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Abstract
BackgroundAlcohol consumption estimates in public health predominantly rely on self-reported survey data which is likely to underestimate consumption volume. Surveys tend to ask specifically about standard drinks and provide a definition or guide in an effort to gather accurate estimates. This study aimed to investigate whether the inclusion of the term standard drinks with pictorial guide is associated with an adjustment in self-reported alcohol volume.MethodsA web-based survey was administered with AUDIT-C questions repeated at the beginning and end of the survey with and without the standard drink term and guide. The order in which respondents were presented with the different question types was randomised. Two cohorts of university/college students in NSW Australia (n = 122) and the US Pacific Northwest (n = 285) completed the survey online.ResultsAustralian students did not adjust their responses to questions with and without the standard drink term and pictorial guide. The US students were more likely to adjust their responses based on the detail of the question asked. Those US students who drank more frequently and in greater volume were less likely to adjust/apply a conversion to their consumption.ConclusionsThis study supports previous findings of the inaccuracy of alcohol consumption volume in surveys, but also demonstrates that an assumption of underestimation cannot be applied to all individual reports of consumption. Using additional questions to better understand drink types and serving sizes is a potential approach to enable accurate calculation of underestimation in survey data.
Highlights
Population-level estimates of alcohol-consumption and the level of risk associated with drinking rely on selfreported data defining consumption in terms of ‘standard drinks’
Here, we investigate whether the inclusion of the standard drink term and pictorial guide is associated with an adjustment in self-reported alcohol consumption among two cohorts of university/college students in New South Wales, Australia, and the US Pacific Northwest
When reported standard drinks were compared with reported drinks/serves combined, there was almost no difference in the Australian sample (0.01, 95% CI: − 0.30 to 0.31, p = 0.977) while the values were significantly different in the US sample (1.88, 95% CI: 1.58 to 2.17, p < 0.001; Table 2)
Summary
Population-level estimates of alcohol-consumption and the level of risk associated with drinking rely on selfreported data defining consumption in terms of ‘standard drinks’. Several studies have reported differences in the volume of alcohol consumption reported in response to varied question styles including quantity-frequency, graduatedfrequency, and recent recall [7,8,9]. Quantity-frequency questions, such as the AUDIT-C, typically use the mid-point for number of drinks and number of days in each response option to generate consumption volume (e.g. assuming 2.5 days per week for the option ‘2 or 3 days per week’), and underestimate consumption compared with a question about how many drinks were consumed on the previous day [12, 13]. Alcohol consumption estimates in public health predominantly rely on self-reported survey data which is likely to underestimate consumption volume. This study aimed to investigate whether the inclusion of the term standard drinks with pictorial guide is associated with an adjustment in self-reported alcohol volume
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