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| Journal of the New Zealand Medical Association,
03-June-2005, Vol 118 No 1216
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New Zealand Pacific peoples’ drinking style: too much
or nothing at all?
John Huakau, Lanuola Asiasiga, Michael Ford, Megan Pledger,
Sally Casswell, Tamasailau Suaalii-Sauni, Ieti Lima
Past New Zealand national and Auckland regional alcohol
telephone surveys1–3 have provided only a
limited picture about the pattern of alcohol consumption among some Pacific
peoples because of the relatively small size of the Pacific population in New
Zealand and because of their lesser access to telephones compared with the
general New Zealand population drinkers
.4
In the New Zealand Drug
Statistics 2001 publication,5 data on
Pacific peoples from several annual Auckland
surveys3 had to be combined to provide a brief
picture about Pacific peoples’ alcohol use. Those findings showed that 59%
(n=760) of Pacific peoples living in Auckland had consumed alcohol in a previous
year, with more males than females reporting that they had done so. The average
quantity of alcohol consumed by males on a typical occasion varied between five
to six drinks for those aged over 30 years, to nine drinks for those aged under
30 years. For females, the average quantity of alcohol consumed on a typical
occasion varied between four to five drinks for those over 30 years, to five to
six drinks for those under 30 years.
In 2003, it was decided to carry out a Pacific specific
national survey to inform policy and practice. The
Pacific Drugs and Alcohol Consumption
Survey
(PDACS)6
sampled 1103 Pacific peoples using both telephone and cell-phone computer
assisted interview survey methods. PDACS collected data over several months from
a nationally representative sample of Pacific peoples with and without landline
telephones. PDACS provides us with the most comprehensive picture to date of the
alcohol consumption patterns of Pacific peoples living in Aotearoa (New
Zealand).
In this paper, we outline Pacific peoples’ patterns of
drinking and harm reported by this survey, and descriptively compare them with
those of the general New Zealand population based on findings from the 2000
National Alcohol Survey (NAS).1 While some
methodological differences exist, this comparison enables us to make cautious
inferences about differences in potential levels of harm Pacific peoples face
due to differences in their pattern of alcohol consumption compared with that of
the general New Zealand population.
MethodsBackground—Between
November 2002 and July 2003, PDACS collected data from 1103 Pacific peoples aged
13–65 years about their patterns of alcohol-use as well as about related
harm.
Interviews—The
sample was interviewed using computer-assisted telephone interviewing (CATI) and
computer assisted cell-phone interviewing (CACI) systems. The survey was
translated into four Pacific languages (Samoan, Cook Islands Maori, Tongan, and
Niuean) and interviewers who were fluent in one of these languages were
available if required. Around 79% of interviews were completed in English, 9% of
interviews in Samoan, 9% of interviews in Tongan, 3% of interviews in Cook
Island Maori, and less than 1% in Niuean.
The survey questionnaire was designed to provide
comparable data to that collected in previous national alcohol
surveys.1,2 The question format used allowed
for collection of beverage and location specific data and has been shown to be a
good measure.7 In the Pacific survey, one new
location (that of celebrations) was added to the locations asked about, and some
locations with lower consumption were excluded explicitly but implicitly
included in the ‘other’ location category.
The alcohol measures included annual volume, frequency
of drinking, quantity of alcohol consumed on a typical occasion, frequency of
drunkenness, and experience of alcohol-related consequences in the previous 12
months from the respondents’ own and others’ drinking.
Sampling—The
survey methodology involved sampling Pacific peoples aged 13 to 65 years from
households with land-line telephones via CATI and from households without
land-line telephones via CACI.
Households selected for the CATI survey were either
selected using random digit dialling (RDD) or randomly selected from a list of
published telephone numbers of households with people with
‘Pacific-seeming’ names (first names or second names) drawn from
their electoral enrolment details (LEXICON).
Households selected for the CACI survey were selected
from within clusters of households from mesh blocks within Statistics New
Zealand Area Units via a systematic walk in a random direction from a random
starting point. During these walks, the recruiter went door to door looking for
Pacific households without a land-line telephone. Pacific members of such
households were then given the opportunity to be interviewed using a cell-phone
the recruiter was carrying. Hence there were three sampling frames used RDD,
LEXICON, and CACI.
Call-backs were done at least 10 times for the RDD and
the LEXICON methods, and at least three times for CACI on unidentified addresses
to see if these were households with no land-line telephone that included
Pacific peoples.
