Health Essays – Binge Drinking Alcohol

Binge Drinking Alcohol

Question: With evidence for a new ‘culture of intoxication’, what are the current attitudes on binge drinking in UK society, and what are the possible causes for the current alcohol consumption patterns in contemporary society?

Introduction

The aim of this thesis is to answer the question: ‘With evidence for a new ‘culture of intoxication’, what are the current attitudes on binge drinking in UK society, and what are the possible causes for the current alcohol consumption patterns in contemporary society?’ This has been done by carrying out primary research in the form of a questionnaire in order to gain an insight into individuals’ drinking behaviours, and their attitudes towards binge drinking in western society.

This piece of work primarily focuses on different drinking patterns and attitudes amongst different social groups in society, and reasons behind these differences. Although social policy is touched upon during the thesis, this is primarily to put the thoughts and behaviours of the sample group into context, and the primary focus is on sociological factors behind the participants’ reactions to alcohol and binge drinking.

In recent years there has been an increasing public awareness and concern regarding binge drinking culture in the UK. Alcohol Concern (2003) stated that their research found that 40% of all male alcohol consumption takes the form of binge drinking sessions, while female binge drinking has increased significantly over the last decade.

The 1995 Government report, ‘Sensible Drinking’ altered the recommended drinking allowance for males and females from a weekly amount to a daily amount, resulting from concern over the UK binge drinking culture and the worry that ‘weekly consumption can have little relation to single drinking episodes and may indeed mask short term episodes which…often correlate strongly with both medical and social harm’. (Sensible Drinking, 1995 cited in Alcohol Concern, 2003)

Gofton (1990 cited in Measham & Brain, 2005; 264) comments that socio economic restructuring during the 1980s has lead to changes in patterns of consumption, and the development of the British ‘lager lout’. Traditionally, drinking has been a male dominated, community based event but the decline in mixed age groups of male workers has meant that landlords cannot afford to rely on their traditional customer base and as a result drinking has developed into a pastime for both mixed and single sex groups; often age specific, participating in heavy sessional drinking during their free time at evenings and weekends. (Mintel, 1998 cited in Measham & Brain, 2005; 265)

Measham and Brain (2005) argue that there have been four key transformations that have led to the recommodification of alcohol and the significant rise in sessional drinking. Firstly, a much wider range of alcoholic beverages have been produced in the last decade, to suit all tastes and budgets. There has also been an introduction of high strength alcoholic products, as well as increased strength of traditional alcoholic beverages such as beer and wine, by up to 50%.

Thirdly, there has been an increase in marketing and advertising of alcohol products to promote a culture of consumption and the need to purchase alcohol as a lifestyle marker and status symbol. The recent image overhaul of drinking establishments as trendy places, with drinks promotions to encourage greater alcohol consumption has also aided the transition towards a binge drinking culture.

The Government Licensing Act and other related policies have aimed to promote civilised drinking by addressing drunkenness and anti social behaviour related to drinking with harsher penalties against offenders and by introducing more liberal 24 hour licensing laws with the aim that having extended hours will encourage a more relaxed approach towards drinking as people will not rush to drink as much as they can before the 11 pm curfew.

Further sanctions have been placed on drinking establishments in an attempt to combat drink related disorder at the source by placing responsibility on licensed establishments to maintain order on their premises, to check for underage drinkers and to refuse to serve those who are already highly intoxicated. (Measham & Brain, 2005; 263)

A recent review of the licensing laws saw that overall, alcohol related crime rates had reduced as a more relaxed drinking climate has resulted from the introduction of 24 hour licensing laws. Culture Secretary, Andy Burnham commented, ‘Our main conclusion is that people are using the freedoms but people are not sufficiently using the considerable powers granted by the Act to tackle problems’. (Burnham, 2008 cited in Donaldson & Vina, 2008)

It would therefore appear that although a more positive image of alcohol consumption is being created in the UK, problems associated with binge drinking still exist and have not necessarily been addressed effectively through the change in licensing laws.

