Scottish Health Survey 2012 - volume 1: main report

Scottish Health Survey 2012 - main report

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3. Alcohol Consumption

Stephen Hinchliffe

Summary

  • In 2012, adults in Scotland drank an average of 11.3 units of alcohol per week (15.2 units for men and 7.6 units for women).
  • Average unit consumption for adults fell from 14.1 to 11.3 units between 2003 and 2012 although levels did not change significantly in the most recent year (11.1 units in 2011 and 11.3 in 2012).
  • In 2012, men drank an average of 4.6 units less per week than in 2003 (19.8 units in 2003 and 15.2 units in 2012). Average unit consumption for women declined from 9.0 units per week in 2003 to 7.6 units in 2012.
  • A quarter of men and 18% of women drank at hazardous or harmful levels (more than 21 units per week for men and more than 14 units for women) in 2012.
  • The proportion of adults drinking at hazardous or harmful levels has declined since 2003 (from 33% of men and 23% of women to 25% of men and 18% of women in 2012) but again there has been no change in the most recent year (2011 figures were identical to 2012).
  • In 2012, men drank an average of 5.6 units of alcohol on their heaviest drinking day in the last week and women drank an average of 2.8 units.
  • On their heaviest drinking day, 42% of men and 30% of women exceeded the recommended daily amount (4 units for men and 3 units for women). A quarter of men and 15% of women drank twice the recommended daily amount.
  • Average unit consumption on the heaviest drinking day declined between 2003 and 2012 from 6.5 to 5.6 units for men and from 3.6 to 2.8 units for women. There has also been a decline in the proportion of men and women exceeding the recommended daily amount on their heaviest drinking day (from 45% in 2003 to 42% in 2012 for men and from 37% to 30% for women). The proportion exceeding twice the recommended daily amount has also declined slightly for men (from 29% to 25%) and women (from 19% to 15%).
  • In 2003, 53% of men and 42% of women drank outwith the weekly and/or daily consumption guidelines. By 2012, 47% of men and 35% of women exceeded the recommended levels.
  • In 2012, men drank on an average of 2.8 days in the previous week and women drank on an average of 2.5 days, a reduction since 2003, when men drank on an average of 3.3 days and women on 2.7 days.
  • Since 2003 there has been a decline in the proportion of adults drinking on more than 5 days in the previous week from 17% to 12% in 2012. The drop has been steeper for men (from 20% to 13%) than women (13% to 10%).
  • In 2012, based on AUDIT scores, one in five (19%) adults exhibited signs of an alcohol use disorder (25% of men and 13% of women).
  • Alcohol use disorder (AUD) prevalence varied significantly by NS-SEC for men but not for women. Men in self-employed households were most likely to be identified as having an alcohol use disorder (35% compared with 14% to 26% of men in other NS-SEC groups).
  • Men in the lowest income households were more likely to display more serious alcohol-related behaviour (harmful drinking or possible alcohol dependence) based on AUDIT scores (11% compared with only 2% of men in the highest income quintile).
  • AUD prevalence did not vary significantly across SIMD quintiles although men in the most deprived quintile were significantly more likely than those in the least deprived quintile to exhibit signs of an AUD (32% compared with 21%).
  • Multivariate analysis was conducted to identify factors independently associated with alcohol use disorder (AUD), identified as an AUDIT score of 8 or more. Among both men and women, those who were younger and those who were cohabiting had higher odds of an AUD. In addition, among men, those living in intermediate households had lower odds of displaying an AUD. Among women, the odds were higher for those who were single and separated or divorced; lower for those in the second income quintile; and lower for those who were mothers living with a child under the age of 16.

3.1 Introduction

Misuse of alcohol contributes to a wide range of health problems, including high blood pressure, chronic liver disease and cirrhosis, pancreatitis, some cancers, mental ill-health, and accidents, as well as social problems such as antisocial behaviour and violent crime. A report published in 2009 attributed 5% of deaths in Scotland to alcohol[45]. The World Health Organization cites alcohol as being the second largest risk factor for ill-health in wealthy countries, behind only tobacco use, and ahead of obesity and high blood pressure[46]. 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[47,48].

Taking into account not only the costs to the health care system but also expenditure on social care, the costs of crime, losses in productivity, and wider societal costs, the annual costs of excessive alcohol consumption in Scotland are estimated to be £3.6 billion[49]. For example, more than 100,000 GP and practice nurse visits, and around 39,000 hospital discharges, each year, are for alcohol-related problems[50,51]., An estimated 1.5 million working days are lost to reduced efficiency in the workplace due to the effects of alcohol, and a similar number are lost due to alcohol-related absence[49]. It is estimated that between 36,000 and 51,000 children in Scotland live with a parent or guardian with an alcohol problem[52]. Half the respondents to a survey of Scottish prisoners reported being drunk at the time of their offence[53].

Each year, accompanying the most up-to-date data on alcohol consumption, the Scottish Health Survey (SHeS) annual report also provides a brief account of the key recent legislative and policy developments in relation to alcohol consumption. These include:

  • The Licensing (Scotland) Act 2005, which came into full force in September 2009.
  • The 2009 publication and subsequent implementation of Changing Scotland's Relationship with Alcohol: A Framework for Action[54].
  • The notable new powers contained within the Alcohol etc. (Scotland) Act 2010 passed by the Scottish Parliament in November 2010 and which came into force in October 2011[55]. The Act included new powers to: ban quantity discounts (such as '3 for 2' deals) in off-sales (complementing the restrictions on irresponsible promotions in the Licensing Act for on-sales) limit price promotions and restrict the display of alcohol promotions in off-sales establishments, and introduce a mandatory 'Challenge 25' age verification scheme for all licensed premises[56].

The February 2012 progress report on the Framework for Action[57] provides a comprehensive overview of all the policies being pursued, and associated funds being invested, to support the 41 actions set out in the Framework. It highlights, for example, the £155 million that had been committed to tackle alcohol misuse between 2008-9 and 2011-2; the establishment of 30 Alcohol and Drug Partnerships that bring together representatives from local authorities, health boards, voluntary agencies and the police to develop strategies and commission services at the local level; the launch of new health behaviour change campaigns (including one targeted specifically at women); and the provision of refreshed advice for parents and carers to support them to talk to young people about alcohol consumption. These examples illustrate the wide range of actions being taken, and the extent of joint-working required to make progress on the Framework's actions.

In addition to the kinds of steps outlined above, significant new legislation is to be implemented. The Alcohol (Minimum Pricing) (Scotland) Bill was introduced to parliament in October 2011, and was passed into law in June 2012[58]. The implementation date is currently uncertain due to an ongoing legal challenge led by the Scotch Whisky Association. The Act allows for a price to be set for a unit of alcohol, below which it cannot be sold. Following two amendments to the Bill, the Act contains a 'sunset clause' imposing a six year time limit on the policy, unless the Scottish Parliament make further provisions to continue its operation, and a requirement to evaluate the effect of the legislation after five years (the review clause)[59]. Informed by modelling carried out by the University of Sheffield[60] - which draws on SHeS alcohol consumption data - Scottish Ministers have indicated their preference for a minimum unit price of 50p for at least the first two years. It 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 each year, and 6,500 fewer hospital admissions. The Act's provisions around evaluation, and the fact that SHeS data were used in the modelling that informed the preferred unit pricing level, mean that the alcohol consumption estimates provided by the survey will continue to perform an important monitoring role should the policy be implemented.

