Middle-aged moderate drinkers worried about respectability – not health

Respectability and the company of others, rather than health, drive the drinking habits of middle-aged people who do not have an alcohol problem, new research has found.
 
Researchers at the University of Adelaide found that drinkers aged 30–65 consider it important to drink in a way that is appropriate to their age or stage of life, and which allows them to meet their responsibilities and avoid obvious signs of drunkenness.
 
Published in the BMC Public Health journal, the study also found that gender played a role in what was considered acceptable drinking, with certain drinks being deemed more appropriate for women and others for men. Drinking at home was associated with women, while drinking in public was associated with men.
 
Dr Paul Grinzi, a GP with a special interest in addiction medicine, was not surprised by the findings.
 
‘If we think about a lot of the public health measures, this generation didn’t grow up with those messages coming through the mass media,’ said he told newsGP. ‘Things like skin care, alcohol, tobacco, it’s all a recent generation [who were exposed to it] than the middle-aged cohort.
 
‘Given that alcohol has such a ubiquitous nature across our culture in Australia, I am also not surprised there are other factors that go into people’s consideration about drinking that go beyond health measures.’

Dr Paul Grinzi says patients are likely to resistant to behavioural-change advice unless healthcare professionals can link between the presenting complaint with alcohol.
 
The study’s authors analysed 13 papers, including nine from the UK, which examined alcohol consumption and how it was experienced in a population that included middle-aged moderate drinkers.
 
The authors have cautioned that, given most of the studies analysed in the review were carried out in the UK, the generalisability of the results to other countries may be limited.
 
However, Dr Grinzi said that while there are some subtle differences in the drinking culture of the UK, the study’s key messages are applicable in Australia. He said GPs need to appreciate that people’s drinking behaviour is not going to be focused solely on health reasons, but also social aspects.
 
‘We need to explore some of the other reasons people will drink before people potentially make behavioural change,’ he said ‘Just giving them reasons for health alone won’t be sufficient.’
 
Dr Grinzi said GPs need to ensure they regularly screen their adult patients and offer appropriate advice.
 
‘As GPs, we do need to be mindful that people will be resistant to behavioural-change advice unless they see it as relevant to themselves. Making a link between their presenting complaint and alcohol may be a nice avenue to do so,’ he said.
 
‘So it may be the patient with psoriasis who gets a flare when they drink, it could be the patient with osteoporosis who is at falls risk, it could be the hypertensive patient who is not well-controlled because of the alcohol, it could be the patient with depression and anxiety whose symptoms have flared up after alcohol.’
 
Study co-author Emma Muhlack said very little was known about the decision-making processes that go into the alcohol consumption of middle-aged drinkers.
 
‘The results from this review help us to better understand how drinking alcohol fits into their everyday lives and which factors may need to be taken into consideration when attempting to reduce alcohol consumption in this group,’ she said.
 
‘It is surprising that health does not strongly factor in the way that this group thinks about their drinking.
 
‘When they do think about health, they use their own experiences as a benchmark – [for example] what it feels like when you drink too much – rather than the guidelines handed down by health organisations.’

alcohol BMC Public Health middle-aged drinkers