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The Scottish Health Survey 2014: Volume 1: Main Report

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2 ALCOHOL

Linsay Gray and Alastair H Leyland

SUMMARY

Daily alcohol consumption

  • In 2014, men drank an average of 5.5 units on their heaviest drinking day in the previous week and women drank 3.1 units.
  • Average unit consumption on the heaviest drinking day in the past week declined between 2003 and 2014 (from 6.5 to 5.5 units for men, and from 3.6 to 3.1 units for women, respectively). However, consumption has not changed significantly in recent years.

Weekly alcohol consumption

  • In 2014, adults consumed an average of 10.3 units of alcohol per week (13.6 for men, 7.4 units for women).
  • In total, 18% of women and 14% of men in 2014 said they did not drink alcohol.
  • Average weekly alcohol consumption has declined from 19.8 units a week for men and 9.0 units for women in 2003, to 13.6 and 7.4, respectively, in 2014. The 2014 figures were not significantly different to those in 2013.
  • In 2014, male drinkers consumed alcohol on 2.7 days in the previous week compared with 2.4 days for female drinkers. Both these figures were lower than in 2003 (3.3 days for men, 2.7 days for women), but have been stable recently.

Adherence to government guidelines on alcohol consumption

  • In 2014, 41% of men drank more than the recommended 3-4 units on their heaviest drinking day in the past week, a reduction from 45% in 2003. A third (33%) of women drank more than their recommended 2-3 daily units, down from 37% in 2003. The 2013 and 2014 figures were not significantly different.
  • In total, 23% of men and 17% of women in 2014 were classified as hazardous / harmful drinkers (consuming more than 21 units per week for men, or more than 14 units per week for women), compared with 33% and 23%, respectively, in 2003. These figures have not changed significantly in recent years.
  • In 2014, 31% of men and 22% of women in the highest income households drank at hazardous / harmful levels compared with 18% of men and 13% of women in the lowest income households. While consumption has declined over time for all groups, this income gap has remained significant.
  • The prevalence of drinking outwith the government guidelines for weekly and / or daily drinking declined significantly from 2003 to 2014 both for men (from 53% to 46%) and women (from 42% to 36%).
  • The increase over time in the proportion of adults who have quit drinking reported last year was maintained in 2014 (5% were ex-drinkers in 2003 compared with 9% in 2014). Lifetime abstinence prevalence has been 7-10% among women since 2003 with no clear trend; the latest figure for men (7%) was significantly higher than it was in the 2003-2009 period (4%).

2.1 INTRODUCTION

In many communities within Scotland, drinking alcohol is an acceptable feature of social gatherings. However, the misuse of alcohol carries a risk of physical and mental health problems, as well as potential negative social consequences. People who consume large quantities of alcohol have increased risks 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] It also identifies higher levels of alcohol dependence and alcohol use disorders in the UK than across Europe as a whole.[2]

A report published in 2009 attributed 5% of deaths in Scotland to alcohol.[3] Alcohol-related mortality has decreased in recent years, with around 1,100 alcohol-related deaths in 2014,[4] but remains higher than it was in the 1980s.[5] More than 94,500 GP consultations and around 36,000 hospital stays each year are for alcohol-related problems, although these figures have declined in recent years.[6],[7] 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.[8],[9],[10]

The harms associated with alcohol misuse are not restricted to those consuming alcohol, with potential impacts on others of injury, neglect, abuse, crime, and from concern for or fear of family members. A report published by Alcohol Focus Scotland in 2014 estimated that 1 in 2 people in Scotland are harmed as a result of someone else's drinking.[11] The relationship between alcohol and crime is also well documented. In the 2014 Scottish Prisoner Survey, 45% of prisoners reported being drunk at the time of their offence.[12] It is also thought that alcohol is involved in 70% of assaults requiring treatment at A&E.[13]

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.[14],[15] 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.[16] In 2007, the total annual cost of excessive alcohol consumption was estimated to stand around £3.6 billion.16 Findings from the 2014 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.[17]

2.1.1 Policy background

One of the National Outcomes underpinning the Scottish Government's core purpose is for people living in Scotland to 'live longer, healthier lives'.[18] 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'.18 Other related indicators include the reduction of premature mortality, reducing reconviction rates and crime victimisation, and reducing deaths on roads.18