The estimates of alcohol consumption discussed in this chapter are based on self-reported data collected in the survey. 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[61,62,63].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))[64]. This volume is sufficient for every adult aged 16 and over in Scotland to drink at the weekly maximum consumption level recommended for men - 21 units. Although self-reported survey estimates are typically lower than estimates based on sales data, surveys can provide valuable information about the social patterning of individuals' alcohol consumption which sales data cannot. The evaluation of the implementation of minimum pricing will use evidence from the SHeS to help assess the impact on consumption patterns across different groups in society.

Overall responsibility for the evaluation of Scotland's alcohol strategy lies with NHS Health Scotland, through the Monitoring and Evaluating Scotland's Alcohol Strategy (MESAS) work programme. The second annual MESAS report, published in December 2012, concluded that, although alcohol consumption and incidences of alcohol-related harm fell slightly between 2009 and 2011, Scotland still has higher levels of alcohol-related harm than the rest of the UK and Western and Central Europe. The report also noted that the fall in alcohol-related harm actually began before 2009, and that it was too early to draw conclusions as to the reasons for any improvements.[48] A more recent MESAS report considers weekly sales data for the 12 months since the Alcohol etc. (Scotland) Act came into force[65]. These figures show a fall of 2.6% in off-trade alcohol sales, largely driven by a 4% fall in wine sales. No such fall was seen in the corresponding figures for England and Wales, which led the authors of the report to conclude that the data support the hypothesis that the Act would lead to a fall in consumption.

This chapter updates the key trends for weekly and daily alcohol consumption presented in previous SHeS reports[66]. It also provides, for the first time, discussion of the associations between excessive alcohol use or dependence, as measured by the Alcohol Use Disorders Identification Test (AUDIT) and key socio-demographic characteristics, such as age, sex, household income and the Scottish Index of Multiple Deprivation (SIMD).

3.2 Methods And Definitions

3.2.1 Definitions used in this chapter

The recommended sensible drinking guideline in the UK is 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. Men who consume over 21 and up to 50 units per week and women who consume over 14 and up to 35 units are usually classed as 'hazardous' drinkers, while those who consume more than 50/35 units a week are considered to be drinking at 'harmful' levels[67]. The term 'harmful drinking' is used to describe drinking at a level which is already causing physical, social or psychological harm. People whose drinking is not currently causing clear evidence of harm, but which may cause harm in the future are described as 'hazardous' drinkers[68].

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. Section 3.2.3 includes a fuller description of the tool[69].

There is no standard definition of 'binge' drinking in the UK. To enable 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:

  • People who adhere to the guidelines, that is:
    • women who drink no more than 14 units per week, and no more than 3 units on their heaviest drinking day
    • men who drink no more than 21 units per week, and no more than 4 units on their heaviest drinking day.
  • People who do not adhere to the guidelines, that is:
    • women who drink more than 14 units per week, and/or more than 3 units on their heaviest drinking day
    • men who drink more than 21 units per week, and/or more than 4 units on their heaviest drinking day.

3.2.2 Data collection in the 2008-2012 surveys

The way in which alcohol consumption is estimated in SHeS was changed significantly in 2008. The revisions made then are detailed extensively in the alcohol consumption chapter of the 2008 report[70] so are not repeated here. The following outlines the methods now used to collect and analyse the alcohol consumption data on the survey.

Three aspects of alcohol consumption are measured: usual weekly consumption, daily consumption on the heaviest drinking day in the previous week, and indicators of potential problem drinking (including physical dependence).

To estimate weekly consumption, participants (aged 16 and over) were asked preliminary questions on whether they drank alcohol at all. For those who reported that they drank, these were followed by 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 (see below for discussion of this process)[71].

As the questions ask about usual behaviour, responses are unlikely to reflect occasions of heavier drinking. Nevertheless, survey estimates provide useful comparisons of the consumption of different population groups and enable change over time to be monitored.

Daily consumption was measured by asking participants about drinking in the week preceding the interview with actual consumption on the heaviest drinking day in that week examined. Participants were asked whether they had drunk alcohol in the past seven days. If they had, they were asked on how many days and, if on more than one, whether they had drunk the same amount on each day or more on one day than others. If they had drunk more on one day than others, they were asked how much they drank on that day. If they had drunk the same on several days, they were asked how much they drank on the most recent of those days. If they had drunk on only one day, they were asked how much they had drunk on that day. In each case, participants were asked for details on the amounts consumed for each of the six types of drink listed above, rather than asking participants to give a direct estimate of units consumed. This part of the process was therefore similar to the one used to estimate weekly drinking.

Prior to 2012, the CAGE questionnaire was included in the survey to screen for potential alcohol problems. In 2012, it was replaced by the AUDIT questionnaire, which is widely considered to be the best screening tool for detecting problematic alcohol use. AUDIT comprises ten indicators of problem drinking, including three indicators of consumption, four of use of alcohol considered harmful to oneself or others, and three of physical dependency on alcohol. These questions were administered in self-completion format due to their (potentially) sensitive nature (see Section 3.2.4 for further discussion of the AUDIT tool).

3.2.3 Unit calculations and conversion factors

In the UK, a standard unit of alcohol is 10 millilitres or around 8 grams of ethanol. As described earlier, the majority of advice given in relation to safe alcohol consumption refers to units. The need for accurate estimates of units consumed is therefore paramount. There are, however, numerous difficulties associated with calculating units at population level, not least of which are the variability of alcohol strengths and the fact that these have changed over time.

As described above, 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 but in response to growing concerns about the reliability of consumption estimates from studies such as this, and the increasing consumption of wine - especially amongst women - extra efforts have been made to measure wine glass sizes since 2008. This was done in two ways. Firstly, participants who reported drinking any wine were asked what size of glass they had been drinking from. Secondly, showcards depicting glasses with 125ml, 175ml and 250ml of liquid were used to help people make more accurate judgements.

The following table outlines how the volumes of alcohol reported on the survey were converted into units (the 2008 report provides full information about how this process has changed over time)[70].

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

3.2.4 Alcohol Use Disorders Identification Test (AUDIT) scale

As outlined in Section 3.2.1, the AUDIT questionnaire was primarily designed to screen for levels of alcohol dependency or high-risk use. In line with the World Health Organisation guidelines on using the tool, responses to each of the ten AUDIT questions were assigned values of between 0 and 4. Scores for the ten questions were summed to form a scale (from 0 to 40) of alcohol use. The questions, and possible responses for the tool are summarised in the following table.

