Chapter 3 Alcohol
- Since 2013, hazardous or harmful drinking (over 14 units a week) has remained at similar levels, fluctuating between 24% and 26% (24% in 2018), as has non-drinking, fluctuating between 16% and 17% (16% in 2018).
24% of adults drank at hazardous or harmful levels, the same figure as in 2017, but down from 34% in 2003.
People living in the least deprived areas were more likely to drink at hazardous or harmful levels than those living in the most deprived areas.
People living in the least deprived areas were less likely to be nondrinkers than those in the most deprived areas.
- Among men, the highest prevalence of hazardous or harmful drinking was found among those aged 55-64 (36%) and for women, prevalence peaked within the 45-54 age group (22%).
The mean number of units of alcohol consumed per week by adult drinkers decreased between 2003 and 2013 and has remained around the same level since.
- For men, the highest mean consumption was among those aged 45-54 (18.5 mean units per week); for women the highest mean consumption was among those aged 16-24 (11.6 mean units per week).
- The mean number of days on which adult drinkers drank alcohol in the last week increased with age; from 2.0 for those aged 16-24 to 3.6 for those aged 75 and over.
- The percentage of men drinking more than four units on their heaviest drinking day declined significantly between 2003 (45%) and 2018 (36%). The percentage of women drinking more than three units on their heaviest drinking day also declined significantly between 2003 (37%) and 2018 (28%).
Harmful use of alcohol is recognised as a major public health challenge in Scotland. Harmful drinking carries with it a risk of physical and mental health problems, as well as social and economic losses to individuals and society. Excessive alcohol consumption at a chronic level results in increased risk of high blood pressure, chronic liver disease and cirrhosis, pancreatitis, some cancers, mental ill-health and accidents. Recent evidence has also established links between harmful drinking and the incidence of infectious diseases such as tuberculosis and HIV/AIDS.
In 2016 alcohol use was the seventh leading risk factor for premature death and disability worldwide and was the highest risk factor among the worldwide population of 15-49 year olds. The World Health Organization (WHO) cites that 3 million deaths (5.3% of all deaths) worldwide in 2016 resulted from the harmful use of alcohol. Death and disability caused by alcohol consumption can occur relatively early in life with 13.5% of the total deaths among those aged 20-39 being alcohol-attributable as well as 7.2% of all premature deaths (among those aged 69 years and younger). The leading contributors to alcohol-related deaths were digestive diseases (21.3%), unintentional injuries (20.9%) and cardiovascular diseases and diabetes (19%).
In 2016, UK alcohol drinkers consumed a greater amount of pure alcohol per person than drinkers across Europe (21.8 litres among males and 7.6 among females in the UK compared with 18.3 among males and 4.7 among females across Europe).
Before Minimum Unit Pricing was introduced on 1 May 2018, alcohol was 64% more affordable in the UK than it was in 1987. It was possible in Scotland prior to 1 May 2018 to exceed the new lower risk guidelines for alcohol (14 units per week) for around £2.50; with the 50 pence minimum unit price, that figure is now £7. In 2018, 9.9 litres (L) of pure alcohol were sold per adult in Scotland, equivalent to 19.0 units per adult per week, representing enough alcohol for every adult to substantially (by 36%) exceed the low risk weekly drinking guideline (14 units); just under a quarter of all off-trade alcohol (23%) was sold at below 50 pence per unit. The 9.9 litres of pure alcohol per adult represents a 3% decrease from 2017 and is the lowest level seen since in Scotland since 1994. The volume of alcohol sold in Scotland in 2018 was 9% higher than in England & Wales which is the smallest difference since 2004.
The risk of alcohol-related harm increases with greater levels of average alcohol consumption in a population. In 2018, alcohol mortality in Scotland increased by 1% since the previous year, with 1,136 alcohol-specific deaths in 2018, up from 1,120 in 2017. This represents an average of 22 deaths per week, and it is still more than three times the number of alcohol-specific deaths in the early 1980s. The number of alcohol-specific deaths was more than twice as high among men than women in 2018. In 2017/18 alcohol-related problems resulted in 35,499 stays in general acute hospitals. Although the rate of alcohol-related stays in general acute hospitals has declined over the past 10 years and is at its lowest in 2017/18 than it has been since 2007/8, the rate per 100,000 population was still over four times higher in 2017/18 than in 1981/82.
