4th November 2011, Volume 124 Number 1345

Santosh Jatrana, Kristie Carter, Sarah McKenzie, Nick Wilson

There is good evidence that episodes of heavy alcohol consumption on single occasions (“binge drinking”) and not simply the total average consumption, play a key role in determining alcohol-related harm in a population.1-3 In New Zealand (NZ), the role of hazardous alcohol consumption in contributing a large morbidity and mortality burden is also well documented.2 4-8 To add to the understanding of the NZ situation, we report here on the largest NZ survey to date on alcohol usage.

Methods—We used data from Wave 3 (2004/05; SoFIE w1-7 data Version 1) of the longitudinal Survey of Family, Income and Employment (SoFIE), a survey of the adult NZ population that is described in detail elsewhere.9 But to summarise, the survey involves a nationally-representative sample with annual (computer-assisted) interviewing conducted in the home.

A total of 19,255 adults (85% of the original sample) responded to the health questionnaire at Wave 3. Of these (18,520; 96%) provided information on alcohol use. During the Wave 3 health module participants who had had a drink containing alcohol (one standard drink was defined as a can or small bottle of beer; a small glass of wine; a single nip of spirits) in the last 12 months were asked how many days in the last four weeks they had drank alcohol (i.e. frequency); and how many drinks containing alcohol they had consumed on a typical day when they were drinking. Participants were also specifically asked whether they had ever had more than eight (for men) or six (for women) standard drinks on one occasion and if so how many occasions in the last 4 weeks.

The frequency of binge drinking (defined here as drinking more than eight (for men) or six (for women) standard drinks on one drinking occasion) in those who reported drinking in the past 12 months was categorised as: never binge, binge monthly, binge two times per month, binge weekly and daily or almost daily binge drinking. Socioeconomic measures included employment status, highest reported education, area deprivation and individual-level deprivation (all measured at Wave 3). Although data are not weighted to represent the NZ population, however the SoFIE sample (at Wave 3) has similar age, sex and ethnicity distribution to the NZ population.

Table 1. Demographic and socioeconomic characteristics of the SoFIE-Health study population with regard to any alcohol use and binge drinking pattern*
Variables
Number of respondents
Never drink
Drink but never binge
Binge monthly
Binge twice per month
Binge weekly
Bingedaily /almost daily
N
row %
row %
row %
row %
row %
row %
All
18520
18.3
60.1
7.7
4.5
5.5
3.8
Sex
Women
Men

9990
8530

21.6
14.5

62.3
57.6

6.7
8.9

3.4
5.9

3.9
7.4

2.2
5.7
Age group (years)
15–24
25–34
35–44
45–54
55–64
65+

2980
2600
3660
3420
2705
3155

21.0
13.7
14.3
17.1
17.4
26.3

43.5
52.5
60.2
64.0
69.9
69.4

10.4
13.3
10.1
7.0
4.6
1.4

6.9
7.5
5.5
3.9
2.6
1.1

10.7
8.5
6.0
4.5
3.1
0.8

7.4
4.6
4.0
3.5
2.2
1.1
Ethnicity
NZ European
Māori
Pacific
Asian
Other

14060
2250
825
960
420

12.8
22.9
55.2
51.6
31.0

65.8
44.9
29.1
43.8
52.4

7.7
12.0
5.5
2.1
4.8

4.7
5.8
3.0
1.0
3.6

5.4
8.7
4.8
1.0
4.8

3.7
6.0
2.4
0.5
3.6
Marital status
Divorced/widowed/separated
Married
Never married

3215
9560
5735

22.1
17.3
17.9

61.1
67.0
48.0

6.1
6.4
10.8

3.4
3.4
7.1

4.0
3.7
9.5

3.1
2.2
6.7
Maximum education qualification
Degree or higher
Post school vocational
School qualification
No qualification


2610
6285
4160
4635


14.6
13.2
14.2
27.6


66.9
63.9
56.7
55.4


7.5
8.6
9.9
5.5


4.2
4.8
6.4
3.2


4.6
5.7
7.8
4.3


2.3
3.8
5.2
3.9
Labour market activity
Working
Unemployed
Inactive

11990
350
6170

11.7
21.4
30.9

61.4
51.4
58.2

9.7
10.0
3.8

5.6
4.3
2.4

7.0
7.1
2.5

4.5
4.3
2.2
Deprivation (small area)
NZDepQ1 (least deprived)
NZDepQ2
NZDepQ3
NZDepQ4
NZDepQ5 (most deprived)

3805
3760
3395
3940
3620

11.0
13.4
17.2
20.2
29.8

68.1
66.1
59.9
58.4
47.4

7.8
7.0
8.7
7.4
7.7

4.5
4.8
5.2
3.9
4.4

5.7
5.2
5.3
6.0
5.7

2.9
3.5
3.5
4.2
4.8
Deprivation – individual level (NZiDep)
0 measure of deprivation
1 measure
2 measures
≥3 measures


