Printad in Great Britain Alcohol Consumption, Alcoholism and Excessive Drinking—Errors in Estimates

A persistent fallacy in epidemiological research into alcoholism is pointed out and the history of its perpetuation discussed. The Implications of recognizing the fallacy are outlined with particular reference to public policy. The problem of alcoholism is increasingly a major focus of concern in the fields of health education and public health (1,2), but precise figures of the pre-valence of alcoholism in the general population are very difficult to obtain. Many definitions of alcoholism involve subjective judgements and are correspondingly difficult to make operational. Survey methods are therefore unlikely to be useful in this field, involving. additional problems of response validity, etc. Experience in the UK with the Family Expenditure Survey shows that total national alcohol consumption estimated from the survey is considerably less than that obtained from taxation statistics, presumably because of under-reporting of expenditure on alcohol (3), either from reluctance to admit to high alcohol consump-tion or from difficulty in recalling expenditure on alcohol. Hospital admission statistics necessarily reflect the provision and public awareness of treatment facilities as much as the number of alcoholics, while drunken driving convictions are influenced by the number of cars on the roads, age of drivers and of course police activity (4). It is against the background of an increasing demand for information on the prevalence of alcoholism and the obvious difficulty of obtaining this information that an approach to these problems with the aim of estimating the prevalence of excessive consump-tion of alcohol has achieved some prominence in the international literature on the epidemiology of alcoholism (5,6)