Drinking alcohol at home feels different from drinking in public places: a qualitative study of midlife Australians

This paper shows how drinking in one's own home affords different affective experiences to drinking in public settings such as bars, pubs and restaurants. A thematic analysis of interviews with 40 Australians aged 30-65 identified three main variations in alcohol-associated feelings, sensations and urges. Alcohol was used at home to decelerate, but in contrast, people were enlivened when drinking in public venues. Drinking in public generated a sense of vigilance and greater requirement to self-monitor than usually felt necessary at home. For some, drinking at home seemed more habitual; governed by urges rather than intentionality, than drinking outside it did. Policy and interventions that target drinking in the home should be prioritised, such as those focussed on off-premise pricing and availability.

Risk and restraint-The key to understanding the decreasing use of alcohol for young people in high income countries?

INTRODUCTION

In this article we seek to understand the changing social position of alcohol use for young people in Australia by identifying how alcohol has become framed as posing a significant risk to their bodies and futures.

METHODS

Forty interviews were conducted with young people aged 18-21 years from Melbourne, Australia, who had previously identified as light drinkers or abstainers. Drawing on insights from contemporary sociologies of risk, we explored how risk was discussed as a governing concept that shaped young people's views of alcohol, and how it encouraged or necessitated risk-avoidance in daily life.

RESULTS

Participants drew on a range of risk discourses in framing their abstention or moderate drinking along the lines of health, wellness, wisdom and productivity. They reiterated social constructions of heavy or regular alcohol use as irresponsible, threatening and potentially addictive. The focus on personal responsibility was striking in most accounts. Participants seemed to have routinised ways of practicing risk avoidance and coordinated drinking practices with other practices in their everyday life, with alcohol therefore 'competing for time'.

DISCUSSION AND CONCLUSIONS

Our findings endorse the idea that discourses of risk and individual responsibility shape the contemporary socio-cultural value of alcohol for young people. Risk avoidance has become routine and is manifested through the practice of restraint and control. This appears particular to high-income countries like Australia, where concerns about young people's futures and economic security are increasing, and where neoliberal politics are the foundations of governmental ideology.

'I just wanted a change, a positive change': Locating hope for young people engaged with residential alcohol and drug services in Victoria, Australia

In this article, we investigate young people's involvement with residential alcohol and other drug (AOD) services as part of their broader engagement with hope. This study draws on qualitative interviews conducted with 20 young people aged 17-23 from Victoria, Australia, who were either in, or had recently left, residential AOD services. Interviews explored their experiences with AOD services and included questions about their hopes for the future. We found hope located in social relationships, productive discourses and AOD settings themselves. Hope also presented differently according to the external resources young people had available to them, giving some young people greater capacity to action their hoped-for futures than others. Given many young people seek reimagined futures as part of their use of residential AOD services, this creates a valuable opportunity for services to help shape achievable hopes and boost service engagement. We suggest that hope can materialise in a variety of ways but caution against relying on it as a motivational strategy without providing young people with other resources. A more sustainable narrative of hope may require a solid foundation of resources, allowing young people with AOD problems to gain a sense of control over their lives and their imagined futures.

Social and contextual factors associated with drinking before, during and after watching Australian Football League games: A pilot ecological momentary assessment study

INTRODUCTION

The aim of this study was to: (i) determine the feasibility of using ecological momentary assessment to collect data from Australian Football League (AFL) fans; (ii) explore pre-game, during-game and post-game consumption patterns of AFL fans; and (iii) explore the social and setting-related factors associated with risky single occasion drinking (5+ drinks) among AFL fans.

METHODS

Thirty-four participants completed up to 10 ecological momentary assessment surveys before, during and after 63 AFL games (n = 437 completed surveys). Surveys collected data about their drinking, and their social and environmental milieu (e.g., location, company). Binary logistic regression analyses clustered by participant identified which game-day characteristics were associated with higher odds of risky single occasion drinking. Significant differences between pre-game, during-game and post-game drinking on social and environmental factors were explored using pairwise comparisons.

RESULTS

Risky single occasion drinking was more likely when games began in the early-afternoon (1-3 pm) than late-afternoon (3-6 pm), when participants watched the game at a stadium or pub compared to home, and when participants watched the game with friends compared to family. Pre-drinking was more likely before night games and post-drinking was more likely after day games. Drinking during the game was heavier when watching the game at a pub and when watching with a combined group of friends and family.

DISCUSSION AND CONCLUSIONS

Preliminary findings suggest that social and contextual factors matter in the way alcohol is consumed while watching AFL games. These findings require further investigation in larger samples.

