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4363.0.55.001 - Australian Health Survey: Users' Guide, 2011-13  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 07/06/2013   
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ALCOHOL

Definition

This topic refers to the consumption of alcoholic drinks, and focuses on two aspects of consumption:

  • intake of alcohol
      • derived from information about the types and quantities of alcoholic drinks (including homemade wines and beers) consumed on the three most recent days, in the week prior to interview, on which alcohol was consumed
      • refers to the quantity of alcohol contained in any drinks consumed, not the quantity of the drinks themselves
      • is used to determine long-term/lifetime risk of alcohol consumption.
  • the frequency of consuming 'at risk' amounts of alcohol in the previous 12 months
      • amounts are defined in terms of 'standard drinks', where an Australian Standard Drink contains 10 grams (equivalent to 12.5 mls) of alcohol
      • is used to determine short term/single occasion risk of alcohol consumption.

Population

Information was collected for persons aged 15 years and over in the NHS.

Methodology

Intake of alcohol - Assessing long term/lifetime risk of alcohol consumption

Respondents were asked how long ago they last had an alcoholic drink. Those who reported they had a drink within the previous week were then asked the days in that week on which they had consumed alcohol (excluding the day on which the interview was conducted). For each of the most recent three days in that last week on which they drank, the types and quantities (number and size) of drinks they had consumed were recorded. They were also asked whether their consumption in that week was more, about the same, or less than their usual consumption. Information was collected separately for the following categories of alcoholic drinks:
  • beer
    • light beer
    • mid-strength beer
    • full-strength beer
  • wine
    • red wine
    • white wine
    • low alcohol wine
    • champagne/sparkling wine
  • ready to drink spirits/liqueurs
  • liqueurs
  • spirits
  • fortified wine
  • cider
  • cocktail
  • other alcoholic drinks.

More than one response was allowed.

If interviewers were unsure in which category a reported drink belonged, details were recorded in 'other alcoholic drinks' for checking/reclassifying as appropriate during later processing.

Respondents were asked to report the number of drinks of each alcohol type they had consumed, the size of the drinks, and where possible the brand name(s) of the drink(s) consumed on each of the most recent three days in the last week on which they had consumed alcohol. Interviewers were able to record this information by selecting from a list in a trigram coder or by recording the details for later coding during processing.

The collection of accurate data on quantity of alcohol consumed is difficult, particularly where recall is concerned, given the nature and possible circumstances of consumption. Interviewers were provided with extensive documentation and training to assist with recording of amounts consumed. Where possible, information was collected in terms of standard containers or measures; i.e. 10 oz glass, stubby, nip, etc. Where the size of the drink did not readily fit into the list provided to interviewers, they were asked to record as much information as necessary to clearly indicate the quantity.

Reported quantities of drinks consumed were converted to millilitres (mls) of alcohol present in those drinks, and then summed to the drink type, day, and week level as required. The methodology to convert drinks to mls of alcohol consumed is as follows:

Alcohol content of the drink consumed (%) x number of drinks (of that type) consumed x vessel size (in mls)

This conversion was performed electronically, supported by clerical coding for cases which could not be coded automatically. From this, an average daily alcohol consumption item was derived. Two indicators of alcohol risk level were created from the average daily alcohol consumption item:
  • average over the 1 to 3 days for which consumption details were recorded
  • average over 7 days of the reference week, i.e. average consumption over 3 days x number of days consumed alcohol / 7.
    Published alcohol data relating to lifetime risk are compiled using the 7 day average.

    According to the average daily intake over the 7 days of the reference week, respondents' long term/lifetime risk levels were determined according to the National Health and Medical Research Council (NHMRC) alcohol consumption risk guidelines (see section below).

    Where precise brand type of drink information was not recorded, default alcohol content values based on drink type were applied. These values are shown below:


    Type of beverage
    Alcohol content / conversion factor

    Light beer
    0.027
    Mid-strength beer
    0.035
    Full-strength beer
    0.049
    Stout
    0.058
    Wine coolers
    0.035
    Low alcohol wines
    0.090
    Fortified wines
    0.178
    White wine
    0.124
    Red wine
    0.133
    Sparkling wine/champagne
    0.133
    Spirits
    0.400
    Liqueurs
    0.200
    Pre-mixed spirits (e.g. UDL)
    0.050
    Alcoholic cider
    0.047
    Extra-strong cider
    0.075
    Cocktails
    0.315
    Other alcoholic beverage
    0.274


    It is recognised that particular types or brands of beverage within each of these categories may contain more or less alcohol than indicated by the conversion factor; for example, full-strength beers are usually in the range 4% to 6% alcohol by volume. The factors are considered to be sufficiently representative of each category as a whole for the purposes of indicating relative health risk as appropriate to the aims of this survey. However, it should be noted that these categories, defined by the conversion factors used, may not reflect exact legal definitions.

    In addition to the information about alcohol consumed in the previous week, respondents were asked how often they had an alcoholic drink in the last 12 months:
    • every day
    • 5 to 6 days a week
    • 3 to 4 days a week
    • 1 to 2 days a week
    • 2 to 3 days a month
    • about 1 day a month
    • less often than 1 day a month.

    Frequency of consuming 'at risk' amounts of alcohol - Assessing short term/single occasion risk of alcohol consumption

    Respondents were asked the number of times they had the following number of standard drinks in a day in the last 12 months:
    • 11 or more
    • 7 or more
    • 5 or more
    • 3 or more.

    The number of standard drinks per day is then used to calculate whether a respondent had consumed alcohol at a 'risky' level in the last 12 months according to the NHMRC short term/single occasion risk guidelines (see section below).

