Declines in alcohol consumption in Australia: some challenges to the theory of collectivity

Abstract

Background and Aims There is significant debate about whether or not changes in per‐capita alcohol consumption occur collectively across the entire distribution of drinking. This study used data from a decade of declining drinking in Australia to test the collectivity of drinking trends. Design Repeated cross‐sectional surveys (2010, 2013, 2016, 2019), analysed with quantile regression techniques assessing trends in drinking for 20 quantile groups. Setting Australia. Participants A general population sample (total n = 85 891; males = 39 182, females = 46 709) aged 14 years and over. Measurements Past‐year volume of alcohol consumed was measured using standard graduated frequency survey questions. Models were stratified by sex and age group. Findings Throughout the whole population, alcohol consumption had declined in all percentile groups, with the largest proportional declines evident for light and moderate drinkers [e.g. drinkers in the 25th percentile declined by 32.7%; 95% confidence interval (CI) = ‐41.6, ‐22.3% per wave]. Broadly collective declines were also found for younger men and women with significant declines in every percentile group, but older groups showed some evidence of polarization. For example, women aged 45–64 years significantly increased their consumption (2.9% per wave, 95% CI = 0.3–5.5%), while consumption for those in the 25th percentile fell significantly (‐16.7%, 95% CI = –27.6, ‐4.2%). Conclusions The declines in Australian drinking since 2010 have included important deviations from the collectivity predicted by Skog's influential theory of collectivity of drinking, with markedly different patterns evident among different demographic groups.

Cross‐sectional survey of a convenience sample of Australians who use alcohol home delivery services

“…The survey comprised 29 questions adapted from Mojica‐Perez et al [10], Jones et al [16] and bespoke questions specifically for this study. Questions were separated into three sections: (i) alcohol consumption; (ii) use of online alcohol home delivery services; and (iii) last online alcohol delivery order (for full survey instrument, see Appendix S2).…”

“…This study builds on a report from Mojica‐Perez et al [10] who surveyed Australians who use alcohol home delivery services. As that study was conducted prior to the COVID‐19 pandemic and subsequent rise in online alcohol retail sales in Australia [18], our study seeks to update understanding of how and why people now use these services.…”

“…Such circumstances could increase short‐term harms (such as accidents or violence) by increasing intoxication that would have otherwise not occurred, in addition to the long‐term harms associated with increased alcohol consumption. While research into online alcohol sales and home delivery is limited, the research conducted to date has found that the use of alcohol delivery services, particularly fast delivery services, may be associated with risky drinking behaviour [10, 11]. For example, a 2019 survey of a convenience sample of 528 Australians who use alcohol home delivery services, found that participants using fast delivery services generally drank more heavily than those who used slower delivery services (e.g., 28% of participants who used fast delivery services reported weekly consumption of ≥11 standard drinks in a single occasion, compared with only 10% of participants who used slower delivery services) [10].…”

Sixteen-year trends in multiple lifestyle risk behaviours by socioeconomic status from 2004 to 2019 in New South Wales, Australia

“…The prevalence of insufficient physical activity has also decreased, albeit slightly, in Australia in the last two decades [40]. Alcohol consumption has declined significantly over the last few decades in the Australian population overall [41], particularly in the younger adult population and among relatively light drinkers in the past decade [42]. There has been a decline between 1997 and 2018 in per capita volume sales of SSBs in Australia, mostly due to a fall in volume sales of sugar-sweetened carbonated soft drinks, suggesting a decline in the sugar contribution of SSBs to the Australian diet [43].…”

Young people with prior health service contacts have increased risk of repeated alcohol‐related harm hospitalisations

“…In Australia, those aged 13–17 years with mental health issues were four times more likely to have been drinking at harmful levels in the last 30 days [11]. Despite recent collective declines in adolescent drinking trends in Australia [12], it does not appear to have corresponded in a shift towards healthier behaviours [13]. In addition, the number of young people aged 15–24 years abstaining from alcohol has increased (26.1% in 2013 to 32.5% in 2019), while little has changed in the proportion of risky drinking.…”