Effects of Drinking Patterns and Social Conditions on Incidence and Chronicity of Alcohol-Related Problems
Hajema, Klaasjan, Knibbe, Ronald A., Drop, Maria J., Contemporary Drug Problems
The central issues of this article are the development and persistence of alcohol-related problems. In a nine-year follow-up study, data were analyzed on the association of chronicity and incidence of alcohol-related problems with several aspects of drinking behavior and some social conditions. The main purpose of the study was to assess which aspects of drinking behavior, other than the level of consumption or heavy drinking, and which social factors contribute to (1) the chronicity and the remission of alcohol-related problems and (2) the incidence of alcohol-related problems. The development and the persistence of alcohol-related problems refer to processes that should be assessed by longitudinal data, as in fact do the concepts of incidence and chronicity. Therefore measurements at Ti and changes at T2 of level of consumption, frequency of heavy drinking, drinking contexts and social conditions were analyzed to find indicators of chronicity and incidence of drinking problems. The longitudinal data of this study offer the opportunity to assess which aspects of drinking patterns, including contexts of drinking, and which social characteristics or changes in social conditions are associated with:
1. The chronicity of alcohol-related problems among drinkers who reported alcohol-related problems at first measurement.
2. The incidence of alcohol-related problems among drinkers free of alcohol-related problems at first measurement.
By definition, alcohol-related problems are likely to emerge, to persist, or to go into remission in association with the consumption of alcohol. No general theory is required to understand that a higher level of consumption means a greater probability of experiencing alcohol-related problems. In alcohol research the two most important aspects of drinking behavior related to drinking problems are the level of consumption and heavy drinking (e.g., Makela & Simpura, 1985; Room, Bondy & Ferris, 1995; Hilton, 1987). Recently Room et al. (1995) found that alcohol-related harm started at less than one drink per day and increased roughly linearly with higher levels of consumption. In the same study, however, heavy drinking was found to be a stronger predictor of alcohol-related harm than average daily consumption.
Only a few studies have examined the influence of aspects of drinking behavior other than volume and heavy drinking (e.g., Gruenewald, Treno, Millar & Mitchell, 1995; Single & Wortley, 1993; Casswell, Zhang & Wyllie, 1993; Stockwell, Lang & Rydon, 1993; Fitzgerald & Mulford, 1983). These studies suggest that besides volume and frequency of heavy drinking, other aspects of drinking behavior, such as contexts of drinking, might also play a significant role in the development of alcohol-related problems. For example, Fitzgerald & Mulford (1984) found that the frequencies of drinking in bars, at others homes, at one's own home, and at sports events contributed to the explanation of drinking problems, even when controlling for volume and heavy drinking. In addition, Harford (1994) found an effect of the frequency of drinking in bars on drinking problems. As an explanation, Harford suggested that drinking in bars might be related to lifestyles at a higher risk for alcohol-related problems. Gruenewald et al. (1995) investigated the influence on alcoholrelated injuries of quantity and frequency of drinking and also of the variation in quantities consumed over time. Among drinking pattern data, the variance in drinking quantities consumed over time was found to be the strongest predictor of alcohol-related injuries.
There are at least two reasons why in research on alcoholrelated problems the study of the effects of social conditions is important. First, social conditions are predictors of the level of consumption, of heavy drinking, and of other aspects of drinking behavior; these variations in drinking behavior produce differences in the amount and development of alcohol-related problems. …