Scottish Health Survey 2017 - volume one: main report
Presents results for the Scottish Health Survey 2017, providing information on the health and factors relating to health of people living in Scotland.
4. Alcohol
Linsay Gray
Summary
- The proportion of adults saying they did not drink alcohol increased from 11% in 2003 to 17% in 2017, the highest level in the time series.
- Levels of hazardous / harmful drinking in 2017 were higher for men (33%) than for women (16%). The overall average weekly alcohol consumption for male drinkers (16.4 units) remained at around twice that for female drinkers (8.6 units).
The average number of units of alcohol consumed per week by drinkers has decreased since 2003, and has remained at around the current level since 2013
- In 2017, male drinkers drank an average of 8.0 units on their heaviest drinking day and the average was 5.3 units for women; a significant fall for women from 2016 (6.1 units).
- The percentage of men drinking more than four units on their heaviest drinking day declined from 2003 to 2017 (45% to 37%). Similarly, the percentage of women drinking more than three units on their heaviest drinking day declined (37% in 2003 to 29% in 2017).
- The percentage of men drinking more than eight units and women drinking more than six units on their heaviest drinking day also declined (24% in 2003 compared with 17% in 2017), with a significant fall since 2016 (from 20% to 17%).
- In 2017, male drinkers consumed alcohol on more days per week than female drinkers on average (2.8 days compared with 2.4 days respectively).
- 13% of male drinkers and 9% of female drinkers drank alcohol on more than five days in the past week.
- Levels of hazardous, harmful or possibly dependent drinking behaviour as defined by AUDIT scores had fluctuated between 22% and 26% among men and between 10% and 13% among women since 2012.
4.1 Introduction
Problematic alcohol use is recognised as a major public health challenge in Scotland carrying a risk of physical and mental health problems, as well as social and economic losses to individuals and society[1]. Before Minimum Unit Pricing[2] was introduced on 1 May 2018 alcohol was 64 per cent more affordable in the UK than it was in 1980: it was possible in Scotland prior to 1 May 2018 to exceed the new lower risk guidelines for alcohol (14 units per week) for less than £2.50[3]. That figure is now £7. The chronic consumption of excessive quantities of alcohol leads to increased risks of high blood pressure, chronic liver disease and cirrhosis, pancreatitis, some cancers, mental ill-health and accidents[4]. The World Health Organization (WHO) cites that 3.3 million deaths (5.6% of all deaths) result from the harmful use of alcohol, and that death and disability caused by alcohol consumption can occur relatively early in life with 25% of the total deaths among those aged 20-39 being alcohol-attributable[5]. It also identifies higher levels of alcohol dependence and alcohol use disorders in the UK than across Europe as a whole[6].
In 2017, in Scotland, 19.6 units of alcohol were sold per adult per week, representing enough alcohol for every adult to substantially (by 40%) exceed the low risk weekly drinking guideline (14 units); nearly half (47%) of all off-trade alcohol was sold at below 50 pence per unit[7].
As average alcohol consumption in a population increases so does the risk of alcohol related harm[8]. Alcohol-related mortality increased between 2012 and 2016, with 1,235 alcohol-related deaths in 2017. There has been a 2% reduction in alcohol-related deaths in 2017[9] over the previous year, however they are still double the number in the early 1980s. In 2017, 1,120 people in Scotland died due to a cause wholly attributable to alcohol; an average of 22 people per week[10]. These alcohol-specific death rates continue to be higher in Scotland than in England & Wales; rates were more than twice as high in men and 75% higher in women in 2016[11]. There are more than 94,500 GP consultations and 36,235 hospital stays each year are for alcohol-related problems[12],[13]. Although the rate of alcohol-related hospital stays has declined over the past 8 years, in 2016/17 the rate was over four times higher than in 1981/82[14].
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[15],[16]. Alcohol-related admissions to general hospitals are linked to deprivation with nearly eight times as many people (per 100,000 population) admitted from the most deprived areas compared to the least deprived areas in 2016/17. In the psychiatric setting in 2015/16, the difference was more pronounced, with just over 15 times as many people from the most deprived areas[17].
