Quantity-frequency Method Research Articles

Alcohol purchases through online stores and mobile applications in the late phase of the COVID-19 pandemic in Poland.

Aim: Online alcohol sales have grown rapidly, but their impact on alcohol consumption and harms is not well understood. This study explores the association between online alcohol purchasing and drinking behaviours during the late phase of COVID-19 pandemic in Poland. Design: A nationally representative survey was conducted in May 2022 of 2000 Polish residents aged 18-50 years selected from a probability-based web panel. Measures included past-year alcohol purchasing through e-stores, food/delivery apps and retail apps. Alcohol consumption was quantified using the Beverage-Specific Quantity-Frequency method. Logistic regression was used to identify sociodemographic and behavioural correlates of online alcohol purchasing. Results: Of the study respondents, 19% purchased alcohol through e-stores, 17% via delivery apps and 15% with retail apps. Spirits were commonly purchased in e-stores (57%), while beer was purchased via apps (58%-60%). Most online buyers took advantage of price promotions (69%-75%) and reported some kind of age verification (67%-68%). Higher odds of online purchasing were found among men (adjusted odds ratio [aOR] 1.38-1.54), younger drinkers (aOR 1.65-2.04) and to some extent university graduates (aOR 1.75 for e-stores purchases). Compared to moderate drinkers, risky (aOR 2.32-3.02) and harmful drinkers (aOR 5.06-6.61) showed substantially increased odds of buying alcohol online. Conclusion: Results suggest online alcohol purchasing, especially through mobile apps, is linked to more excessive drinking. Apps enable easy access to alcohol anytime anywhere, circumventing policies restricting sales to minors and intoxicated persons. With youth drinking declining globally, online sales are an emerging issue for public health. Restricting mobile app-based alcohol delivery could be an important policy measure to curb excessive drinking enabled by digital sales.

Alcohol consumption among Iranian population based on the findings of STEPS survey 2021

Alcohol production and consumption have been prohibited in Iran for over four decades, leading to a typical underestimation of its consumption. This study aimed to assess the prevalence of alcohol consumption, its associated factors, and estimate per capita alcohol consumption among Iran’s adult population. In this population-based survey, 27,874 adults from across Iran were selected using systematic proportional-to-size cluster sampling. Alcohol consumption was evaluated through a modified Persian version of the STEPS questionnaires from previous studies, applied over different timespans. Per capita consumption was calculated using the quantity-frequency method, expressed in liters of pure alcohol. Adjusted odds ratios were reported for associates of alcohol consumption concerning metabolic risk factors, sociodemographic elements, and lifestyle variables. The prevalence of lifetime alcohol consumption was 6.9% (95% CI 6.5–7.2) in the adult population, with a notable sex difference (males: 13.7% [95% CI 13–14.4]; females: 1.4% [95% CI 1.1–1.6]). The 12 month prevalence was 3.8% (95% CI 3.6–4.1). For individuals aged 18 and older, the per capita alcohol consumption in Iran was 0.12 L. Factors such as being a lifetime smoker, younger, wealthier, and having 7–12 years of education were significantly linked to higher alcohol consumption. Significant associations were also observed between alcohol consumption and having a history of heart attacks (OR = 2.04, 95% CI 1.44–2.89), and physical injuries (OR = 1.88, 95% CI 1.34–2.64). The estimated lifetime and 12-month prevalence of alcohol use in our study were higher among some of the subpopulations. The findings also revealed a complex relationship between alcohol consumption, behavioral risk factors, and metabolic profiles. Consequently, immediate preventive measures tailored to each factor’s association with alcohol use are recommended.

Methods for calculation of per capita alcohol consumption in a Muslim majority country with a very low drinking level: Findings from the 2011 Iranian mental health survey