Alcohol Concern (2003) has noted that people in the UK have yet to understand fully the dangers of binge drinking. The majority view it as having a good time, a social norm and part of growing up. In the 1993 survey, findings showed that 42% of those who regularly binge drank recognised that it was harmful to their health but only 24% males and 31% females were motivated to change their drinking habits to improve their health.

Further to this the recent GENACIS study of gender and drinking found that the majority of individuals were willing to accept the negative experiences that sometimes occurred as a result of binge drinking in order to enjoy the mainly positive experiences of drunkenness.

To summarise, ‘drinking and drugs can be seen as indicators of socio economic and cultural change in the relationship between work, leisure and consumption. Not only do young people form their identities through consumption but the psychology of consumption is centred on the search for gratification, integration and identity formation’. (Measham & Brain, 2005; 276)

As such, it is understandable if binge drinking has developed as the latest moral panic based on established ideas about binge drinking and social disorder. It is therefore the aim of this study to uncover the attitudes and beliefs of those in current UK society regarding binge drinking and related drinking habits.

This piece of research into the attitudes and beliefs of people in the UK takes on an interpretive social perspective whereby studying a subject from a sociological perspective, it is important to consider that people are ‘active conscious beings’ (McNeill & Chapman, 2005; 19) and it is necessary to take into account how people’s thoughts and beliefs influence their decisions of how they act as autonomous individuals interpreting the social world around them.

Weber believed that external causes on their own are not adequate explanations for people’s actions and that it is necessary to understand individual’s motivations and how they interpret the situation in order to fully understand social actions. (McNeill & Chapman, 2005; 19)

As noted by Carey (2001), using the term binge drinking can cause some confusion as there are a number of definitions, largely based around amounts of alcohol consumed, which can cause the connotation of binge drinking to vary. For use in this survey, ‘binge drinking’ refers to excessive sessional consumption, which can lead to feelings of intoxication and drunkenness, whether intentional or unintentional. A qualitative definition of binge drinking has been used for this research as the disadvantages of allocating a certain quantitative unit of alcohol to the definition means that binge drinking becomes associated with levels of drinking dangerous to health and negative consequences.

It also fails to address that, although binge drinking frequently or over long periods of time can lead to a greater likelihood of problems or negative consequences as a result, that this is not always the case and that many people enjoy and have experienced positive effects from occasional binge drinking. (Weschler et al, 2000 cited in Carey, 2001; 285) By allocating quantitative measures it fails to address that binge drinking and drunkenness are subjective as different amounts of alcohol affect individuals at different levels, and perceived behavioural control is a primary influencing factor where alcohol consumption is concerned.

Research Methods

For this study, a combination of descriptive and explanatory primary research was carried out, in order to create an overview of people’s attitudes towards binge drinking, and individual drinking habits, as well as attempting to produce an explanation as to why people binge drink and why this is perceived as a social problem in society. (McNeill & Chapman, 2005; 7)

A self completion questionnaire was decided upon as the most appropriate method of research as it was the most time and labour effective method of data collection. It is possible to obtain relatively extensive data from a large sample over a short time span using a questionnaire, which can increase the representativeness of the results making them more generalisable. (McNeill & Chapman, 2005; 10)

After deciding on the issue of binge drinking, a limited literature review was carried out to ensure the subject to be studied was viable, and also in order to identify common themes and key questions to ask candidates. Literature included journal articles by Measham and Brain (2005), Ajzen and Madden (1986), and Johnston and White (2002).

A hypothesis was not developed as the research aimed to look for any general patterns in binge drinking behaviour and underlying reasons for the behaviour, and it was therefore felt that to create any specific hypotheses would create too much of a reductionist viewpoint from which to start the investigation.

As previously mentioned, a limited literature review was carried out in order to identify key issues that had occurred in previous research to develop an idea of significant areas to be covered in the questionnaire, but overall the aim was to maintain a broad perspective based around an interpretive reflection of findings and attempt at a causal analysis. The aim of the survey was to cover a variety of age groups with different socio economic circumstances, and different gender groups, to see if this affected attitudes towards binge drinking.