The harms associated with alcohol misuse are not restricted to those consuming alcohol, with potential impacts on others of injury, neglect, abuse, crime, and from concern for or fear of family members. A report published by Alcohol Focus Scotland in 2015 estimated that 1 in 2 people in Scotland are harmed as a result of someone else's drinking[18]. Those aged over 65 years are significantly more likely to report having experienced this kind of harm than younger age groups[19]. Evidence suggests a clear relationship between alcohol and crime with 60% of young offenders stating that they were drunk at the time of their offence[20]. In over two fifths (42%) of violent crimes in Scotland, the victim reported the offender was under the influence of alcohol[21]. Awareness of the harmfulness of alcohol has increased amongst the Scottish population with 60% citing it as the drug which causes most problems in Scotland[22].
Misuse of alcohol also has a negative impact on children with an estimated 36,000 to 51,000 children in Scotland living with a parent (or guardian) whose alcohol use is potentially problematic[23].
Between 2010 and 2015, there was a considerable decrease in the proportion of those aged 15 who reported drinking alcohol in the last week, from 34% to 17% according to the Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS)[24]. The proportion of pupils who had ever had an alcoholic drink had decreased since 2013 –the figure at its lowest level for both age groups than at any time since SALSUS began in 1990 (28% of those aged 13 and 66% of those aged 15). However Scotland remains one of the countries with the highest rates of alcohol use among young people in the world[25].
There are also economic impacts to problematic alcohol use; in 2010 the Scottish Government estimated that the excessive consumption of alcohol in Scotland costs £3.6 billion a year[26]. 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[27].
4.1.1 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[28]. 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 behaviours[24].
In January 2016, the UK Chief Medical Officers published new guidelines on alcohol consumption. This included advice that for both men and women that it is safest not to regularly consume more than 14 units of alcohol per week. This represents 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[29].
The Alcohol (Minimum Pricing) (Scotland) Act 2012 allowed for the setting of a price for a unit of alcohol, below which it cannot be sold. Following a public consultation[30], the Scottish Government set the minimum price at 50 pence per unit in 2018. 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[31].
Between 2010 and 2016, evaluation of Scotland's alcohol strategy lay with NHS Health Scotland, 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 set out to achieve with the second monitoring report published in 2018[32]. The impact of Minimum Unit Pricing itself will be subject to comprehensive evaluation[33].
The Fairer Scotland Action Plan[34], published in 2016, sets out plans for a new alcohol framework to tackle health inequalities through public health measures. The Scottish Government is refreshing the Alcohol Framework in 2018 to build on the progress made so far. In addition, measures to improve alcohol treatment and recovery support will be included in a new alcohol and drugs treatment strategy.
4.1.2 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 disjuncture can largely be explained by participants' under-reporting of consumption, due in part to not accounting for atypical / special occasion drinking[35], and there is also some evidence that survey non-responders are more likely than responders to engage in risky health behaviours, including hazardous alcohol use[36],[37],[38]. The most recently available annual estimates of alcohol sales in Scotland show that 10.2 litres (19.6 units per adult per week) of pure alcohol per person aged 16 years and over were sold in 2017 (the equivalent figure for England and Wales was 8.9 litres (17.2 units per adult per week)[39].
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.
4.1.3 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.
Problem drinking including levels of alcohol dependency and high risk alcohol use, as measured by the Alcohol Use Disorders Identification Test (AUDIT), are also presented.
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[40].
4.1.4 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[41]. 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.
4.2 Methods and Definitions
4.2.1 Methods
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[42].
In 2017, the SHeS questionnaire covered the following aspects of alcohol consumption:
- usual weekly consumption,
- daily consumption on the heaviest drinking day in the previous week,
- problem drinking.
Weekly consumption
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
- wine
- 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 4.2.2) and multiplied by the amount they said they usually drank on any one day[43].
Daily consumption
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[44]. 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.
Problem drinking
Since 2012 the AUDIT questionnaire has been used to assess problem drinking. AUDIT is widely considered to be the best screening tool for detecting problematic alcohol use. It comprises ten indicators of problem drinking: three indicators of consumption, four of use of alcohol considered harmful to oneself or others, and three of physical dependency on alcohol. Given the potentially sensitive nature of these questions, they were administered in self-completion format for all participants.
4.2.2 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.
4.2.3 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 | 250ml glass | 3.0 |
| 175ml glass | 2.0 | |
| 125ml glass | 1.5 | |
| 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 |
4.2.4 Definitions
The UK 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 all[29].