There is a paucity of data on volume of alcohol use from Muslim majority countries. We aimed to present estimation methods for alcohol consumption with the use of survey data for these societies and provide an estimation for age 15+ per capita consumption of pure alcohol for Iran. The Iranian Mental Health Survey was a nationally representative household survey on individuals aged 15-64 years, with a multistage, cluster sampling design. We used the 'Last Week' method and 'Quantity-Frequency' methods for gathering data on alcohol consumption and combined these to provide more complete estimates. The response rate was 85.7%. From the total of 7840 respondents, 5.7% and 1% reported past 12 months and past week alcohol use, respectively. The highest estimation for age 15+ per capita consumption of pure alcohol was yielded by the 'combination method' (0.108 L ethanol/person/year) followed by the Quantity-Frequency method (0.079 L). The 'Last Week' method provided the lowest estimate (0.059 L). Unlike in surveys of non-Muslim countries, frequency of drinking from recent recall (last week) was much lower than from recall of usual drinking in the last year. We conclude that 0.108 L (SE = 0.03) is the best survey-based estimate of age 15+ per capita consumption, which translates to about 5 750 000 L of national consumption per year in Iran. However, this method is still likely to under-estimate per capita consumption due to evidence of under-reporting in the survey.

Self-reports of consumption of amphetamines, cocaine and heroin in a survey among marginalized drug users

Background and aimScientific literature offers few measurements of the quantities consumed by individual drug users. Such measurements are used for calculating the total drug consumption by the quantity–frequency method, and are extremely important for the comparison with waste water derived consumption estimates. The aim of this study was to measure quantities of amphetamines, cocaine and heroin consumed by marginalized drug users, using a multi-city questionnaire survey design. Variation by gender, age, frequency of use, main drug used and city was explored. ResultsThe self-reported quantity used on the last day of use was for amphetamines on average 800mg, for cocaine 1014mg and for heroin 682mg. The self-reported usual dose was on average 297mg, 487mg and 297mg respectively, while the median value was 250mg for all three drugs. Overall, gender and age group were less important than frequency of use and the main drug used for establishing differences regarding the outcome variables. There were some differences regarding cities. No measure of purity was carried out at the interview sites, so the calculation of pure quantities was based on aggregate results from analyses of seizures by police and customs. ConclusionsThe self-reported quantities of drugs consumed in three cities in Norway was equal to or somewhat higher among marginalized users than earlier assumed, where assumptions were based on limited literature and anecdotal information.

Alcohol Consumption and Dietary Patterns: The FinDrink Study

The aim of this population-based study was to investigate differences in dietary patterns in relation to the level of alcohol consumption among Finnish adults. This study was part of the FinDrink project, an epidemiologic study on alcohol use among Finnish population. It utilized data from the Kuopio Ischaemic Heart Disease Risk Factor Study. A total of 1720 subjects comprising of 816 men and 904 women aged 53–73 years were included in the study in 1998–2001. Food intake was collected via a 4-day food diary method. Self-reported alcohol consumption was assessed with quantity-frequency method based on the Nordic Alcohol Consumption Inventory. Weekly alcohol consumption was categorized into three groups: non-drinkers (<12 grams), moderate drinkers (12–167.9 grams for men, 12–83.9 grams for women) and heavy drinkers (≥168 grams for men, ≥84 grams for women). Data were analyzed for men and women separately using multiple linear regression models, adjusted for age, occupational status, marital status, smoking, body mass index and leisure time physical activity. In women, moderate/heavy drinkers had lower fibre intake and moderate drinkers had higher vitamin D intake than non-drinkers. Male heavy drinkers had lower fibre, retinol, calcium and iron intake, and moderate/heavy drinkers had higher vitamin D intake than non-drinkers. Fish intake was higher among women moderate drinkers and men moderate/heavy drinkers than non-drinkers. In men, moderate drinkers had lower fruit intake and heavy drinkers had lower milk intake than non-drinkers. Moderate drinkers had higher energy intake from total fats and monosaturated fatty acids than non-drinkers. In contrast, energy intake from carbohydrates was lower among moderate/heavy drinkers than non-drinkers. In conclusion, especially male heavy drinkers had less favorable nutritional intake than moderate and non-drinkers. Further studies on the relationship between alcohol consumption and dietary habits are needed to plan a comprehensive dietary intervention programs in future.

