Interpretation and use of official drinking guidelines by adults in England and Scotland: a qualitative study

Background The UK Government is reviewing its low risk drinking guidelines for adults. However, there is a lack of evidence on the public's understanding and use of official guidance on alcohol consumption. We aimed to explore qualitatively adult drinkers' awareness, interpretation, and use of current drinking guidelines; and their beliefs and practices around self-regulation of their alcohol consumption. Methods 12 focus groups were conducted in England and Scotland during early 2014 with drinkers aged from 19 to 64 years (n=66). Independent market research consultants identified, recruited, and took informed consent from participants. Participants were recruited door-to-door from eight locations in England and Scotland. Participants were each given £25 for taking part. Participants were purposively sampled and grouped by age, sex, and socioeconomic background (professional and technical, unskilled and manual). Participants were asked about their awareness of the current drinking guidelines, their views on the purpose of guidelines, how they interpret and use the guidelines, and other strategies they have for regulating their alcohol consumption. The focus groups were audiorecorded, transcribed verbatim, and coded with NVivo (version 10) software. The data were analysed thematically. Ethics approval was granted by the University of Sheffield and the University of Stirling. Findings Participants disregarded the drinking guidelines for two main reasons. First, the guidelines were regarded as irrelevant to participants' existing drinking practices. Reasons given included the dissonance between the guidelines, which are aimed towards regular drinking, and the participants' tendency to binge drink at weekends; the disconnect between amounts given in the guidelines and participants' typical consumption levels; and problems of measuring and monitoring units. Second, participants perceived a lack of information on the scientific evidence behind the guidelines and the consequences of exceeding them. Interpretation Governments need to ensure that guidance they provide on alcohol consumption is useful and meaningful to drinkers, and understand how people use it to inform their behaviour. Our findings suggest a disconnect between the drinking guidelines and commonplace drinking practices, and a credibility gap that is a barrier to the guidelines' effective use. People responsible for developing and designing drinking guidelines should seek to better reflect drinking practices and evidence concerns when communicating guidance