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,. The rate of alcohol-related mortality among those aged 45-74 years in Scotland's most deprived areas in 2017 was 8 times higher than in the least deprived areas (228.3 compared with 28.9 per 100,000 population). The gap in mortality rates between those living in the most and least deprived areas of Scotland has increased since 1997 (from 181.8 per 100,000 to 199.4 in 2017) although it has decreased since its peak in 2002 (285.1 per 100,000). Alcohol-related admissions to general hospitals are linked to deprivation with just over seven times as many people (per 100,000 population) admitted at least once from the most deprived areas compared to the least deprived areas in 2017/18. In the psychiatric setting in 2016/17, the difference was more pronounced, with patient rates in the most deprived areas of Scotland just over 14 times higher than those in the least deprived areas.
The harms associated with alcohol are not restricted to those consuming alcohol. A survey by Alcohol Focus Scotland found that 1 in 2 people in Scotland reported that they had been harmed as a result of someone else's drinking. Evidence suggests that those aged under 65 years are more likely to report having experienced this kind of harm than older people and younger people, aged under 35, are four times more likely to report harm from others in public places. In 2017/18 in just under half (46%) of violent crimes in Scotland, the victim reported the offender was under the influence of alcohol.
Alcohol also has a negative impact on children, based on Scottish Health Survey data from 2008-10, it is estimated that 36,000 to 51,000 children in Scotland live with a parent (or guardian) whose alcohol use is potentially problematic. Evidence suggests a link between increasing parental alcohol consumption and greater proportions of children reporting problems, such as conflict with a parent and a parent being more unpredictable than usual. Scotland also remains one of the countries with the highest rates of alcohol use among young people in the world.
Problematic alcohol use carries considerable economic costs; in 2010 the Scottish Government estimated that the excessive consumption of alcohol in Scotland costs £3.6 billion a year, equivalent to £900 per adult. The most recent estimates (2007) are that over 1.7 million working days are lost per year in Scotland to reduced efficiency in the workplace due to the effects of alcohol, and a similar number lost due to alcohol-related absence.
3.1.1. Policy background
Being 'healthy and active' is recognised as one of the National Outcomes underpinning the Scottish Government's revised National Performance Framework to improve the wellbeing and quality of life of people in Scotland. Tackling problematic alcohol use is integral to ensuring that people in Scotland are healthy and to reducing the inequalities that exist in society. The government's commitment to addressing problematic alcohol use is evidenced by the inclusion of a National Performance Framework National Indicator to 'reduce the proportion of people with multiple health risk behaviours24.
The UK Chief Medical Officers published new guidelines on alcohol consumption in January 2016, advising both men and women that it is safest not to regularly consume more than 14 units of alcohol per week. This represented a reduction in the low risk guidelines for men. Advice was also included to spread the amount drunk over a number of days and limit the amount consumed in a single session.
Following the Alcohol (Minimum Pricing) (Scotland) Act 2012 the Scottish Government introduced a statutory minimum price of 50 pence for a unit of alcohol, below which it cannot be sold. This was considered to provide a proportionate response to tackling problematic alcohol use whilst providing a reasonable balance between public health and social benefits and intervention in the market. It is estimated that twenty years after implementation of the policy, when it is considered to have reached full effectiveness, there would be around 120 fewer alcohol-related deaths per annum and around 2,000 fewer hospital admissions per annum.
The evaluation of Scotland's alcohol strategy lay with NHS Health Scotland between 2010 and 2016, through the Monitoring and Evaluating Scotland's Alcohol Strategy (MESAS) work programme; the final annual report was published in 2016. The MESAS group continues to monitor headline statistics for high-level indicators particularly relevant to the outcomes that Scotland's alcohol strategy aimed to achieve with the latest monitoring report published in 2019. The impact of Minimum Unit Pricing itself is subject to comprehensive evaluation including an analysis of its impact upon those drinking at harmful levels which is expected to be published in mid-2021. The final report is due in 2023.
