groups of interest are:

Adheres to guidelines

Does not adhere to guidelines

Men drinking

no more than 21 units per week

AND

no more than 4 units on heaviest drinking day

more than 21 units per week

AND/OR

more than 4 units on heaviest drinking day

Women drinking

no more than 14 units per week

AND

no more than 3 units on heaviest drinking day

more than 21 units per week

AND/OR

more than 4 units on heaviest drinking day

3.2.4 Alcohol Use Disorders Identification Test (AUDIT) scale

The AUDIT questionnaire was primarily designed to screen for levels of alcohol dependency or high-risk use. In line with the WHO guidelines on using the tool, responses to each of the ten AUDIT questions were assigned values of between 0 and 4.[32] Scores for the ten questions were summed to form a scale, from 0 to 40, of alcohol use.

The WHO guidelines[31] for interpreting AUDIT scale scores are as follows:

Score

Category description

0 to 7

low-risk drinking behaviour, or abstinence

8 to 15

medium level of alcohol problems, with increased risk of developing alcohol-related health or social problems (sometimes described as hazardous drinking behaviour)

16-19

high level of alcohol problems, for which counselling is recommended (harmful drinking behaviour)

20 or above

warrants further investigation for possible alcohol dependence.

3.3 TRENDS IN ESTIMATED CONSUMPTION, FREQUENCY AND ADHERENCE TO DRINKING GUIDELINES

3.3.1 Trends in usual weekly alcohol consumption since 2003

Self-reported weekly alcohol consumption for men, women and all adults is presented in Table 3.1 for the 2003 to 2013 period. The figures show an overall decline in alcohol consumption over this period.

The reported mean number of units of alcohol consumed per adult (aged 16 and above) declined from 14.1 units per week in 2003 to 10.1 units in 2013. Mean weekly unit consumption declined for both men and women over this period (from 19.8 to 13.7 units for men and from 9.0 to 6.8 units for women). Most of the decline in weekly unit consumption occurred between 2003 and 2011. Average weekly unit consumption declined significantly for men between 2012 and 2013 (from 15.2 units per week to 13.7 units) but not for women.

As outlined in Section 3.2.3, moderate weekly alcohol consumption is defined as no more than 21 units for men, and no more than 14 units for women. Those who exceed the guideline on weekly consumption are commonly referred to as hazardous or harmful drinkers. Reported hazardous or harmful drinking declined between 2003 and 2013. In 2003, a third (33%) of men were classified as drinking at hazardous or harmful levels. This fell to a quarter (25%) in 2011 and 2012, and in 2013 just over a fifth (22%) of men fell into the hazardous/ harmful group. Similarly for women, 23% were drinking at hazardous or harmful levels in 2003; by 2010 this had fallen to 18%, and has remained at a similar level since then (16% in 2013). Changes between 2012 and 2013 were not statistically significant for either men or women.

Correspondingly, reported non-drinking increased between 2003 and 2013 for both sexes. In 2003, less than a tenth (8%) of men said that they did not drink alcohol. By 2010, 12% did, and it has remained at this level (11-12%) since then. Similarly, in 2003 and 2008 13% of women reported not drinking, rising to 16-17% between 2009 and 2012 and to 20% in 2013. Figure 3A, Table 3.1

Figure 3A Percentage exceeding guidelines on weekly alcohol consumption (over 21 units for men, over 14 units for women), 2003-2013, by sex

3.3.2 Trends in alcohol consumption on the heaviest drinking day in last week since 2003

Data were collected on the amount of alcohol consumed on the heaviest drinking day in the week prior to interview. This allows estimates for the proportion of the population exceeding recommended daily limits during the last week to be produced, along with the proportion binge drinking during the last week. These data are presented in Table 3.2 for 2003 onwards.

The mean number of units consumed by men on their heaviest drinking day in the previous week fell from 6.5 units in 2003 to 5.2 units in 2013. While these figures represent a decrease over the decade, the most recent figure is still in excess of the recommended daily maximum of 3-4 units for men. For women, daily consumption decreased from an average of 3.6 units in 2003 to 2.8 units in 2012 and 2013 - the latter figure being just under the recommended limit of no more than two to three units per day.