AUDIT questionnaire

Questions 0 1 2 3 4
1. How often do you have a drink containing alcohol? Never Monthly or less 2-4 times a month 2-3 times a week 4 or more times a week
2. How many drinks containing alcohol do you have on a typical day when you are drinking? 1 or 2 3 or 4 5 or 6 7 to 9 10 or more
3. How often do you have six or more drinks on one occasion? Never Less than monthly Monthly Weekly Daily or almost daily
4. How often during the last year have you found that you were not able to stop drinking once you had started? Never Less than monthly Monthly Weekly Daily or almost daily
5. How often during the last year have you failed to do what was normally expected of you because of drinking? Never Less than monthly Monthly Weekly Daily or almost daily
6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? Never Less than monthly Monthly Weekly Daily or almost daily
7. How often during the last year have you had a feeling of guilt or remorse after drinking? Never Less than monthly Monthly Weekly Daily or almost daily
8. How often during the last year have you been unable to remember what happened the night before because of your drinking? Never Less than monthly Monthly Weekly Daily or almost daily
9. Have you or someone else been injured because of your drinking? No Yes, but not in the last year Yes, during the last year
10. Has a relative, friend, doctor, or other health care worker been concerned about your drinking last year? No Yes, but not in the last year Yes, during the last year

World Health Organization guidelines[69] on interpreting scores on the scale is as follows:

  • 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
  • 16 to 19 - high level of alcohol problems, for which counselling is recommended
  • 20 or above - warrants further investigation for possible alcohol dependence.

The following conventions are used when referring to AUDIT scores:

  • 8 or above: indicator of an alcohol use disorder (AUD)
  • scores of 8 to 15: hazardous drinking behaviour, although this group tends not to be considered in isolation.
  • scores of 16 to 19: harmful drinking behaviour, and again this group tends not to be discussed in isolation.

3.3 Weekly Alcohol Consumption Levels

3.3.1 Trends in weekly alcohol consumption since 2003

Alcohol consumption at the population level can be measured in a number of different ways, several of which are recorded in Table 3.1. On all of these measures, 2012 consumption figures, for both men and women, were very close to 2011 levels.

In 2012, 12% of men (aged 16 and above) said that they did not drink alcohol. This represents a significant increase from 2003, when 8% were non-drinkers, and from 2008 and 2009, when 10% did not drink. Around one in six (17%) women (aged 16 and above) in 2012 reported that they did not drink alcohol. This is an increase on the 13% who described themselves as a non-drinker in 2003 and 2008 but is similar to the 2010 and 2011 figures.

As discussed in Section 3.2, moderate weekly consumption is defined as no more than 21 units for men, and no more than 14 units for women. Those who exceed the moderate consumption guidelines are commonly referred to as hazardous or harmful drinkers. Prevalence of hazardous or harmful drinking declined between 2003 and 2012 (Figure 3A). In 2003, a third of men were classified as drinking at hazardous or harmful levels. This fell to a quarter in 2011, where it remained in 2012. Twenty-three percent of women were drinking at hazardous or harmful levels in 2003; by 2011 this had fallen to 18% and remained at this level in 2012.

Figure 3A Proportion exceeding guidelines on weekly alcohol consumption (over 21 units for men, over 14 units for women), 2003-2012, by sex

Figure 3A Proportion exceeding guidelines on weekly alcohol consumption (over 21 units for men, over 14 units for women), 2003-2012, by sex

There has also been a decline in the average number of units consumed per person since 2003 (from 14.1 to 11.3 units in 2012). In 2003, men consumed an average of 19.8 units per week, only just below the recommended weekly limit for men. By 2012, mean unit consumption for men had fallen to 15.2 units. The average number of units consumed by women in 2003 was 9.0. By 2012, this had fallen to 7.6 units, although the figure has changed little since 2009. Figure 3A, Table 3.1

3.3.2 Weekly alcohol consumption, 2012, by age and sex

In 2012, women were significantly more likely than men to report not drinking any alcohol (17% compared with 12%). The proportion of men and women describing themselves as a non-drinker varied significantly by age. Among men, over a quarter (28%) of those aged 75 and above described themselves as a non-drinker, compared with 10 to 14% of 25 to 74 year olds, and just 5% of those aged between 16 and 24. Four in ten (41%) women aged 75 or over were non-drinkers as were 22% of those aged 65-74. For women under the age of 65, non-drinking prevalence ranged between 10% and 16%.

Hazardous or harmful drinking was more common among men than women in 2012 (25% and 18% respectively). With the exception of the oldest age group (those aged 75 and over), the proportion of men drinking to hazardous or harmful levels varied very little by age (ranging between 24% and 28% compared with 11% for those aged 75 and over). For women, the pattern was more obvious with the proportions demonstrating hazardous or harmful behaviour decreasing with increasing age. More than a quarter (28%) of those aged 16 -24 drank above the recommended weekly limits, compared with 18% to 21% of those aged 25 to 64, 13% of those aged 65-74, and just 5% of those aged 75 and above.

The pattern for mean unit consumption per week was similar to that for drinking above the recommended weekly limits. On average, men consumed more units per week than women (15.2 compared with 7.6). For men, those aged 75 and above drank, on average, half the amount of alcohol per week consumed by those in the other age groups (7.6 units, compared with between 14.7 and 16.5). For women, those aged 75 and above consumed an average of only 2.4 units per week. This is around a fifth of the average amount consumed by women aged 16 to 24 (11.8 units per week), and a third of the average amount consumed by women in the other age groups (6.0 to 8.6 units per week). Table 3.2

3.4 Estimated Daily Consumption

3.4.1 Trends in alcohol consumption on the heaviest drinking day 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 to be produced for the proportion of the population exceeding recommended daily limits during the last week, and the proportion of the population binge drinking during the last week to be produced. These data are presented in Table 3.1 for 2003 onwards.

Trends in alcohol consumption on the heaviest drinking day are shown in Figure 3B from 2003 to 2012. In 2003, 45% of the adult male population exceeded the recommended limit of four units in any one day. This decreased significantly to 42% in 2012. A quarter of men consumed more than twice this limit (classified as binge drinking) in 2012, also down from 29% in 2003. Thirty percent of women drank more than three units on their heaviest drinking day in the past week in 2012, down from 37% in 2003. Binge drinking prevalence among women (more than six units a day) was approximately half of this level (15%) and has followed a similar trend over time.

Figure 3B Proportion of men exceeding 4 units, women exceeding 3 units and all adults exceeding 3/4 units, on the heaviest drinking day in the previous week, 2003-2012, by sex

Figure 3B Proportion of men exceeding 4 units, women exceeding 3 units and all adults exceeding 3/4 units, on the heaviest drinking day in the previous week, 2003-2012, by sex

Trends in mean unit consumption on the heaviest drinking day followed similar patterns to the other measures of consumption discussed earlier. In 2003, men consumed an average of 6.5 units on their heaviest drinking day in the previous week. By 2012 this had fallen to 5.6 units still in excess of the recommended limit of four units. In this same period, average daily consumption for women fell from a mean of 3.6 units to 2.8 units - just under the three unit limit. Figure 3B, Table 3.1

3.4.2 Alcohol consumption on the heaviest drinking day, 2012, by age and sex

In 2012, women were less likely than men to exceed their recommended daily limits. While three in ten women drank more than 3 units on their heaviest drinking day in the previous week, just over four in ten (42%) men drank over four units.