13340
2785
1105
1275


15.9
23.2
23.5
28.6


63.7
52.6
50.7
47.5


7.3
8.8
8.6
9.0


4.5
4.8
4.5
4.3


5.2
6.5
7.2
5.5


3.4
4.1
5.4
5.1
Notes: * For the past 12 months, results are unweighted and unadjusted (see main text for details); All numbers of respondents presented in this paper are random rounded to the nearest multiple of five, with a minimum value of 5, as per Statistics New Zealand protocol. Row percentages may not always add up to 100% because of rounding or missing values.

Results & Discussion—Table 1 presents the demographic and socioeconomic characteristics of the study sample in the five categories of binge drinking and never drinkers. Notable findings are that:

  • Binge drinking was more common in men than women (monthly, weekly and daily levels). Women were more likely to abstain.
  • Binge drinking was particularly frequent in the 15–24 age-group. There was a decline in binge drinking (across all frequencies) with increasing age.
  • All non-NZ European ethnic groups reported more abstention than NZ European. Correspondingly non-NZ European ethnic groups reported lower levels of drinking, in particular “never binge” in the last 12 months than the NZ European group. Māori respondents reported high levels of binge drinking at the monthly, weekly and daily levels compared to other ethnic groups.
  • Binge drinking was more common in those reporting being “never married”, compared to the other relationship categories.
  • Frequency of binge drinking generally increased as educational level declined. This was a consistent pattern for the first three educational categories listed in the table (for monthly, weekly and daily levels), but the pattern was more mixed for when considering the “no qualification” group. The pattern by work status was also mixed, but with some indication of a higher frequency of daily binge drinking in the working vs unemployed groups.
  • The patterns for both area and individual-level deprivation were generally mixed. Nevertheless, there was a clear gradient for increasing daily binge drinking frequency with each increment in greater area deprivation. There was a similar pattern for individual-level deprivation.

These patterns are generally consistent with previous (albeit smaller) NZ national surveys. For example, a national survey in 2007/08 found that most (61.6%) NZ drinkers consumed more than six (for men) or four (for woman) standard drinks at least once in the previous year, with 12.6% consuming similar amounts in a single drinking occasion at least weekly in the previous year.10 It reported that: “youth, Maori men and women, Pacific men, and people living in more deprived neighbourhoods were more likely to drink higher amounts than recommended, to engage in risky drinking behaviours, and to experience more harm due to alcohol use”. A similar survey in 2004 also reported that 14.7% of adults consumed large amounts of alcohol at least once a week (as per the level of standard drinks in the 2007/08 survey).11 Hazardous drinking patterns were more common for men, young adults, and Māori vs non-Māori.

The 2006/07 NZ Health Survey reported a hazardous drinking pattern for 21.1% of adults, with relatively more hazardous patterns for: men, 18-24 year olds, Māori, Pacific peoples, and with increasing area deprivation (statistically significant for both sexes).12 An earlier national health survey reported a lower hazardous drinking pattern for 17.2% of adults. There were relatively more hazardous patterns for: men, 15-24 year olds and Māori (a gradient for increasing area deprivation was suggestive, but not statistically significant).13 The earlier national health survey in 1996/97 reported similar levels of hazardous drinking in adults, but there was evidence for an increase since this time for Māori men.12

The role of these demographic and socioeconomic factors in causal pathways that result in binge drinking are not detailed here. Such information may follow from additional analyses of subsequent waves of SoFIE-Health data. Nevertheless, for policy-makers who wish to address the hazardous drinking situation in NZ, it is likely that successful control measures will tend to reduce gender, ethnic and socioeconomic inequalities in health.

NZ has a good evidence base upon which to improve alcohol control in the form of a major Law Commission Report14 and a large body of local research (some summarised recently15). A subsequent Select Committee process occurred and a Report for Parliament produced, but it is unclear what will happen with this process given the failure of legislative action prior to the 2011 election. Furthermore, key components of the Law Commission’s recommendations were missing from the Select Committee’s Report (e.g., higher alcohol taxes, lower drink driving levels, and major restrictions on marketing). Criticisms of the limited response by the Government have been published,16 15 and the lack of action contrasts with high public support for improved policies around access to alcohol and enforcement of alcohol-related laws.17 In particular, the lack of action on higher alcohol pricing is not consistent with the evidence for this being the most effective18 and cost-effective intervention to reduce alcohol-related harm.19 20

In summary, this large national survey extends previous research to indicate that binge drinking is relatively prevalent in the NZ population and affects all population groups. That said, hazardous drinking patterns are particularly prevalent in: men, young adults, Māori, and (to a variable extent) higher deprivation groups. So improved policy-making for alcohol control will benefit the whole of society and may also contribute to reducing gender, ethnic and socioeconomic inequalities in health in this country.