On average about one respondent per household was
interviewed. The selection criteria used a combination of random numbers and a
birthday question. The birthday question asked, “Who had the last
birthday?”
Halfway through the survey, the question changed to:
“who had the last birthday?” and “who will have the next
birthday?” This change in procedure was made because it was found that the
first person contacted was volunteering inappropriately to do the survey. If
there was only one Pacific person in a household their probability of selection
was adjusted to be 50%.
At the end of the interview a detailed enumeration of
the household was made, including ethnic groups to which each member belonged,
and then independent random numbers were used to select other members from that
household to be interviewed. (The enumeration procedure was not carried out at
the beginning of the interview (as is commonly done) because of concern that
with this particular population such a procedure would reduce the response
rate.)
Selection probabilities at this stage were modified so
that people from smaller ethnic groups; for example, Niueans had a higher
probability of being interviewed than those from the larger ethnic groups such
as Samoan. The goals here were to have enough numbers for Pacific
ethnic-specific information as well as obtaining a representative sample of
Pacific peoples.
Post-stratification weighting was necessary because
different Pacific peoples had different chances of being selected for the
survey. The weighting took into account: RDD/LEXICON/CACI sampling frame,
household selection, individual selection within each household, compound
ethnicity, and census size of each ethnic group (as smaller Pacific ethnic
groups were over-sampled). More detail about the weighting is presented
elsewhere.6
Of the 1103 respondent interviews, 388 were RDD, 610
LEXICON, and 105 CACI. The response rate varied according to the sampling frame
used. The response rate for the RDD was 60%, the response rate for the LEXICON
was 77% and the response rate for CACI was 44%. The survey had an overall
composite response rate of around 66%.
Table 1 shows that the sample is representative of the
national Pacific population as the weighted data reasonably matches the gender
and age profile of the national Pacific population enumerated in Census
2001.4
Analysis—The
data were analysed using SAS8 and
SUDAAN9 statistical software following the same
procedures for calculating measures of alcohol consumption as used for the 2000
NAS. Small changes in the questions were taken into account in producing derived
variables. Where gender and age differences are reported, they are statistically
significant at the 5% level.
Table 1. Sample profile shown by gender and age
group
 ResultsTable 2 displays various measures
relating to patterns of alcohol consumption for the 2003 PDACS and 2000 NAS
surveys.
Percentage of
drinkers—In 2003, Table 2
shows that over half (57%) of the Pacific respondents were drinkers; more males
(61%) than females (51%) drank. In comparison, 85% of the general New Zealand
population were drinkers in the year 2000; similar proportions of males and
females drank.
Annual
consumption—In 2003, Table 2 shows that the average annual volume
of absolute alcohol consumed by Pacific drinkers was 21 litres of per annum, and
males consumed more alcohol annually than females. In comparison, the average
annual amount of absolute alcohol consumed by drinkers in the general New
Zealand population was 11 litres in 2000, with males consuming more alcohol
annually than females.
Frequency of
drinking—In 2003, Table 2 shows that (on average) Pacific drinkers
drank approximately two to three times per week, and that Pacific male drinkers
(on average) drank more often than Pacific female drinkers. In comparison,
drinkers in the general New Zealand population drank approximately three times
per week of whom male drinkers drank more often than female drinkers.
Typical
quantity—In 2003, Pacific drinkers’ average quantity of
alcohol consumed on a typical occasion was 8 drinks (1 drink is equal to 15 ml
of absolute alcohol—thus 8 drinks is equivalent to 120 ml of absolute
alcohol), while Pacific males drinkers’ consumed an average of 9 drinks
and Pacific female drinkers’ an average of 6 drinks on a typical occasion.
In comparison, the general New Zealand population drinkers’ average
quantity of alcohol consumed on a typical occasion was 4 drinks (61 ml of
absolute alcohol) in 2000; of whom males drinkers consumed an average of 5
drinks, and female drinkers an average of 3½ drinks on a typical occasion,
respectively.
Table 2. Patterns of alcohol consumption: the 2003
Pacific survey and 2000 National survey compared
 NAS=National
Alcohol Survey; PDACS=Pacific Drugs and Alcohol Consumption
Survey.
Frequency of
‘drinking enough to feel drunk’—In 2003, a third (33%)
of Pacific drinkers consumed enough to feel drunk at least once a week, with
more males (41%) than females (25%) reported doing so. In comparison, 9% of the
general New Zealand population drinkers consumed enough to feel drunk at least
once a week; and again, more males (13%) than females (6%) reported doing
so.