The Scottish Government published its alcohol strategy Changing Scotland's Relationship with Alcohol: a framework for action in 2009.[19] 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.[20] The European Court of Justice is expected to make a preliminary ruling on the challenge in late 2015. Informed by modelling carried out by the University of Sheffield,[21] 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.[22]

Evaluation of Scotland's alcohol strategy lies with NHS Health Scotland, through the Monitoring and Evaluating Scotland's Alcohol Strategy (MESAS) work programme. The fourth annual MESAS report, published in December 2014, concluded that 'alcohol-related mortality and morbidity, and inequalities in these harms, are continuing to decline in Scotland, and on some measures are improving more quickly than in England & Wales'.5 However, levels remain higher than in England & Wales, and higher than they were in the 1980s.5

2.1.2 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, due in part to not accounting for atypical / special occasion drinking,[23] 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.[24],[25],[26],[27] The most recently available annual estimates of alcohol sales in Scotland show that 10.5 litres (20.3 units per adult per week) of pure alcohol per person aged 16 and over were sold in 2014 (the equivalent figure for England and Wales was 9.0 litres (17.3 units per adult per week)).[28]

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.

2.1.3 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. Supplementary tables on alcohol consumption are available on the survey website.[29] These include levels of alcohol dependency and high risk alcohol use, as measured by the Alcohol Use Disorders Identification Test (AUDIT).

2.1.4 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 estimates from these surveys and / or those from SHeS are "not comparable".[30] 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.

2.2 METHODS AND DEFINITIONS

2.2.1 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.[31]

In 2014, 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.[32]

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.[33] 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

Indicators of potential problem drinking, beyond levels of consumption, are not reported here. Details of how these are measured in the survey are provided in the 2013 report.[34]

2.2.2 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 2A 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).31 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 2A 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

2.2.3 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 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. Women who consume over 14 and up to 35 units per week and men who consume over 21 and up to 50 units are classed as 'hazardous' drinkers, while those who consume more than 35 / 50 (women / men) units a week are considered to be drinking at 'harmful' levels.[35]

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

2.3 TRENDS IN ALCOHOL CONSUMPTION SINCE 2003

2.3.1 Trends in usual weekly alcohol consumption since 2003

Trends in self-reported weekly alcohol consumption are presented by sex for adults aged 16 and over in Table 2.1.

The estimated weekly mean number of units of alcohol consumed in 2014 for all adults was 10.3 units, similar to the 10.1 units seen in 2013. This followed the previously reported34 long-term decline from 14.1 units in 2003. This long-term decline was seen for both sexes, though the decrease among men from 19.8 units per week in 2003 to 13.6 in 2014 occurred via a series of gradual steps across the years, whereas for women most of the decline (from 9.0 units per week for women in 2003 to 7.4 units in 2014) took place between 2003 and 2011, with more recent figures somewhat flatter (with an outlier of 6.8 in 2013).

As outlined in Section 2.2.3, moderate weekly alcohol consumption is defined as no more than 14 units for women, and no more than 21 units for men. Individuals exceeding the moderate consumption guidelines are classified as hazardous or harmful drinkers. Drinking at hazardous or harmful levels has declined overall (from 28% in 2003 to 20% in 2014) but has remained relatively static from 2009 onwards at 19-23%. As in every year of the survey, hazardous or harmful drinking was higher among men (23%) than women (17%) in 2014, with both groups showing a significant decline (from 33% for men and 23% for women in 2003) but no significant recent changes.

Non-drinking prevalence followed a broadly similar rising pattern for both men and women over time. In 2003, 8% of men said they did not drink alcohol, rising to 10-12% between 2008 and 2013, and 14% in 2014. In total, 13% of women reported being non-drinkers in both 2003 and 2008, rising to 16-17% in the 2009-2012 period, though the increase to 20% in 2013 has now been followed by 18% in 2014. Figure 2A, Table 2.1

Percentage exceeding guidelines on weekly alcohol consumption (over 21 units for men, over 14 units for women), 2003-2014, by sex

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

Trends in the amount of alcohol reportedly consumed on the heaviest drinking day in the week prior to interview are presented in Table 2.2. Estimates for the proportions of the population exceeding recommended daily limits, and for binge drinking (twice the daily limits), during the last week are included separately for men, women and all adults.