    In addition to this, respondents were asked whether their consumption of alcohol had increased, decreased, or stayed about the same since the same time last year.

    National Health and Medical Research Council (NHMRC) guidelines for consumption of alcohol

    The 2011-12 survey reported alcohol risk based on both the 2001 and 2009 NHMRC alcohol consumption guidelines.

    2001 NHMRC guidelines

    The 2001 NHMRC guidelines for reducing long-term and short term health risks associated with alcohol consumption are as follows:

    2001 NHMRC GUIDELINES

    Low risk
    Risky
    High risk

    Minimising risk in the longer term
    Males (on an average day)
    up to 4 standard drinks
    5–6 standard drinks
    7 or more standard drinks
    Females (on an average day)
    up to 2 standard drinks
    3–4 standard drinks
    5 or more standard drinks
    Minimising risk in the short term
    Males (on any day)
    up to 6 standard drinks
    7–10 standard drinks
    11 or more standard drinks
    Females (on any day)
    up to 4 standard drinks
    5–6 standard drinks
    7 or more standard drinks


    2009 NHMRC guidelines

    The 2009 NHMRC guidelines for reducing lifetime and single occasion health risks associated with alcohol consumption on any day are as follows:

    2009 NHMRC GUIDELINES(a)

    Does not exceed guidelines
    Exceeds guideline

    Guideline 1 - Lifetime risk
    up to and including 2 standard drinks on average
    more than 2 standard drinks on average
    Guideline 2 - Single occasion risk
    up to and including 4 standard drinks
    more than 4 standard drinks

    (a) For both males and females.

    For more information see NHMRC alcohol guidelines.

    Data items

    The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads page of this product.

    Interpretation

    Points to be considered in interpreting alcohol data include the following:
    • Some under-reporting of alcohol consumption, both in terms of persons identifying as having drunk alcohol in the reference week, and in the quantities reported, is expected to have occurred. Investigations in relation to previous surveys showed possible under-reporting to be as high as 50% for some types of drink. In the 2011-12 survey, interviewers were given the opportunity to indicate whether a parent was present at the time of the interview for persons aged 15 to 17 years, to assist with analysis of some aspects of under-reporting.
    • The extent to which under-reporting has occurred and its effects on the accuracy of survey estimates are unknown.
    • Respondents were asked to record all days in the previous week on which they had consumed alcohol, but details of consumption (type and amount of drink) were only collected for the three most recent days on which they had consumed alcohol. Due to the fact that more people were interviewed early in the week, this methodology may have resulted in the possibility that mid-week drinking occasions could be under-represented in the calculation of level of risk, and weekend drinking occasions could be over-represented.
    • The first column of the table below shows, for each day of the week, the proportion of people who reported drinking on that day in response to the question regarding which days they had consumed alcohol in the last week. The second column shows, for persons who reported drinking on a given day, the proportion who provided consumption details for that day (i.e. that day was one of the three most recent days on which they had consumed alcohol).


    % of respondents who drank in reference week who drank on that day
    Of those who drank on that day % for which consumption details were recorded for that day
    Day on which consumed alcohol
    %
    %

    Monday
    37
    70
    Tuesday
    37
    65
    Wednesday
    39
    60
    Thursday
    39
    50
    Friday
    56
    66
    Saturday
    66
    77
    Sunday
    50
    78



    • As shown in the table above, the proportion of persons reporting drinking was highest on weekends, and the proportion of persons providing consumption details was also highest for weekends. ABS analysis indicated that the 3 day methodology has a small impact on the overall level of health risk at the population level, however, as the effect is considered to be stable over time, analysis of relative risk levels over time should not be affected.
    • To assist users of the data, a 'Weekend Consumption Flag' has been derived to indicate whether consumption during the weekend (i.e. Friday, Saturday, Sunday) is fully, partly or not recorded in the data.
    • It was assumed that the level of alcohol consumption in the week recorded was typical.
    • It should be noted that whereas the NHMRC risk levels assume ongoing consumption at the levels reported, indicators derived in the 2011-12 NHS relate to consumption during the reference week only and take no account of whether or not consumption in that week was more than, less than, or similar to usual consumption levels. In addition, this indicator takes no account of other factors related to health status, or other lifestyle behaviours which may influence the absolute level of personal health risk from drinking alcohol. While data may not reflect the usual drinking behaviour of the respondent at the individual level, at the population level this is expected to average out and be representative of the total population.
    • Where quantities of alcohol consumed have been converted to standard drinks, a factor of 12.5 mls of pure alcohol per standard drink has been applied (equivalent to 10 grams of alcohol).
    • Whether alcohol consumption had increased, decreased or stayed the same since 12 months ago is based on self-perception.

    Comparability with 2007-08

    The methodology used in the 2011-12 survey for the collection of data about the quantity of alcohol consumed was the same as that used in the 2007-08 survey.

    The 2011-12 NHS used a trigram brand coder which enabled a specific alcohol percentage to be applied for each type of drink. The 2007-08 NHS collected brand via a text box for allocation of specific alcohol percentages. However it did not collect brand for wine, champagne/sparkling wine and cocktails, instead using a generalised alcohol percentage for these drink types.

    Consideration should also be given to the social factors and general changes in health awareness which have occurred in the period between surveys and which may have influenced the levels of reporting. In addition, a new alcohol tax was introduced prior to the commencement of data collection for the 2011-12 NHS survey. The introduction of this tax may have resulted in the alcohol in some drinks being reduced by some manufacturers. This reduction in alcohol changed the number of standard drinks in the container of that brand product.


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