The percentage of men exceeding the recommended daily maximum of 3-4 units in any one day fell from 45% in 2003 to 40% in 2013. Similarly, the percentage of men consuming more than eight units per day (which is classified as binge drinking) declined from 29% in 2003 to 25% from 2011 onwards. Over the same period, the percentage of women exceeding their recommended limit no more than 2-3 units on their heaviest drinking day fell from 37% in 2003 to 30% in 2012 and 31% in 2013. Binge drinking prevalence among women (drinking more than six units a day) followed a similar trend over time falling from 19% in 2003 to 15% in 2012 and 2013. Figure 3B, Table 3.2

Figure 3B Percentage men exceeding 4 units and 8 units, and women exceeding 3 units and 6 units, on the heaviest drinking day in the previous week, 2003-2013

3.3.3 Trends in adherence to weekly and daily drinking guidelines since 2003

In contrast with the results discussed in the previous sections, there has been little change in the proportion of adults adhering to the guidelines on weekly and/or daily drinking. The percentage of men drinking within the government guidelines ranged between 39% and 42% over the 2003-2013 period. Similarly, among women adherence was 45% in both 2003 and 2013, with little variation in the intervening period.

However, the percentage of the men drinking outwith the government guidelines on weekly and/or daily consumption fell significantly from 53% to 45% between 2003 and 2013; the equivalent figures for women were 42% and 35%, respectively.

The mismatch in the magnitude of change between those drinking outwith and within the recommended guidelines was largely explained by a shift in the proportion of adults classifying themselves as ex-drinkers. In 2003, 4% of men said they no longer drank, compared with 7% who reported this in 2013. Over the same period, the corresponding figure for women doubled from 5% to 10%. Prevalence of lifelong abstinence has remained stable over the last decade at around 5% for men and 7-10% for women. Table 3.3

3.3.4 Trend in number of days alcohol was consumed in the past week since 2003

The mean number of days on which male and female drinkers consumed alcohol in the previous week has declined since 2003 (Table 3.4). For male drinkers, the average fell from 3.3 days per week in 2003 to 2.8 days by 2013 (the same average number as in 2011 and 2012). The decline was less pronounced for female drinkers (2.7 days per week in 2003, compared with 2.4 days in 2013). The percentage of male drinkers who drank on more than five days out of the previous seven fell from 20% in 2003 to 13% in 2011, and has remained at this level since then (12% in 2013). The equivalent figure for female drinkers was 13% in 2003, and has been 9-10% since 2008. Table 3.4

3.4 ESTIMATED CONSUMPTION, FREQUENCY AND ADHERENCE TO DRINKING GUIDELINES IN 2013, BY AGE AND SEX

3.4.1 Weekly alcohol consumption in 2013, by age and sex

Reported weekly alcohol consumption in 2013 is presented, in Table 3.5, by age and sex. In line with findings from previous years,[25],[27] men consumed more units of alcohol per week than women (an average of 13.7 units, compared with 6.8 units), a pattern which was consistent across all age groups. Generally, for both men and women, those in the middle age groups had the highest reported average weekly consumption levels. For example, men aged 45-64 on average consumed between 15.3 and 17.1 units per week, compared with 8.2 to 13.5 units for men in other age groups.

Similar to the pattern for weekly unit consumption, across all age groups, hazardous or harmful drinking (drinking over the recommended weekly limits) was more prevalent among men than women in 2013 (22% and 16% respectively). The oldest age group (those aged 75 and over) were least likely to be hazardous or harmful drinkers (13% of men and 5% of women this age, compared with 19-29% of men under 75, and 13-21% of women under 75).

Correspondingly, in 2013, women were significantly more likely than men to report not drinking any alcohol (20%, compared with 12%); again, this was the case across all age groups. The proportion of adults describing themselves as a non-drinker also varied significantly by age, with those aged 25-44 least likely to do so. Just 7-9% of men aged 25-44 reported being a non-drinker, compared with 12-13% of those aged 45-74, and 24% of those aged 75 and above. The pattern for women was slightly different: 13-16% of those aged 25-64 described themselves as a non-drinker, compared with 27% of those aged 65-74 and 45% of those aged 75 and above. Table 3.5

3.4.2 Alcohol consumption on the heaviest drinking day in 2013, by age and sex

Table 3.5 also presents findings, for 2013, on the average number of units of alcohol consumed on the heaviest drinking day in the previous week. As with weekly consumption, men consumed more units of alcohol on their heaviest drinking day than women (an average of 5.2 units, compared with 2.8 units) and this higher level of consumption was true across all age groups.

Men were also more likely than women to exceed the government guideline on daily consumption. While four in ten (40%) men exceeded the recommended maximum of no more than 3-4 four units, just over three in ten (31%) women drank outwith their daily limit. In 2013, a quarter of men and 15% of women binge drank (more than 8 units for men and more than 6 units for women) on their heaviest drinking day.