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 volumes 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.
'Hazardous' / 'harmful' drinking can also be defined according to scores on the AUDIT questionnaire. Guidance on the tool, which is primarily intended to screen respondents for levels of alcohol dependency or high-risk use, has been published by the World Health Organisation (WHO). Section 4.2.5 includes a fuller description of the tool[45].
Alcohol Use Disorders Identification Test (AUDIT) scale.
The AUDIT questionnaire was primarily designed to screen for levels of alcohol dependency or high-risk use. In line with the WHO guidelines on using the tool, responses to each of the ten AUDIT questions were assigned values of between 0 and 4[46]. Scores for the ten questions were summed to form a scale, from 0 to 40, of alcohol use.
The WHO guidelines[47] for interpreting AUDIT scale scores are as follows:
| Score | Category description |
|---|---|
| 0 to 7 | low-risk drinking behaviour, or abstinence |
| 8 to 15 | medium level of alcohol problems, with increased risk of developing alcohol-related health or social problems (sometimes described as hazardous drinking behaviour) |
| 16-19 | high level of alcohol problems, for which counselling is recommended (harmful drinking behaviour) |
| 20 or above | warrants further investigation for possible alcohol dependence. |
4.3 Usual Weekly Alcohol Consumption
4.3.1 Trends in usual weekly alcohol consumption since 2003
There was a significant drop in prevalence of hazardous or harmful drinking levels among all adults between 2003 and 2013 (34% to 25% respectively) with prevalence remaining at a similar level since, fluctuating between 24% and 26% from 2014 to 2017. Trends for men and women show a similar pattern.
The mean number of units of alcohol consumed by all adults declined significantly from 2003 (16.1 units) to 2011 (13.1 units) and since then levels have remained stable, fluctuating between 12.2 and 13.3 units (12.5 units in 2017). A similar pattern was found for male and female drinkers (see Figure 4A). Male drinkers' mean reported weekly alcohol consumption declined by almost 5 units from 2003 (21.8 units) to 2011(17.0 units) and has fluctuated between 15.7 and 17.5 units since (16.4 units in 2017). Female drinkers mean alcohol unit consumption per week also decreased from 2003 (10.6 units) to 2011 (9.1 units) and has fluctuated between 8.6 and 9.3 units (8.6 units in 2017) since.
There have been significant increases since 2003 in the proportions of adults saying they did not drink alcohol; the percentage increased from 11% in 2003 to 17% in 2017. Non-drinking prevalence among men rose from 8% in 2003 to 14% in 2014, with similar levels thereafter (14% in 2017). Among women, 13% reported being non-drinkers in 2003 and 2008 rising to 20% in 2013 and remaining between 18% and 19% since (19% in 2017). Figure 4A, Table 4.1
4.3.2 Usual weekly alcohol consumption in 2017, by age and sex
As in previous years, levels of hazardous/harmful drinking in 2017 were higher for men than for women (33% compared to 16% respectively). Prevalence of hazardous/harmful drinking varied by age for both men and women but with no discernible pattern. In men prevalence decreased from 35% among those aged 16-24 to 24% among those aged 35-44 and increased to the highest prevalence of 39% among those aged 55-64; decreasing again to the lowest prevalence amongst those aged 75 and over (23%). In women, prevalence decreased from 18% among those aged 16-24 to 9% among those aged 25-44, and increased to the highest prevalence (24%) among those aged 55-64; similarly to men, prevalence then decreased to its lowest among those aged 75 and over (5%).
The prevalence of non-drinking in 2017 also varied significantly by age for all adults with the highest prevalence among those aged 75 and over (35%) and the lowest amongst those aged 45-54 (12%). Patterns differed for men and women with the lowest non-drinking prevalence for men among those aged 25-34 (8%) and for women among those aged 35-44 and 45-54 (13%). The highest prevalence of non-drinking was among those aged 75 and over for both men and women (29% and 40% respectively).