Consumption on the heaviest drinking day was lowest among older people. As shown in Figures 3C and 3D, only 11% of men aged 75 and over consumed more than four units on the heaviest drinking day in the past week, and only 4% consumed more than eight (binge drinking). In contrast, between 44% and 49% of men aged 16 to 54 drank more than four units on the heaviest drinking day and between 25% and 33% of this age group drank more than eight. For women, the proportion consuming more than three units peaked at 39% of those aged 35 to 44, and fell to just 7% of those aged 75 and above. The proportion classified as binge drinking (consuming more than six units in any one day), was greatest for those aged 16-24 (26%).

Figure 3C Proportion of men who drank more than 4 units, & more than 8 units, on heaviest drinking day (HDD) in the past week, 2012

Figure 3D Proportion of women who drank more than 3 units, & more than 6 units, on heaviest drinking day (HDD) in the past week, 2012

On average, men drank twice the number of units of alcohol as women on their heaviest drinking day in the previous week (5.6 and 2.8 units respectively).

Mean unit consumption also varied by age. Men aged 16 to 44 drank between 6.8 and 7.0 units on their heaviest drinking day, equivalent to a little over three pints of beer or lager (4% ABV) or three-quarters of a bottle of wine (12.5% ABV). From age 45 onwards, there was a steady decrease in consumption, to a mean of 1.7 units for those aged 75 and above. There was a similar age-related pattern for women, with those aged 16 to 54 consuming an average of 3.3 to 3.8 units, falling to 0.7 units for those aged 75 and above. Figure 3C, Figure 3D, Table 3.2

3.5 Adherence To Weekly And Daily Drinking Advice

3.5.1 Trends in adherence to weekly and daily drinking advice since 2003

Given that there has been a trend of increased adherence to guidance on weekly alcohol consumption (see Section 3.3), and a trend of increased adherence to guidance on daily alcohol consumption (see Section 3.4) it is not surprising to find a decline in the proportion of adults exceeding the recommended levels of alcohol consumption. In 2003, 53% of men and 42% of women exceeded either the daily and/or weekly recommended maximum amounts. By 2012 the equivalent figures were 47% and 35% respectively.

The decline in people drinking outwith the recommended guidelines was not coupled with a significant increase in adherence to the guidelines (42% in 2003 and 44% in 2012). Instead, the proportion of adults classing themselves as ex-drinkers increased. In 2003, 4% of men said they no longer drank. This increased to 6% in 2008, and was at 7% by 2012. The percentage of women who stopped drinking alcohol also increased steadily from 5% in 2003 to 9% in 2012. Table 3.1

3.5.2 Adherence to weekly and daily drinking advice, 2012, by age and sex

In line with findings from previous years, in 2012, men were more likely than women to drink outwith the recommended guidelines on weekly and daily drinking (47% compared with 35%). Adherence levels varied by age for both genders. The percentage of men drinking outwith the guidelines increased with age, peaking at 35-44 (55%), then steadily declined to 42% for 65-74 year olds before dropping sharply to 15% of those aged 75 or above. Among women, those aged 16 to 54 were most likely to drink outwith the recommended daily and weekly levels (between 40% and 43%), while those aged 75 or over were least likely to do so (10%). Table 3.2

3.6 Number Of Days Alcohol Was Consumed In Past Week

3.6.1 Trends in number of days alcohol was consumed in past week since 2003

The average number of days per week on which adults consumed alcohol decreased from 3.0 to 2.7 days between 2003 and 2012. In 2003, male drinkers drank on an average of 3.3 days. By 2012, this had fallen to 2.8 days. In 2003, one in five male drinkers drank on at least six out of seven days. This had fallen to 13% in 2012. Female drinkers drank on an average of 2.7 days in 2003, falling to 2.5 days in 2008 and remaining at that level for all subsequent years. Thirteen percent of female drinkers drank on at least six days per week in 2003. Since 2008 the equivalent figure has been between 9% and 10% (10% in 2012). Table 3.1

3.6.2 Number of days alcohol was consumed in past week, 2012, by age and sex

In 2012, men consumed alcohol on an average of 2.8 days per week; the equivalent figure for women was significantly lower at 2.5 days. There was a significant association between the number of days on which alcohol was consumed and age, increasing from 2.1 days for those aged 16-24 to 3.7 days for those aged 75 or above. The age-related pattern was true for both men and women. Male drinkers aged 16-24 drank on an average of 2.0 days per week, with just 3% drinking on at least six days out of seven. Frequency increased by age and at age 75 or over, men (who drank alcohol) drank on an average of 4.1 days with four in ten drinking on at least six days per week. Similarly among female drinkers, 16-24 year olds drank on an average of 2.1 days per week, with just 2% drinking on at least six of the seven days, compared with those aged 75 or above who drank on 3.3 days on average and over a quarter (28%) of whom drank on at least six out of seven days.

As shown in Figure 3E, this pattern is in contrast to other measures of alcohol consumption, which showed that actual consumption is lowest among the oldest age groups. Older drinkers, however, consume small amounts, but regularly, whereas younger drinkers are more likely than older drinkers to consume larger quantities, albeit less frequently than them. Figure 3E, Table 3.2

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), 2012, by age and sex

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), 2012, by age and sex

3.7 Audit Scores By Socio-Demographic Factors

3.7.1 AUDIT scores, 2012, by age and sex

Scores calculated from responses to the alcohol use disorder identification test (AUDIT) provide an alternative way of assessing hazardous and harmful drinking to daily and weekly alcohol consumption. Details of the AUDIT questionnaire, including guidance on scoring, are discussed in detail in Section 3.2.4.

In 2012, eight in ten (81%) adults (aged 16 and above) had an AUDIT score between 0 and 7, indicating that they either did not drink or were classified as low-risk drinkers. Women were more likely than men to fall into this category (87% compared with 75%).

Audit scores varied by age for both men and women. While three-quarters of all men were classified as either abstinent or low-risk drinkers, the proportion varied from 61% of 16-24 year olds to 96% of those aged 75 or above. The proportion of women classified as low risk or abstinent ranged from 68% (16-24 year olds) to 100% (aged 75 or over).

Figure 3F AUDIT scores for men, 2012, by age

Figure 3F AUDIT scores for men, 2012, by age

Figure 3G AUDIT scores for women, 2012, by age

Figure 3G AUDIT scores for women, 2012, by age

Around one in five men (21%) and one in ten women (11%) were classed as hazardous drinkers (AUDIT score of between 8 and 15) in 2012. Hazardous drinking decreased by age for men, ranging from 30% of those aged 16 to 24 to 4% of those aged 75 and over. Similarly, less than 0.5% of women aged 75 and above were hazardous drinkers compared with 22% of those aged 16-24.

An AUDIT score of between 16 and 19 is indicative of harmful drinking behaviour. In 2012, 3% of men and 1% of women fell into this group. Harmful drinking behaviour varied by age for both genders. While none of those aged 75 and above were drinking harmfully, 8% of men and 5% of women aged 16-24 were doing so. One percent of men and women displayed behaviours associated with possible alcohol dependence (AUDIT score of 20 or above).

A score of 8 or more on the AUDIT tool indicates an alcohol use disorder (AUD). Two in ten (19%) adults had an AUD in 2012. The proportion of men with an AUD (25%) was exactly the same as the proportion drinking at hazardous or harmful levels as measured by unit consumption (See Section 3.3.2). Thirteen percent of women exhibited signs of an alcohol use disorder according to AUDIT, whereas 18% were drinking at hazardous or harmful levels according to their unit consumption.

