1. Female heavy drinkers in Glasgow and Edinburgh- similar but different
Jan Gill 1, Jonathan Chick1,
Heather Black1, Jane Doogan1, Christine Galloway1,
Rebecca Lawrence2, Helene Leslie2, Fiona O’May1,
Barbara McPake1, Cheryl Rees1, Robert Rush1,
Frances Skelton3, Iain Smith3.
1Queen Margaret University, 2NHS Lothian, 3NHS Greater Glasgow,
Background:
Alcohol-related deaths for women in Scotland are 1.75 times those reported for women in England and Wales (Beeston et al, 2013) and in actually exceeded those of men in England and Wales. According to the Scottish Health Survey as many as 13% of women exhibited signs of a possible alcohol use disorder according to their scores on the Alcohol Use Disorders Identification Test (AUDIT) screening tool (Scottish Government, 2012). While heavy drinkers are inevitably linked to a large proportion of the societal cost of alcohol misuse, these drinkers are poorly described by most national surveys for they can be difficult to reach and consequently, by default, are frequently excluded from participation in research monitoring population alcohol consumption.
Aims;
To describe and quantify the beverages (type, cost and place of purchase) consumed by female medical in-patients identified as having alcohol problems, and attenders and admissions at alcohol-problems clinics, according to their self report.
Methods:
Baseline data were collected by questionnaire at interviews with in-patients hospitalised with alcohol problems and out-patients attending alcohol treatment clinics within NHS settings in Edinburgh and Glasgow. Last (or typical) week’s beverages consumed, brand, purchase volume, price paid, and where purchased were documented. Participants were asked to self-complete the Alcohol Related Problems Questionnaire (ARPQ). This is an eleven point questionnaire used to assess severity of alcohol related harm. Scores can range from zero to eleven with the highest indicating greatest harm. Other details recorded included age, gender and postcode, the latter acting as a proxy for socioeconomic status using the Scottish Index of Multiple Deprivation (The Scottish Government, 2012).
Findings:
Among female participants (N= 181) median consumption was UK units (1 UK unit = 8 g of ethanol), with 97.5% of purchases from off-sale settings. The characteristics of the participants in each city are summarized in Table 1 below.
Table 1
Total female sample
Edinburgh
Glasgow
City comparison N
181 97 84
Age (years)
mean (SD)
44.47 (10.9)
45.0 (11.8)
43.8 (9.9)
n.s.
Cigarettes smoked per day
Mean (SD)
13.1 (13.6)
10.9 (11.7)
15.7 (15.1)
p = 0.018
Number of days spent dinking in ‘typical’ or last week.
6.4 (1.4)
6.3 (1.5)
6.5 (1.3)
Total UK units consumed in the week
Median (IQR)
179.7 (162.4)
136.5 (151.6)
186.0 (167.1)
p = 0.02
UK Unit price paid.(pence)
40.0 (17) )
39.0 (16)
Total expenditure in the week (£)
62.5 (54.1)
49.9 (52.8)
74.6 (54.4)
p = 0.006
Total score in ARPQ
7.0 (4.0)
6.0 (4.0)*
8.0 (3.0)
P < 0.001
Total % units purchased as any off sales in the week
97.5 (11.4)
96.4 (14.7)
98.9 (5.0)
The distribution of drinks purchased in each city is illustrated in figure 2 and again vodka is the most popular choice. There was no significant difference in price paid for vodka between the two cities . For fortified wine (sherry etc) 99% was purchased in Glasgow. In the case of white cider equal numbers of drinkers were located in each city.
Figure 2
Figure 4
In both cities the vast majority of purchases were from off-sale outlets. In Edinburgh, over one half of these units were purchased from supermarkets, while in Glasgow this percentage of purchases was linked to independent local shops and licensed grocers (See figure 3).
An important distinction between the two samples is SIMD profile (See figure 4). Almost two thirds (65.5%) of Glasgow women belonged to SIMD quintile 1 (the most deprived).
* 3 Edinburgh women did not complete ARPQ
Women in Glasgow did not differ from their Edinburgh counterparts in terms of mean age, number of days spent drinking in the week, the median price paid per unit of alcohol or a preference for Off-sale outlets. However significant differences between the two groups were evident in terms of mean number of cigarettes smoked per day, total units of alcohol consumed per week, total expenditure in the week and total score in the ARPQ.
White cider, white wine and vodka accounted for the majority of units purchased with vodka alone accounting for 40.5% of all units consumed (See figure 1).
Conclusions:
A median consumption of 180 UK units per week is in sharp contrast to the definition of harmful levels for women of exceeding 35 units per week adopted in the Scottish Health Survey (2012).
The popularity of the spirit drink vodka in both cities is consistent with the findings for the general population and highlighted by Beeston et al. (2013); viz. In Scotland 2.4 times more vodka is sold off-trade at between pence per unit than in England and Wales.
While we detected no difference in the price paid per unit for alcohol in each city, the amount consumed, cigarette use, ARPQ score and the most popular location of purchase did vary between cities.
A clear distinguishing feature of the two samples is evident in relation to SIMD profile
Figure 3
Figure 1
References:
Beeston, C, Reid, G, Robinson, M Craig, N, McCartney, G, Graham, L and Grant I. Monitoring and Evaluating Scotland’s Alcohol Strategy. Third Annual Report. Edinburgh: NHS Health Scotland; 2013.
Scottish Government. Scottish Health Survey: reports and Publications [online]
Available at:
Accessed 10th April 2014 
Scottish Government The Scottish Index of Multiple Deprivation. Web Portal available at
Accessed 10th April 2014
Poster designed by Elspeth Talbot, Media Services, Queen Margaret University, Edinburgh