The oldest men and women (aged 75 and over) were least likely to exceed their recommended daily maximum (13% of men and 6% of women this age did so). The corresponding figures for men and women in other age groups were much higher: 33-51% for men, and 21-40% for women. Binge drinking prevalence also varied significantly by age for both genders (Figure 3C & Figure 3D). Similar to weekly consumption, binge drinking prevalence was lowest among men and women aged 75 and over (3% and 1% respectively). Between 25% and 39% of men aged 16-64 binge drank on their heaviest drinking day, falling to 14% for those aged 65-74. Around a fifth of younger women (16-54) binge drank, dropping to 11% for those aged 55-64 and then to 5% for those aged 65-74. Figure 3C, Figure 3D, Table 3.5

Figure 3C Percentage men who drank more than 4 units and more than 8 units on heaviest drinking day (HDD) in past week, 2013, by age

Figure 3D Percentage women who drank more than 3 units and more than 6 units on heaviest drinking day (HDD) in past week, 2013, by age

3.4.3 Adherence to weekly and daily drinking guidelines in 2013, by age and sex

Concurrent with findings in previous reports,[25] at all ages, men were more likely than women to drink outwith the recommended guidelines on weekly and/or daily drinking (45%, compared with 35%) in 2013. For men, prevalence was greatest among those aged 25-64 (ranging from 47% to 55%), lower among those aged 16-24 (43%) and 65-74 (39%), and lowest for those aged 75 and over (21%). Between 37% and 43% of women aged 16-64 drank outwith the guidelines, compared with 25% of those aged 65-74 and just 9% of those aged 75 and over.

As expected, lifelong abstinence prevalence was high in the youngest age group (those aged 16 to 24) for both men (13%) and women (17%). However, abstinence was most common among women in the oldest age group (24% of those aged 75 and over). Table 3.5

3.4.4 Number of days alcohol was consumed in past week in 2013, by age and sex

The average number of days on which drinkers consumed alcohol in the week prior to interview is also presented in Table 3.5. In 2013, male drinkers drank on an average of 2.8 days per week, significantly more than female drinkers (2.4 days). There was a clear age-related association to the number of days on which alcohol was consumed, with both frequency of drinking days, and the proportion drinking on more than 5 days of the week, increasing in line with age.

As shown in Figure 3E and Table 3.5, this pattern is somewhat at odds with the per capita mean number of alcohol units consumed per week, which was lowest among the oldest age groups. The interpretation is that older drinkers consume smaller amounts with greater frequency, whereas younger drinkers are more likely to consume larger quantities in fewer drinking sessions. Figure 3E, Table 3.5

Figure 3E Mean number of units of alcohol consumed per week (all adults), and mean number of days on which alcohol was consumed (drinkers only), 2013, by age and sex

3.5 DRINKING CATEGORY AND ESTIMATED WEEKLY ALCOHOL CONSUMPTION BY EQUIVALISED HOUSEHOLD INCOME

To increase the sample size available for analysis, the data from the 2012 and 2013 surveys have been combined to report weekly alcohol consumption by equivalised household income quintile (Table 3.6). It is, however, important to note that even with this combined sample, the bases for hazardous/harmful drinkers are relatively small so the mean unit estimates for those groups have wide confidence intervals. To ensure that the comparisons presented are not confounded by the different age profiles of the groups the data have been age-standardised (see the Glossary at the end of this Volume for a detailed description of both age-standardisation and equivalised household income).

For both men and women, there was a significant and linear association between weekly alcohol consumption and equivalised household income. Those in the highest income households were the most likely to drink at hazardous or harmful levels (27% of men and 25% of women), whereas those on the lowest incomes were least likely to do so (20% of men and 11% of women).

Table 3.6 also presents average weekly unit consumption by drinking category, for each of the household income quintiles. Hazardous or harmful drinkers in the lowest household income quintile drank more, on average (58.1 units for men and 35.1 units for women), than hazardous or harmful drinkers in other income quintiles (whose average weekly consumption ranged from 36.8 to 41.2 units for men and 25.5 to 27.6 units for women). This suggests that while people in the lowest income households are less likely than their higher income counterparts to drink at hazardous or harmful levels, those who do, on average consume a far higher number of units. This is in line with findings presented in previous reports.[27] Figure 3F, Table 3.6

Figure 3F Percentage drinking at hazardous or harmful levels, and mean number of units of alcohol consumed per week by those drinking at hazardous or harmful levels, 2013, by equivalised annual household income and sex

3.6 AUDIT SCORES IN 2012/2013 COMBINED, BY AGE AND SEX

In addition to measuring daily and weekly alcohol consumption, assessment of hazardous and harmful drinking behaviour can also be determined using scores calculated from responses to the AUDIT questionnaire (see Section 3.2.4 for further details on the tool, including guidance on scoring). To increase the sample size available, the analysis presented in this chapter is based on data from the 2012 and 2013 surveys combined.

