Abstract
In most epidemiological literature, harmful drinking—a drinking pattern recognized as closely linked to alcohol-attributable diseases—is recorded using the measure risky single-occasion drinking (RSOD), which is based on drinking above a certain quantity. In contrast, subjective intoxication (SI) as an alternative measure can provide additional information, including the drinker’s subjective perceptions and cultural influences on alcohol consumption. However, there is a lack of research comparing both. The current article investigates this comparison, using data from the Standardized European Alcohol Survey from 2015. We analysed the data of 12,512 women and 12,516 men from 17 European countries and one region. We calculated survey-weighted prevalence of SI and RSOD and compared them using Spearman rank correlation and regression models. We examined the role of the required quantity of alcohol needed for the drinker to perceive impairments and analysed additional demographic and sociodemographic characteristics as well as drinking patterns. In the most locations, the prevalence of SI was lower or equal to the prevalence of RSOD. Both prevalence estimates were highly correlated. Almost 8% of the variance in the difference between the individual-level frequencies of the SI and RSOD measures was explained by the individual quantity of alcohol needed to perceive impairments. Sociodemographic characteristics and drinking patterns explained less than 20% in the adjusted perceived quantity of alcohol needed. In conclusion, our results indicated that subjective measures of intoxication are not a preferable indicator of harmful drinking to the more conventional measures of RSOD.
Highlights
Alcohol consumption is a major risk factor for the burden of disease and mortality in European adults [1, 2]
The prevalence based on subjective intoxication (SI) was 12.5% lower than those based on risky single-occasion drinking (RSOD)
The greatest difference between RSOD and SI-based prevalence was observed in Estonia at 33.6%, whereas the smallest was in Croatia at 0.1%
Summary
Alcohol consumption is a major risk factor for the burden of disease and mortality in European adults [1, 2]. Different patterns of drinking contribute to this burden, including risky single-occasion drinking (RSOD), usually defined as drinking more than 60 grams of pure ethanol on one single occasion [3]. This definition was derived from risk functions, i.e., it constitutes the threshold above which the risk for most diseases causally linked to alcohol use is elevated. These drinking levels are further thought to roughly correspond to the phenomenon of intoxication. For prevention purposes and alcohol policy formulation, the investigation of patterns, causes, characteristics and consequences of subjective intoxication (SI) and its correspondence to RSOD appear to be worthwhile
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