Approaching people directly and e-mailing copies of the questionnaire out to individuals developed a snowball sample whereby the questionnaire was passed on to others by initial participants and so the sample ‘snowballed’. Due to the vast number of people who use e-mail in contemporary society, and the convenience of using this medium of communication, it meant that e-mail was an especially viable method of contacting potential participants. (Sheehan & Hoy, 1999 in Seale, 2004; 107)

An initial draft questionnaire was developed using a variety of open and closed questions, primarily using closed questions to establish simple answers such as age, gender, income, etc with open questions primarily used as follow up to the closed questions to find out more detail and reason behind the answers selected in the closed questions. Some Likert scales were used to enable participants to express strength of opinion, which could be compared with other participants’ answers.

The advantage of closed questions is that they could easily be pre coded to enter directly onto the SPSS software programme to be analysed, while it can be difficult to organise answers of open questions into categories for post coding and comparing participants’ answers. (Moser & Kalton, 1971 in Seale, 2004; 83) While closed questions can verify their meaning by giving participants a selection of answers to choose from, and makes the survey easier for respondents to complete, it also results in a loss of spontaneity and detail in answers, and subjects may find that there is not always a category suitable for the answer they wish to give.

In contrast, although open questions are more time consuming to complete, they allow for more detailed and unusual answers to be given, as well as reducing demand characteristics enabling participants to give more open and less influenced answers. (Bryman, 2004; 147) For this reason, combinations of the two sorts of questions were used in order to enhance the effectiveness of the survey.

After a pilot run of the questionnaire that identified any faults, improvements were made and the final complete questionnaire was distributed amongst individuals with a range of ages. The disadvantage of snowball sampling is that it is much less systematic than other forms of sampling as it is based on the presumption that by selecting key individuals, other similar individuals will come forward who would make the sample representative, but this may not necessarily be the case.

On this occasion, gathering a sample based on this premise proved successful as no one age category had a significantly higher number of participants than any other. The overall constituency of the sample consisted of 14.3% Under 18s, 24.7% 18-30s, 19.5% 31-45s, 22.1% 46-60s, and 19.5% 61 and over.

In order to analyse the data the closed questions were pre coded and the open questions divided into common themes and post coded, then entered onto the SPSS software system in the form of figures and symbols which could be counted and added up, in order for the data to be analysed using a variety of statistical analysis techniques; primarily cross tabulation tables. (McNeill & Chapman, 2005; 52)

After producing cross tabulation tables from the data collected, it was found that many of the supporting Chi Square Test results produced values bigger than 0.05, suggesting no significant relationships between the variables. This could have occurred for a number of reasons; the sample may not have been big enough, or large tables with many cells may not have had enough cases in each cell to generalise from even where the differences in percentages on the table appear to have quite a large difference.

In these cases, patterns could often be identified visually from looking at the tables based on the premise that a significant relationship could have been found if a larger sample had been used. However, caution in generalising these findings had to be taken based on the Chi Square results.

Secondary data in the form of literature reviews and statistics collected by others were also used to develop ideas, and also to verify findings from the primary research; more than one source of data is used to cross check findings and verify their validity. (Bryman, 2004; 545)

The reliability of the research is considerably higher than other methods that could have been used as questionnaires can be replicated with the exact questions and phrasing as many times as needed. However, with regard to the nature of some of the questions asked for this particular questionnaire about drinking habits which involve memory, reliability may be affected as people’s memories may not be accurate or may base their answers on their most recent drinking activity, so if asked another time may produce different answers. (Moser & Kalton, 1971 in Seale, 2004; 81)

The validity of this research could be considered to build a relatively realistic picture of what is being studied as the validity of people’s answers could be checked by comparing what they say their attitudes towards alcohol consumption is, with their actual reported drinking behaviours.