Table 2.2 and Figure 2B show that the 2014 figures for the various heaviest drinking day measures were all generally consistent with the previously reported34 overall downward trend in the proportions exceeding the daily units recommended, binge drinking and total mean units consumed. The mean units of alcohol consumed by men on the heaviest drinking day in the previous week fell from 6.5 units in 2003 to 5.5 in 2011 and was identical (5.5 units) in 2014. Women's mean unit consumption decreased from 3.6 units in 2003 to 3.1 in 2014 (but has fluctuated between 2.8 and 3.2 units since 2009). Although these figures represent an overall decline, even the most recent figures still exceed the recommended daily limits of 3-4 units for men and 2-3 units for women.

The percentage of men drinking more than their recommended limit of 3-4 units in a day decreased steadily from 45% in 2003 to 41% in 2014 although, as Figure 2B illustrates, little real change was seen from 2011 onwards (40-42% each year). Likewise, the proportion of men consuming more than eight units per day (considered as binge drinking) also fell overall: from 29% in 2003 to 25% in 2011 and then staying relatively steady to 2014 (24%). The percentage of women exceeding their recommended limit of 2-3 units in any one day decreased overall from 37% in 2003 to 33% in 2014, with a period low of 30% in 2012. Binge drinking prevalence among women (more than six units a day) also declined from 19% in 2003 to 17% in 2009 and has subsequently fluctuated between 15% and 17% (16% in 2014). Figure 2B, Table 2.2

Percentage of men exceeding 4 units and 8 units, and women exceeding 3 units and 6 units, on the heaviest drinking day in the previous week, 2003-2014

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

Table 2.3 presents trends in adherence to both the weekly and daily drinking advice. As noted last year, and distinct from the results in Tables 2.1 and 2.2, the proportion of adults who adhere to the guidelines on weekly and / or daily drinking has been fairly static over time (39% of men and 45% of women in 2003, compared with 40% of men and 46% of women, in 2014). In contrast, while the recent figures for the proportions drinking outwith government guidelines have also been quite static, there has been a significant decline overall (from 53% in 2003 to 46% in 2014 for men; and from 42% in 2003 to 36% in 2014 for women).

As previously reported, the decline in drinking outwith the guidelines was largely accounted for by the increased proportion of ex-drinkers in the population (from 4% to 8% in men and from 5% to 10% in women, between 2003 and 2014). While the prevalence of lifelong abstinence from alcohol has typically been stable in this period, the latest figure for men (7%) was significantly higher than the 4% seen in the 2003-2009 period. The figures for women have fluctuated at 7-10% in the same period, but with no clear pattern (the lowest levels were seen in 2008 and 2014). Table 2.3

2.3.4 Trends in frequency of alcohol consumption since 2003

Table 2.4 shows that the mean number of days in the past week that adult drinkers consumed alcohol, and the proportion drinking on more than five days, have both declined overall. The figures in 2014 were either identical, or very similar, to those in 2013, with most of the significant change occurring earlier in the series. The mean number of days for male drinkers decreased significantly from 3.3 in 2003 to 2.7 in 2014. There was a smaller decrease for female drinkers: from 2.7 mean days in 2003 to 2.4 days by 2014. Prevalence of drinking on more than five days a week also decreased significantly, from 20% in 2003 to 11% in 2014 among male drinkers, and from 13% in 2003 to 8% by 2014 among female drinkers. Table 2.4

2.4 TRENDS IN WEEKLY ALCOHOL CONSUMPTION BY INCOME SINCE 2003

Table 2.5 presents trends in weekly alcohol consumption by household income. To ensure that the comparisons presented by income are not confounded by the different age profiles of the sub-groups, the data have been age-standardised. The income data have been equivalised to take account of the number of persons in the household. See the Glossary at the end of this Volume for a detailed description of both age-standardisation and equivalised household income.