One percent of adults aged 16 and above had an AUDIT score of 20 or more in 2012/2013, indicating that they had possible dependence on alcohol (2% for men and 1% for women). Harmful drinking behaviour (an AUDIT score of 16-19) stood at 2% (2% for men and 1% for women), while hazardous drinking behaviour (an AUDIT score of 8-15) was identified in one in six (15%) adults (21% of men, 10% of women).

Two summary figures are also presented in Table 3.7, the first combines all those with an AUDIT score of 16 or above i.e. harmful and possibly dependent drinking behavior (3% of adults, 4% of men, 2% of women). The second presents all those with a score of 8 or above (18% of adults, 25% of men, 12% of women), i.e. hazardous, harmful or possibly dependent drinking behaviour.

Audit scores varied significantly by age for both men and women (Figures 3G and 3H). The proportion of men classified as either abstinent or low-risk drinkers increased from 60% of those aged 16-24 to 96% of those aged 75 or above. The equivalent figures for women were 73% and 100%, respectively. Prevalence of hazardous, harmful or possibly dependent drinking behaviour was highest for those aged 16-24 (33% of adults) and decreased with age to just 2% for those aged 75 and over. This pattern was seen for both men and women. Figure 3G, Figure 3H, Table 3.7

Figure 3G AUDIT scores for men, 2013, by age

Figure 3H AUDIT scores for women, 2013, by age

Table list

Table 3.1 Estimated usual weekly alcohol consumption level, 2003 to 2013
Table 3.2 Estimated units consumed on heaviest drinking day, 2003 to 2013
Table 3.3 Adherence to weekly and daily drinking guidelines, 2003 to 2013
Table 3.4 Number of days on which drank alcohol in the past week, 2003 to 2013
Table 3.5 Estimated usual weekly alcohol consumption level, units consumed on heaviest drinking day, adherence to weekly and daily drinking advice, and number of days on which drank alcohol in the past week, 2013, by age and sex
Table 3.6 Estimated usual weekly alcohol consumption level, 2012/2013 combined, (agestandardised), by equivalised household income quintile and sex; and mean units by drinking category, equivalised household income quintile and sex
Table 3.7 AUDIT scores, 2012/2013 combined, by age and sex

Additional tables available on the survey website include:

  • Frequency of drinking any alcoholic drink in the last 12 months, by age & key demographics
  • Mean units consumed weekly, by age & key demographics
  • Weekly drinking category, by age & key demographics
  • Consumed more than 3/4 units on heaviest drinking day, by age & key demographics
  • Consumed more than 6/8 units on heaviest drinking day, by age & key demographics
  • Mean units consumed on heaviest drinking day, by age & key demographics
  • Adherence to both weekly and daily guidelines, by age & key demographics
  • Drank on 6 or more days a week, by age & key demographics
  • Mean number of days in last week on which drank alcohol, by age & key demographics
  • Alcohol Use Disorders Identification Test Score (AUDIT), by age & key demographics
  • Alcohol Use Disorders Identification Test indicators (AUDIT), by age & key demographics
  • Where drink alcohol most, by age & key demographics
  • Who drink alcohol most with, by age & key demographics

Table 3.1 Estimated usual weekly alcohol consumption level, 2003 to 2013

Aged 16 and over

2003 to 2013

Alcohol units per week

2003

2008

2009

2010

2011

2012

2013

%

%

%

%

%

%

%

Men

Estimated usual weekly alcohol consumption levela

Non-drinker

8

10

10

12

11

12

12

Moderate

58

59

63

61

64

63

65

Hazardous/Harmful

33

30

27

27

25

25

22

Mean units per week

19.8

18.0

17.5

16.0

15.0

15.2

13.7

SE of the mean

0.62

0.53

0.75

0.50

0.42

0.59

0.48

Women

Estimated usual weekly alcohol consumption levela

Non-drinker

13

13

16

17

17

17

20

Moderate

64

67

66

65

65

65

64

Hazardous/Harmful

23

20

19

18

18

18

16

Mean units per week

9.0

8.6

7.8

7.6

7.4

7.6

6.8

SE of the mean

0.31

0.34

0.24

0.24

0.23

0.33

0.25

All adults

Estimated usual weekly alcohol consumption levela

Non-drinker

11

12

13

15

14

15

16

Moderate

61

63

64

63

64

64

65

Hazardous/Harmful

28

25

23

22

21

21

19

Mean units per week

14.1

13.1

12.4

11.6

11.1

11.3

10.1

SE of the mean

0.36

0.34

0.40

0.29

0.27

0.35

0.29

Bases (weighted):

