Academic journal article Alcohol Research

Biomonitoring for Improving Alcohol Consumption Surveys: The New Gold Standard?

Academic journal article Alcohol Research

Biomonitoring for Improving Alcohol Consumption Surveys: The New Gold Standard?

Article excerpt

An important focus of alcohol research is measuring alcohol consumption levels of larger populations to get a better understanding of real-life consumption patterns as well as the health and social consequences of drinking. Although this sounds fairly straightforward, it actually is quite challenging to devise measurement tools that allow for accurate and reliable reporting of alcohol consumption by larger numbers of subjects in surveys, with a low reporting burden to the participants. Measurements of blood alcohol concentrations (BACs) would provide the most reliable information on a key biological counterpart to alcohol consumption but are invasive and thus not feasible outside of very limited, usually laboratory-based studies. Breath alcohol concentration (BrAC) measurements are less invasive to obtain, but to be useful they also require demanding, repeated measurements. Self-reports of alcohol consumption (e.g., via drinking diaries or summary measures) are more convenient and can be implemented even in studies that include large numbers of participants; however, these self-reports also have their drawbacks, principally potential recall bias. Consequently, researchers are looking at developing other tools for monitoring alcohol levels through objective biological measures in a convenient, noninvasive manner.

This article explores how biological measures have been used to validate and increase the accuracy of self-reports of alcohol consumption in general-population epidemiologic surveys. After reviewing some of the limitations and difficulties associated with self-report alcohol consumption measures, the article briefly reviews studies involving two biomonitoring devices-the SCRAM(TM) device and the WrisTAS(TM) device-and describes in more detail a study that compared alcohol consumption reported via traditional self-report drinking diaries and period summaries with measurements using the WrisTAS(TM) device. It is important to note, however, that these findings to date are at an early stage and additional, well-controlled studies are necessary to confirm the findings. The article also briefly touches on the benefits and limitations associated with such biomonitoring devices as well as their value for improving alcohol intake pattern measurement in general population surveys.

Self-Report Alcohol Measurements and Their Limitations

The most commonly used approach to determining people's drinking levels in various studies is self-reported alcohol consumption as established using such assessment tools as quantity-frequency, graduated-frequency (GF), short-term recall, or time-line follow-back (TLFB) measures. Quantity-frequency measures simply ask respondents how often they drink and what amount of alcohol (i.e., how many drinks) they typically consume on each day or each drinking occasion. These measures can be expanded by distinguishing between beverage types, adding questions on binge or episodic heavy drinking, and assessing drinking patterns over different recall periods (Rehm 1998). GF measures attempt to get a more accurate measure of actual alcohol volumes consumed by grouping the number of drinks consumed in a day into graduated categories. Starting with the maximum number of drinks (Greenfield et al. 2006) respondents report having consumed on 1 day during a specified time period (e.g., the past month or year), they are asked how often they have drunk progressively fewer drinks per day during the same time period. This approach allows researchers a better estimate of specific drinking patterns and improves the accuracy of the estimate of total consumption (Greenfield 2000). Short-term recall measures ask respondents to recall all alcohol that they have consumed during each day in a recent short period (e.g., the last week) (Rehm et al. 1999), based on the assumption that respondents are able to remember consumption more accurately over such short periods. A similar approach is the TLFB method (Sobell and Sobell 2000), which asks respondents to provide retrospective estimates of their drinking using a calendar, going back in time from the time of the interview. …

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