Location of
drinking—In 2003, 72% of Pacific male and 58% of Pacific female
drinkers drank in their own home, on average once per week. On such a typical
occasion, Pacific males had 11 drinks and Pacific females had 8 drinks. In
comparison, around 90% of male and female general New Zealand population
drinkers drank in their own home in 2000, on average twice per week. On such a
typical occasion, males had 6 drinks and females had 3 to 4 drinks.
Around 65% of Pacific male and female drinkers had alcohol
at other peoples’ homes on average less than once per week, and on such an
occasion (in other people’s homes) Pacific males had 12 to 13 drinks and
Pacific females had 9 drinks. In comparison, around 85% of male and female
general New Zealand population drinkers drank in other peoples’ homes in
2000, on average once per week; of whom (on a typical occasion) males had 6
drinks and females had 4 drinks
Forty-four percent of Pacific male and 39% of Pacific female
drinkers drank at pubs, hotels, or taverns on average once per week, and males
had 9 drinks and females had 7 to 8 drinks on a typical occasion. In comparison,
61% of male and 51% of female general New Zealand population drinkers drank at
pubs, hotels, or taverns, on average once per week for males and less than once
per week for females; and males drank 6 drinks and females drank 4 drinks on a
typical occasion.
Table 3 contains measures of alcohol related harms including
harms reported as a result of other peoples’ drinking and problems
reported from own drinking.
Table 3. Alcohol-related harms: the 2003 Pacific survey
and 2000 National survey compared
 NAS=National Alcohol
Survey; PDACS=Pacific Drugs and Alcohol Consumption Survey.
Problems from other
people’s drinking—In Table 3, findings from the 2003 PDCAS
show that Pacific men (18%) were more likely than Pacific women (10%) to have
reported being physically assaulted in the past 12 months by someone who had
been drinking. Pacific women (10%) were, however, more likely than Pacific men
(5%) to have reported being sexually harassed by someone who had been drinking.
In comparison, the 2000 NAS findings show that 8% of males
and 5% of females reported physical assaults; 2% of males and 1% of females
reported being in a motor vehicle accident; and 3% of males and 10% of females
reported sexual harassment in the past 12 months as a result of other
people’s drinking.
Problems from own
drinking—Table 3 shows that close to 50% of Pacific drinkers had
felt the effects of alcohol (at least once in the previous 12 months) after
drinking the night before. Moreover, close to 30% of Pacific male and female
drinkers were unable to remember some of their actions while drinking; around
25% of Pacific male and 16% of Pacific female drinkers got drunk when there was
an important reason to stay sober; around 20% of Pacific male and female
drinkers had a serious argument after drinking; 15% of Pacific male and 11% of
Pacific female drinkers got into a physical fight because of their drinking, and
11% of Pacific male and 8% of Pacific female drinkers reported staying
intoxicated for several days.
The 2000 NAS showed that 55% of male and 45% of female
drinkers felt the effects of alcohol after drinking the night before; 21% of
male and 15% of female drinkers were unable to remember their actions after
drinking; 8% of male and 5% of female drinkers got drunk when there was an
important reason to stay sober; 12% of male and 8% of female drinkers had a
serious argument after drinking; 5% of male and 3% of female drinkers had a
physical fight because of their drinking; and 4% of male and 2% of female
drinkers stayed intoxicated for several days in the previous 12
months.
DiscussionThe
2003 Pacific Drugs and Alcohol Consumption
Survey study is important for several reasons. Firstly, it is the first
nationally representative survey of the alcohol consumption patterns of Pacific
peoples in Aotearoa (New Zealand); secondly, the sample size is large enough to
test for differences across gender and age groups; and thirdly, the similarity
in methodology with the 2000 NAS has allowed for some descriptive comparisons to
be made.
PDACS 2003 has shown that Pacific male drinkers tended to
consume more alcohol annually than Pacific females drinkers apart from the
18–20 and 35–44 year aged groups where both sexes consumed similar
annual amounts. In general, Pacific drinkers aged 18–20, 21–29, and
30–34 consumed more alcohol annually than their 13–17, 35–44,
45–54, and 55–65 age groups. The finding that males tended to
consume more alcohol than females, and younger age groups consumed more alcohol
than older age groups, is common to most populations (including the general New
Zealand population.