The age-standardised prevalence of hazardous / harmful weekly drinking by men was significantly higher for those in the highest household income quintile than those in the lowest quintile for each year from 2003 to 2014. In 2003, 42% of men in the highest income quintile were hazardous / harmful drinkers compared with 25% in the lowest income quintile, with the 17 percentage point gap between them being the highest seen across the years. However, although hazardous / harmful drinking declined significantly from year to year among men overall, significant differences by income remained. By 2014, 31% of men in the highest income households drank at hazardous / harmful levels in 2014 compared with 18% in the lowest.

The picture for women was similarly pronounced. In every year, there was a markedly higher age-standardised prevalence of hazardous / harmful weekly drinking among women in the highest income quintile compared with the lowest income quintile. The biggest difference between these two groups, in 2003, was as much as 21 percentage points. (37% in the highest income group were hazardous / harmful drinkers, as were 16% in the lowest). By 2014 the gap had reduced to nine percentage points largely due to a decline in hazardous / harmful drinking among women in the highest income quintile (to 22%), whereas the figure for those in the lowest quintile (13%) was only slightly lower than in 2003. However, while drinking levels did decline significantly over time, the differences by income across all the quintiles did not vary significantly over time.

The patterns for weekly unit consumption generally followed those described above. Adults in the highest income quintile drank the most units per week, and drank more units than those in the lowest income quintiles (ranging between 1.7 and 5.2 units more across the years), although those in the lowest quintile did not generally have the lowest consumption levels across all groups. These overall patterns were true for women in every year, while there was some variation among men, for example mean unit consumption did not differ notably by income quintile in 2008 or 2010. For both sexes, but especially for men, the units of alcohol consumed declined significantly over time, and while this was universally true regardless of income, significant differences by income remain in 2014. Table 2.5

2.5 ALCOHOL CONSUMPTION BY AGE AND SEX IN 2014

2.5.1 Weekly alcohol consumption in 2014

Table 2.6 shows self-reported usual weekly alcohol consumption by age and sex in 2014. As previously reported, 34 men consumed more alcohol than women, and consumption differed significantly with age, with different patterns evident for men and women.

In 2014, men consumed 13.6 mean units of alcohol per week compared with 7.4 units for women. Men's weekly mean unit consumption was higher than women's in all age groups, albeit with less of a difference among those aged 16-24 (12.2 for men, 10.3 for women) than for older age groups. Among men, average consumption was highest in the 45-74 age group (15.0-17.2 units) with lower levels found for those aged 16-44 (10.1-13.3 units) and 75 and over (9.3 units). The pattern for women was significantly different: consumption was highest for those aged 16-24 (10.3 units) and 45-54 (9.9 units), and then declined steadily with age to 3.4 units for those aged 75 and over.

As with weekly unit consumption, men were more likely than women (23% and 17%, respectively) to be hazardous or harmful drinkers (drinking over the recommended weekly limits) in 2014. Levels of hazardous or harmful drinking were broadly similar in men and women aged 16-54, but prevalence was between 10 and 18 percentage points higher for men than women for those aged 55 and over. In contrast, the prevalence of moderate drinking (i.e. within the recommended weekly limits) was similar for men (63%) and women (65%); and this was generally true in each age group.

Women were significantly more likely than men to describe themselves as non-drinkers (18% compared with 14%) in 2014. The proportion of adult non-drinkers also varied significantly by age, with distinct patterns for men and women. Among men, non-drinking prevalence was highest among those aged 75 and over (23%) and notably lower in the 16-74 age group (11-16%). The increase in non-drinking prevalence occurred at a younger age among women: 10-16% of those aged 16-64 did not drink, rising to 23% of those aged 65-74 and 37% of those aged 75 and over. As these figures suggest, the overall difference between men and women was particularly pronounced in the 65 and over age group. Table 2.6

2.5.2 Alcohol consumption on the heaviest drinking day in 2014

Data on reported alcohol consumption on the heaviest drinking day in the previous week in 2014 are presented by age and sex in Table 2.7. Figures are shown for mean unit consumption, as well as exceeding the daily recommended limits of 3-4 units for men or 2-3 units for women, and binge drinking (more than 8 units for men, more than 6 for women).