The Fairer Scotland Action Plan, published in 2016, sets out plans for a new alcohol framework to tackle health inequalities through public health measures. The Scottish Government published Alcohol Framework 2018: Preventing Harm in November 2018. The framework endorses the WHO Safer initiative of five evidence-based strategies that WHO recommends governments should prioritise to tackle alcohol related harm. It continues to take an evidence-based approach to tackling the three central themes of Scotland's 2009 alcohol strategy; reducing consumption; positive attitudes, positive choices and supporting families and communities. The key actions for the next few years laid out in the new framework are to:
- Put the voices of young people at the heart of developing preventative measures on alcohol.
- Reduce alcohol consumption through affordability and sales and review the Minimum Unit Price of 50 pence two years after implementation.
- Keep the licensing system under review to ensure it can deliver for public health.
- Consult on marketing restrictions to protect children and young people from alcohol marketing.
- Press the UK Government to improve measures to protect children and young people from exposure to alcohol marketing.
- Improve the programme of substance use education in schools.
- Continue to raise awareness of the UK CMO guidelines and the harmful effects of alcohol.
- Review evidence on alcohol brief interventions to ensure they are being carried out in the most effective manner.
3.1.2 Measuring alcohol consumption in surveys
The alcohol consumption estimates discussed in this chapter are based on self-reported data collected during the survey interview. It is, however, important to note that surveys consistently obtain lower consumption estimates than those implied by alcohol sales or tax revenue data. This discrepancy can largely be explained by participants' under-reporting of consumption, due in part to not accounting for atypical/special occasion drinking, and there is also some evidence that survey non-responders are more likely than responders to engage in hazardous alcohol use among other risky health behaviours,,. The most recently available annual estimates of alcohol sales in Scotland show that 9.9 litres (19.0 units per adult per week) of pure alcohol per person aged 16 years and over were sold in 2018 (the equivalent figure for England and Wales in 2018 was 9.1 litres (17.5 units per adult per week).
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 SHeS have been used in the MESAS evaluation of the Alcohol Framework and in the modelling of estimated impact of minimum unit pricing on consumption patterns across different groups in society.
3.1.3 Reporting on alcohol consumption in the Scottish Health Survey (SHeS)
Key trends and breakdowns for weekly and daily alcohol consumption are updated and presented in this chapter. For weekly consumption, categories are based on the revised guidelines; hence all weekly consumption category figures for men, going back to 2003, have been revised. Figures for mean consumption are presented for drinkers only.
The area deprivation data are presented in Scottish Index of Multiple Deprivation (SIMD) quintiles. To ensure that the comparisons presented are not confounded by the different age profiles of the quintiles, the data have been age-standardised. Readers should refer to the Glossary at the end of this volume for a detailed description of both SIMD and age-standardisation.
Supplementary tables on alcohol consumption are also published on the Scottish Health Survey website.
3.1.4 Comparability with other UK statistics
The Health Surveys for England and Northern Ireland and the National Survey for Wales all provide estimates for alcohol consumption. A report published by the Government Statistical Service in 2016 advised that alcohol estimates across the UK were 'not comparable' at that time. While questions are similar in each of the surveys, questions on alcohol consumption were delivered through self-completion in the Welsh Health Survey prior to 2015/16, complicating comparisons. These questions are now included in the National Survey for Wales which is delivered face-to-face; the same mode of collection as SHeS. However, categorisation of drinkers and non-drinkers is also inconsistent across the surveys and further differences exist in the way some alcoholic drinks are categorised. On these bases, no attempt is made to compare alcohol estimates from SHeS to those from other surveys.
3.2 Methods And Definitions
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 (e.g. being interviewed with a parent). All those aged 16-17 years are asked about their consumption via the self-completion, as are some of those aged 18-19 years, at the 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.
In 2018, the SHeS questionnaire covered the following aspects of alcohol consumption:
- usual weekly consumption,
- daily consumption on the heaviest drinking day in the previous week.
