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Sally Casswell and Krishna Bhatta
Alcohol & Public Health Research Unit, May 2001

These research findings are based on a rigorous methodology allowing comparisons over time.  The consistency in the results for the different measures also adds to the credibility of the results and allows for confidence when drawing conclusions from the findings.
Having ten annual measurement points provides a rich and unusual source of data to identify trends.  The data are drawn from the Auckland region and reflect an urban drinking environment and demographic changes which have been specific to Auckland. While some differences from the national picture have been identified in this report overall it is likely that the trends seen in Auckland were similar to those elsewhere in the country. These data have provided a clear picture of a worsening situation, from a public health perspective.
Much of the alcohol related harm experienced in New Zealand is a consequence of heavier drinking.  This study has found significant increases in a number of measures of heavier drinking across the decade. The typical quantities consumed on a drinking occasion have increased, as have complementary measures such as frequency of drinking enough to feel drunk, and frequency of drinking larger amounts.  These increases have been particularly marked among the youngest people in the sample, 14-19 year olds, but increases were also found among the heaviest drinking group, the younger (under 30) men. There were also increases among women of all ages, although on average they continue to drink smaller quantities than men.  The only group not to report increases in measures of heavier drinking were the men over 30.
In keeping with the known relationship between heavier drinking occasions and alcohol-related harm, the experiences of problems associated with people’s own drinking reported in the survey have also increased slightly over the decade, as have reports of alcohol related violence such as physical assault and sexual harassment by drinkers.
While the increases in the quantities consumed are not large across the whole sample - an increase from an average of 3 drinks to 3-4 drinks on a typical drinking occasion, they are most pronounced among younger 14-17 year old drinkers an increase from 2-3 in 1990 to 5-6 drinks in 1999. Such increases in consumption among the younger group in the population are of concern from a public health perspective in terms of the increases in acute harm experienced by that group. They are also of concern given the evidence that heavier drinking cohorts of young people go on to be heavier drinkers in later life and to experience more alcohol related harm (Fillmore et al., 1991; Chou and Pickering, 1992; Yu and Williford, 1992; Pedersen and Skrondal, 1998).  These trends therefore suggest accumulated problems as this cohort moves through into adulthood.
The survey data also allowed an examination of the drinking locations in which heavier drinking occasions had increased. These increases have occurred in the context of a changing drinking environment in Auckland over the last decade.  New kinds of licensed venues and alcohol outlets have opened, there are more of them and they are open for longer trading hours.  Sales in supermarkets, for example, have increased the availability of wine. Nightclubs contributed to increased accessibility for younger people at the beginning of the decade and are a venue in which the under 20s have engaged in heavier drinking occasions, particularly in the second part of the decade. Nightclubs and pubs have been able to operate for longer hours and these are both venues in which people have engaged in heavier drinking occasions. Such changes in the drinking hours, allowing longer drinking sessions, have been shown in overseas research to contribute to heavier drinking and alcohol related harm (Smith, 1988; Goddard, 1991; Edwards et al., 1994).
The Sale of Liquor Act (1989) also introduced changes to the conditions of licences which were intended to reduce intoxication, and various community level initiatives have also taken place. However, enforcement of the sale of alcohol was not stringent over the decade and in the context of a more liberal social climate these measures have not been sufficient to prevent increases in heavier drinking occasions.
Other locations in which there have been increases in heavier drinking occasions have been in homes and non licensed locations, such as outdoor public places and cars. These increases point to more generalised influences on consumption than those directly affecting drinking on licensed premises. The greater availability of takeaway alcohol, particularly sale of wine in supermarkets, is a likely contributor.  Other research has shown that the introduction of wine to supermarkets was responsible for a 16% increase in wine consumption in New Zealand (Zhang and Casswell, 1999).  Qualitative research suggested this was particularly important for women (Wyllie et al., 1993) and in this research increases were found for both younger and older women.
The increases are also likely to reflect other changes in the alcohol environment which have taken place over the decade. Major changes occurred in the marketing of alcohol with the introduction of alcohol brand advertising on television and radio in 1992. The likelihood that this exposure to powerful broadcast advertising has contributed to an increase in heavier drinking is supported by other research evidence which has shown that the television advertising in 1992-1993 increased heavier drinking by beer drinkers (Casswell and Zhang, 1998).  Other international evidence has also suggested a contributory effect of alcohol advertising to heavier drinking (Hill and Casswell, 2001).
Widespread broadcast advertising has also been linked to changes in the social climate surrounding alcohol (Wallack, 1983).  Evidence from these surveys suggests the development of a more positive climate.  There have been decreases in the number of people concerned about the drinking of others, despite the increase in heavier drinking and alcohol related problems. The greater availability of wine, including its sale in supermarkets may have also contributed to a process of normalisation. Over the decade more people believed that wine was a drink suitable for most times of the day. Wine’s availability in supermarkets and drinking more wine with meals also increased as reasons for drinking more.
Another influence in the media environment has been the proliferation of messages claiming that alcohol is good for health, based in large part on evidence of a reduced risk of ischemic heart disease (Edwards et al., 1994).  The surveys also found increases in the number of people who said drinking was good for their health was a reason for drinking more.
Measures introduced to counter negative effects of alcohol use over the decade have included compulsory breath testing and anti-drink-driving advertisements . However, there has been a decrease in the number of people who cited being ‘worried about being caught drinking and driving’ as a reason for drinking less since the peak in 1993 when CBT was introduced. This decline was confined to younger men and women however (those under 30).
Overall, however, there are indications of less caution over drinking, both from the increases in typical quantities being consumed and the complementary measure of drinking enough to feel drunk as well as from the more liberalised attitudinal changes found in the surveys.
There is evidence that economic changes influence consumption but this effected how often people drank, not the typical quantities they consumed. During the recession in the early years of the decade all income groups drank less often. Having less money to spend on alcohol was given as a reason for drinking less by more people at the time of the economic recession and this declined in popularity as a reason for drinking less as the economy recovered. Economic circumstances also affected the numbers of people who chose not to drink anything in the year prior to the survey. This was true of the lower and middle income groups who included fewer drinkers than the higher income group at the beginning of the decade and whose numbers of drinkers declined further in the first part of the decade. An upward turn in the Auckland economy was matched by an increase in drinking by all groups.  The higher income group, whose real income improved during the economic recovery, increased their frequency of drinking to pre-recession levels. However, their frequency of drinking levelled off in the second part of the decade when there was an increase in the real price of alcohol. 
These indications of the effects of economic change on how often people drink are of policy interest. They suggest that increases in consumption which are facilitated by improved economic conditions can be mitigated by an increase in the real price of alcohol.  This has policy implications since the real price is affected by taxation.
While it appears that taxation policy can contribute to reduced alcohol related harm by constraining how often people drink it did not constrain increases in heavier drinking occasions. Other policies related to how and when alcohol is made available and the management of licensed premises may require review in the light of these research results.


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