Australia’s drinking culture is well documented. As we prepare for a warm weekend with summer fast approaching, millions of Australians will be considering their alcohol of choice to help them unwind at the end of the working week.
The Foundation for Alcohol Research and Education (FARE) found in their 2017 annual alcohol poll that the overwhelming majority, 78 per cent of Australians are concerned about excessive drinking and most (92 per cent) believe alcohol is linked to family and domestic violence.
Researchers, Helen O’Brien, Sarah Callinan, Michael Livingston, Joseph Doyle and Paul Dietze have just completed a highly-detailed report in which they examined population-level AUDIT scores and hazardous drinking in Australia over the period 2007 to 2016.
Various tools have been used to screen populations for harmful alcohol use, including the Alcohol Use Disorders Identification Test (AUDIT). The AUDIT is a simple, internationally validated and reliable method of screening for hazardous drinking and dependence, which has been used in a range of studies including surveys of general populations and clinical studies. The AUDIT has been found to have excellent sensitivity and specificity in many populations, and its use worldwide facilitates comparisons between countries.
While other studies have looked at general trends in alcohol consumption, the research team could find no contemporary peer-reviewed published studies of Australian AUDIT scores and the findings will serve as a benchmark for future research in this area.
An overall strength of this study is its large sample size (96,015 people) and its representativeness of the general population due to the sampling and weighting strategy used. Respondents ranged in age from 14 to 98 years.
The research found despite an overall decline in AUDIT scores over the survey period, nearly one-quarter of Australians reported hazardous drinking.
Australian alcohol consumption has changed significantly in recent years. Per capita alcohol consumption has been declining since around 2008, reaching a low in 2017 not seen since the early 1960s. Importantly, this decline has not been evenly distributed among the population.
More males screened positive for hazardous drinking than females and hazardous drinking was highest in males ages 18-24 and 24-29 years, and females aged 18-24 years.
The marked declines in hazardous drinking among young people (aged 14-17 years) are positive, but trends observed among those aged 40-59 and 60+ years suggests targeted interventions for older Australians are needed.
Historically, there has been a trend for older people’s consumption to decline. It has been postulated that female baby boomers may be bucking this trend, as this is the first female generation for whom it has been socially acceptable to drink alcohol frequently.
The research report says that although the changes among the older age groups are small, in a rapidly ageing population they are cause for concern. Older people have a reduced capacity to metabolize alcohol, even if their consumption remains the same, their risk may still increase.
Many theories have been postulated to explain the downward trends in alcohol consumption and hazardous use. Changing social norms, economic pressures, significant investments on health promotion and prevention programs, the effects of social media, changes in parenting practices, and an increased awareness of the detrimental health effects of alcohol are all proposed as explanations for the decline.
The report’s findings, while positive in places, highlights that alcohol continues to be a significant cause of morbidity and mortality, estimated to account for 4.6% of the total burden in Australia in 2011.
Aside from individual harm, there are significant social and economic costs and at a population level, any proposed protective health effects of alcohol are far outweighed by the negative effects. Harmful patterns of drinking have both acute and chronic health risks that are underestimated by individuals. What’s more, risky drinkers are more likely to believe they can consume excess alcohol without putting their health at risk than low-risk drinkers.
According to the researchers, ‘by applying the AUDIT to national survey data, we have demonstrated a relatively high burden of alcohol use disorders in the Australian population, making a robust case for strengthening preventative measures.’
‘Disaggregating the results by age and gender reveal several significant trends. Our results support the findings of other contemporary research in this area demonstrating the changing trends in alcohol habits in young people. There is a strong imperative to monitor these trends as it is likely that they will continue as this cohort ages, and so prevention programs and policy changes should be tailored to respond to these trends,
‘The rise in alcohol consumption that was seen in 2018 is not explored in this study, and therefore the results of the next wave of the Australian NDSHS are eagerly awaited.’
View the full article in the Australian and New Zealand Journal of Public Health: Population patterns in Alcohol Use Disorders Identification Test (AUDIT) scores in the Australian population; 2007-2016