Participants (aged 16 years 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, stout, cider and shandy
- strong beer, lager, stout and cider
- sherry and martini
- spirits and liqueurs
- alcoholic soft drinks (alcopops)
From these questions, the average number of days per 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 (see Section 3.2.2) and multiplied by the amount they said they usually drank on any one day.
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. Details on the amounts consumed for each of the six types of drink listed in the weekly consumption section above were collected and converted into units of alcohol consumed.
The AUDIT questionnaire which has been used on SHeS to assess problem drinking since 2012 was not included in the 2018 questionnaire as these questions will now be in the survey every other year. These will next be collected in 2019 and reported on in 2020.
3.2.2 Calculating alcohol consumption in SHeS
The guidelines on lower risk 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 4A below outlines how the volumes of alcohol reported in the survey were converted into units (the 2008 report provides full information about how this process has changed over time)40. 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.
3.2.3 Age-standardised estimates for weekly alcohol consumption
The area deprivation data presented for weekly alcohol consumption are presented in Scottish Index of Multiple Deprivation (SIMD) quintiles. To ensure that the comparisons presented are not confounded by the different age profiles of the quintiles, the data have been age-standardised. Readers should refer to the Glossary at the end of this volume for a detailed description of SIMD and age-standardisation.
Table 4A 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 (including Champagne and Prosecco)||250ml glass||3.0|
|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|
The UK CMO alcohol guidelines consist of three recommendations:
- A weekly guideline on regular drinking;
- Advice on single episodes of drinking; and
- A guideline on pregnancy and drinking.
According to the weekly guideline, adults are safest not to regularly drink more than 14 units per week, to keep health risks from drinking alcohol to a low level. If you do drink as much as 14 units a week, it is best to spread this evenly over three days or more. On a single episode of drinking, advice is to limit the total amount drunk on any occasion, drink more slowly, drink with food and alternate with water. The guideline on drinking and pregnancy, or planning a pregnancy, advises that the safest approach is not to drink alcohol at all29.
Consumption of more than three units (women) or four units (men) on a single day is also reported in this chapter. This allows comparison with previous SHeS reports although these daily amounts of alcohol are no longer included in the most recent guidance from the UK Chief Medical Officers. Consumption of double this amount (six units for women and eight for men) is also reported.
3.3 usual Weekly Alcohol Consumption
3.3.1 Trends in usual weekly alcohol consumption since 2003
The levels of hazardous or harmful drinking in the adult population dropped significantly between 2003 and 2013 (from 34% to 25%) and since 2013, hazardous or harmful drinking has remained at similar levels, fluctuating between 24% and 26%. Since 2003, the proportion of men drinking at hazardous or harmful levels has been at least twice that of women.
Correspondingly, non-drinking prevalence among adults increased between 2003 and 2013 (from 11% to 16%) and has remained stable since (16-17%) with consistently higher proportions of women reporting being non-drinkers than men. Among women, prevalence of non-drinking rose from 13% in 2003 to 20% in 2013 and has remained stable since (18-19%). Among men non-drinking prevalence rose from 8% in 2003 to 14% in 2014 and has stabilised since (13-14%).
The mean number of units of alcohol consumed by all adults has decreased since 2003 (16.1 units in 2003 compared with 12.5 in 2018) with the lowest mean recorded in 2013 at 12.2 units per adult; since then, the rate has fluctuated between 12.4 and 12.9. The trend in mean number of units of alcohol consumed per week has followed a similar pattern for both men and women, with men consistently consuming significantly more units of alcohol per week on average than women. For both sexes, mean units consumed per week dropped from a 2003 peak (21.8 for men and 10.6 for women) to as low as 15.7 for men and 8.6 for women in 2013; fluctuating since between 15.9 and 17.2 for men and between 8.6 and 9.0 for women, see Figure 3A.
