The enigma of 'harmful' alcohol consumption: evidence from a mixed methods study involving female drinkers in Scotland

Background/Aims: An appreciation of the drinking patterns of population subgroups may usefully inform tailored interventions. For this purpose research has highlighted a need to better describe the drinking behaviour of UK women. This study aims to characterise the purchasing and consumption behaviour of female heavy, harmed, drinkers in contact with Scottish health services in two cities and explore the factors that influence the link to harm.Methods: Mixed method study involving cross sectional survey questionnaires and one-to-one interviews (5). The questionnaires documented (i) demographic data (including derived deprivation score), last week’s (or ‘typical’ weekly) consumption (type, brand, volume, price, place of purchase), self-reported illnesses and (ii) Alcohol Related Problem Questionnaire score.Results: Median consumption was 157.6 UK units for the recorded week, with almost exclusive purchase from ‘off sale’ retail outlets. Preferred drinks were white cider, vodka and white wine. Increasing problems was positively associated with drinking more in the week, being younger, and belonging to Glasgow.Participants: 181 patients with serious health problems linked to alcohol, recruited within NHS hospital clinics (in- and out- patient settings), in two Scottish cities during 2012.Conclusion: For Scottish women the current definition of ‘harmful’ consumption likely captures a fourfold variation in alcohol intake, with gender differences less apparent. While current alcohol-related harm is positively associated with dose and being younger, there is clear evidence of an influence of the less tangible ‘Glasgow effect’. Future harm concerns are warranted by data relating to pattern, alcohol dose and cigarette use