Who supports drug-checking services in Australia? An analysis of 2019 National Drug Strategy Household Survey data

INTRODUCTION

Drug-checking services can minimise the potential harms from drug use and have received increased attention in recent policy debates in Australia. In this brief report, we aim to better understand the prevalence of support for drug-checking services among individuals of certain demographic groups, social status and social attitudes towards drug and alcohol policy.

METHODS

This report uses data from the 2019 National Drug Strategy Household Survey, a national population study of alcohol and other drug use conducted triennially in Australia. We examined support for drug-checking services descriptively, alongside associations between demographic, social and substance use variables and support of drug-checking using Generalised Linear Model analyses with a Poisson distribution and log link.

RESULTS

Overall, 56% of the sample supported policies related to drug-checking services. Support was highest among those aged 25-34 years (62%), most socioeconomically advantaged (66%), with an income over $104,000 (64%), with a bachelor's degree or higher (65%), living in major cities (58%), recent consumers of commonly tested drugs (88%) and other drugs (77%), and risky drinkers (64%). In the multivariable model, those who were younger, women and had the highest level of education were more likely to support the policy compared to those who were aged 55+ years, men and had lower levels of education.

DISCUSSION AND CONCLUSION

This report highlights that, while there were different degrees of support based on demographic characteristics, substance use status and social attitudes towards drug and alcohol policy, the overall majority of the sample supported the provision of drug-checking services.

"There's a lot of stereotypes going on": A cross-national qualitative analysis of the place of gender in declining youth drinking

INTRODUCTION

Significant declines in drinking among young people have been recorded in many high-income countries over the past 20 years. This analysis explored the role of gender - which we interpret as socially constructed and relational - to provide insight into whether and how gender might be implicated in declining youth drinking.

METHODS

Interview data from four independent qualitative studies from Australia, Denmark, Sweden and the UK (n=194; participants aged 15-19 years) were analysed by researchers in each country following agreement about analytical focus. Findings were collated by the lead author in a process of 'qualitative synthesis' which involved successive rounds of data synthesis and feedback from the broader research team.

FINDINGS

Our analysis raised two notable points in relation to the role of gender in declining youth drinking. The first concerned the consistency and vehemence across three of the countries at which drinkers and states of intoxication were pejoratively described in gendered terms (e.g., bitchy, sleazy). The second related to the opportunities non- and light-drinking offered for expressing alternate and desirable configurations of femininities and masculinities.

CONCLUSIONS

We identified an intolerance towards regressive constructions of gender that emphasise weakness for women and strength for men and a valorisation of gendered expressions of maturity through controlled drinking. Though subtle differences in gendered drinking practices between and within countries were observed, our findings offer insight into how young people's enactions of gender are embedded in, and evolve alongside, these large declines in youth drinking.

Declining drinking among adolescents: Are we seeing a denormalisation of drinking and a normalisation of non-drinking?

BACKGROUND

In the early 2000s, alcohol use among young people began to decline in many western countries, especially among adolescents (ages between 12-17 years old). These declines have continued steadily over the past two decades, against the backdrop of much smaller declines among the general population.

ARGUMENT

Hypotheses examining individual factors fail adequately to provide the necessary 'big picture' thinking needed to understand declines in adolescent drinking. We use the normalisation thesis to argue that there is strong international evidence for both processes of denormalisation of drinking and normalisation of non-drinking occurring for adolescents in many western countries.

CONCLUSIONS

Research on declining adolescent drinking provides evidence of both denormalisation of alcohol consumption and normalisation of non-drinking. This has implications for enabling policy environments more amenable to regulation and increasing the acceptability of non-drinking in social contexts. Normalisation theory (and its various interpretations) provides a useful multi-dimensional tool for understanding declines in adolescent drinking.

Double shifts, double trouble: Alcohol as a problematic panacea for working mothers

Alcohol consumption among midlife women has become an area of research focus. We suggest it is important to examine the social roles that many midlife women take on - specifically working mothers. Working mothers balance both employment and the unequal burden of caring/domestic duties, leading to 'double shifts' of paid and unpaid labor. This creates unique stresses that may impact their drinking. This is particularly important as a growing number of mothers re-enter the workforce after childbirth. In this commentary, we suggest that working mothers' drinking tends to be overlooked or even endorsed as a means of managing the gendered stresses they face - stresses which have been exacerbated during the pandemic. We highlight the dearth of literature focusing on the drinking patterns, practices, and motives of working mothers and argue that gendered expectations placed on working mothers may be an increasingly important social determinant of health among this group.