Figure 3A, Table 3.1
Mean number of units of alcohol consumed per week among adults, 2003-2018, by sex
3.3.2 Usual weekly alcohol consumption in 2018, by age and sex
In 2018 the level of hazardous or harmful drinking in the adult population was at 24%, with men significantly more likely to drink at this level than women (32% and 16% respectively). Prevalence of hazardous or harmful drinking also differed significantly by age with those aged 75 and over less likely to drink at hazardous or harmful levels than other adults (12% compared with 22-27% for other age groups).
Different patterns by age were found for men and women, see Figure 3B. Among men, the highest prevalence of hazardous or harmful drinking was found among those aged 55-64 (36%) and the lowest among those aged 75 and over (24%) closely followed by those aged 16-24 (27%). Among women, prevalence peaked within the 45-54 age group (22%) and was lowest among those aged 75 and over (5%) followed by those aged 65-74 (13%) and those aged 25-34 (14%).
Figure 3B, Table 3.2
Hazardous/Harmful drinking, 2018, by age and sex
The proportion of adults who were non-drinkers in 2018 was 16%, with a higher proportion of women reporting being non-drinkers (19%) than men (13%). Non-drinking also varied significantly by age. Non-drinking prevalence was highest among those aged 65 and over (30% of those aged 75 and over and 21% of those aged 65-74); prevalence ranged from 13% to 15% for the younger age groups. A similar pattern was found for men and women.
Figure 3C, Table 3.2
Non-drinkers, 2018, by age and sex
The mean number of units of alcohol usually consumed per week by adults in 2018 was 12.5 with men likely to consume more units per week on average than women (a mean of 16.1 units per week for men compared with 8.9 for women). The mean number of units of alcohol usually consumed per week also differed by age with lower levels of consumption among those aged 75 and over than among other age groups (8.4 units, compared with 11.8-14.0 units for younger age groups) Similar patterns by age were found for men and women.
3.3.3 Usual weekly alcohol consumption in 2018 (age-standardised), by area deprivation and sex
As in previous years, age-standardised alcohol consumption levels in 2018 differed by area deprivation.
Levels of hazardous or harmful drinking were highest among those living in the least deprived areas (27%) and lowest among those living in the most deprived areas (18%) with little difference in prevalence in the remaining areas (23-25%). Different patterns of hazardous or harmful drinking by deprivation were found for men and women. For women hazardous or harmful drinking prevalence generally decreased by deprivation from 20% among those in the least deprived area to 10% among those in the most deprived area. There was no clear pattern by deprivation for men.
There was a clear association between area of deprivation and age-standardised non-drinking prevalence. Those living in the least deprived areas were least likely to be non-drinkers (12%) and there was a stepped increase with level of deprivation with those in the most deprived areas being most likely to be non-drinkers (24%). A similar pattern was found for both men and women.
Figure 3D, Table 3.3
Non-drinkers and hazardous/harmful drinkers, 2018, age-standardised and by area of deprivation
No significant difference was found between the mean units of alcohol consumed per week and area of deprivation for all drinkers or for those drinking at hazardous or harmful levels. However, although not statistically significant, the figures suggest that the mean number of units consumed by men drinking at hazardous or harmful levels was higher in the most deprived areas (45.7 units) than the other areas where levels ranged from 31.6 - 34.6 units.
3.4 Alcohol Consumption On The Heaviest Drinking Day In Last Week
3.4.1 Trends in alcohol consumption on the heaviest drinking day in last week since 2003
The percentage of men drinking more than four units on their heaviest drinking day has declined significantly between 2003 (45%) and 2018 (36%). The percentage of women drinking more than three units on their heaviest drinking day also declined significantly between 2003 (37%) and 2018 (28%). A similar pattern was found for all adults, see Figure 3E.
Figure 3E, Table 3.4
Over 4 units of alcohol for men and over 3 units of alcohol for women consumed on heaviest drinking day, 2003 to 2018, by sex
In 2018, 23% of men consumed more than 8 units on their heaviest drinking day, significantly lower than the rate of 29% in 2003. While appearing to follow a general downwards trend, the level in 2018 was not significantly different from that in the intervening years. For women, prevalence of consuming more than 6 units of alcohol on their heaviest drinking day was also significantly lower in 2018 (14%) than in 2003 (19%), with a slight downward trend over the years in between, see Figure 3F.