The main findings were that the proportion of Pacific
drinkers is less than the proportion of drinkers in the general New Zealand
population. Forty-three percent of Pacific peoples abstained from drinking
alcohol (during the previous year) compared to 15% of the general New Zealand
population. However, Pacific drinkers consumed larger annual volumes of absolute
alcohol and higher quantities of absolute alcohol (on a typical occasion) than
general New Zealand population drinkers.
The lower proportion of drinkers among Pacific peoples may
be a result of alcohol not existing in the Pacific Islands prior to first
contact with Europeans and due to the fact that the acceptability of drinking
alcohol within Pacific cultures is low. Large quantities of alcohol being
consumed on a typical occasion is similar to findings from qualitative
research.10
Previous research has concluded that alcohol plays a social
role similar to that of food in Pacific societies. Like food, alcohol brings
people together and as such alcohol is drunk in groups with a generous quantity
of alcohol available because the quantity of alcohol represents the generosity
of the group towards its members.11 And just
like food, alcohol is usually consumed until a person is full or until it is
finished.11
Compared to general New Zealand population drinkers, higher
proportions of Pacific drinkers reported occasions of being in physical fights,
having serious arguments, staying intoxicated for several days, and getting
drunk when there was an important reason to stay sober (as a result of their own
drinking). However, the proportions of Pacific drinkers who reported feeling the
effects of alcohol the next day and while at work, study, or doing household
duties was similar to the proportions reported by general New Zealand population
drinkers.
In addition, compared to the general New Zealand population,
higher proportions of Pacific peoples reported being involved in motor vehicle
accidents, other accidents that caused serious injury and physical assaults (as
a result of other people’s drinking).
The 2003 PDACS and the 2000 NAS differ in some of their
methodology. The 2000 NAS did not have a CACI sampling frame so only those
households with land-line telephones were interviewed. However, previous
research has indicated that alcohol measures for the general New Zealand
population are not affected by the absence of non-telephone households in the
survey (as land-line telephone ownership is
high).12 In order to achieve a sufficient
sample of Pacific peoples in PDACS, three sampling approaches were used. While
each had its limitations, the combination of the three provided a reasonably
representative sample.
The PDACS interview schedule included very similar
questions, and the CATI interview process was identical. Details about the
measures obtained and the CACI interviewing procedure are available in
previously published material.1,13
We must also take care when making comparisons between the
2003 PDACS and the 2000 NAS because (as previously mentioned) there were some
differences in measures between the two surveys. The main difference in measures
was the addition of celebrations as a location where alcohol was drunk.
Celebrations were included given the known importance of this location for
Pacific drinkers. An artefact of the inclusion of this location may be an
increase in consumption measures. However, celebrations accounted for only 4% of
the total volume of annual alcohol consumed for Pacific drinkers (2% for males
and 5% for females) and therefore it is unlikely that the inclusion of this
location is responsible for the large differences seen in annual consumption and
typical occasional quantity between Pacific drinkers and general New Zealand
population drinkers.
The 2000 NAS is the most current available data that is
comparable to the PDACS, but the 2003 alcohol environment was different compared
to 2000 because there was approximately 6% more total alcoholic beverage
available for consumption14 and this needs to
be considered when interpreting differences. Finally, comparison with data from
the Auckland-only sample of Pacific drinkers collected in the 1990s showed
similar levels of consumption.
In conclusion, we are confident that (compared with the
general New Zealand population) these findings show that relatively fewer
Pacific peoples drink alcohol, although those who do drink consume larger annual
amounts of absolute alcohol and quantities of absolute alcohol on a typical
occasion.
Indeed, that finding coupled with the measures of
self-reported harm show that Pacific peoples’ drinking patterns are more
harmful (both to themselves and others) than those of the general New Zealand
population.
Author information:
John Huakau, Pacific Postdoctoral Fellow; Lanuola Asiasiga, Researcher; Michael
Ford, Statistician; Megan Pledger, Statistician; Sally Casswell, Director,
Centre for Social and Health Outcomes Research and Evaluation (SHORE), Massey
University, Auckland; Tamasailau Suaalii-Sauni, Director; Ieti Lima, Director,
Pacific Research & Development Services Ltd, Auckland.
Acknowledgements: We
thank the Public Health Intelligence group of the Ministry of Health as well as
the Ministry of Pacific Island Affairs for their funding of the PDACS. We also
thank the CATI and CACI interviewers and supervisors and the Pacific peoples for
their participation in the survey.
Correspondence: Dr
John Huakau, SHORE, PO Box 6137, Wellesley Street, Auckland. Fax: (09) 366 5149;
email: j.t.huakau@massey.ac.nz
References:
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