All drinking is not equal: Drinking occasions as the unit of analysis for understanding alcohol consumption John Holmes Sheffield Alcohol Research Group, ScHARR, University of Sheffield

What alcohol consumption statistics don’t tell us How much drinking takes place at meal-times? Who pre-loads, when did it start and how has it changed over time? Have big nights out become less common, less intoxicated or otherwise changed? At what times does home drinking happen, does it vary across the week, are children present and in which families? How does Scotland’s drinking culture differ from England’s?

What do alcohol consumption data tell us about alcohol use? How much? How often? Where? When? Why? How? Who with? Alongside what?

The public health questions we cannot answer? Not just what works but… Why does it work? When do effects emerge and decay? For which people? In which settings? For which outcomes? Are there unanticipated or unintended consequences? How can we speak to political concerns?

The individualised model (A BRIEF CRITIQUE OF) The individualised model

What did you drink yesterday? vs.

Drinkers as decision-makers Substantial autonomy Predictable behaviour Within-individual determinants (e.g.) Values Goals Utilities Capabilities Motivations

Problems with the individualised model Modest predictive power Underwhelming interventions Responsibility and blame But policy implications are…. Straightforward Inexpensive Popular Ineffective(?)

Theories of social practice AN ALTERNATIVE APPROACH: Theories of social practice

From the actor to the action “A practice is a routinized type of behaviour which consists of several elements, interconnected to one another: forms of bodily activities, forms of mental activities, “things” and their use, a background knowledge in the form of understanding, know-how, states of emotion and motivational knowledge” Reckwitz A. Toward a Theory of Social Practices: A Development in Culturalist Theorizing, European Journal of Social Theory 2002: 5: 243–263.

What is a practice? Routinised behaviour: Often passive, unconscious or repeated Interconnected elements: Materials – drinks, glassware, televisions, dancefloors Meanings – sophistication, relaxation, transgression Competencies – managing tolerance, corkscrews, toasting Shove E., Pantzar M., Watson M. The dynamics of social practice: everyday life and how it changes London: Sage; 2012.

Five principles for using Social practice theory for quantitative study of drinking cultures

Our five proposed principles Drinking cultures are comprised of drinking practices British drinking culture Big nights out Drinks with friends Socialising at home Finnish drinking culture Big nights out Socialising at home Sauna drinking

Our five proposed principles Drinking cultures are comprised of drinking practices

Individuals’ drinking occasions are measurable performances of drinking practices Big nights out Drinks with friends Socialising at home

Our five proposed principles Drinking cultures are comprised of drinking practices Individuals’ drinking occasions are measurable performances of drinking practices

The unit of analysis is the practice (but individuals still matter) Person #1 Big night out Home alone Out for a meal Person #2 Big night out Drinks with friends

Our five proposed principles Drinking cultures are comprised of drinking practices Individuals’ drinking occasions are measurable performances of drinking practices The unit of analysis is the practice (but individuals still matter)

Practices are recognisable by the coming together of unique combinations of elements Big nights out Drinks with friends Socialising at home

Our five proposed principles Drinking cultures are comprised of drinking practices Individuals’ drinking occasions are measurable performances of drinking practices The unit of analysis is the practice (but individuals still matter) Practices are recognisable by the coming together of unique combinations of elements Drinking practices vary both in character and prevalence over time, space and social groups.

Summary of the argument Drinking cultures comprise drinking practices Practices comprise elements (e.g. locations, beverages meanings, skills) Drinking occasions and their characteristics given us insights into: The relationships between elements of drinking practices The types of practices which exist The prevalence of those practices Variation in practices and practice elements over time, place and social groups This gives us more detailed insights into how drinking varies across society and over time This promises new possibilities for epidemiology and prevention research.

Further information Email: john.holmes@sheffield.ac.uk Twitter: @JHolmesSheff and @SARG_ScHARR Google: Sheffield Alcohol Research Group Reading: Ally et al. (2016) 'Developing a social practice-based typology of British drinking culture in 2009-2011: Implications for alcohol policy analysis', Addiction, 111 (9), pp.1568-79 Meier et al. (2017) ‘All drinking is not equal: How a social practice theory lens could enhance public health research on alcohol’, Addiction, DOI:10.1111/add.13895