Men

3791

3011

3576

3388

3551

2253

2303

Women

4215

3319

3912

3711

3874

2464

2501

All adults

8006

6330

7488

7098

7425

4717

4805

Bases (unweighted):

Men

3558

2796

3276

3064

3239

2095

2108

Women

4482

3579

4232

4076

4220

2657

2724

All adults

8040

6375

7508

7140

7459

4752

4832

a Non-drinker: no units per week; Moderate: >0 units and up to 21 units for men / 14 units for women; Hazardous/harmful: more than 21 units for men / 14 units for women

Table 3.2 Estimated units consumed on heaviest drinking day, 2003 to 2013

Aged 16 and over

2003 to 2013

Alcohol units per day

2003

2008

2009

2010

2011

2012

2013

%

%

%

%

%

%

%

Men

Units consumed on heaviest drinking day (HDD)

Consumed over 4 units on HDD

45

44

44

43

41

42

40

Consumed over 8 units on HDD

29

27

26

26

25

25

25

Mean units on HDD

6.5

6.2

5.9

6.0

5.5

5.6

5.2

SE of the mean

0.18

0.19

0.17

0.21

0.15

0.21

0.19

Women

Units consumed on heaviest drinking day (HDD)

Consumed over 4 units on HDD

37

36

34

33

34

30

31

Consumed over 8 units on HDD

19

18

17

16

17

15

15

Mean units on HDD

3.6

3.5

3.2

3.1

3.2

2.8

2.8

SE of the mean

0.10

0.14

0.09

0.09

0.09

0.11

0.10

All adults

Units consumed on heaviest drinking day (HDD)

Consumed over 4 units on HDD

41

40

39

38

37

36

35

Consumed over 8 units on HDD

24

22

21

21

20

20

19

Mean units on HDD

4.9

4.8

4.5

4.5

4.3

4.1

3.9

SE of the mean

0.12

0.13

0.10

0.12

0.10

0.13

0.12

Bases (weighted):

Men

3819

3015

3521

3386

3549

2264

2270

Women

4254

3320

3865

3710

3860

2460

2498

All adults

8073

6335

7385

7096

7409

4724

4768

Bases (unweighted):

Men

3580

2801

3244

3066

3242

2104

2082

Women

4507

3579

4202

4083

4217

2659

2721

All adults

8087

6380

7446

7149

7459

4763

4803

Table 3.3 Adherence to weekly and daily drinking guidelines, 2003 to 2013

Aged 16 and over

2003 to 2013

Adherence to weekly and daily drinking guidelinesa,b

2003

2008

2009

2010

2011

2012

2013

%

%

%

%

%

%

%

Men

Never drunk alcohol

4

4

4

6

5

5

5

Ex drinker

4

6

6

7

6

7

7

Drinks within government guidelinesa

39

39

41

39

42

41

42

Drinks outwith government guidelinesb

53

51

49

49

46

47

45

Women

Never drunk alcohol

9

7

8

9

9

9

10

Ex drinker

5

6

7

8

9

9

10

Drinks within government guidelinesa

45

47

47

45

44

47

45

Drinks outwith government guidelinesb

42

40

38

38

38

35

35

All adults

Never drunk alcohol

7

6

6

7

7

7

8

Ex drinker

5

6

7

7

8

8

9

Drinks within government guidelinesa

42

43

44

42

43

44

44

Drinks outwith government guidelinesb

47

45

43

43

42

41

40

Bases (weighted):

Men

3769

2981

3519

3355

3520

2234

2240

Women

4203

3296

3862

3675

3827

2442

2469

All adults

7972

6277

7381

7030

7347

4677

4709

Bases (unweighted):