A person is more likely to be open about their opinions and behaviours in writing than if asked to talk about them due to dissociation with the response. However, questionnaires can be affected by demand characteristics, particularly with closed questions, and people may pick what they believe to be the most socially acceptable rather than what they actually believe. (Moser & Kalton, 1971 in Seale, 2004; 75)

A further problem experienced with this questionnaire was that a number of questions were not completed on some questionnaires. It is not possible to know whether this is because participants accidentally missed the questions, or did not wish to disclose particular information. Further to this, some answers for questions such as asking people to select socially acceptable places to consume alcohol, it is possible that they selected those which reflected their own drinking habits, rather than what they thought the majority of society would view as socially acceptable. This may affect the validity of the final results.

This appears to be an ethically sound piece of research as all the participants were informed of the purpose of the research and what the disclosed information would be used for. It was made clear that their participation was voluntary, and they were therefore giving informed consent.

In an attempt to safeguard the privacy of research subjects, especially as the questionnaire required some personal information to be disclosed, all participants remained anonymous so that the information they disclosed remained confidential and could not be traced back to the individual. (McNeill & Chapman, 2005; 13) It could be viewed as a concern that Under 18s were not asked to provide parental consent before completing the questionnaire, but due to the anonymity of the survey it was felt that it was unnecessary providing the participant themselves gave informed consent.

One way the overall research process could have been improved would have been to carry out more in depth preparatory investigations such as focus groups to discuss the issue with individuals and gain a deeper understanding of their perspective on the situation, and what they thought the key issues related to binge drinking were. A focus group could have helped create clearer guidelines for research and possibly aided the development of a hypothesis to create a more focused piece of research. (McNeill & Chapman, 2005; 32)

Alternative or additional methods of research could have been used to investigate the binge drinking culture in the UK. One option could have been to carry out an ethnography. This would allow the researcher to witness participant behaviour in their natural setting, without demand characteristics affecting the situation. However, for the purposes of this investigation it would have affected the representativeness of the population as certain places attract certain types of people.

Also, people will act differently in different situations and may be less likely to binge drink when at home than when out, but it would not be possible to observe this using an ethnography based in a single social setting. A further problem with ethnographies is that they can be the subjects of experimenter bias, as the experimenter must interpret the situation they are observing which is based on a subjective understanding of the situation. (Hammersley, 1991 in Seale, 2004; 243)

A further alternative method could have been to interview participants rather than using a questionnaire. This method could have collected factual and attitudinal data in greater depth than a questionnaire. However, interviewing is more time consuming as it involves recording and transcribing the conversations before it can be coded and analysed.

There is also the problem of interview bias, whereby the interviewee attempts to interpret what the interviewer wants from the situation based on their response to certain answers and the leading questions they ask. As mentioned before, the reduced anonymity of interviewing as a result of having to speak to someone face to face may affect the openness of the answers that participants give, and they may be less truthful or disclose less accurate information. (Bryman, 2004; 338)

Overall, it was felt that a questionnaire was the most appropriate method of data collection for this piece of research, providing the most effective means of collecting relevant data.

Culture of Consumption

‘Culture’ in this context is referring to the workings of society, from policy relating to the selling and consumption of alcohol, through to market influences and post traditional lifestyles and relationships which are leading to shared beliefs and values regarding binge drinking in contemporary society. Culture is important as it is through exposure to it within specific societal contexts that people develop their own thoughts and values regarding certain behaviours and what is socially acceptable.

According to the relevant Chi Square Test results, none of the Charts 1-4 in Appendix A showed a significant or reliable relationship between the variables. However, observations can be made from all the charts produced. Chart 1 which demonstrates the frequency of alcohol consumption of women with different levels of disposable income, shows that regardless of disposable income levels, the majority of women for each income category reported consuming alcohol more than once a week; 80% of those with a disposable income of less than £100 reported doing so, 100% of the £101-£400 per week doing so, and 66.7% of the over £400 per week.

This could suggest that although disposable income may restrict the frequency of alcohol consumption to some extent, overall a culture has developed whereby alcohol consumption is viewed as an important aspect of socialising, relaxation and leisure time.