The majority of those exhibiting either harmful drinking behaviour or possible alcohol dependence (an AUDIT score of 16 or above) were men aged 16-24 (9% of this age group), men aged 25-34 (8%), and women aged 16-24 (9%). No more than 4% of any other age group displayed signs of harmful drinking behaviour or possible alcohol dependence.

The age-related pattern is more apparent when examining AUDIT data than consumption data. The difference is possibly a reflection of the ways in which alcohol is consumed by men and women in different age groups. Figure 3F, Figure 3G, Table 3.3

3.7.2 AUDIT scores (age-standardised), 2012, by NS-SEC of household reference person and sex

AUDIT scores, by socio-economic classification (NS-SEC of the household reference person) are presented in Table 3.4. A description of NS-SEC is provided in the glossary to this report. To ensure that the comparisons presented are not confounded by the different age profiles of the groups the data have been age-standardised. Age-standardisation allows comparisons to be made across groups which are not confounded by their different age profiles (see the Glossary at the end of this Volume for a detailed description of age-standardisation).

Among adults there was no clear pattern to drinking behaviour by NS-SEC. Those in intermediate households were most likely to be non-drinkers or low-risk drinkers (87% compared with between 77% and 82% in all other household types) and least likely to exhibit signs of an alcohol use disorder (AUD) (12% compared with 23% of small employers and own-account workers). Those in small employer and own-account worker households were most likely to have a score of 8+ (23%) and 16+ (6%).

There was a significant association between AUD prevalence and NS-SEC for men but not for women. Men in self-employed households were most likely to display signs of possible alcohol use disorder (35%) while those in intermediate households were least likely to (14%). The proportion of men in other types of household with an AUDIT score of 8 or more was between 24% and 26%. Six percent of men in self-employed households scored 20 or more (indicating a risk of alcohol dependence) on the AUDIT scale compared with 1% of all men. Table 3.4

3.7.3 AUDIT scores (age-standardised), 2012, by equivalised household income and sex

Differences in drinking behaviour according to equivalised household income were not linear. For both men and women, those in the highest and lowest income households displayed similar prevalence of an alcohol use disorder (AUDIT score of 8+).

Over a quarter (28%) of men in the highest income quintile, and 29% in the lowest income quintile showed indications of an alcohol use disorder. However, men in the lowest income quintile were much more likely than others to display more serious alcohol-related behaviour (harmful drinking or possible alcohol dependence). One in ten of this group scored 16 or more on the AUDIT scale, compared to just 2% of those in the highest income quintile.

Among women, 16% in the highest income quintile and 17% in the lowest showed indications of an alcohol use disorder (AUDIT score of 8+) with lower prevalence (8% to 13%) in the middle three quintiles. However, similar to men, women in the lowest quintile are more likely to display more serious behaviours (harmful drinking, or possible alcohol dependence)(4% compared with 1% to 2% in the other groups). The overall association between having a score of 16 or more and income quintile was not, however, significant for women. Table 3.5

3.7.4 AUDIT scores (age-standardised), 2012, by Scottish Index of Multiple Deprivation and sex

The overall association between AUDIT scores and SIMD was not statistically significant for either men or women. In each quintile, between 11% and 15% of women displayed indications of an alcohol use disorder. Men in the most deprived quintile were, however, significantly more likely than those in the least deprived quintile to have an AUD (32% compared with 21%). Table 3.6

3.8 Factors Associated With Alcohol Use Disorders (Aud)

Multivariate logistic regression was used to examine the independent effect of a range of socio-demographic factors associated with an alcohol use disorder (an AUDIT score of 8 or more).

The factors investigated include the key socio-economic factors considered in Tables 3.3 to 3.6: age, socio-economic classification (in terms of the NS-SEC of the household reference person, area deprivation (as measured by SIMD), and equivalised household income. Other factors included were: parental socio-economic classification, economic status, educational attainment, marital status, and being a parent of any child in the household.

The odds ratios for displaying signs of an alcohol use disorder are presented in Table 3.7. The odds of a reference group (shown in the table with a value of 1) are compared with that of the other categories for each of the individual factors. An odds ratio of greater than 1 indicates that the group in question has increased odds of an alcohol use disorder (AUD), compared with the reference category. An odds ratio of less than 1 indicates decreased odds. By simultaneously controlling for a number of factors in the model, the independent association each factor has with the dependent variable (alcohol use disorder) can be established. For more information about logistic regression, and how to interpret the results, see the glossary.

Age and marital status, for both men and women, were the only factors displaying significant independent associations with alcohol use disorder. For men, the NS-SEC of the household reference person also demonstrated a significant independent association. For women, equivalised household income, and being the mother of someone under the age of 16 in the household were also significant.

The odds of a man over the age of 55 displaying signs of an alcohol use disorder were less than half those of a man aged 16-24 (odds ratios of 0.07 to 0.45). Similarly, the odds of a woman over the age of 45 displaying such signs were half or less of those of a woman aged 16-24 (odds ratios of 0.01 to 0.50). The pattern of the association indicated by the logistic regression confirms that shown in Table 3.3, with the odds of alcohol use disorder decreasing as age increases.

Marital status was the other variable to be associated with alcohol use disorder for both men and women. Compared with being married or in a civil partnership, cohabiting men and women both had increased odds of an alcohol use disorder (odds ratio 2.02 for men, and 1.83 for women). In addition, single and separated or divorced women also had increased odds (odds ratio 2.41 and 2.51 respectively).

For men, the odds of those in intermediate households (clerical, sales or service) displaying an alcohol use disorder were less than half of those in managerial or professional households (odds ratio 0.47). The overall pattern confirms that shown in Table 3.4, although other differences are not significant.

Compared with other women, mothers who lived with a child under the age of 16 had lower odds of exhibiting an alcohol use disorder (odds ratio 0.62). The association with fatherhood was in the same direction, but was not statistically significant.

No significant associations were seen for the following factors: socio-economic classification of one's parents (when aged 14), area deprivation, economic status and highest educational qualification (see footnote to Table 3.7).

