Contribution of drinking patterns to differences in rates of alcohol related problems between three urban populations

OBJECTIVES

To examine, on empirical data, whether drinking patterns, in addition to overall alcohol consumption, contribute to differences in rates of alcohol related problems between populations.

DESIGN

Cross sectional survey.

SETTINGS

One Russian, one Polish, and one Czech city.

PARTICIPANTS

1118 men and 1125 women randomly selected from population registers.

MAIN OUTCOME MEASURES

Problem drinking; negative social consequences of drinking; alcohol consumption and drinking pattern.

RESULTS

Rates of problem drinking and of negative consequences of drinking were much higher in Russian men (35% and 18%, respectively) than in Czechs (19% and 10%) or Poles (14% and 8%). This contrasts with substantially lower mean annual intake of alcohol reported by Russian men (4.6 litres) than by Czech men (8.5 litres), and with low mean drinking frequency in Russia (67 drinking sessions per year, compared with 179 sessions among Czech men). However, Russians consumed the highest dose of alcohol per drinking session (means 71 g in Russians, 46 g in Czechs, and 45 g in Poles), and had the highest prevalence of binge drinking. In women, the levels of alcohol related problems and of drinking were low in all countries. In ecological and individual level analyses, indicators of binge drinking explained a substantial part of differences in rates of problem drinking and negative consequences of drinking between the three countries.

CONCLUSIONS

These empirical data confirm high levels of alcohol related problems in Russia despite low volume of drinking. The binge drinking pattern partly explains this paradoxical finding. Overall alcohol consumption does not suffice as an estimate of alcohol related problems at the population level.

Alcohol consumption and binge drinking in Novosibirsk, Russia, 1985-95

AIMS

It has been suggested that the effects of alcohol, and binge drinking in particular, contributed to the dramatic fluctuations in Russian mortality rates: rapid decline in 1985-87, slow increase in 1988-91 and sharp increase in 1992-94. To date, there have been no data available to substantiate this claim. We examine for the first time the trends in alcohol intake and binge drinking in a Russian urban population.

METHODS

Independent random samples of men and women aged 25-64 in two districts of Novosibirsk city (Western Siberia) have been examined in 1985/86 (1535 men and 1296 women), 1988/89 (1700 men, no women), and 1994/95 (1539 men and 1511 women). Response rates ranged from 71% to 73%. The subjects reported frequency of drinking alcohol, average amount of alcohol consumed at a typical occasion, and their alcohol intake in the week preceding the interview. Two cut-off points to define binge drinking were adopted: > or = 80 g and > or = 120 g at a single occasion.

RESULTS

The proportion of men who drank at least once a week increased from 27% in 1985/86 to 38% in 1994/95; corresponding figures among women were 0.6% and 6.5%, respectively. The mean consumption of pure alcohol at a single occasion in men was 90 g in 1985/86, 119 g in 1988/89 and 112 g in 1994/95; in women, it was 33 g in 1985/86 and 32 g in 1994/95. Between the first and the last survey, the mean weekly intake of pure alcohol increased from 120 g to 184 g in men and from 31 g to 41 g in women. Prevalence rates of binge drinking (> or = 80 g at least once a month) in the three surveys were 36%, 52% and 51%, respectively, in men, and 0.4% in the first and 5% in the last survey among women.

CONCLUSION

Alcohol consumption and prevalence of binge drinking were high in men and low in women. The frequency of binge drinking among men increased between 1985/86 and 1988/89 and remained stable between 1988/89 and 1994/95. This is not consistent with trends in mortality. Shorter-term fluctuations between surveys, however, cannot be excluded.