Figure 3F, Table 3.4
Over 8 units of alcohol for men and over 6 units of alcohol for women consumed on heaviest drinking day, 2003 to 2018, by sex
The estimated mean number of units of alcohol consumed on the heaviest drinking day by adult drinkers remained stable at 7.2 units in 2018, fluctuating between 7.7 and 6.7 units since 2003.
As in previous survey years, in 2018, male drinkers drank on average more units than female drinkers on their heaviest drinking day (8.5 units for men compared with 5.7 units for women). Among male drinkers the mean units of alcohol consumed on the heaviest drinking day has fluctuated between 8.0 and 9.0 units since 2003. The mean number of units for female drinkers has fluctuated between 5.3 and 6.2 over the same period, see Figure 3G.
Figure 3G, Table 3.4
Mean number of units of alcohol consumed on heaviest drinking day, 2003 to 2018, by sex
3.5 Number Of Days On Which Drank Alcohol In The Past Week
3.5.1 Trends in the number of days on which adults drank alcohol in the past week since 2003
The percentage of adults who drank alcohol on more than 5 days in the week before their interview decreased significantly from 17% in 2003 to 10% in 2014 and has fluctuated between 11% and 13% since (11% in 2018). Consistent with previous years, in 2018, a higher proportion of men than women drank alcohol on more than 5 days in the last week (13% of men compared to 9% of women).
The mean number of days on which adults drank alcohol in the last week decreased significantly from 3.0 in 2003 to 2.7 in 2009 and has remained at 2.6-2.7 days per week since then (2.7 in 2018). For women, the mean number of days on which they drank alcohol in the last week was 2.5 in 2018 and has been relatively stable since 2008 (between 2.3 and 2.5) following the highest level in 2003 of 2.7. Similarly, for men, the highest mean number of days on which they drank alcohol in the last week was in 2003 at 3.3; since 2009 it has fluctuated between 2.7 and 2.9 (2.9 in 2018).
Figure 3H, Table 3.5
Mean number of days on which adults drank alcohol in the last week, 2003-2018, by sex
3.5.2 The number of days on which adult drinkers drank alcohol in the past week for 2017/2018 combined, by age and sex
In 2017/2018, the proportion of drinkers who drank alcohol on more than five days in the past week increased with age (from 1% for those aged 16-24 to 28% for those aged 75 and over), this is consistent with previous survey years. A similar pattern was found for both men and women (from 1% and <0.5% for those aged 16-24 to 32% and 24% for those aged 75 and over, respectively) with a higher proportion of men drinking alcohol on more than five days in the past week than women (13% compared with 9%).
Figure 3I, Table 3.6
Proportion of adult drinkers drank alcohol more than 5 days in the past week, 2017/2018 combined, by age and sex
In 2018, male drinkers drank alcohol on more days per week on average than female drinkers (2.9 mean days for men compared to 2.5 mean days for women), again this is consistent with previous survey years. The mean number of days on which all drinkers drank alcohol in the last week also increased with age; from 2.0 for those aged 16-24 to 3.6 for those aged 75 and over. The same pattern by age was evident for both men and women. Men aged 16-24 consumed alcohol on 2.1 days per week compared with those aged 75 and over who consumed alcohol on 3.9 days per week. Women aged 16-24 consumed alcohol on 1.8 days per week compared with those aged 75 and over who consumed alcohol on 3.3 days per week.