Rates of alcohol consumption and risk status among Australian university students vary by assessment questions

Different self-report methods tend to produce different estimates of alcohol consumption. The present study compares differences in rates and risk levels based on responses to a modified version of the Daily Drinking Questionnaire (m-DDQ) and quantity-frequency (QF) questions. The sample comprised 2082 university students, 61% of whom were female and 39% male with a mean age of 23.5 years. An email containing an online link to a brief six-question survey was e-mailed to students enrolled in participating faculties at the University of Wollongong, Australia. Current drinkers completed m-DDQ and QF questions about alcohol consumption. QF methods identified significantly lower estimates of consumption (Mean = 9.15, SD = 12.51) compared with m-DDQ (Mean = 13.06, SD = 14.07). Allocation to risk categories based on the Australian Alcohol Guidelines were conducted for both the m-DDQ and QF methods. Almost twice as many students were found to be drinking at levels considered risky using the m-DDQ method compared with QF. In addition, the relative rank order of participants varied significantly between the two methods. The m-DDQ method identified higher rates of drinking and categorised almost twice as many individuals into risky categories of drinking compared with QF. Such variations have major implications for identification of risk groups in health promotion or prevention programs.

Comparison of a food-frequency questionnaire method and a quantity-frequency method to classify risky alcohol consumption in women

Population surveys use a variety of methods to collect data on alcohol consumption. Comparability of results across methods is a prime consideration. Different methods have been demonstrated to be robust in terms of ranking individuals' alcohol use, while results have been mixed regarding comparability in terms of volume of consumption. In Australia, evidence-based guidelines have been developed that identify critical thresholds of consumption that are associated with increased risk of alcohol-related morbidity. This study investigated whether the identification of individuals consuming alcohol above these thresholds was consistent across two methods used to collect data on consumption. The Australian Longitudinal Study of Women's Health (ALSWH) incorporated both a quantity-frequency (QF) method and a food-frequency questionnaire (FFQ) to collect data on alcohol consumption. Comparisons were made between these two methods on the ability to classify women consuming alcohol as risky (between 176 and 350 ml of pure alcohol weekly) and at high risk (greater than 350 ml of pure alcohol weekly) levels. The ranking of individuals was robust across methods. However, concordance in identifying risky/high-risk drinkers varied considerably based on the assumptions underlying the different methods used to calculate drinking volume using the FFQ. Similarly, the sensitivity and specificity of the FFQ methods compared to QF in terms of identifying risky/high-risk consumers were high but variable. This study indicated that the proportion of respondents exceeding consumption thresholds was sensitive to the instrument used to collect data on alcohol intake. Quantifying such differences is important when making comparisons between surveys that use different methodologies.

Measuring average alcohol consumption: the impact of including binge drinks in quantity–frequency calculations

Average daily alcohol consumption is usually calculated based on self-reports of the quantity (number of drinks consumed per drinking-day) and frequency (number of drinking-days) of alcohol consumption within a given time period. However, this method may underestimate average daily alcohol consumption (and in turn, the prevalence of heavy drinking), because studies demonstrate that respondents do not typically include binge drinking occasions in estimates of their 'usual' or 'average' daily alcohol consumption. We used the Behavioral Risk Factor Surveillance System (BRFSS), an annual random-digit telephone survey of US adults aged 18 years or older, to estimate average daily alcohol consumption using standard quantity-frequency questions, and then recalculated this measure by including self-reports of binge drinking. The proportion of respondents who met a standard, sex-specific definition of heavy drinking based on average daily alcohol consumption was then assessed nationally and for each state. Compared to standard quantity-frequency methods, including binge drinks in calculations of average daily alcohol consumption increased the relative prevalence of heavy drinking among all adults by 19% to 42% (depending on the method used to estimate the number of drinks per binge). Among binge drinkers, the overall prevalence of heavy drinking increased 53% relative to standard quantity-frequency methods. As a result, half of women binge drinkers and half of binge drinkers aged 55 or older met criteria for heavy drinking. Including binge drinks (especially the application of age- and sex-specific estimates of binge drinks) in the calculation of average daily alcohol consumption can improve the accuracy of prevalence estimates for heavy drinking among US adults, and should be considered to increase the usefulness of this measure for alcohol surveillance.

Self-reported ecstasy use: the impact of assessment method on dosage estimates in recreational users

While research has associated recreational ecstasy use with negative outcomes, there remain a number of methodological limitations of human studies. The present study examined the impact of self-report methodology on lifetime ecstasy dosage figures using three estimation methods: a single question estimation, a context-based timeline method and a quantity-frequency method. We used a repeated measures design, testing 38 participants aged over 18 years who reported using ecstasy on ten or more occasions. Methodology was found to impact on estimations made, with the timeline method producing higher figures than the single question. While single question and timeline estimations were positively correlated, there was no relationship between either of these methods and the quantity-frequency method. The present findings are in keeping with indications in the alcohol and other drug literature that the use of contextual memory cues increases accuracy of recall as indicated by higher estimations, and that quantity-frequency methods may not adequately assess variability in lifetime drug-use patterns.