Table list

Table 3.1 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, 2003 to 2012

Table 3.2 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, 2012, by age and sex

Table 3.3 AUDIT scores, 2012, by age and sex

Table 3.4 AUDIT scores (age standardised), 2012, by NSSEC and sex

Table 3.5 AUDIT scores (age standardised), 2012, by income

Table 3.6 AUDIT scores (age standardised), 2012, by SIMD

Table 3.7 Estimated odds ratios for hazardous or harmful drinking behaviour or possible alcohol dependence (AUDIT score 8+)

Table 3.1 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, 2003 to 2012

Aged 16 and over 2003 to 2012
Alcohol units per weeka / alcohol units per dayb / adherence to weekly and daily drinking advicec,d / % who drank on >5 days / mean number of days drank alcohol in last weeke 2003 2008 2009 2010 2011 2012
% % % % % %
Men
Estimated usual weekly alcohol consumption levela
Non-drinker 8 10 10 12 11 12
Moderate 58 59 63 61 64 63
Hazardous/Harmful 33 30 27 27 25 25
Mean units per week 19.8 18.0 17.5 16.0 15.0 15.2
SE of the mean 0.62 0.53 0.75 0.50 0.42 0.59
Units consumed on heaviest drinking day
Consumed over 4 units on HDDb 45 44 44 43 41 42
Consumed over 8 units on HDD 29 27 26 26 25 25
Mean units on HDD 6.5 6.2 5.9 6.0 5.5 5.6
SE of the mean 0.18 0.19 0.17 0.21 0.15 0.21
Adherence to weekly and daily drinking advice
Never drunk alcohol 4 4 4 6 5 5
Ex drinker 4 6 6 7 6 7
Drinks within government guidelinesc 39 39 41 39 42 41
Drinks outwith government guidelinesd 53 51 49 49 46 47
Number of days on which drank alcohol in the past weeke
Drank on >5 days 20 17 14 15 13 13
Mean number of days 3.3 3.1 2.9 2.9 2.8 2.8
SE of the mean 0.05 0.05 0.04 0.05 0.05 0.06
Women
Estimated usual weekly alcohol consumption levela
Non-drinker 13 13 16 17 17 17
Moderate 64 67 66 65 65 65
Hazardous/Harmful 23 20 19 18 18 18
Mean units per week 9.0 8.6 7.8 7.6 7.4 7.6
SE of the mean 0.31 0.34 0.24 0.24 0.23 0.33
Units consumed on heaviest drinking day
Consumed over 3 units on HDDb 37 36 34 33 34 30
Consumed over 6 units on HDD 19 18 17 16 17 15
Mean units on HDD 3.6 3.5 3.2 3.1 3.2 2.8
SE of the mean 0.10 0.14 0.09 0.09 0.09 0.11
Adherence to weekly and daily drinking advice
Never drunk alcohol 9 7 8 9 9 9
Ex drinker 5 6 7 8 9 9
Drinks within government guidelinesc 45 47 47 45 44 47
Drinks outwith government guidelinesd 42 40 38 38 38 35
Number of days on which drank alcohol in the past weeke
Drank on >5 days 13 10 9 10 10 10
Mean number of days 2.7 2.5 2.5 2.5 2.5 2.5
SE of the mean 0.05 0.05 0.04 0.04 0.05 0.06
All Adults
Estimated usual weekly alcohol consumption levela
Non-drinker 11 12 13 15 14 15
Moderate 61 63 64 63 64 64
Hazardous/Harmful 28 25 23 22 21 21
Mean units per week 14.1 13.1 12.4 11.6 11.1 11.3
SE of the mean 0.36 0.34 0.40 0.29 0.27 0.35
Units consumed on heaviest drinking day
Consumed over 3/4 units on HDDb 41 40 39 38 37 36
Consumed over 6/8 units on HDD 24 22 21 21 20 20
Mean units 4.9 4.8 4.5 4.5 4.3 4.1
SE of the mean 0.12 0.13 0.10 0.12 0.10 0.13
Adherence to weekly and daily drinking advice
Never drunk alcohol 7 6 6 7 7 7
Ex drinker 5 6 7 7 8 8
Drinks within government guidelinesc 42 43 44 42 43 44
Drinks outwith government guidelinesd 47 45 43 43 42 41
Number of days on which drank alcohol in the past weeke
Drank on >5 days 17 14 11 13 12 12
Mean number of days 3.0 2.8 2.7 2.7 2.7 2.7
SE of the mean 0.04 0.04 0.03 0.04 0.04 0.05
Bases (weighted):
Men: alcohol units per week 3791 3011 3576 3388 3551 2253
Men: alcohol units per day 3819 3015 3521 3386 3549 2264
Men: adherence to weekly and daily drinking advice 3769 2981 3519 3355 3520 2234
Men: number of days drank alcohol in last week 2762 2160 2497 2307 2406 1551
Women: alcohol units per week 4215 3319 3912 3711 3874 2464
Women: alcohol units per day 4254 3320 3865 3710 3860 2460
Women: adherence to weekly and daily drinking advice 4203 3296 3862 3675 3827 2442
Women: number of days drank alcohol in last week 2472 1953 2199 2070 2152 1283
All adults: alcohol units per week 8006 6330 7488 7098 7425 4717
All adults: alcohol units per day 8073 6335 7385 7096 7409 4724
All adults: adherence to weekly and daily drinking advice 7972 6277 7381 7030 7347 4677
All adults: number of days drank alcohol in last week 5234 4113 4696 4377 4557 2834
Bases (unweighted):
Men: alcohol units per week 3558 2796 3276 3064 3239 2095
Men: alcohol units per day 3580 2801 3244 3066 3242 2104
Men: adherence to weekly and daily drinking advice 3543 2778 3242 3042 3222 2085
Men: number of days drank alcohol in last week 2590 1967 2266 2057 2174 1405
Women: alcohol units per week 4482 3579 4232 4076 4220 2657
Women: alcohol units per day 4507 3579 4202 4083 4217 2659
Women: adherence to weekly and daily drinking advice 4469 3560 4199 4055 4192 2643
Women: number of days drank alcohol in last week 2609 2053 2346 2200 2256 1361
All adults: alcohol units per week 8040 6375 7508 7140 7459 4752
All adults: alcohol units per day 8087 6380 7446 7149 7459 4763
All adults: adherence to weekly and daily drinking advice 8012 6338 7441 7097 7414 4728
All adults: number of days drank alcohol in last week 5199 4020 4612 4257 4430 2766
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 HDD = Heaviest drinking day during previous week
c 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
d 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
e Of those who drank alcohol in the last week

Table 3.2 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, 2012, by age and sex

