Alcohol self-reported consumption data in UK surveys the impact of moving drinking questions from the General Lifestyle Survey to the Opinions and Lifestyle Survey Dr Yang Meng Sheffield Alcohol Research Group School of Health and Related Research (ScHARR) University of Sheffield
Background Source: HMRC 2010
The need for individual-level survey consumption data Many research requires individual-level data to represent consumption distribution, individual-level usual/average consumption and binge/singe-occasion drinking, and additional information on age, gender, income and other important demographic information. Alcohol policy model (e.g., the Sheffield Alcohol Policy Model) to appraise potential intervention policies (e.g., minimum unit price, taxation, promotion bans) on reducing alcohol consumption and alcohol-related harms. Analyses and modelling of the effects of age, period and birthcohorts on alcohol abstention, light drinking, heavy drinking, etc....
100% Men Women % of total alcohol consumed 80% 60% 40% 20% 0% Men 16-24 Men 25-44 Men 45-64 Men 65+ Women 16-24 Women 25-44 Women 45-64 Women 65+ Normal beer Strong beer Spirits Fortified wine Wine Alcopops Major variations by age and gender - need to be understood when trying to understand policy impacts
Brief history of drinking questions in the GHS/GLF Drink sections began to be included in the GHS 1978 Up to 2009, 21 sequential surveys include drink sections Questions to establish whether or not people drink Consistent throughout (drinknow and drinkany variables) More detailed questions since the GHS 1992/93 Questions to establish usual alcohol volume nowadays Quantity-frequency questions (not available in the GHS 2003/04, 2004/05 and 2007) Details of questions change over time (new beverages, updated conversion factors, etc.) Questions to establish alcohol usage in the last 7 days before the survey
Proposed changes to the drinking questions in the GLF Reduced number of questions on drinking in the new Opinion and Lifestyle Survey from 2012
Comparison of previous and proposed new drinking questions in the OLS Key questions The GLF 2009 The OLS (from 2012) Establish whether drink at all nowadays Quantity frequency questions over the last 12 months Drinking in the last 7 days 6 questions, including whether a lifetime abstainer or stopped drinking, and reasons for lifetime abstainer and stopping drinking. Frequency (from almost every day to not at all in last 12 months) and quantity on any one day (e.g., half pint, a medium glass) of normal/strong beer, spirits, sherry, wine, alcopops, Whether drink in the last 7 days, and, if so, how many days had a drink. For the last drinking day (not the heaviest drinking day), the quantity of normal/strong beer, spirits, sherry, wine, alcopops, 2 questions to establish whether ever drink nowadays, including very occasional drinking. Only one variable indicating the overall frequency of drinking in the last 12 months. Same questions. Choose respondent All adults in the household Random adult in the
Methods for designing alcohol use questions in surveys Quantity-frequency questions (QF) Used in the GHS/GLF Graduated-frequency questions (GF) E.g., How often in the last 12 months you have had each of the following glasses of wine in a day, items including 10 or more glasses, 6-9 glasses,..., 1 glass Respondent choose from every day, 5-6 days per week,..., not at all Recent recall Drink yesterday Drink in the last/heaviest drinking day in the last week (used in the GHS/GLF) Each day in the last 7 days Drinking/purchase diary Note: for all methods, either generic or beverage specific questions can be asked. The GLF used the beverage specific option.
Comparison of key survey methods Estimate individual average consumption Estimate subgroup/populat ion average consumption Underreporting (Stockwell et al. 2004) QF Yes Yes 65% No GF Yes Yes 69% No Estimate binge/single occasion drinking Yesterday No Yes 81% For subgroup level L7-lastdrinkday No No n/a Yes L7-heavyday No No n/a Yes L7-each day No Yes n/a Yes Diary No Yes n/a Yes We estimated that the GHS/GLF covers around 50-60% of the HMRC adult per capital consumption from 1986-2008
Implications of the new drinking questions The new drinking questions in the OLS do not allow for direct estimate of usual/average alcohol consumption. There is no established method to estimate usual alcohol consumption from the questions (alcohol consumed in the last drinking day, if any, in the last 7 days). Reasons for being lifetime abstainers and stopping drinking will no longer be collected. Some important demographic variables which were in the GLF for the last 30 years may no longer be collected; or the wording of the questions has significantly changed.
Alternative non-commercial surveys The ONS Opinions Survey (formally The ONS Omnibus Survey) Will be the OLS The Health Survey for England Only information for the last 7 days (similar to the GLF/OLS) No quantity-frequency questions to establish usual consumption level The Expenditure and Food Survey Alcohol purchase diary for 2 weeks Focus on purchase, not consumption The Scottish Health Survey Similar to the current GLF drinking questions; but limited to Scottish population The National Diet and Nutrition Survey Quantity-frequency questions and consumption diary for 4 days Small sample size
Discussion and recommendation After 2011, there will be no public-funded surveys providing robust individual-level data on estimating usual/average alcohol consumption for the population in England and Wales. Proposed alcohol questions in the OLS (consumption in the last 7 days) are not ideal to estimate the average alcohol consumption of individuals or sub-groups. To estimate average alcohol consumption, researchers have to make various assumptions and use various statistical methods; or seek alternative commercial data. We recommend that the OLS adopt at least one of the established methodologies (e.g., QF, GF or Yesterday) so that people s usual drinking level can be estimated. If beverage specific questions are not feasible, at least generic questions should be included.
ANY QUESTIONS?