As for previous survey years, in 2017 the overall mean number of units of alcohol usually consumed per week for male drinkers (16.4 units) remains at around twice that of female drinkers (8.6 units). The mean number of units of alcohol usually consumed per week varied by age group. Among all adults the highest mean consumption was amongst the middle age groups (14.1 units for those aged 45-54 and 15.3 units for those aged 55-64) whilst the lowest mean consumption was amongst those aged 75 and over (8.6 units) closely followed by those aged 25-34 (9.2 units). This pattern was reflected in men, however the mean number of units consumed by women aged 16-24 was similar to that of women in the middle age groups (9.7 units for those aged 16-24 and 45-54, and 11.2 units for those aged 55-64). Table 4.2
4.3.3 Usual weekly alcohol consumption in 2017 (age-standardised), by area deprivation
As in previous years, in 2017, the association between area deprivation and age-standardised alcohol consumption level categories (non-drinker and hazardous/harmful) was significant.
Among both men and women there were higher levels of hazardous/harmful drinking among those living in the least deprived quintiles than in the most deprived quintiles. For men, 37-38% drank at hazardous/harmful levels in the two least deprived quintiles compared with 26-31% in the remaining quintiles, for women 22% in the least deprived quintile were drinking at hazardous/harmful levels compared with 12-16% in the other quintiles.
The association between area deprivation and non-drinking prevalence was clear and consistent among adults. As in previous years, in 2017 the highest prevalence was reported among those living in the most deprived areas (23%) followed by a stepped decrease to 12% of those living in the least deprived areas (see Figure 4B). This pattern was observed for both men and women.
The mean units of alcohol consumed per week by all drinkers did not vary significantly by area deprivation in 2017. However women in the least deprived areas consumed more units per week on average than women in the most deprived areas (10.0 units compared to 7.8 units).
The figures suggest that mean units of alcohol consumed per week by hazardous/harmful drinkers was higher amongst those living in the most deprived areas than those living in the least deprived areas (mean units of alcohol consumed per week by hazardous/harmful drinkers steadily increased with deprivation from 28.2 units in the least deprived quintile areas to 37.1 units in the most deprived quintile areas). However due to small numbers in the hazardous/harmful drinkers category, this association was not statistically significant. Figure 4B, Table 4.3
4.4 Alcohol Consumption on the Heaviest Drinking Day in Last Week
4.4.1 Trends in alcohol consumption on the heaviest drinking day in last week since 2003
The estimated mean number of units of alcohol consumed on the heaviest drinking day by adult drinkers fell significantly by one unit from 2003 (7.7 units) to 2017 (6.7 units), fluctuating between 7.6 and 6.9 over the intervening survey years.
Male drinkers drank on average 2.7 units more than female drinkers on their heaviest drinking day in 2017 (8.0 units for men compared with 5.3 units for women); men have consistently consumed more units on the heaviest drinking day than women since the start of the time-series. Among male drinkers the mean units of alcohol consumed on the heaviest drinking day fell from 9.0 units in 2003 to 8.0 units in 2017. The mean number of units for female drinkers has fallen significantly from 6.1 units in 2016 to 5.3 units in 2017. This is the lowest it has been since the beginning of the time series (from 2003 to 2016, figures have fluctuated between 5.6 and 6.2), see Figure 4C.
The percentage of men drinking more than four units on their heaviest drinking day has declined significantly from 2003 (45%) to 2017 (37%). The percentage of women drinking more than three units on their heaviest drinking day also declined significantly from 2003 (37%) to 2017 (29%).
The percentage of men drinking more than eight units on their heaviest drinking day declined significantly from 2003 (29%) to 2017 (21%), fluctuating between 27% and 24% over the intervening survey years. The trend for women drinking more than six units on their heaviest drinking day showed a significant decline from 19% in 2003 to 15% in 2012; levels were 14-17% thereafter until 2017 when it fell significantly to 13%. The figures for 2017 indicate a recent decline in the units consumed by adults on their heaviest drinking day; 2018 survey data will provide further insight into whether this indicates a further downward trend. Figure 4C, Table 4.4
4.5 Number of Days on Which Drank Alcohol in the Past Week
4.5.1 Trends in the number of days on which adults drank alcohol in the past week since 2003
The mean number of days on which adults drank alcohol in the last week significantly decreased from 3.0 days in 2003 to 2.7 days in 2009. Since then, the mean number of drinking days has remained relatively stable (2.6-2.7). This trend continued in 2017, with adults drinking alcohol on an average of 2.7 days per week.