Men

3543

2778

3242

3042

3222

2085

2061

Women

4469

3560

4199

4055

4192

2643

2702

All adults

8012

6338

7441

7097

7414

4728

4763

a Drank no more than 4 units (men) or 3 units (women) on heaviest drinking day, and drank no more than 21 units (men) or 14 units (women) in usual week
b Drank more than 4 units (men) or 3 units (women) on heaviest drinking day, and/or drank more than 21 units (men) or 14 units (women) in usual week

Table 3.4 Number of days on which drank alcohol in the past week, 2003 to 2013

Aged 16 and over and drank alcohol in past week

2003 to 2013

% who drank on >5 days / mean number of days drank alcohol in last weeka

2003

2008

2009

2010

2011

2012

2013

%

%

%

%

%

%

%

Men

Number of days on which drank alcohol in the past weeka

Drank on >5 days

20

17

14

15

13

13

12

Mean number of days

3.3

3.1

2.9

2.9

2.8

2.8

2.8

SE of the mean

0.05

0.05

0.04

0.05

0.05

0.06

0.06

Women

Number of days on which drank alcohol in the past weeka

Drank on >5 days

13

10

9

10

10

10

9

Mean number of days

2.7

2.5

2.5

2.5

2.5

2.5

2.4

SE of the mean

0.05

0.05

0.04

0.04

0.05

0.06

0.05

All adults

Number of days on which drank alcohol in the past weeka

Drank on >5 days

17

14

11

13

12

12

11

Mean number of days

3.0

2.8

2.7

2.7

2.7

2.7

2.6

SE of the mean

0.04

0.04

0.03

0.04

0.04

0.05

0.04

Bases (weighted):

Men

2762

2160

2497

2307

2406

1551

1538

Women

2472

1953

2199

2070

2152

1283

1285

All adults

5234

4113

4696

4377

4557

2834

2823

Bases (unweighted):

Men

2590

1967

2266

2057

2174

1405

1392

Women

2609

2053

2346

2200

2256

1361

1354

All adults

5199

4020

4612

4257

4430

2766

2746

a Of those who drank alcohol in the last week

Table 3.5 Estimated usual weekly alcohol consumption level, units consumed on heaviest drinking day, adherence to weekly and daily drinking guidelines and number of days on which drank alcohol in the past week, 2013, by age and sex

Aged 16 and over

2013

Alcohol units per weeka / alcohol units per day / adherence to weekly and daily drinking guidelinesb,c / % who drank on >5 days / mean number of days drank alcohol in last weekd

Age

Total

16-24

25-34

35-44

45-54

55-64

65-74

75+

%

%

%

%

%

%

%

%

Men

Estimated usual weekly alcohol consumption levela

Non-drinker

15

7

9

12

13

13

24

12

Moderate

66

68

71

65

58

66

63

65

Hazardous/Harmful

19

24

20

23

29

21

13

22

Mean units per week

11.6

13.5

13.1

15.3

17.1

13.4

8.2

13.7

SE of the mean

1.32

1.05

1.05

1.30

1.29

1.07

0.90

0.48

Units consumed on heaviest drinking day (HDD)

Consumed over 4 units on HDD

36

51

42

42

45

33

13

40

Consumed over 8 units on HDD

25

39

25

26

25

14

3

25

Mean units on HDD

5.1

7.5

5.4

5.6

5.3

3.6

1.9

5.2

SE of the mean

0.65

0.69

0.40

0.40

0.34

0.26

0.20

0.19

Adherence to weekly and daily drinking guidelines

Never drunk alcohol

13

4

5

4

3

2

9

5

Ex drinker

2

4

3

8

11

11

15

7

Drinks within government guidelinesb

42

37

45

40

37

48

55

42

Drinks outwith government guidelinesc

43

55

47

48

49

39

21

45

Number of days on which drank alcohol in the past weekd

Drank on >5 days

3

4

7

11

22

24

29

12

Mean number of days

1.9

2.3

2.6

2.8

3.4

3.5

3.5

2.8

SE of the mean

0.13

0.10

0.12

0.13

0.15

0.17

0.24

0.06

Women

Estimated usual weekly alcohol consumption levela

Non-drinker

20

13

14

16

15

27

45

20

Moderate

65

73

69

64

66

59

50

64

Hazardous/Harmful

15

14

18

21

19

13

5

16

Mean units per week

7.5

6.5

7.1

9.0

7.5

5.5

2.4

6.8

SE of the mean

0.97

0.51

0.47

0.76

0.58

0.58

0.34

0.25

Units consumed on heaviest drinking day (HDD)