Consistent with the patterns for weekly drinking (above), and previous reports,34 in 2014, men drank significantly more units of alcohol on their heaviest drinking day than women (5.5 and 3.1 units, respectively). This was true for all age groups.

Men were also more likely than women in 2014 to drink more than their recommended daily limits (41% of men compared with 33% of women), and to binge drink - 24% of men did this, as did 16% of women.

Age-related differences in consuming more than the recommended daily limits, and in binge drinking, followed similar patterns (albeit with different overall levels) in 2014. Among men, those aged 75 and over stood out as the least likely group to exceed daily limits or to binge drink, whereas for women, the two oldest groups (65-74 and 75 and over) were the most distinctive. To illustrate, 40-47% of men aged 16-74 drank in excess of the daily limits compared with 18% of men in the oldest age group, while the equivalent figures for binge drinking were 21-28% and 5%, respectively. Among women, 33-45% of those aged 16-64 exceeded the daily limits, which declined to 17% for those aged 65-74 and 9% in the oldest age group. Binge drinking prevalence was 21-22% among women aged 16-54, and declined with age successively after that to just 5% at age 65-74 and 1% for those aged 75 and over.

Table 2.7

2.5.3 Adherence to weekly and daily drinking guidelines in 2014

Reported adherence to the guidelines on weekly and daily drinking in 2014 are presented in Table 2.8 and Figures 2C and 2D, by age and sex.

As in previous years,34 a higher percentage of men (46%) than women (36%) drank in excess of the recommended guidelines for weekly and / or daily drinking in 2014. While this was not true for all age groups (figures were similar for men and women aged 16-24, and 35-54) the gap between the sexes was most notable for those aged 65 and over, where the figures for men were around twice those for women. Levels were broadly similar (45-53%) for men aged under 75 (with a peak within this of 50-53% for those aged 45-64), but much lower, at 24%, for the oldest group. The pattern for women was more varied. Among those aged 16-54, women aged 25-34 were the least likely to drink outwith the guidelines (35% compared with 44-49% for the rest of this age group), and prevalence then declined steadily from the age of 55-64 onwards, to just 12% for the oldest group.

In 2014, 40% of men and 46% of women drank alcohol within the government guidelines. Women aged 65 and over (51-55%), and men aged 75 and over (53%), were the most likely to do this.

Ex-drinkers were more likely to be older and this was true for both sexes in 2014. Lifelong abstinence from alcohol among men was highest (10-13%) for the two youngest groups (aged 16-34) and those aged 75 and over (9%), compared with 3-6% for all other age groups. In contrast, the oldest women were the most likely to have never drunk alcohol (18%), with the figures for all other age groups ranging between 4% and 9% with no clear pattern. Figure 2C, Figure 2D, Table 2.8

Men's adherence to weekly and/or daily government drinking guidelines in 2014, by age

Women's adherence to weekly and/or daily government drinking guidelines in 2014, by age

2.5.4 Number of days alcohol was consumed in past week in 2014

The reported numbers of days on which drinkers consumed alcohol in the past week in 2014 are presented by age and sex in Table 2.9. Consistent with previous reports,34 in 2014 male drinkers consumed alcohol on more days per week than did female drinkers (2.7 compared with 2.4). Similarly, the mean number of drinking days in the past week increased with age (from 1.9 for drinkers aged 16-34 to 3.7 for those aged 75 and over); this pattern was true for men and women.

Male drinkers were also more likely than female drinkers to have drunk alcohol on more than five days in the past week (11% and 8%, respectively) in 2014. This was due primarily to the higher prevalence among men aged 45 and over. Drinking on five or more days was relatively rare for drinkers aged 16-44 (2-4%), but increased to 23% for those aged 65-74 and to 32% for those aged 75 and over.

As highlighted in previous reports, there is a discrepancy between the age-related patterns in weekly mean unit consumption (which is lowest in the oldest groups, see Table 2.1) and the number of days on which alcohol was consumed in the past week (highest in the oldest groups). Together, these data suggest that younger drinkers tend to consume larger quantities in fewer drinking sessions, while older drinkers consume smaller amounts with greater frequency. Table 2.9