The problem of over-medicalisation: How AOD disease models perpetuate inequity for young people with multiple disadvantage

Young people who experience multiple disadvantage have been identified as some of the most marginalised and under-serviced people in the alcohol and other drug (AOD) system. In this paper, we draw on a range of research evidence to argue that one of the challenges in responding appropriately to the needs of these young people are models of care which seek to ameliorate 'illness' rather than promote wellness. While disease approaches have some important benefits, overly-medicalised AOD treatment responses also have negative impacts. We argue that disease models rest on understandings of substance use as an individual enterprise and thereby pay insufficient attention to the material disadvantage that shape young people's substance use, creating feelings of shame, failure and a reluctance to return to care if they continue to use. Additionally we draw on literature that shows how disease models construe young people's substance use as compulsive, perpetuating deficit views of them as irrational and failing to account for the specific meanings that young people themselves give to their substance use. By focusing on clinical solutions rather than material and relational ones, medicalised treatment responses perpetuate inequity: they benefit young people whose resources and normative values align with the treatments offered by disease models, but are much less helpful to those who are under-resourced,. We suggest that alternative approaches can be found in First Nations models of care and youth programs that attend to social, cultural, and material wellbeing, making living well the focus of treatment rather than illness amelioration.

Beyond 'drinking occasions': Examining complex changes in drinking practices during COVID-19

Introduction

‘Drinking occasions’ are commonly used to capture quantities of alcohol consumed. Yet this standardised terminology brings with it numerous assumptions and epistemological limitations. We suggest that social changes brought on by COVID‐19 restrictions have influenced routines, patterns of time use and drinking practices, highlighting the need to re‐examine how we conceptualise drinking and ‘drinking occasions’ in alcohol research.

Methods

This analysis draws on data gathered from 59 qualitative interviews conducted during the second half of 2020 with Australian drinkers aged 18 and over. The interviews explored how COVID‐19 restrictions impacted daily practices and alcohol consumption patterns.

Findings

Participants spoke about their work, study and social routines changing, which influenced the times, timing and contexts of their drinking practices. We separated these shifts into four overarching themes: shifting of structures shaping drinking; the permeability of drinking boundaries; the extension of drinking occasions; and new contexts for drinking.

Discussion and Conclusion

COVID‐19 restrictions have led to shifts in the temporal boundaries and contexts that would otherwise shape people's drinking, meaning drinking practices may be less bound by structures, norms, settings and rituals. The drinking occasions concept, although a simple tool for measuring how much people drink, has not been able to capture these complex developments. This is a timely consideration given that COVID‐19 may have enduring effects on people's lifestyles, work and drinking practices. It may be useful to examine drinking as practice, rather than just an occasion, in order to better contextualise epidemiological studies going forward.

Examining trends in the representation of young people and alcohol in Australian newspapers over twenty years (2000-2019)

BACKGROUND

The news media can reflect and influence public opinion, as well as affect individual practice. In the context of significant changes in alcohol consumption among young people over the past twenty years, we examined Australian newspaper reporting of young people (under 18 years) and alcohol to assess whether there have been changes over time in the content and slant of articles that reflect or elucidate these trends.

METHODS

Factiva was used to search newspaper articles from major Australian newspapers over a twenty year period (2000-2019). After screening, two researchers coded 2415 newspaper articles across four key domains: article type, article theme, sources cited and topic slant (e.g. approving, disapproving tone). Change over time across the study period was assessed using joinpoint Poisson regression analyses.

RESULTS

There was a significant increase in articles on young people and alcohol between 2000 and 2008, before a corresponding decrease to 2019. Policy or prevention strategies were the most common theme of articles (35.8%), followed by articles reporting on risks or harms associated with alcohol use for young people (18.1%). Researchers were the most common source reported (25.1%), followed by politicians (19.0%). Three quarters of articles (75.9%) had a socially disapproving topic slant, which increased significantly up until 2011, with a corresponding decrease thereafter.

CONCLUSION

Attention to, and problematisation of, young people and alcohol increased in the first decade of this millennium which may have acted to sustain or accelerate declining drinking trends. However, this dissipated back to baseline levels in the second decade, which may indicate a lag time in recognition of young people's drinking becoming less of a public health 'problem'.

Why we stopped using the term 'aftercare'

The words we choose to describe alcohol and other drug (AOD) treatments and interventions reveal assumptions about how we understand AOD use. Moreover, they have important implications for how the treatment is imagined, implemented and funded. Service provision which follows engagement in an intensive (usually residential) program is often called 'aftercare' in the international AOD field. In this commentary, we argue that the term 'aftercare' fails to articulate the nature of ongoing care required by people who are managing AOD use. We maintain that 'aftercare' positions post-residential care as being less important than other treatment modalities, rather than as integral to a continuum of care. It is a term that implies that care should be acute, like much treatment delivered through a medical model, and assumes that people follow linear pathways in managing their AOD use. Assumptions embedded in the term 'aftercare' such as these may disincline governments from funding ongoing services for people exiting intensive programs. Alternative terms including 'continuing coordinated care' more aptly signal the integrated and ongoing service provision that should be available to support people in sustaining changes initiated through other AOD interventions.