This pattern was reflected in both men and women. For men, the mean number of days decreased significantly between 2003 (3.3) and 2009 (2.9), and has remained relatively stable since fluctuating between 2.7-2.9 (2.8 in 2017). For women, the mean number of days decreased significantly between 2003 (2.7) and 2008 (2.5), and has remained relatively stable since, fluctuating between 2.3-2.5 (2.4 in 2017).
For all adults who drank alcohol in the week prior to interview, the percentage drinking alcohol on more than five days in that week decreased significantly from 17% in 2003 to 10% in 2014 then, following a rise to 13% in 2016, the level returned to 11% in 2017. A similar pattern was found for both men and women. Figure 4D, Table 4.5
4.5.2 The number of days on which adult drinkers drank alcohol in the past week for 2016/2017 combined
As in previous years[48], in 2016/2017 male drinkers consumed alcohol on more days per week on average than female drinkers (2.9 days compared with 2.5 days respectively). For each age group the average number of days per week that alcohol was consumed ranged between 0.2 and 0.6 days higher for male than female drinkers.
As reported in previous surveys[49], in 2016/2017 the average number of days on which alcohol was consumed in the past week by adult drinkers generally increased with age (from between 2.0 and 2.2 days for those aged 16-44 to 3.6 days for those aged 75 and over). This was true for both men and women.
In 2016/2017, 12% of adult drinkers drank alcohol on more than five days in the past week with a significantly higher percentage of male drinkers (14%) than female drinkers (10%) doing so. Drinking on more than five days in the last week was significantly associated with age, rising from 3-6% among those aged 16-44 to 31% among those aged 75 years or over. A similar pattern was observed for both male and female drinkers. Table 4.6
4.6 Problem Drinking in 2016/2017 (Combined)
4.6.1 Trends in problem drinking since 2012
Drinking at low levels of risk or abstinence has remained relatively stable between 2012 and 2017 (fluctuating between 74%-78% among men and between 87%-90% among women).
Hazardous, harmful or possibly dependent drinking behaviour (AUDIT scores of 8 or more) among adults has remained at a similar level since 2013, fluctuating between 17% and 18% (17% in 2017). No discernible pattern was apparent for men or women; percentage values among men ranged between 22% and 26% since 2012 (25% in 2017) whilst among women the levels ranged between 10% and 13% (10% in 2017).
Prevalence of hazardous drinking (AUDIT score of 8-15) among adults has remained stable since 2012, fluctuating between 15% and 16% (16% in 2017). Similar patterns were found for men and women. Harmful drinking and possible alcohol dependence prevalence (AUDIT scores of 16 or more) have also remained stable for both men (between 3% and 4%) and women (between 1% and 2%) from 2012 to 2017.
4.6.2 Problem drinking in 2016/2017 combined, by age
In 2016/2017, among all adults, 83% drank at a low level of risk or were abstinent (AUDIT score of 0-7), 16% drank at hazardous levels (AUDIT score of 8-15), 1% drank at harmful levels (AUDIT score of 16-19) and 1% had a possible alcohol dependency (AUDIT score of 20 or more) combined.
According to their AUDIT scores, men were significantly more likely than women to drink at hazardous levels (21% compared with 11% respectively), or to have possible alcohol dependency (2% compared with 1% respectively). Men were significantly less likely to drink at a low risk level or be abstinent than women (76% compared with 88% respectively).
As in previous years, AUDIT scores varied significantly by age in 2016/2017. The prevalence of drinking at low levels of risk or abstinence increased with age from 66% for adults aged 16-24 to 97% for those aged 75 and over; prevalence of hazardous drinking decreased by age from 30% among those aged 16-24 to 3% among those aged 75 and over.
Although prevalence of hazardous and harmful drinking (AUDIT score of 8 or more) declined with age for both men and women, men were more likely to continue to drink at a hazardous/harmful or possibly dependent level up to age 75 and over than women (8% of men aged 75 and over compared with less than 0.5% of women aged 75 and over). Figure 4E, Table 4.8
4.6.3 Problem drinking in 2016/2017, by area deprivation
Men living in the most deprived areas were more likely to drink at harmful levels and have possible alcohol dependence (AUDIT score of 16 or more) than those living in the least deprived areas (5% compared with 2% respectively). There was not a significant difference by deprivation for women. Table 4.9
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