Assessing alcohol consumption: beverage-specific versus grouped-beverage questions.

The quantity-frequency method is commonly used to measure alcohol intake in large surveys. Because of time and space constraints, questionnaires are often shortened by combining questions on all types of alcohol into a single question. We investigated the effect of this practice using data from the Behavioral Risk Factor Surveillance System. We examined data collected from 213,842 respondents to surveys conducted by 32 states and the District of Columbia participating in the years 1987, 1988, 1989 and 1990. The 1987 and 1988 surveys asked questions about respondents' frequency and level of intake of specific alcohol-containing beverages. The 1989 and 1990 surveys asked about the frequency and quantity of intake of alcohol-containing beverages by combining all beverages into a single group. Among drinkers, the mean number of drinks per month was higher for those who were asked beverage-specific questions than for those who were asked grouped-beverage questions (men: 37.0 vs 29.6; women: 17.0 vs 13.9). Caution must be used in comparing level of alcohol intake from surveys in which beverages are not grouped identically.

Treating grouped data as continuous in alcohol consumption measures

In quantity-frequency methods used for self-report measurement of alcohol intake (or other exposures), respondents mark the appropriate ranges, e.g. '5 to 8 drinks', '5 or 6 times per week'. To calculate average consumption only single values, not ranges, can be multiplied, and midpoints are commonly used. This results in bias if the range lies in the tail of a distribution, as often happens with drinks per occasion. The same bias occurs when risk, for example, is plotted against consumption levels, which inevitable are grouped into ranges. Consequently, estimates of aggregate consumption can be exaggerated and curves of risk against exposure level can be misleading. A method is described to calculate a relatively unbiased representative value for a range, requiring only knowledge of the normal distribution table, the log-normal distribution, and basic arithmetic. Part of the procedure is also useful for estimating percentile points in data that have been grouped differently, such as income in dollar groups.

Does alcohol contribute to accident and emergency department attendance in elderly people?

To evaluate the possible contribution of alcohol to presentation of elderly subjects at a hospital accident and emergency (A&E) department. 105 patients aged 70 years and over who attended the department were interviewed by a single observer using a structured questionnaire based on previously validated general population surveys. Details of alcohol consumption within the previous 24 hours were recorded. Usual consumption of alcohol in the preceding 12 months was estimated by the quantity frequency method. Alcohol dependence was screened for by the CAGE questionnaire. An assessment of disability was made using the Barthel index. Breath alcohol was measured. In only 2% of attenders was alcohol thought to be a contributory factor. Breath alcohol measurements were technically unsatisfactory in this age group. Regular drinkers were functionally and socially more independent than non-regular drinkers. Drinking patterns in this age group may partly be determined by the physical ability to obtain alcohol. Alcohol was not found to be a major factor in A&E attendance in elderly people.

How much can data on days with heavy drinking decrease the underestimation of true alcohol consumption?

An adjusted quantity-frequency method, with questions on occasions with heavy drinking, was used to estimate the consumption of alcohol during the last 30 days. The purpose was to analyze if it was possible to decrease the underestimation of true alcohol consumption. The questionnaire was mailed to a randomized sample of 1,500 individuals, 20-75 years of age, living in the city of Malmö, Sweden; 930 persons (64.3%) participated. Data on alcohol consumption were validated by comparison to sales of alcohol for the city of Malmö. The estimated per capita consumption of alcohol in the population was equivalent to 77.0% of the registered sale of alcohol in Malmö. By adding days with heavy drinking, the estimated weekly per capita consumption of alcohol among the alcohol consumers increased from 74.5 grams to 77.1 grams (+3.5%; p < .001). Of the alcohol consumers, 15.1% increased their reported consumption. In order to decrease even more the underestimation of the true alcohol consumption, we suggest the use of questions about any alcohol consumption that deviates from the typical consumption of each individual.

Measuring alcohol consumption: a comparison of the retrospective diary and the quantity-frequency methods in a college drinking survey.

