ALCOHOL

Definition

This topic refers to the consumption of alcoholic drinks, and focuses on two aspects of consumption:

• intake of alcohol
  • derived from information about the types and quantities of alcoholic drinks (including homemade wines and beers) consumed on the three most recent days, in the week prior to interview, on which alcohol was consumed
  • refers to the quantity of alcohol contained in any drinks consumed, not the quantity of the drinks themselves
  • is used to determine long-term/lifetime risk of alcohol consumption.
• the frequency of consuming 'at risk' amounts of alcohol in the previous 12 months
  • amounts are defined in terms of 'standard drinks', where an Australian Standard Drink contains 10 grams (equivalent to 12.5 mls) of alcohol
  • is used to determine short term/single occasion risk of alcohol consumption.

Population

Information was collected for persons aged 15 years and over in the NATSIHS.

Methodology

Intake of alcohol - Assessing long term/lifetime risk of alcohol consumption

Respondents were asked how long ago they last had an alcoholic drink. Those who reported they had a drink within the previous two weeks, were then asked about the day they consumed the most alcohol followed by the last three drinking days in the previous week (excluding the day on which the interview was conducted). For each of the drinking days on which respondents stated having drunk, the types and quantities (number and size) of drinks they had consumed were recorded. They were also asked whether their consumption in that week was more, about the same, or less than their usual consumption. Information was collected separately for the following categories of alcoholic drinks:

• beer
  • light beer
  • mid-strength beer
  • full-strength beer
• wine
  • red wine
  • white wine
  • low alcohol wine
  • champagne/sparkling wine
• ready to drink spirits/liqueurs
• liqueurs
• spirits
• fortified wine
• cider
• cocktail
• other alcoholic drinks.

More than one response was allowed.

If interviewers were unsure in which category a reported drink belonged, details were recorded in 'other alcoholic drinks' for checking/reclassifying as appropriate during later processing.

Respondents were asked to report the number of drinks of each alcohol type they had consumed, the size of the drinks, and where possible the brand name(s) of the drink(s) consumed on each of the most recent three days in the last week on which they had consumed alcohol. Interviewers were able to record this information by selecting from a list in a trigram coder or by recording the details for later coding during processing.

The collection of accurate data on quantity of alcohol consumed is difficult, particularly where recall is concerned, given the nature and possible circumstances of consumption. Interviewers were provided with extensive documentation and training to assist with recording of amounts consumed. Where possible, information was collected in terms of standard containers or measures; i.e. 10 oz glass, stubby, nip, etc. Where the size of the drink did not readily fit into the list provided to interviewers, they were asked to record as much information as necessary to clearly indicate the quantity.

Reported quantities of drinks consumed were converted to millilitres (mls) of alcohol present in those drinks, and then summed to the drink type, day, and week level as required. The methodology to convert drinks to mls of alcohol consumed is as follows:


This conversion was performed electronically, supported by clerical coding for cases which could not be coded automatically. From this, an average daily alcohol consumption item was derived. Two indicators of alcohol risk level were created from the average daily alcohol consumption item:

• average over the 1 to 3 days for which consumption details were recorded
• average over 7 days of the reference week, i.e. average consumption over 3 days x number of days consumed alcohol / 7.

Published alcohol data relating to lifetime risk are compiled using the 7 day average.

According to the average daily intake over the 7 days of the reference week, respondents' long term/lifetime risk levels were determined according to the National Health and Medical Research Council (NHMRC) alcohol consumption risk guidelines (see section below).

Where precise brand type of drink information was not recorded, default alcohol content values based on drink type were applied. These values are shown below:

Type of beverage Alcohol content / conversion factor Light beer 0.027 Mid-strength beer 0.035 Full-strength beer 0.049 Stout 0.058 Wine coolers 0.035 Low alcohol wines 0.090 Fortified wines 0.178 White wine 0.124 Red wine 0.133 Sparkling wine/champagne 0.133 Spirits 0.400 Liqueurs 0.200 Pre-mixed spirits (e.g. UDL) 0.050 Alcoholic cider 0.047 Extra-strong cider 0.075 Cocktails 0.315 Other alcoholic beverage 0.274

It is recognised that particular types or brands of beverage within each of these categories may contain more or less alcohol than indicated by the conversion factor; for example, full-strength beers are usually in the range 4% to 6% alcohol by volume. The factors are considered to be sufficiently representative of each category as a whole for the purposes of indicating relative health risk as appropriate to the aims of this survey. However, it should be noted that these categories, defined by the conversion factors used, may not reflect exact legal definitions.

In addition to the information about alcohol consumed in the previous week, respondents were asked how often they had an alcoholic drink in the last 12 months:

• every day
• 5 to 6 days a week
• 3 to 4 days a week
• 1 to 2 days a week
• 2 to 3 days a month
• about 1 day a month
• less often than 1 day a month.

Frequency of consuming 'at risk' amounts of alcohol - Assessing short term/single occasion risk of alcohol consumption

Respondents were asked the number of times they had the following number of standard drinks in a day in the last 12 months:

• 11 or more
• 7 or more
• 5 or more
• 3 or more.

The number of standard drinks per day is then used to calculate whether a respondent had consumed alcohol at a 'risky' level in the last 12 months according to the NHMRC short term/single occasion risk guidelines (see section below).