"No one associates alcohol with being in good health": Health and wellbeing as imperatives to manage alcohol use for young people

Young people's drinking has declined markedly in Australia over the past 15 years, and this may be linked to changing norms and values around health. We take the view that healthism-a discourse that privileges good health and renders people personally responsible for managing health-has become pervasive, creating new pressures influencing young people's alcohol practices. Through interviews with 50 young light drinkers and abstainers, we explored these notions of health and alcohol. Although health was not the only reason that participants abstained or drank lightly, many avoided drinking to minimise health risks and to pursue healthy lifestyles. Their understanding of health came from multiple sources such as the media, schools, parents-and often reinforced public health messages, and healthist discourse. This discourse influenced how participants perceived health norms, engaged with health in everyday life and managed their alcohol consumption. Because the need to be healthy incorporated bodily health, mental health and social wellbeing, it also created tensions around how young people could drink while maintaining their health. This highlights the importance of health as a key consideration in the alcohol practices of light drinking and abstaining young Australians, which could help explain broader declines in youth drinking.

How much are we exposed to alcohol in electronic media? Development of the Alcoholic Beverage Identification Deep Learning Algorithm (ABIDLA)

BACKGROUND

Evidence demonstrates that seeing alcoholic beverages in electronic media increases alcohol initiation and frequent and excessive drinking, particularly among young people. To efficiently assess this exposure, the aim was to develop the Alcoholic Beverage Identification Deep Learning Algorithm (ABIDLA) to automatically identify beer, wine and champagne/sparkling wine from images.

METHODS

Using a specifically developed software, three coders annotated 57,186 images downloaded from Google. Supplemented by 10,000 images from ImageNet, images were split randomly into training data (70 %), validation data (10 %) and testing data (20 %). For retest reliability, a fourth coder re-annotated a random subset of 2004 images. Algorithms were trained using two state-of-the-art convolutional neural networks, Resnet (with different depths) and Densenet-121.

RESULTS

With a correct classification (accuracy) of 73.75 % when using six beverage categories (beer glass, beer bottle, beer can, wine, champagne, and other images), 84.09 % with three (beer, wine/champagne, others) and 85.22 % with two (beer/wine/champagne, others), Densenet-121 slightly outperformed all Resnet models. The highest accuracy was obtained for wine (78.91 %) followed by beer can (77.43 %) and beer cup (73.56 %). Interrater reliability was almost perfect between the coders and the expert (Kappa = .903) and substantial between Densenet-121 and the coders (Kappa = .681).

CONCLUSIONS

Free from any response or coding burden and with a relatively high accuracy, the ABIDLA offers the possibility to screen all kinds of electronic media for images of alcohol. Providing more comprehensive evidence on exposure to alcoholic beverages is important because exposure instigates alcohol initiation and frequent and excessive drinking.

Correlates of Reduced Alcohol Consumption among a Sample of Young Australians

AIMS

Population data suggest that a significant proportion of young drinkers are reducing or ceasing their alcohol use; however, there is a lack of information about the characteristics of young people who do so. Our study aimed to determine characteristics associated with self-reported attempted and successful alcohol reduction and cessation among young people in Victoria, Australia.

METHODS

Data are from a cross-sectional online survey with young people aged 15-29 years living in Victoria, Australia. Participants who reported consuming alcohol in the past 12 months were included in the analysis (N = 1,162).

RESULTS

Alcohol drinking cessation in the past 12 months was reported by 3.8% (n = 44) and reduced alcohol consumption was reported by 32.1% (n = 371) of participants. Characteristics associated with trying to reduce or cease alcohol consumption were older age, being born overseas, drinking at hazardous levels, experiencing alcohol-related harms and interest in health content on social media. Characteristics associated with successful alcohol reduction or cessation were being born overseas and experiencing alcohol-related harm, while being a member of a religious group was negatively associated.

CONCLUSIONS

Recent reduction in alcohol consumption was common among young people in this study. Recent reduction in alcohol consumption was common among young people in this study. A combination of factors appear to be correlated with recent attempts to reduce drinking young people including socio-demographic characteristics, religiosity, drinking practices and experience of harm, and interest in health.