Alcohol Preferences and Associated Negative Behaviors in Swiss Men

There are many studies out there examining beverage preference among individuals, frequently as it relates to negative consequences associated with alcohol consumption and as it relates to marketing strategies for advertisements or public health initiatives.  These studies have shown that alcohol preference varies widely in the population, specifically with socio-demographic characteristics like gender, age, income, education, country of residence, et cetera.  There are some issues comparing these types of studies to one another, as there are frequently different methodologies used to collect the data, and at times potential confounding variables are not controlled for, thus manipulating the results from actuality in some cases.

Today, I present a study building upon this wealth of knowledge in the alcohol preferences literature, which focuses on

Swiss men as the study population.  Specifically, this study aimed to examine the relationships between various socio-demographic characteristics and beverage preference, as well as whether or not these different beverages are associated with an increase in “risky” behavior or negative consequences related to problem drinking.

Methods

Study subjects were recruited from centers that recruit young men for military service in Switzerland, which covers 21 of 26 cantons in the country.  These sites were chosen as nearly all men in Switzerland must go through this process to determine military eligibility at around age 19.  In total, 5,399 men were recruited for this study, with 2441 being German-speaking and 2958 being French-speaking.

The average age for German subjects was 19.13 years, while the average age for French subjects was slightly higher at 19.76 years.  French subjects had also received a higher level of education than German subjects, which may very well be due to the fact that French subjects were older, on average, than German subjects.  More German-speaking subjects lived in rural areas than French-speaking subjects.

Though all subjects were similar ages, for analysis they were placed into two groups:  less than 20 years of age, and more than 20 years of age.  Subjects were also sorted by highest education level achieved as well as residence type (i.e. rural or urban).

All information about alcohol preferences and consumption patterns were collected via self-reported surveys.

Drinking patterns were determined by questions related to quantity and frequency of alcohol consumption.  The frequency of risky single occasion drinking was defined at consuming at least 6 drinks in during a single event.  Subjects were considered “at risk” for this behavior if they reported this drinking pattern occurring more than once per month.  At risk volume drinking was defined as consuming at least 21 drinks per week.  From these definitions, the three drinking patterns defined were: 1) low-risk consumption; 2) At-risk single occasion drinking or volume drinking; 3) both at-risk single occasion drinking AND volume drinking.

Beverage preference was determined by a week-long drinking diary that subjects were asked to provide detailing the number of drinks consumed each day, as well as the number of each type of beverage consumed on each day.  A particular beverage typed was deemed as “preferred” if it was consumed 2/3 of the time during this week of time, though if a 2/3 majority could not be determined, then the preference was considered “mixed” for those individuals.

The following information was collected from study subjects, all of which pertained to the previous 12 months:  1) number of alcohol-related negative consequences (i.e. taking drugs to ease effects of alcohol, unplanned unprotected sex, blackouts, etc); 2) at-risk for daily cigarette smoking; 3) at-risk for marijuana smoking (more than once per week); 4) at-risk for use of other illegal drugs (excluding marijuana).

Results

• Around 50% of participants reported mixed preferences for beverage types, while 31.7% preferred beer alone, 11.5% preferred “other” types of alcohol alone, and 5.4% preferred wine along.
• French-speaking subjects were less likely to prefer beer than German-speaking subjects.
• Those subjects with less education tended to prefer beer or other types of alcohol.
• Those subjects living in rural areas tended to prefer beer or other types of alcohol.
• Likelihood of reporting at-risk single occasion and/or volume drinking was higher in those subjects preferring beer than those preferred a mixed selection of alcohol types.
• Likelihood of reporting at-risk single occasion and/or volume drinking was lower in those subjects preferring wine alone.
• Subject that were older than 20 years old were less likely to report at-risk single occasion and/or volume drinking than younger subjects.
• Subjects that had only completed primary school or a higher vocational school were more likely to report both at-risk single occasion and volume drinking than those that completed high school or university.
• Rural residents tended to report higher levels of at-risk single occasion or volume drinking than urbanites.
• Subjects with a preference for wine typically reported experiencing fewer instances of negative consequences related to alcohol consumption, and were less likely to smoke cigarettes on a daily basis.
• Subjects with a preference for beer or other types of alcohol were more likely to smoke marijuana on a regular basis and were more at risk for using other illegal drugs.
• Those reporting more risky alcohol consumption patterns were more likely to experience at least 4 negative consequences related to alcohol consumption, more likely to smoke cigarettes and/or marijuana, and also more likely to use other drugs.
• French-speaking subjects were more likely to be at risk for marijuana and/or other drug use compared with German-speaking subjects.
• A greater percentage of subjects older than 20 years old reported at risk cigarette, marijuana, and other drug use.
• Urbanites tended to report greater at risk behaviors for cigarettes, marijuana, and other drugs.

Conclusions

The results of this study provide interesting information on the alcohol preferences and behavior of Swiss men, specifically from the younger cohort.  In general, these Swiss men tended to prefer a mixed variety of alcoholic beverages, or a preference for beer.  Wine was actually the least preferred alcohol type for the 5,399 Swiss men who participated in this study.  Comparing wine preferences with beer and/or other alcohol preferences, the results of this study showed that those that preferred wine alone were less likely to experience the negative consequences of alcohol consumption as well as at-risk behaviors for cigarettes or other drug use.  The authors speculated that these results could

be due to several factors, including but not limited to 1) personality differences between beer and/or other alcohol drinkers and wine drinkers (not studied); and 2) the fact that wine tends to be consumed during meals, which effectively lowers the BAC of the individual consuming the beverage (also not examined in this study).

Though these results are (or aren’t?) interesting, it’s important to point out that they may be very limiting, in that the study population does not represent the general population as a whole.  The demographics of this study population were relatively restricted, with only young males (around 19 years of age +/- 1 or 2 years or so) from Switzerland participating.  Since this population is relatively specific, one cannot simply take these results and apply it across the board to all consumers of alcohol. Studies have shown there are differences between males and females in terms of alcohol preferences and drinking behavior, as well as differences between these “micro-populations” from different age cohorts in different countries.

There was actually quite a lot that didn’t seem to be controlled for in this study, so the results should be taken with a grain of salt.  Participants were separated by age, education level, and place of residence, though it seems to me there may be other factors at play as well that weren’t controlled for in this study (i.e. income, family history, personality, etc).

Depending upon what your ultimate goals are, results from these types of studies could be either very helpful to you, or not at all useful or interesting.  For this particular study, the results could be very helpful in implementing marketing strategies or public health policies for reducing problematic alcohol consumption in young men.  The authors of this study also suggested these results could be used to implement policies for increasing the prices of beer and other alcohol, as currently the prices of these items tend to be significantly cheaper than that of wine, making it much easier for this younger cohort to obtain and potentially abuse.

What do you all think of this study?  What problems do you see with the methodology here?  Perhaps you thought the methods were fine but you have different ideas for application of the results?  Please feel free to share any questions/comments/thoughts you have on this subject!

Source: Dey, M., Gmel, G., Studer, J., Dermota, P., Mohler-Kuo, M. 2013. Beverage preferences and associated drinking patterns, consequences and other substance use behaviours. The European Journal of Public Health (printed online advance of print) 1-6.