Good practice principles low rik drinking EU RARHA

• A literature review into practical aspects of the Standard Drink (consumers’ perceptions and
the size of actual drinks poured) and into uses of SDs in surveys of drinking patterns and in
alcoholic beverage labelling undertaken by the Health Research Board in Ireland (HRB) [5];
• An online survey of consumer views relating to alcohol risk communication implemented by
Eurocare in 21 European countries [ 6 ];
• A Delphi survey with European experts in public health and addiction, focused on questions
related to low risk drinking guidelines and carried out by the National Institute for Health and
Welfare (THL) in collaboration with RARHA partners [ 7 ].
Uses of Standard Drink definitions
The Standard Drink concept is mainly used in three different contexts: in surveys of drinking habits to
help people report on their alcohol consumption; in drinking guidelines to describe alcohol intake levels
associated with low or high risk; on alcoholic beverage bottles or cans to indicate the amount of pure
alcohol contained in the package.
Surveys
When surveys of alcohol consumption are conducted, respondents are generally provided with the
definition of a Standard Drink used in that country and then asked about their alcohol consumption
with that definition in mind. Alcoholic drinks are often defined for the respondents in terms of the
typical container sizes of beer, wine or spirits to illustrate what constitutes a Standard Drink. Terms
such as ounces, millilitres, or grams of ethanol are generally not used as they are not easily understood
by consumers.[ 8 ]
However, research clearly demonstrates that there are considerable differences between
respondents’ perceptions of what a Standard Drink constitutes and the definition of a Standard Drink,
especially in relation to spirits and wine. Regardless of the SD definition provided, some respondents
may report the number of drinks they actually consume. Confusion over Standard Drinks can affect the
precision and reliability of the results of the survey.
It has long been recognised that population surveys of self-reported alcohol consumption result in
estimates of per capita consumption well below the level estimated from alcohol sales data. The usual
range of coverage from surveys is in the region of 40-60%.[ 9 ] The literature indicates that there are
three reasons why self-reported alcohol consumption does not accurately reflect per capita alcohol
sales: the confusion regarding what constitutes a Standard Drink, variations in drinking vessels and
variations in alcoholic beverages’ percentage ABV (pure alcohol by volume).[ 10 , 11 , 12 ] When conducting
surveys it is critical that researchers and respondents define a Standard Drink in a comparable way.[ 13 ]
Discrepancies can have implications when self-reported alcohol consumption levels are used to
determine thresholds for risky single occasion drinking and harmful drinking patterns. For example, if
respondents underreport their true levels of consumption, which is feasible given the published
literature on consumers’ understanding of standard drinks, then the thresholds used in surveys for risky
and harmful drinking may be unsuitable.
In Joint Action RARHA’s Work Package “Monitoring”, the Standardized European Alcohol Survey
(SEAS) was developed to provide cross country comparable data on levels and patterns of alcohol
consumption and alcohol-related harm. The concept of a Standard Drink was used in the
questions relating to the quantity of alcohol consumed per occasion, to risky single occasion
drinking (RSOD), and to drunkenness. For the RSOD question, partner countries were free to use
national Standard Drinks or to describe otherwise the relevant amount of alcohol that corresponds
to the intake 40 grams or 60 grams of pure alcohol, respectively for women and men. In a number
of countries a Standard Drink was an obvious option as a majority of drinkers are aware of what it
is. The national SD definitions used varied from 8 to 15 grams of pure alcohol. In other countries it
would have been quite artificial to teach respondents what a Standard Drink is all about. d
d
Information provided by Jacek Moskalewicz, June 2016.
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Good practice principles for low risk drinking guidelines