References and notes
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22. Scottish Crime and Justice Survey 2017/18: Main Findings Edinburgh: Scottish Government, 2018. Available from: https://www.gov.scot/binaries/content/documents/govscot/publications/statistics/2019/03/scottish-crime-justice-survey-2017-18-main-findings/documents/scottish-crime-justice-survey-2017-18-main-findings/scottish-crime-justice-survey-2017-18-main-findings/govscot%3Adocument/scottish-crime-justice-survey-2017-18-main-findings.pdf
23. Framework for Action: Changing Scotland's relationship with alcohol. Final business and regulatory impact assessment for minimum price per unit of alcohol as contained in Alcohol (Minimum Pricing) (Scotland) Bill. Edinburgh: Scottish Government, 2012. Available from: www.gov.scot/Resource/0039/00395549.pdf
24. 'Like sugar for adults' The effect of non-dependent parental drinking on children and families. October 2017. Alcohol Focus Scotland. Institute of Alcohol Studies. Alcohol and Families Alliance. Available here: http://www.ias.org.uk/News/2017/18-October-2017-Like-sugar-for-adults-report-highlights-anxiety-about-parents-drinking.aspx
25. World Health Organization (2016). Growing Up Unequal: Gender and Socioeconomic Differences in Young People's Health and Well-being. Health Behaviour in School-aged Children (HBSC) Study: International Report from the 2013/2014 survey. Available from: http://www.euro.who.int/__data/assets/pdf_file/0003/303438/HSBC-No.7-Growing-up-unequal-Full-Report.pdf
27. The Societal Cost of Alcohol Misuse in Scotland for 2007, Edinburgh: Scottish Government, 2010. Available from: www.gov.scot/Publications/2009/12/29122804/21
28. Further information on Scotland Performs can be found at: http://nationalperformance.gov.scot/
30. Angus C, Holmes J, Pryce R, Meier P and Brennan A (2016). Model-based appraisal of the comparative impact of Minimum Unit Pricing and taxation policies in Scotland: An adaptation of the Sheffield Alcohol Policy model version 3. Sheffield: University of Sheffield. Available from: www.sheffield.ac.uk/polopoly_fs/1.565373!/file/Scotland_report_2016.pdf
31. NHS Health Scotland (2019) Monitoring and evaluating Scotland's Alcohol Strategy (MESAS) Available from: http://www.healthscotland.scot/media/2587/mesas-monitoring-report-2019.pdf
33. Fairer Scotland Action Plan. Edinburgh: Scottish Government, 2017. Available From: https://www.gov.scot/Publications/2016/10/9964/7
34. Alcohol Framework 2018: Preventing Harm. Next steps on changing our relationship with alcohol. Available From: https://www.gov.scot/publications/alcohol-framework-2018-preventing-harm-next-steps-changing-relationship-alcohol/pages/2/
35. World Health Organization (2018) SAFER initiative. Available from: https://www.who.int/substance_abuse/safer/launch/en/
36. Bellis MA, Hughes K, Jones L, Morloe M, Nichols J, McCoy E, Webster J and Sumnall H (2015). Holidays, celebrations, and commiserations: measuring drinking during feasting and fasting to improve national and individual estimates of alcohol consumption. BMC Med; 13(1): 113. Available from: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0337-0
37. Torvik FA, Rognmo K and Tambs K (2012). Alcohol use and mental distress as predictors of non-response in a general population health survey: the HUNT study. Social Psychiatry and Psychiatric Epidemiology; 47(5):805-816. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328681/
38. Gorman E, Leyland AH, McCartney G, White IR, Katikireddi SV, Rutherford L, Graham L and Gray L (2014). Assessing the representativeness of population-sampled health surveys through linkage to administrative data on alcohol-related outcomes. American Journal of Epidemiology; 180(9): 941-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207717/
39. Gorman E, Leyland AH, McCartney G, Katikireddi SV, Rutherford L, Graham L, Robinson M and Gray L (2017). Adjustment for survey non-representativeness using record-linkage: refined estimates of alcohol consumption by deprivation in Scotland. Addiction; 112(7): 1270-1280. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/add.13797
40. NHS Health Scotland (2019) Monitoring and evaluating Scotland's Alcohol Strategy (MESAS) Available from: http://www.healthscotland.scot/media/2587/mesas-monitoring-report-2019.pdf