Aged 16 and over 2012
Alcohol units per weeka / alcohol units per dayb adherence to weekly and daily drinking advicec,d / % who drank on >5 days / mean number of days drank alcohol in last weeke Age Total
16-24 25-34 35-44 45-54 55-64 65-74 75+
% % % % % % % %
Men
Estimated usual weekly alcohol consumption levela
Non-drinker 5 12 10 12 14 13 28 12
Moderate 70 64 65 62 59 61 61 63
Hazardous/Harmful 25 24 24 27 28 27 11 25
Mean units per week 16.2 16.5 15.0 16.1 16.1 14.7 7.6 15.2
SE of the mean 2.08 2.00 0.99 1.16 1.36 1.14 0.88 0.59
Units consumed on heaviest drinking day
Consumed over 4 units on HDDb 44 49 49 46 39 34 11 42
Consumed over 8 units on HDD 33 29 33 25 23 13 4 25
Mean units on HDD 6.8 7.0 6.8 5.4 5.0 3.8 1.7 5.6
SE of the mean 1.01 0.65 0.43 0.32 0.35 0.27 0.24 0.21
Adherence to weekly and daily drinking advice
Never drunk alcohol 5 9 4 2 3 4 9 5
Ex drinker - 3 6 9 11 9 20 7
Drinks within government guidelinesc 47 37 34 36 42 45 57 41
Drinks outwith government guidelinesd 48 51 55 52 45 42 15 47
Number of days on which drank alcohol in the past weeke
Drank on >5 days 3 5 10 14 19 21 40 13
Mean number of days 2.0 2.3 2.7 2.9 3.2 3.4 4.1 2.8
SE of the mean 0.17 0.15 0.13 0.14 0.14 0.15 0.26 0.06
Women
Estimated usual weekly alcohol consumption levela
Non-drinker 10 16 14 11 16 22 41 17
Moderate 62 65 66 70 66 65 54 65
Hazardous/Harmful 28 20 21 19 18 13 5 18
Mean units per week 11.8 7.8 8.6 8.5 7.1 6.0 2.4 7.6
SE of the mean 1.64 0.71 0.79 0.61 0.56 0.57 0.32 0.33
Units consumed on heaviest drinking day
Consumed over 3 units on HDDb 32 35 39 37 31 21 7 30
Consumed over 6 units on HDD 26 20 21 18 11 5 0 15
Mean units on HDD 3.8 3.3 3.6 3.3 2.5 1.8 0.7 2.8
SE of the mean 0.52 0.33 0.24 0.21 0.17 0.14 0.08 0.11
Adherence to weekly and daily drinking advice
Never drunk alcohol 9 7 7 4 7 10 24 9
Ex drinker 2 9 7 7 9 12 17 9
Drinks within government guidelinesc 47 45 43 49 47 53 49 47
Drinks outwith government guidelinesd 42 40 43 40 37 25 10 35
Number of days on which drank alcohol in the past weeke
Drank on >5 days 2 4 5 10 12 19 28 10
Mean number of days 2.1 2.0 2.4 2.6 2.7 2.9 3.3 2.5
SE of the mean 0.17 0.16 0.10 0.12 0.13 0.19 0.31 0.06
All Adults
Estimated usual weekly alcohol consumption levela
Non-drinker 8 14 12 11 15 18 36 15
Moderate 66 64 65 66 62 63 57 64
Hazardous/Harmful 27 22 22 23 23 19 7 21
Mean units per week 14.0 12.2 11.7 12.1 11.5 10.1 4.5 11.3
SE of the mean 1.42 1.10 0.64 0.66 0.76 0.68 0.44 0.35
Units consumed on heaviest drinking day
Consumed over 3/4 units on HDDb 38 42 44 41 35 27 9 36
Consumed over 6/8 units on HDD 29 25 27 21 16 9 2 20
Mean units 5.3 5.2 5.2 4.3 3.7 2.7 1.1 4.1
SE of the mean 0.57 0.38 0.24 0.19 0.21 0.16 0.11 0.13
Adherence to weekly and daily drinking advice
Never drunk alcohol 7 8 6 3 5 7 18 7
Ex drinker 1 6 6 8 10 11 18 8
Drinks within government guidelinesc 47 41 39 43 44 49 52 44
Drinks outwith government guidelinesd 45 46 49 46 41 33 12 41
Number of days on which drank alcohol in the past weeke
Drank on >5 days 3 5 8 12 16 20 34 12
Mean number of days 2.1 2.2 2.5 2.8 3.0 3.2 3.7 2.7
SE of the mean 0.15 0.11 0.09 0.10 0.11 0.13 0.21 0.05
Bases (weighted):
Men: alcohol units per week 298 378 373 419 361 251 172 2253
Men: alcohol units per day 301 381 377 420 361 251 173 2264
Men: adherence to weekly and daily drinking advice 282 378 372 418 361 251 172 2234
Men: number of days drank alcohol in last week 213 263 279 291 256 176 73 1551
Women: alcohol units per week 299 370 411 453 382 287 263 2464
Women: alcohol units per day 286 375 414 454 382 287 263 2460
Women: adherence to weekly and daily drinking advice 277 370 411 453 382 287 263 2442
Women: number of days drank alcohol in last week 156 183 232 279 215 144 73 1283
All adults: alcohol units per week 597 748 784 872 743 538 435 4717
All adults: alcohol units per day 586 756 792 874 743 539 435 4724
All adults: adherence to weekly and daily drinking advice 559 748 783 871 743 538 435 4677
All adults: number of days drank alcohol in last week 369 447 511 570 471 319 146 2834
Bases (unweighted):
Men: alcohol units per week 152 224 341 408 363 384 223 2095
Men: alcohol units per day 153 227 343 409 363 385 224 2104
Men: adherence to weekly and daily drinking advice 144 224 340 407 363 384 223 2085
Men: number of days drank alcohol in last week 105 160 253 280 260 255 92 1405
Women: alcohol units per week 210 325 470 497 442 387 326 2657
Women: alcohol units per day 203 328 474 498 442 388 326 2659
Women: adherence to weekly and daily drinking advice 196 325 470 497 442 387 326 2643
Women: number of days drank alcohol in last week 107 155 263 317 249 186 84 1361
All adults: alcohol units per week 362 549 811 905 805 771 549 4752
All adults: alcohol units per day 356 555 817 907 805 773 550 4763
All adults: adherence to weekly and daily drinking advice 340 549 810 904 805 771 549 4728
All adults: number of days drank alcohol in last week 212 315 516 597 509 441 176 2766
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 HDD = Heaviest drinking day
c 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
d 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
e Of those who drank alcohol in the last week

Table 3.3 AUDIT scores, 2012, by age and sex

Aged 16 and over 2012
AUDIT Age Total
16-24 25-34 35-44 45-54 55-64 65-74 75+
% % % % % % % %
Men
Low risk drinking or abstinence (0-7) 61 68 72 77 79 86 96 75
Hazardous drinking (8-15) 30 24 26 19 19 12 4 21
Harmful drinking (16-19) 8 6 1 2 1 0 - 3
Possible alcohol dependence (20+) 2 2 1 2 1 1 - 1
8+ 39 32 28 23 21 14 4 25
16+ 9 8 2 4 2 1 - 4
Women
Low risk drinking or abstinence (0-7) 68 82 84 88 94 96 100 87
Hazardous drinking (8-15) 22 17 13 11 6 3 0 11
Harmful drinking (16-19) 5 0 1 0 0 1 - 1
Possible alcohol dependence (20+) 4 0 2 0 - 0 - 1
8+ 32 18 16 12 6 4 0 13
16+ 9 1 3 1 0 1 - 2
All Adults
Low risk drinking or abstinence (0-7) 64 75 78 83 87 92 99 81
Hazardous drinking (8-15) 26 20 19 15 12 7 1 16
Harmful drinking (16-19) 6 3 1 1 1 1 - 2
Possible alcohol dependence (20+) 3 1 1 1 0 0 - 1
8+ 36 25 22 17 13 8 1 19
16+ 9 4 3 2 1 1 - 3
Bases (weighted):
Men 292 337 338 384 326 224 134 2033
Women 274 344 377 407 350 259 219 2232
All adults 566 680 715 791 676 483 353 4265
Bases (unweighted):
Men 149 199 312 377 325 341 174 1877
Women 192 300 434 452 406 349 275 2408
All adults 341 499 746 829 731 690 449 4285

