Ecological analysis of collectivity of alcohol consumption in England: importance of average drinker.

Abstract

To assess whether the average consumption of alcohol is associated with the prevalence of heavy drinking, problem drinking, and abstention in England. Ecological analysis using data from a cross sectional household based survey of English adults. Random sample of 32,333 adults from the English population who participated in the 1993 and 1994 health surveys for England. Association, expressed as the correlation coefficient, between the regional mean and median alcohol consumption and the regional prevalence of heavy drinking, problem drinking, and abstention. Mean consumption of alcohol in light to moderate drinkers was strongly positively associated with the prevalence of heavy drinking (r = 0.75 in men and r = 0.62 in women for drinking more than 21 and 14 units per week respectively). A similar association was found between median consumption and prevalence of heavy drinking. Abstention was not significantly associated with mean consumption in drinkers (r = 0.08 for men and r = -0.29 for women). Both the median and mean consumption in drinkers were positively associated with the prevalence of problem drinking as defined by the CAGE questionnaire on alcohol use (r = 0.53 for men and r = 0.42 for women for the association with mean consumption). Factors that increase the average consumption of alcohol in the population may result in an increase in the prevalence of heavy drinking and related problems.