Abstract
BackgroundUnder-reporting of alcohol consumption is widespread; surveys typically capture 40-60% of alcohol sales. However the population distribution of under-reporting is not well understood.MethodsMixed-methods study to identify factors associated with under-reporting, using the nationally-representative Health Survey for England (HSE) 2011 (overall response rate 66%). Comparison of retrospective computer-assisted personal interview and seven-day drinking diary (n = 3,774 adults 18+, 50% women, diary response rate 69%) to identify factors associated with diary responses exceeding those of the interview using multivariable linear regression for three outcomes: drinking days in the week recorded, volume consumed on heaviest drinking day in the week recorded, and weekly alcohol consumption. Qualitative semi-structured interviews (n = 10) explored reasons for under-reporting in further detail.ResultsNumber of drinking days was slightly greater in the diary than the interview (P < 0.001). Reported consumption was higher in the diary than in the interview for heaviest drinking day in the week recorded (0.7 units greater among men, 1.2 units among women, P < 0.001), and weekly alcohol consumption in women only (1.1 units among women, P = 0.003). Participants who drank more frequently, more heavily, and had a more varied drinking pattern with respect to the types of drink consumed or choice of drinking venues had a larger difference between their diary week and their interview week.The qualitative interviews identified having a non-routine drinking pattern, self-perception as a non-frequent drinker, and usually tracking drinking using experiential approaches as linked to more drinking being reported in the diary than the retrospective interview.ConclusionsHeavy drinking and non-routine drinking patterns may be associated with greater under-reporting of alcohol consumption. Estimates of drinking above recommended levels are likely to be disproportionately under-estimated.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1297) contains supplementary material, which is available to authorized users.
Highlights
Under-reporting of alcohol consumption is widespread; surveys typically capture 40-60% of alcohol sales
Quantitative sub-study Descriptive statistics For both men and women, frequency and quantity of alcohol consumption were slightly higher in the diary than the computer-assisted personal interview (CAPI)
There were no substantive trends in the difference between the CAPI and diary measures by demographic and social factors that were consistent across the three outcomes (Additional file 1: Table S1)
Summary
Under-reporting of alcohol consumption is widespread; surveys typically capture 40-60% of alcohol sales. Reported alcohol consumption typically amounts to 4060% of total alcohol sales [1,2,3,4,5,6]. Some recent studies have used a gamma distribution to align alcohol consumption with or close to sales [20,21,22,23]. This allows the extent of under-reporting to vary by consumption level. We know of few studies that have attempted to identify wider risk factors for differences between two measures of alcohol consumption using a test-retest methodology
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