The Beverage Alcohol Concentration at Intake and Estimated Blood Alcohol Concentrations

Abstract

Belief in differential health risks for different alcoholic beverages continues despite a relative lack of supporting evidence, and continues to influence alcohol policy debate both in Finland and elsewhere. The present data from a survey of Finnish drinking habits conducted in 1992 suggest that the central issue is not the actual strength of the beverage itself but rather the solution at intake and the amount of alcohol imbibed. The results are based on a one week survey of all occasions on which alcohol was consumed from a general population survey of drinking habits. Spirits are diluted almost two times out of three when spirits are taken. The data indicate that the median alcohol content of spirits at intake was about 13 percent of volume: i.e. on half of the occasions when spirits were imbibed, the actual alcohol content was not higher than that of unfortified wines. Beer and wine were rarely diluted, white spirits and rum were almost always diluted, whereas cognac and liqueurs were taken unmixed. The data also provide a basis for estimating the blood alcohol concentration (BAC) reached on each drinking occasion. There was hardly any correlation between the BAC and the actual alcohol concentration of the beverages imbibed. More detailed analyses showed mixed results. Drinking to intoxication (estimated BAC < 20 mM) was more likely with those spirits that are typically diluted than those drunk straight, but a higher percentage of the spirit intake in general occurred on such intoxicating occasions than was reported for other beverages. Older respondents reported that the primary beverage used when drinking to intoxication was spirits, but younger ones said beer. The results are only for Finland, but show little basis here for the traditional tripartite (beer, wine, spirits) division of beverages in prevention of alcohol-related harm.