The limits of measuring binge drinking prevalence for epidemiological surveillance: An example from Spain

• Published in: Drug and alcohol dependence 2021-11, Vol.228, p.109022-109022, Article 109022
• Main Authors: Donat, Marta, Barrio, Gregorio, Pulido, José, Pérez, César, Belza, María J., Regidor, Enrique
• Format: Article
• Language: English
• Subjects: Age; Alcohol Drinking; Binge drinking; Binge Drinking - epidemiology; Consistency; Drinking behavior; Drinks; Epidemiological surveillance; Epidemiology; Ethanol; Female; Frequency; Humans; Indicators; Male; Men; Middle age; Middle Aged; Older people; Prevalence; Public health; Sex; Sex disparity; Spain - epidemiology; Surveillance; Trends; Women; Young adults; Young men; Young women
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2021.109022

•Binge-drinking trends were different for population rate and prevalence.•Age-sex disparity in binge drinking varied by the indicator used.•Cumulative exposure measures should be used for monitoring binge drinking. The public health impact of binge drinking depends on its population prevalence and its frequency and intensity among binge drinkers. The objective is to assess the consistency of time trends and age-sex disparities between binge-drinking prevalence and binge-drinking exposure indicators that combine such prevalence with the number of binge-drinking days among binge drinkers. Data come from 11 biennial national household surveys from 1997 to 2017 in young (15−34 years) and middle-aged adults (35−64 years) in Spain (n = 211,961). Binge-drinking was the intake of 5+ standard drinks (4+ in women from 2009 onwards) in approximately two hours. Three monthly indicators were analyzed: binge-drinking prevalence, population rate of binge-drinking days, and proportion of drinking days with binge drinking. Results were stratified for sex and two age groups. Annual percent changes (APCs), ratios of young to middle-aged people (age ratios) and men-to-women ratios were obtained from negative binomial regression. Although the three indicators showed considerable consistency as an intense increase in binge drinking from 2009 to 2017 among middle-aged people, especially women, there were relevant inconsistencies. In 2009−2017 the APCs for prevalence and rate were +1.3 % and −1.6 %, respectively, in young women, and -0.6 % and −3.0 % in young men. Age ratios were significantly higher for prevalence and proportional ratio than rates, while men-to-women ratios were lower, especially in middle-aged people. Adequate monitoring of binge drinking should incorporate indicators of absolute exposure, which better reflect its impact on public health, such as the population rate of binge-drinking days.