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 obtained for persons aged 15 years and over in the 2014-15 NHS.

Methodology

Information about alcohol consumption was published in the National Health Survey: First Results, 2014-15 based on a sample of 15,396 people aged 15 years and over. Additional information relating to alcohol consumption was also published inHealth Service Usage and Health related Actions, Australia, 2014-15.

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
  • White wine
  • Red wine
  • Low alcohol wine
  • Champagne/sparkling wine
• Pre-mixed/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, where possible, the brand name(s) of the drink(s), the size of the drink(s), and the number of drinks of each alcohol type they had 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, 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:

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 2014-15 NHS 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:

		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:

	Does Not Exceed Guidelines	Exceeds Guidelines
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 questionnaire, data items and related output categories for this topic are available in pdf/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 2014-15 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	34	71
Tuesday	34	66
Wednesday	37	60
Thursday	37	50
Friday	55	67
Saturday	64	77
Sunday	49	80

• 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, an 'Alcohol 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.
• 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 2011-12

The methodology used in the 2014-15 NHS for the collection of data about the quantity of alcohol consumed was the same as that used in the 2011-12 NHS.

In 2014-15 some changes were made to the 'serving size' question including removal of some categories and addition of others. The 'serving size' question was also asked before the 'number of drinks' question in the 2014-15 NHS, whereas in 2011-12 NHS they were asked the other way around.

Both the 2014-15 and 2011-12 NHS surveys used an Alcohol Type trigram coder which contained a list of the types and brands of alcoholic drinks, along with their pure alcohol content.