Chart 3 showing frequency of alcohol consumption for the total sample with different levels of disposable income, also supports these findings. Interestingly, the £101-£400 per week disposable income group appears to consume alcohol the most frequently. This could be as a result of having a higher disposable income to spend on alcohol, yet more leisure time than those who earn more – who possibly work longer hours – in which to drink it.

From observing Chart 2 which shows the frequency of alcohol consumption of women with different sources of income, it can be seen that although the Chi Square has not shown a significant relationship between the two variables it would appear that whether income is earned – suggesting employment participation – seems to influence the frequency of alcohol consumption in women. 92.3% of those women who received income from employment consumed alcohol more than once a week, compared with 61.1% of those with an unearned income.

Reasons for this could be that women who work tend to drink more to reduce stress levels and as a method of relaxation, or it could be that those with an unearned income may have a lower disposable income to spend on alcohol, or that they feel the money is not theirs to spend on such luxuries so freely.

Alcohol related attitudes and behaviours which have been discussed so far in this study highlight changes which have occurred over time, not in isolation, but against a backdrop of economic, social and cultural change in transition from an industrial to a post industrial consumer society, and a ‘culture of consumption’. (Measham & Brain, 2005; 275)

In relation to alcohol Measham and Brain (2005) argue that the economy in the UK relies on the exploitation of hedonism. The UK nighttime economy, which has developed extensively over the last decade, thrives on the promotion of consumer excess and intoxication. Daniel Bell (1975, cited in Measham & Brain, 2005; 275) argues that in contemporary society individuals have lost the influence of the traditional sources of structuring such as occupation and family, and as a result new sources of collective identity have been formed, based around the market and in terms of alcohol, around the night time hedonistic culture of consumption; individuals seek to construct their identity through consumer products.

This transition has facilitated greater opportunities for individuals to engage in hedonistic consumption, along with the decline in traditional norms and values that limited excessive consumption of alcohol. Cofield and Gofton (1994, cited in Measham & Brain, 2005; 275) argue that amongst this hedonistic economy, drinking is no longer viewed only as a form of social integration, but more emphasis is placed on relaxation through the purchase of consumer products such as alcohol.

This idea is supported by James (Cited in Wessely, 1998) who views contemporary society as a ‘low serotonin society’ and claims that individuals in society are more depressed than ever before, and that the increased pace and competition of life has led to family breakdown and higher stress levels. James concludes that people in contemporary society are self obsessed and overly concerned with their emotional well being; as a result of this people are looking for methods of relaxation and escapism, alcohol of which is one, which in turn has lead to social changes and a culture of consumption in the pursuit of happiness. (Wessely, 1998)

This could be seen to support observations in chart 2 as those whose incomes come from paid employment drink more frequently, which is likely to be as a result of the stresses and strains of everyday life. Further to this it could be argued that the reason there is only a marginal difference between income and frequency of consumption is that it relates more to individual life circumstances and the stress levels in individuals’ lives rather than money available to spend on alcoholic products.

Chart 4, which shows differences in preferred alcohol beverage by different disposable income groups shows that no significant relationship exists between disposable income and preferred alcoholic beverage. However, it can be noted that overall the most popular alcohol beverage was wine/champagne, with 52.8% of the total sample selecting this as their preferred beverage. A reason for this may be that there are such a wide range of wines available to suit all tastes and budgets. 100% of those who had a disposable income of more than £400 per week chose wine/champagne as their preferred beverage.

This may be because expensive wine/champagne can be bought as a symbol of status in society, particularly if consuming in public places such as restaurants or high status bars. It can also be noted that 100% of those who selected alcopops as their preferred beverage were in the £100 per week or less disposable income category. This may be because generally alcopops are popular with younger drinkers, who are also likely to be those with a lower disposable income available to spend on alcohol.