In addition to this, respondents were asked whether their consumption of alcohol had increased, decreased, or stayed about the same since the same time last year.

National Health and Medical Research Council (NHMRC) guidelines for consumption of alcohol

The 2012-13 NATSIHS reported alcohol risk based on both the 2001 and 2009 NHMRC alcohol consumption guidelines.

2001 NHMRC guidelines

The 2001 NHMRC guidelines for reducing long-term and short term health risks associated with alcohol consumption are as follows:

2001 NHMRC GUIDELINES Low risk Risky High risk Minimising risk in the longer term Males (on an average day) up to 4 standard drinks 5–6 standard drinks 7 or more standard drinks Females (on an average day) up to 2 standard drinks 3–4 standard drinks 5 or more standard drinks Minimising risk in the short term Males (on any day) up to 6 standard drinks 7–10 standard drinks 11 or more standard drinks Females (on any day) up to 4 standard drinks 5–6 standard drinks 7 or more standard drinks

2009 NHMRC guidelines

The 2009 NHMRC guidelines for reducing lifetime and single occasion health risks associated with alcohol consumption on any day are as follows:

	Does not exceed guidelines	Exceeds guideline
Guideline 1 - Lifetime risk	up to and including 2 standard drinks on average	more than 2 standard drinks on average
Guideline 2 - Single occasion risk	up to and including 4 standard drinks	more than 4 standard drinks
(a) For both males and females.

For more information see NHMRC alcohol guidelines.

Data items

The data items and related output categories for this topic are available in the Data Item List in the Downloads page of this product.

Interpretation

Points to be considered in interpreting data on alcohol consumption from this survey include:

• Some under-reporting of consumption, both in terms of persons identifying as having drank alcohol in the reference week, and in the quantities reported, is expected to have occurred. However, the under-reporting which has occurred does not invalidate the survey results as indicators of relative consumption levels (current and over time), and of the relative health risks of the consumption levels identified.
• The extent to which under-reporting has occurred and its effects on the accuracy of survey estimates are unknown.
• Respondents that reported having drank in the previous two weeks to interview were then asked to give the consumption details (type and amount of drink) for the day they drank the most. This information allowed for further reporting on binge drinking habits.
• Respondents were then asked to record all days in the previous week on which they had consumed alcohol, but details of consumption (type and amount of drink) were only collected for the three most recent days on which they had consumed alcohol. Due to the fact that more people were interviewed early in the week, this methodology may have resulted in the possibility that mid-week drinking occasions could be under-represented in the calculation of level of risk, and weekend drinking occasions could be over-represented.
• To assist users of the data, a 'Weekend Consumption Flag' has been derived to indicate whether consumption during the weekend (i.e. Friday, Saturday, Sunday) is fully, partly or not recorded in the data.
• It should be noted that whereas the NHMRC risk levels assume ongoing consumption at the levels reported, indicators derived in the 2012-13 NATSIHS relate to consumption during the reference week only and take no account of whether or not consumption in that week was more than, less than, or similar to usual consumption levels. In addition, this indicator takes no account of other factors related to health status, or other lifestyle behaviours which may influence the absolute level of personal health risk from drinking alcohol. While data may not reflect the usual drinking behaviour of the respondent at the individual level, at the population level this is expected to average out and be representative of the total population.
• Where quantities of alcohol consumed have been converted to standard drinks, a factor of 12.5 mls of pure alcohol per standard drink has been applied (equivalent to 10 grams of alcohol). This resulted in some persons having a record of 0 standard drinks because they consumed a very small amount of alcohol in the time period of interest.
• Whether alcohol consumption had increased, decreased or stayed the same since 12 months ago is based on self-perception.

Comparability with 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS)

The method of measuring alcohol percentage has been revised between the 2004-05 and 2012-13 NATSIHS. In the 2004-05 survey the percentage of alcohol allocated to wine, beer and champagne differed to those in the 2012-13 survey, and in some cases it was identified by the respondent in 2004-05. In addition, alcohol consumption was collected from persons 18 years and over in 2004-05, rather than any person 15 years and over as in the 2012-13 survey. The 2004-05 NATSIHS did not collect details of alcohol consumption for the day a respondent drank the most alcohol in the last two weeks. Despite these methodological differences the derived data items on lifetime and single occasion health risks are considered comparable.

Consideration should also be given to the social factors and general changes in health awareness which have occurred in the period between surveys which may have influenced the levels of reporting. Also, a new alcohol tax was introduced prior to the commencement of data collection for the 2012-13 NATSIHS. The introduction of this tax may have resulted in the alcohol in some drinks being reduced by some manufacturers. This reduction in alcohol changed the number of standard drinks in the container of that brand product.

Comparability with 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS)

Alcohol consumption was collected primarily for 3 most recent drinking days in the last week in the 2012-13 NATSIHS, whereas the 2008 NATSISS collected data on a usual drinking day. However, both surveys collected data on the day drunk the most in the last two weeks and specific items are available in the 2012-13 NATSIHS for comparisons with the 2008 NATSISS. However, differences in the approach taken to collect the specific details of alcohol consumed should be considered when comparing the data.

Comparability with 2011-12 National Health Survey (NHS)

Alcohol consumption questions in the 2012-13 NATSIHS are conceptually the same, and therefore are considered comparable to the 2011-12 NHS. Note that NHS did not specifically collect or identify data about the day drunk the most in the last two weeks.

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