41. See: www.gov.scot/scottishhealthsurvey
42. Comparing official statistics across the UK. Government Statistical Service, 2016. Available from: https://gss.civilservice.gov.uk/policy-store/comparing-official-statistics-across-the-uk/
43. Reid S (2012). Chapter 3: Alcohol consumption. In: Bromley C, Bradshaw P and Given L. (eds.) The 2008 Scottish Health Survey – Volume 1: Main Report. Edinburgh: Scottish Government. 2009. Available from: www.gov.scot/Publications/2009/09/28102003/31
44. For participants aged 16 and 17, details on alcohol consumption were collected as part of a special smoking and drinking self-completion questionnaire. Some aged 18 and 19 also completed the self-completion if the interviewer felt it was appropriate. For all other adult participants, the information was collected as part of the face-to-face interview. The method of estimating consumption follows that originally developed for use in the General Household Survey and is also used in the Health Survey for England. For six types of alcoholic drink (normal strength beer/lager/cider/shandy, strong beer/lager/cider, spirits/liqueurs, fortified wines, wine, and alcoholic soft drinks), participants were asked about how often they had drunk each one in the past twelve months, and how much they had usually drunk on any one day. The amount given to the latter question was converted into units of alcohol, with a unit equal to half a pint of normal strength beer/lager/cider/alcoholic soft drink, a single measure of spirits, one glass of wine, or one small glass of fortified wine. A half pint of strong beer/lager/cider was equal to 1.5 units. The number of units was then multiplied by the frequency to give an estimate of weekly consumption of each type of drink. The frequency multipliers were:
|Drinking frequency||Multiplying factor|
|Almost every day||7.0|
|5 or 6 times a week||5.5|
|3 or 4 times a week||3.5|
|Once or twice a week||1.5|
|Once or twice a month||0.375|
|One every couple months||0.115|
|Once or twice a year||0.029|
The separate consumption figures for each type of drink were rounded to two decimal places and then added together to give an overall weekly consumption figure.
45. Participants were first asked if 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.
46. Gray, L. and Leyland, A (2018). Chapter 4: Alcohol. McLean, J., Christie, S., and Gray, L. (eds). The Scottish Health Survey – 2017 edition: volume 1: main report. Edinburgh: Scottish Government. Available from: https://www.gov.scot/publications/scottish-health-survey-2017-volume-1-main-report/pages/6/
47. Gray, L. and Leyland, A (2018). Chapter 4: Alcohol. McLean, J., Christie, S., and Gray, L. (eds). The Scottish Health Survey – 2017 edition: volume 1: main report. Edinburgh: Scottish Government. Available from: https://www.gov.scot/publications/scottish-health-survey-2017-volume-1-main-report/pages/6/
48. Gray, L. and Leyland, A (2018). Chapter 4: Alcohol. McLean, J., Christie, S., and Gray, L. (eds). The Scottish Health Survey – 2017 edition: volume 1: main report. Edinburgh: Scottish Government. Available from: https://www.gov.scot/publications/scottish-health-survey-2017-volume-1-main-report/pages/6/
49. Gray, L. and Leyland, A (2018). Chapter 4: Alcohol. McLean, J., Christie, S., and Gray, L. (eds). The Scottish Health Survey – 2017 edition: volume 1: main report. Edinburgh: Scottish Government. Available from: https://www.gov.scot/publications/scottish-health-survey-2017-volume-1-main-report/pages/6/
50. Gray, L. and Leyland, A (2018). Chapter 4: Alcohol. McLean, J., Christie, S., and Gray, L. (eds). The Scottish Health Survey – 2017 edition: volume 1: main report. Edinburgh: Scottish Government. Available from: https://www.gov.scot/publications/scottish-health-survey-2017-volume-1-main-report/pages/6/
Table 3.1 Estimated usual weekly alcohol consumption level, 2003 to 2018
Table 3.2 Estimated usual weekly alcohol consumption level, 2018, by age and sex
Table 3.3 Estimated usual weekly alcohol consumption level, (age-standardised), 2018, by area deprivation and sex
Table 3.4 Estimated units consumed on heaviest drinking day, 2003 to 2018
Table 3.5 Number of days on which adult drinkers drank alcohol in the past week, 2003 to 2018
Table 3.6 Number of days on which adult drinkers drank alcohol in the past week, 2017/2018 combined, by age and sex