The popular demand for wine as an alcoholic beverage is supported by Duffy’s research (1981; 200) which found that the consumption of alcohol products almost doubled between 1963 – 1979, particularly wine and spirits. He also comments that a reason for this is that the relative price of drink has declined which has enabled consumers to purchase alcohol in larger quantities. The British Medical Association has argued that raising the price of alcohol beyond inflation levels would aid the control of the problem of binge drinking, and that this could be achieved by introducing minimum prices for each type of alcoholic drink. (Louth, 2008)

However, it has been argued that increasing prices will not deter those who feel a ‘need’ for alcohol, just as increasing the prices of cigarettes has not stopped smokers buying them. It is an issue of personal demand over anything else. (Louth, 2008) Further to this, there are so many alcoholic drinks marketed by different producers that it would require an entirely new governmental system to control restrictions on the price and marketing of alcoholic beverages.

Duffy (1981; 202) investigated whether advertising and/or taxation contribute in any way to official alcohol control policy. The income elasticities were found to be 0.8 for beer, 1.7 for spirits and 2.2 for wine – these figures show the elasticity of demand in relation to income. These estimates of elasticity appear to correspond with the findings of chart 4, which suggests that wine is one of the luxury products which people tend to consume more of, especially in the privacy of their own homes, particularly as their disposable income increases.

The findings of Duffy’s research also suggest market demand for wine has increased at a greater rate than other alcoholic beverages, with consumption of wine increasing at a faster rate than the consumers’ relative income. (Duffy, 1981; 204) In 1970, on average individuals drank approximately seven litres a year of pure alcohol compared with an average of nine litres a year in contemporary society. Whereas the consumption of beer and spirits has remained relatively stable over a long period of time, the consumption of wine increased dramatically, representing over 80% of total alcohol consumption.

This would also suggest that increases in alcohol consumption cannot be directly related to anti social behaviour as many of those middle class individuals, reflected in the findings relating to income and preferred alcoholic beverage, will not be seen creating disturbances and expressing anti social behaviour in public spaces. Many prefer to consume alcohol within the privacy of their own homes. (Louth, 2008)

Yet Government statistics for middle class individuals who participate in habitual wine drinking show that they are consuming enough alcohol to cause considerable damage to their health, and government research has suggested this hidden drinking culture is also problematic in terms of putting pressure on the NHS through alcohol related hospital admissions, but largely ignored as it occurs behind closed doors. The Public Health Minister, Dawn Primarolo commented ‘Most of these (admissions) are not young people; they are ‘everyday’ drinkers who have drunk too much for too long.’ (Primarolo, 2007 cited in Boseley, 2007)

Duffy also found that the estimated elasticities for advertising of all alcoholic beverages were low, especially for wine. The assumption here is that there are so many adverts for other alcohol products competing against each other and against other products in general, that they cancel each other out and have relatively little impact upon the consumer. However, their continuous presence is likely to contribute to the popular cultural belief of alcohol consumption as an integral part of social life in western society. (Duffy, 1981; 205)

It can also be noted that the shots category was not selected by anyone as a preferred beverage and as such is not shown on the chart. However, this may be because shots are not drunk as a primary beverage on a night out but as a supplement, or as a chaser, in order to catalyse the development into a state of drunkenness. Measham and Brain’s research (2005) found that although shots and shooters were not considered a primary product to consume on a night out drinking, they were becoming an established part of a night out binge drinking.

They were mainly drunk as a cheap addition to a night’s alcohol consumption with 40-60% of participants in the study reporting consuming at least one shot on a night out. (Measham & Brain, 2005; 270) The main reasons found for consumers purchasing shots were to quicken the process of achieving drunkenness, and as a cheap way of making an inexpensive gesture towards friends by buying them shots too – they are cheaper than a typical round of drinks for those who cannot afford to pay out more.

The increasing popularity of ‘doing’ shots has created concerns regarding issues of responsible drinking patterns. By consuming shots alongside long drinks it increases the speed and quantity of alcohol consumed as shots tend to be ‘downed in one’ as well as encouraging people to mix their drinks, which can heighten the state of intoxication.

Drinking patterns such as these can be seen to hav