Consumed over 4 units on HDD

35

33

38

40

34

21

6

31

Consumed over 8 units on HDD

19

19

21

21

11

5

1

15

Mean units on HDD

3.2

3.3

3.6

3.5

2.6

1.7

0.7

2.8

SE of the mean

0.40

0.30

0.27

0.20

0.18

0.15

0.09

0.10

Adherence to weekly and daily drinking guidelines

Never drunk alcohol

17

7

7

5

5

12

24

10

Ex drinker

4

6

7

11

11

16

21

10

Drinks within government guidelinesb

39

49

44

41

47

47

46

45

Drinks outwith government guidelinesc

40

37

42

43

38

25

9

35

Number of days on which drank alcohol in the past weekd

Drank on >5 days

-

2

4

7

17

18

24

9

Mean number of days

1.6

1.9

2.1

2.4

3.0

2.9

3.1

2.4

SE of the mean

0.09

0.10

0.10

0.11

0.15

0.18

0.29

0.05

All adults

Estimated usual weekly alcohol consumption levela

Non-drinker

18

10

11

14

14

21

36

16

Moderate

65

71

70

64

62

62

55

65

Hazardous/Harmful

17

19

19

22

24

17

8

19

Mean units per week

9.6

9.9

10.0

12.1

12.2

9.3

4.8

10.1

SE of the mean

0.80

0.62

0.58

0.88

0.78

0.67

0.47

0.29

Units consumed on heaviest drinking day (HDD)

Consumed over 4 units on HDD

35

42

40

41

39

26

9

35

Consumed over 8 units on HDD

22

29

23

23

18

9

2

19

Mean units on HDD

4.1

5.3

4.5

4.5

3.9

2.6

1.2

4.0

SE of the mean

0.39

0.42

0.26

0.25

0.21

0.17

0.11

0.12

Adherence to weekly and daily drinking guidelines

Never drunk alcohol

15

6

6

4

4

7

18

8

Ex drinker

3

5

5

10

11

14

19

9

Drinks within government guidelinesb

40

44

44

41

42

47

50

44

Drinks outwith government guidelinesc

41

46

44

45

43

32

14

40

Number of days on which drank alcohol in the past weekd

Drank on >5 days

2

3

5

9

20

21

27

11

Mean number of days

1.8

2.1

2.3

2.6

3.2

3.3

3.3

2.6

SE of the mean

0.08

0.08

0.09

0.09

0.12

0.13

0.19

0.04

Bases (weighted):

Men: alcohol units per week

309

362

387

435

365

267

178

2303

Men: alcohol units per day

300

358

383

428

356

266

178

2270

Men: adherence to weekly and daily drinking guidelines

280

350

383

428

355

265

178

2240

Men: number of days drank alcohol in last week

189

263

263

295

256

173

99

1538

Women: alcohol units per week

298

386

412

460

381

303

263

2501

Women: alcohol units per day

308

380

409

456

382

300

263

2498

Women: adherence to weekly and daily drinking guidelines

286

376

407

455

381

300

263

2469

Women: number of days drank alcohol in last week

150

188

243

277

219

130

78

1285

All adults: alcohol units per week

607

748

798

895

746

570

441

4805

All adults: alcohol units per day

608

738

792

884

738

567

441

4768

All adults: adherence to weekly and daily drinking guidelines

566

726

791

884

736

566

441

4709

All adults: number of days drank alcohol in last week

339

451

506

571

475

303

177

2823

Bases (unweighted):

Men: alcohol units per week

187

305

339

393

351

316

217

2108

Men: alcohol units per day

184

303

335

385

343

315

217

2082

Men: adherence to weekly and daily drinking guidelines

172

297

335

385

341

314

217

2061

Men: number of days drank alcohol in last week

115

214

233

267

245

200

118

1392

Women: alcohol units per week

221

416

431

538

441

373

304

2724

Women: alcohol units per day

228

412

430

535

441

371

304

2721

Women: adherence to weekly and daily drinking guidelines

216

409

428

534

440

371

304

2702

Women: number of days drank alcohol in last week

97

201

248

320

246

153

89

1354

All adults: alcohol units per week

408

721

770

931

792

689

521

4832

All adults: alcohol units per day

412

715

765

920

784

686

521

4803

All adults: adherence to weekly and daily drinking guidelines

388

706

763

919

781

685

521

4763

All adults: number of days drank alcohol in last week

212

415

481

587

491

353

207

2746

a Non-drinker: no units per week; Moderate: >0 units and up to 21 units for men / 14 units for women; Hazardous/harmful: more than 21 units for men / 14 units for women
b Drank no more than 4 units (men) or 3 units (women) on heaviest drinking day, and drank no more than 21 units (men) or 14 units (women) in usual week
c Drank more than 4 units (men) or 3 units (women) on heaviest drinking day, and/or drank more than 21 units (men) or 14 units (women) in usual week
d Of those who drank alcohol in the last week

