Abstract
BackgroundNational estimates on per capita alcohol consumption are provided regularly by various sources and may have validity problems, so corrections are needed for monitoring and assessment purposes. Our objectives were to compare different alcohol availability estimates for Spain, to build the best estimate (actual consumption), characterize its time trend during 2001–2011, and quantify the extent to which other estimates (coverage) approximated actual consumption.MethodsEstimates were: alcohol availability from the Spanish Tax Agency (Tax Agency availability), World Health Organization (WHO availability) and other international agencies, self-reported purchases from the Spanish Food Consumption Panel, and self-reported consumption from population surveys. Analyses included calculating: between-agency discrepancy in availability, multisource availability (correcting Tax Agency availability by underestimation of wine and cider), actual consumption (adjusting multisource availability by unrecorded alcohol consumption/purchases and alcohol losses), and coverage of selected estimates. Sensitivity analyses were undertaken. Time trends were characterized by joinpoint regression.ResultsBetween-agency discrepancy in alcohol availability remained high in 2011, mainly because of wine and spirits, although some decrease was observed during the study period.The actual consumption was 9.5 l of pure alcohol/person-year in 2011, decreasing 2.3 % annually, mainly due to wine and spirits. 2011 coverage of WHO availability, Tax Agency availability, self-reported purchases, and self-reported consumption was 99.5, 99.5, 66.3, and 28.0 %, respectively, generally with downward trends (last three estimates, especially self-reported consumption). The multisource availability overestimated actual consumption by 12.3 %, mainly due to tourism imbalance.ConclusionsSpanish estimates of per capita alcohol consumption show considerable weaknesses. Using uncorrected estimates, especially self-reported consumption, for monitoring or other purposes is misleading. To obtain conservative estimates of alcohol-attributable disease burden or heavy drinking prevalence, self-reported consumption should be shifted upwards by more than 85 % (91 % in 2011) of Tax Agency or WHO availability figures. The weaknesses identified can probably also be found worldwide, thus much empirical work remains to be done to improve estimates of per capita alcohol consumption.Electronic supplementary materialThe online version of this article (doi:10.1186/s12963-016-0090-4) contains supplementary material, which is available to authorized users.
Highlights
National estimates on per capita alcohol consumption are provided regularly by various sources and may have validity problems, so corrections are needed for monitoring and assessment purposes
The range of estimates was very small for beer (0.1 lpa/py), while it was large for wine (1.1 lpa/py), and especially for other beverages (2.3 lpa/py) – in the first case, due to low Tax Spanish Tax Agency (Agency) and World Health Organization (WHO) estimates, and in the second, to very low Food and Agriculture Organization (FAO) estimates (Table 1, Fig. 1)
Substantial between-agency discrepancies in alcohol availability have been found, which probably exist in many countries
Summary
National estimates on per capita alcohol consumption are provided regularly by various sources and may have validity problems, so corrections are needed for monitoring and assessment purposes. In some countries like Spain, wine is exempt from excise duty This proxy mainly includes legal wholesale alcohol sales, which occur at the beginning of the marketing process and do not adequately reflect alcohol consumption by residents. Correction algorithms generally are not internationally standardized, are sometimes not even explicit, and are based on many parameters that require empirical data, which are often lacking and must be assumed or extrapolated from elsewhere [1, 6, 12,13,14,15] Despite these threats to validity, the process by which individual countries make these estimates has rarely been assessed, nor have estimates from various sources been systematically compared
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