As part of a larger study of college drinking, the quantity-frequency (Q-F) measure of alcohol consumption was compared to the retrospective diary (RD) method with 494 drinkers out of 606 respondents (75.8%) of 800 randomly selected undergraduates. Respondents were representative by sex and year in school of virtually all full-time undergraduates at Rutgers, the State University of New Jersey. The study tested the hypothesis that the RD would yield higher estimates of average alcohol consumption and of "heavy drinking" as defined by NIAAA typology (average two or more drinks per day) and of "peak drinking," a Q-F standard consisting of five or more drinks at least once per week. The study also compared the two methods as correlates of self-reported problems related to drinking. Results supported the major hypotheses that the RD would detect more overall consumption, heavy drinking and peak drinking than the Q-F. Results also demonstrated good consistency between the Q-F and RD as well as comparable correlations with the alcohol problem score.

The reliability and stability of a quantity-frequency method and a diary method of measuring alcohol consumption

The study aimed to assess the test-retest reliability of two commonly used measures of alcohol consumption, the quantity-frequency (QF) method and the diary method, as well as the stability of scores on the two measures over time. Two methods of assessing reliability and stability were employed. The first was a traditional method based on calculation of correlation coefficients for agreement between scores on repeated measures over a short retest interval to yield test-retest reliability coefficients, and over a long retest interval to yield stability coefficients. The second method was that devised by Wiley and Wiley (1970) to differentiate the effects of reliability and stability on repeated measures over time. The two methods were applied to a sample of heavy drinkers and to a sample of light drinkers. The results indicated that both the QF and diary measures are reliable in measuring alcohol consumption of light drinkers. Both measures are less reliable for heavy drinkers. The results indicate, in addition, that drinking consumption levels of light drinkers demonstrate a high degree of stability. However, the consumption levels of heavy drinkers demonstrate less stability, especially over a long time period. Heavy drinkers significantly reduced reported levels of alcohol consumption on both measures after the first test, suggesting a regression to the mean effect or the possibility of unintended intervention effects due to repeated measurement of drinking behaviour.

Comparison of a quantity-frequency method and a diary method of measuring alcohol consumption.

This study compared the results obtained with two measures of alcohol consumption, a quantity-frequency (QF) method and a retrospective diary method, using a worksite sample. In order to control for the possibility of order effects, a subsample was chosen for readministration of the alcohol measures, when the order of presentation of the two measures was reversed for half of the subsample. Varying the order of presentation of the alcohol consumption items did not significantly affect the results obtained, except for an interaction effect between drinking group and order of presentation. Although subjects reported greater alcohol use on the diary than on the QF method at lower levels of consumption, the findings were reversed for higher levels of consumption. The relationship between the two measures is linear, with slope less than 1. Overall, subjects reported statistically significantly more alcohol consumption on the diary (mean [+/- SD] = 18.3 +/- 19.1 drinks) than on the QF method (mean = 16.9 +/- 19.5 drinks). The diary measure identified 20.9% of drinkers reporting consumption of more than 28 drinks per week, compared with 17.8% for the QF. However, the diary measure identified only 10.6% of drinkers reporting more than 42 drinks per week, compared with 10.2% for the QF. Consequently, the usefulness of the diary in detecting heavy drinkers appears to decrease with increasing consumption. These findings suggest the need for careful selection of alcohol consumption measures for research purposes and the need for caution in comparing the results of studies using different measures of alcohol consumption.

The reliability of a timeline method for assessing normal drinker college students' recent drinking history: Utility for alcohol research

The test-retest reliability of male ( n = 40) and female ( n = 40) college students' reports of recent drinking behavior was evaluated using a timeline (TL) procedure. The students also completed a quantity-frequency (QF) questionnaire (Cahalan, Cisin, & Crossley, 1969) often used to categorize subjects' drinking histories in alcohol research studies. The TL-derived data were found to have generally high reliability (usually r's ≥ .87) for both males and females, with males having slightly higher reliabilities overall. Subjects were classified into drinker categories based on the QF questionnaire answers, and the resulting groups were compared using their TL-derived data on quantity, frequency, and quantity X frequency (mean number of drinks per drinking day) measures of drinking. The drinking behavior of subjects (as assessed by the TL) had great variability within the QF categories, and there was extensive overlap between subjects classified by the QF method as heavy, moderate and light drinkers. Thus, QF categorization provides a relatively insensitive measure of individual differences in drinking behavior as compared to TL-derived data. The TL method also can be used to generate a variety of potentially useful dependent variables, whereas the QF method generates a single variable.