Author Information

Santosh Jatrana1, Kristie Carter2, Sarah McKenzie2, Nick Wilson2. 1. Alfred Deakin Research Institute, Deakin University, Victoria, Australia. 2. Department of Public Health, University of Otago, Wellington, New Zealand

Correspondence

Kristie Carter

Correspondence Email

kristie.carter@otago.ac.nz

References

  1. Bobak M, Room R, Pikhart H, et al. Contribution of drinking patterns to differences in rates of alcohol related problems between three urban populations J Epidemiol Comm Health 2004;58:238-42.
  2. Connor J, Broad J, Rehm J, et al. The burden of death, disease, and disability due to alcohol in New Zealand. NZ Med J 2005;118(1213):1412.
  3. Rehm J, Gmel G, Sempos CT, Trevisan M. Alcohol related morbidity and mortality. Alcohol Research and Health 2003;27:39-51.
  4. Connor J, You R, Casswell S. Alcohol-related harm to others: a survey of physical and sexual assault in New Zealand. NZ Med J 2009;122(1303):10-20.
  5. Huckle T, Huakau J. Young People and Drinking in New Zealand 2004. Auckland: Centre for Social and Health Outcomes Research and Evaluation and Te Ropu Whariki, Massey University, 2005.
  6. Huckle T, Pledger M, Casswell S. Trends in alcohol-related harms and offences in a liberalized alcohol environment. Addiction 2006;101(2):232-40.
  7. Kypri K, Paschall MJ, Langley J, et al. Drinking and Alcohol-Related Harm Among New Zealand University Students: Findings From a National Web-Based Survey. Alcoholism: Clinical and Experimental Research 2009;33(2):307-14.
  8. Wilson N, Imlach Gunasekara F, Thomson G. The benefits and harms of alcohol use in New Zealand: what politicians might consider. NZ Med J 2011;124(1336):85-9.
  9. Carter K, Cronin M, Blakely T, et al. Cohort profile: Survey of Families, Income and Employment (SoFIE) and Health Extension (SoFIE-health). Int J Epidemiol 2009;39(3):653-59.
  10. Ministry of Health. Alcohol Use in New Zealand: Key results of the 2007/08 New Zealand Alcohol and Drug Use Survey. Wellington: Ministry of Health, 2009.
  11. Ministry of Health. Alcohol Use in New Zealand: Analysis of the 2004 New Zealand Health Behaviours Survey – Alcohol Use. Wellington: Ministry of Health. http://www.moh.govt.nz/moh.nsf/indexmh/alcohol-use-in-new-zealand-2004, 2007.
  12. Ministry of Health. A Portrait of Health: Key Results of the 2006/07 New Zealand Health Survey. Wellington: Ministry of Health. http://www.moh.govt.nz/moh.nsf/indexmh/portrait-of-health, 2008.
  13. Ministry of Health. A Portrait of Health: Key results of the 2002/03 New Zealand Health Survey. Wellington: Ministry of Health. http://www.moh.govt.nz/moh.nsf/pagesmh/3333, 2004.
  14. New Zealand Law Commission. Alcohol in Our Lives: Curbing the Harm (NZLC R114). Wellington: New Zealand Law Commission. http://www.lawcom.govt.nz/project/review-regulatory-framework-sale-and-supply-liquor/publication/report/2010/alcohol-our-lives, 2010.
  15. Wilson N, Imlach Gunasekara F. National alcohol plans. New Zealand's alcohol plan is less than "half hearted". BMJ 2011;342:d2147.
  16. Kypri K, Maclennan B, Langley JD, Connor JL. The Alcohol Reform Bill: more tinkering than reform in response to the New Zealand public's demand for better liquor laws. Drug Alcohol Rev; 2011;30(4):428-33.
  17. Maclennan B, Kypri K, Langley J, Room R. Public sentiment towards alcohol and local government alcohol policies in New Zealand. Int J Drug Policy 2011;[E-publication 8 July].
  18. Wagenaar AC, Tobler AL, Komro KA. Effects of alcohol tax and price policies on morbidity and mortality: a systematic review. Am J Public Health 2010;100(11):2270-8.
  19. Cobiac L, Vos T, Doran C, Wallace A. Cost-effectiveness of interventions to prevent alcohol-related disease and injury in Australia. Addiction 2009;104:1646-55.
  20. NICE (National Institute for Health and Clinical Excellence). Alcohol-use disorders: preventing the development of hazardous and harmful drinking (NICE public health guidance 24) London: NICE.http://www.nice.org.uk/nicemedia/live/13001/48984/48984.pdf, 2010.