An exploration of the lived experiences of people with alcohol-related harm in Scotland

Fiona O’May,Jan Gill,Heather Black,Cheryl Rees,Jonathan Chick

doi:10.1080/14659891.2016.1235732

Abstract

ABSTRACTBackground: Alcohol consumption has posed well-documented problems for Scottish society in terms of morbidity, mortality, and wider societal costs. Objectives: To investigate the lived experiences and drinking behaviors of people with alcohol-related harm in Scotland against a backdrop of recent economic downturn, falling incomes, welfare reform, and changes to state benefits. Methods: As part of a larger Scottish study (2012–2014) of 639 individuals attending hospital or admitted, relating to an alcohol problem, 20 participants completed semistructured interviews about their drinking and purchasing habits that were subjected to thematic analysis. Conclusions: Key themes elucidated participants’ everyday drink-related behaviors within their local environment including drinking triggers, sourcing alcohol, resourcing alcohol purchase, and views relating to substitution. The majority of participants had experienced reduced income and adapted their alcohol-purchasing behaviors accordingly, including “trading down” to cheaper alcohol. A reduction in food purchasing and heating was a common outcome, as was falling into, or increasing current, debt. More attention should be paid to the prevalence and accessibility of alcohol within local communities. Ultimately, as long as there is highly visible and easily accessible cheap alcohol, heavy drinkers may struggle to undertake positive steps to reduce their damaging consumption levels.

Highlights

Despite recent welcome improvements in Scottish alcohol-related mortality and morbidity statistics (Beeston et al, 2016), alcohol consumption still exacts a considerable societal cost
Of relevance, are several factors impacting on personal finances, e.g. economic downturn (2007-2013) and increasing prices, UK welfare reform (HM Government, 2012) including housing benefit, falling incomes and unemployment (Scottish Parliament, 2015)
Drinkers described in detail how they negotiated, frequently on a daily basis, the external and internal challenges to maintaining their required levels of alcohol consumption

Summary

Introduction

Despite recent welcome improvements in Scottish alcohol-related mortality and morbidity statistics (Beeston et al, 2016), alcohol consumption still exacts a considerable societal cost. Of relevance, are several factors impacting on personal finances, e.g. economic downturn (2007-2013) and increasing prices, UK welfare reform (HM Government, 2012) including housing benefit (which has for many resulted in social benefit delays, reductions and sanctions), falling incomes and unemployment (Scottish Parliament, 2015). In Scotland, alcohol is available as ‘on-sales’ (public houses, bars, restaurants) and off-sales (supermarkets, off-licences, corner shops etc.). In the latter case, the alcohol cost price is typically considerably less than that paid for on-sales; an average of 52 pence per unit (ppu) compared to 166ppu in 2014 (Robinson et al, 2015). The number of off-sale licenses issued in Scotland has gradually increased over the past few years (Scottish Government, 2015b)

Results

Discussion

Conclusion