Table 3.4 AUDIT scores (age standardised), 2012, by NSSEC and sex

Aged 16 and over 2012
AUDIT NS-SEC of household reference person
Managerial & Professional Intermediate Small employers & own account workers Lower supervisory & technical Semi-routine & routine
% % % % %
Men
Low risk drinking or abstinence (0-7) 76 86 65 74 74
Hazardous drinking (8-15) 21 13 25 22 20
Harmful drinking (16-19) 2 0 3 2 4
Possible alcohol dependence (20+) 1 - 6 3 2
8+ 24 14 35 26 26
16+ 3 0 9 5 6
Women
Low risk drinking or abstinence (0-7) 87 88 92 87 86
Hazardous drinking (8-15) 10 10 7 9 13
Harmful drinking (16-19) 1 2 0 2 1
Possible alcohol dependence (20+) 1 1 1 1 1
8+ 13 12 8 13 14
16+ 2 2 1 3 1
All Adults
Low risk drinking or abstinence (0-7) 82 87 77 80 80
Hazardous drinking (8-15) 16 11 17 16 16
Harmful drinking (16-19) 2 1 2 2 2
Possible alcohol dependence (20+) 1 0 4 2 1
8+ 18 13 23 20 20
16+ 3 2 6 4 4
Bases (weighted):
Men 856 143 199 202 588
Women 874 264 166 181 705
All adults 1729 407 365 383 1293
Bases (unweighted):
Men 738 131 213 210 555
Women 929 272 208 209 748
All adults 1667 403 421 419 1303

Table 3.5 AUDIT scores (age standardised), 2012, by income

Aged 16 and over 2012
AUDIT Equivalised annual household income quintile
1st (highest) 2nd 3rd 4th 5th (lowest)
% % % % %
Men
Low risk drinking or abstinence (0-7) 72 79 73 77 71
Hazardous drinking (8-15) 25 19 22 20 18
Harmful drinking (16-19) 2 2 2 1 7
Possible alcohol dependence (20+) 0 0 3 2 4
8+ 28 21 27 23 29
16+ 2 2 5 3 11
Women
Low risk drinking or abstinence (0-7) 84 92 90 87 83
Hazardous drinking (8-15) 15 7 8 11 13
Harmful drinking (16-19) 1 0 2 1 2
Possible alcohol dependence (20+) 0 1 1 1 2
8+ 16 8 10 13 17
16+ 1 1 2 2 4
All Adults
Low risk drinking or abstinence (0-7) 78 85 82 83 78
Hazardous drinking (8-15) 20 13 15 15 16
Harmful drinking (16-19) 1 1 2 1 4
Possible alcohol dependence (20+) 0 1 2 2 3
8+ 22 15 18 17 22
16+ 2 2 4 2 7
Bases (weighted):
Men 431 385 349 298 316
Women 384 372 371 401 377
All adults 815 757 720 699 693
Bases (unweighted):
Men 384 369 340 298 280
Women 416 415 413 446 400
All adults 800 784 753 744 680

Table 3.6 AUDIT scores (age standardised), 2012, by SIMD

Aged 16 and over 2012
AUDIT Scottish Index of Multiple Deprivation quintile
5th (least deprived) 4th 3rd 2nd 1st (most deprived)
% % % % %
Men
Low risk drinking or abstinence (0-7) 79 76 74 77 68
Hazardous drinking (8-15) 19 20 22 20 24
Harmful drinking (16-19) 2 3 4 1 4
Possible alcohol dependence (20+) 0 1 1 2 4
8+ 21 24 26 23 32
16+ 3 4 5 3 7
Women
Low risk drinking or abstinence (0-7) 89 87 86 88 85
Hazardous drinking (8-15) 8 11 12 12 11
Harmful drinking (16-19) 2 1 1 0 2
Possible alcohol dependence (20+) 1 0 1 1 1
8+ 11 13 14 12 15
16+ 3 2 2 1 3
All Adults
Low risk drinking or abstinence (0-7) 84 82 80 82 78
Hazardous drinking (8-15) 13 15 17 16 17
Harmful drinking (16-19) 2 2 2 0 3
Possible alcohol dependence (20+) 1 1 1 1 2
8+ 16 18 20 18 22
16+ 3 3 3 2 5
Bases (weighted):
Men 435 436 410 422 338
Women 471 439 450 449 421
All adults 907 875 860 871 759
Bases (unweighted):
Men 391 442 427 357 260
Women 489 545 534 458 382
All adults 880 987 961 815 642

Table 3.7 Estimated odds ratios for hazardous or harmful drinking behaviour or possible alcohol dependence (AUDIT score 8+)

Aged 16 and over 2012
Independent variablesa Men Women
Base (weighted) Odds ratio 95% CIa Base (weighted) Odds ratio 95% CIb
2033 2232
Age (p=0.009) (p<0.001)
16-24 292 1.00 274 1.00
25-34 337 0.67 0.34 , 1.31 344 0.90 0.49 , 1.63
35-44 338 0.69 0.34 , 1.39 377 0.90 0.50 , 1.62
45-54 384 0.49 0.24 , 1.01 407 0.50 0.27 , 0.93
55-64 326 0.45 0.21 , 0.97 350 0.26 0.12 , 0.56
65-74 224 0.29 0.12 , 0.70 259 0.15 0.06 , 0.40
75+ 134 0.07 0.02 , 0.26 219 0.01 0.00 , 0.06
NS-SEC of household reference person (p=0.038) (p=0.300)
Managerial & professional 857 1.00 876 1.00
Intermediate 145 0.47 0.25 , 0.87 263 0.70 0.38 , 1.27
Small employers & own account workers 202 1.41 0.89 , 2.24 167 0.49 0.24 , 1.03
Lower supervisory & technical 200 0.89 0.57 , 1.39 181 0.76 0.38 , 1.55
Semi-routine & routine 587 0.90 0.56 , 1.45 704 0.77 0.43 , 1.36
Missing 42 0.56 0.21 , 1.51 41 1.45 0.42 , 4.96
Equivalised Income (p=0.693) (p=0.036)
1st (highest) 430 1.00 392 1.00
2nd 387 0.84 0.53 , 1.32 376 0.53 0.29 , 0.94
3rd 350 1.12 0.71 , 1.76 369 0.66 0.36 , 1.23
4th 300 0.89 0.50 , 1.59 402 0.84 0.43 , 1.64
5th (lowest) 314 1.02 0.55 , 1.91 376 1.10 0.55 , 2.18
Missing 252 0.65 0.33 , 1.29 316 1.26 0.70 , 2.28
Marital status (p=0.016) (p<0.001)
Married / civil partnership 1027 1.00 1039 1.00
Living as married 271 2.02 1.34 , 3.04 260 1.83 1.13 , 2.98
Single 547 1.49 0.97 , 2.28 464 2.41 1.65 , 3.53
Separated from married or civil partner / divorced / dissolved civil partnership 118 1.32 0.79 , 2.21 223 2.51 1.54 , 4.07
Widowed / surviving civil partner 70 1.56 0.67 , 3.66 245 1.92 0.75 , 4.92
Parent of any child in household (p=0.084) (p=0.010)
Not parent 1586 1.00 1612 1.00
Parent 447 0.70 0.46 , 1.05 619 0.62 0.43 , 0.89
a Other factors included in the model which were not significant: area deprivation (SIMD), parental socio-economic classification, economic status and educational attainment
b Confidence interval

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Email: Julie Landsberg

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