Table 3.6 Estimated usual weekly alcohol consumption level, 2012/2013 combined, (age-standardised), by equivalised household income quintile and sex, mean units by drinking category, equivalised household income quintile and sex

Aged 16 and over

2012/2013 combined

Drinking categorya/ Units per week

Equivalised annual household income quintile

1st

2nd

3rd

4th

5th

(highest)

(lowest)

%

%

%

%

%

Men

Non-drinker

5

7

11

14

24

Moderate

69

65

67

65

56

Hazardous/Harmful

27

27

22

21

20

Mean units

Moderate

8.6

7.2

7.5

6.7

6.6

Hazardous/Harmful

41.0

36.8

38.5

41.2

58.1

SE of the mean

Moderate

0.32

0.31

0.38

0.38

0.42

Hazardous/Harmful

1.71

1.10

2.14

2.80

5.01

Women

Non-drinker

11

12

16

21

27

Moderate

64

70

66

67

62

Hazardous/Harmful

25

18

17

12

11

Mean units

Moderate

4.8

4.2

4.0

3.8

3.5

Hazardous/Harmful

26.0

27.6

25.5

26.3

35.1

SE of the mean

Moderate

0.22

0.19

0.18

0.20

0.21

Hazardous/Harmful

1.06

2.06

1.21

1.61

3.01

Bases (weighted):

Men

929

913

704

674

632

Men: moderate

637

598

472

435

352

Men: hazardous/harmful

250

248

155

145

127

Women

842

826

799

854

810

Women: moderate

539

577

529

574

501

Women: hazardous/harmful

211

151

138

102

92

Bases (unweighted):

Men

839

824

693

685

589

Men: moderate

561

544

455

444

329

Men: hazardous/harmful

228

220

150

132

122

Women

900

905

900

982

870

Women: moderate

578

633

620

636

534

Women: hazardous/harmful

246

173

143

103

101

a Non-drinker: no units per week; Moderate: >0 but <21 (men) or <14 (women) units; Hazardous: >=21 but <51 (men) or >=14 but <36 (women) units; Harmful: >=51 (men) or >=36 (women) units

Table 3.7 AUDIT scores, 2012/2013 combined, by age and sex

Aged 16 and over

2012/2013 combined

AUDIT

Age

Total

16-24

25-34

35-44

45-54

55-64

65-74

75+

%

%

%

%

%

%

%

%

Men

Low risk drinking or abstinence (0-7)

60

65

75

77

79

86

96

75

Hazardous drinking (8-15)

33

28

22

18

19

12

4

21

Harmful drinking (16-19)

5

5

2

2

1

1

-

2

Possible alcohol dependence (20+)

2

2

2

2

1

1

0

2

Score of 8 or more

40

35

25

23

21

14

4

25

Score of 16 or more

7

7

3

4

2

2

0

4

Women

Low risk drinking or abstinence (0-7)

73

84

87

89

94

96

100

88

Hazardous drinking (8-15)

21

15

11

10

5

3

0

10

Harmful drinking (16-19)

3

0

1

1

0

0

-

1

Possible alcohol dependence (20+)

3

0

1

0

0

0

-

1

Score of 8 or more

27

16

13

11

6

4

0

12

Score of 16 or more

6

1

2

1

1

1

-

2

All adults

Low risk drinking or abstinence (0-7)

67

75

81

83

87

91

98

82

Hazardous drinking (8-15)

27

21

16

14

12

7

2

15

Harmful drinking (16-19)

4

2

1

1

0

1

-

2

Possible alcohol dependence (20+)

2

1

1

1

1

1

0

1

Score of 8 or more

33

25

19

17

13

9

2

18

Score of 16 or more

7

4

3

3

1

1

0

3

Bases (weighted):

Men

584

656

686

795

653

483

282

4140

Women

577

715

757

840

700

543

436

4567

All adults

1160

1371

1443

1635

1354

1026

718

8708

Bases (unweighted):

Men

333

483

621

743

643

636

357

3816

Women

413

696

844

962

815

690

529

4949

All adults

746

1179

1465

1705

1458

1326

886

8765