Substance Use & Misuse, 49:1473–1479, 2014 C 2014 Informa Healthcare USA, Inc. Copyright ISSN: 1082-6084 print / 1532-2491 online DOI: 10.3109/10826084.2014.912233
ORIGINAL ARTICLE
Exploring Risky Drinking and Knowledge of Safe Drinking Guidelines in Older Adults Kim-Michelle Gilson1 , Christina Bryant2 and Fiona Judd3 1
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; 2 School of Psychological Sciences, University of Melbourne, Melbourne, Australia; 3 Centre for Women’s Mental Health, Royal Women’s Hospital, Melbourne, Australia BACKGROUND
Background: Risky drinking criteria in older adults lack consistency across the literature. The variable definitions of risk have contributed in part, to widely differing prevalence estimates for risky drinking, ranging from 1% to 15%. Objectives: (1) To identify the prevalence of different types of risky drinking by applying several different criteria, (2) To investigate whether older adults have knowledge of the National Health and Medical Research Council recommended guidelines for safe drinking. Methods: The study population consisted of community dwelling past-year drinkers (n = 292) aged ≥60 years. Participants completed a postal survey on alcohol consumption using the AUDIT-C. Results: Applying multiple risky drinking criteria indicated that 6.6% to 31.7% of women and 21.6% to 44.8% of men were risky drinkers. Men were more likely than women to have inaccurate knowledge of the NHMRC guidelines, and nearly 59.2% of men who exceeded 14 drinks per week reported either not knowing the recommended limits or reported limits that exceeded the guidelines. Conclusions/Importance: A substantial number of older men drank at risky levels and overestimated safe drinking limits. Greater education on the vulnerability to alcohol-related harm together with greater screening practice by health professionals and service providers is recommended. Findings illustrate how different risky drinking criteria vary in their average AUDIT-C scores, with the NHMRC criteria showing greater average scores compared to other criteria. Results also imply that cutoff scores of ≥4 for women and ≥6 for men are consistent with a range of risky drinking criteria in older adults.
It is estimated that 1% to 15% of older adults consume alcohol at a level that constitutes “risky drinking” (Blow & Barry, 2002; Moore et al., 2006) and older adults have been found to drink more frequently than younger age groups (Australian Institute of Health and Welfare [AIHW], 2011). With the proportion of people over the age of 65 years within Australia estimated to reach 20.5% by 2026 (Australian Bureau of Statistics, 2000), there is a great need to better understand and define risky drinking in older adults. In late life, the ability to metabolize alcohol decreases as a result of age-related physiological changes that increase the sensitivity to alcohol and increase the chance of alcohol-related harm (Blow & Barry, 2002). Older adults are also likely to take multiple medications that have adverse interactions with alcohol (Moore et al., 2009; Rakshi, Wilson, Burrow, & Holland, 2011). This greater sensitivity to alcohol affects the appropriateness of applying standard criteria for risky drinking to older adults, because modest levels of alcohol can have adverse consequences on health (Blow & Barry, 2002). Despite this, there is much confusion over what consumption criteria constitute risky drinking in old age, with different consumption-based criteria commonly cited. The absence of any “gold standard” definition of risky drinking makes it very difficult to carrying out screening and compare the prevalence of risky drinking in older adults. Research on risk-related harm is far from consistent and definitions of risk that account for both preexisting health and medication use are recommended (Fink et al., 2002; Moore et al., 1999); however, it can be difficult to attain the depth of this information in both research and clinical contexts. Guidelines from the National Institute on Alcohol Abuse and Alcoholism (NIAAA, 1998) in the United
Keywords older adults, risky drinking, alcohol, guidelines, prevalence, AUDIT-C
Address correspondence to Dr Kim-Michelle Gilson, PhD, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; E-mail: [email protected].
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States recommend that older adults should not exceed one standard drink (14 g) per day or seven standard drinks per week (Blow, 1998). In contrast, the National Health and Medical Research Council (NHMRC) in Australia do not recommend a specific consumption level for older adults. The NHMRC suggest that no more than two standard drinks on any day (1 drink = 10 g) should be consumed in order to reduce the lifetime risk of harm from alcohol-related disease or injury. Interpreting this guideline as a weekly consumption limit might suggest that up to 14 drinks per week is “low risk,” which is significantly more than the NIAAA’s recommendations. Another approach to investigate risky drinking in old age is with the use of screening tools, such as the Alcohol Use Disorders Identification Test-Consumption (AUDITC). Rather than to define risk by quantity and frequency levels, a cutoff value is applied to an overall consumption score based on quantity, frequency, and binge drinking frequency. However, it is currently unclear which cutoff values are best suited to older adults given the little research within this area. Our study intends to highlight the difficulty in selecting risky drinking criteria for older adults and how this can affect the prevalence figures reported across studies. Furthermore, to date, research has not examined whether older adults are aware of the recommended guideline drinking levels; therefore, a focus of the current study is to also establish the proportion of older adults who have accurate knowledge of the safe drinking guidelines (NHMRC) and whether this differed across risky drinkers. Objectives
The study objectives were: (1) to identify the prevalence of different types of risky drinking by applying several different criteria, and (2) to investigate whether older adults have knowledge of the NHMRC-recommended guidelines for safe drinking.
TABLE 1. Characteristics of drinkers Variable Gender Men Women Age 60–69 70–79 80+ Marital status Married Widowed Divorced or separated Single Other Employment status Full-time employed Part-time employed Unemployed Fulltime house duties Retired Financial status Insufficient to meet needs Adequate to meet needs Sufficient to meet needs More than enough to meet needs Ethnicity Australian (% yes) Education Less than high school High school Trade certificate University degree Religious Yes Self-rated health Poor Fair Good Very good Excellent
n (%) 125 (42.8) 167 (57.2) 145 (49.7) 107 (36.6) 40 (13.7) 188 (64.4) 25 (8.6) 26 (8.9) 7 (2.4) 46 (15.8) 40 (13.7) 36 (12.4) 3 (1) 37 (12.7) 175 (60.1) 7 (2.5) 88 (32) 152 (55.3) 28 (10.2) 273 (93.5) 139 (48.8%) 43 (15.1%) 48 (16.8%) 55 (19.3%) 243 (84.4%) 7 (2.4) 42 (14.4) 109 (37.5) 109 (37.5) 24 (8.2)
METHODS Participants and Procedure
Protocol used in this study was fully approved by the Human Ethics Committee of the University of Melbourne, and all participants gave their informed consent. Community-dwelling older adults (aged ≥60 years) were invited to participate in this study. These participants were randomly selected from the electoral rolls of Victoria and New South Wales, Australia, and were part of a larger longitudinal study on health and aging (N = 7,615). Please refer to Murray et al. (2004) for details of this study. Questionnaires were mailed to 1,206 participants who had agreed to be contacted for future waves of data collection and met the age criterion. No exclusion criteria were applied. Valid questionnaire responses were received from 527 participants, resulting in a response rate of 44%. Of those who did response, missing data on age and gender was identified for 106 participants and these were excluded from the study. Subsidiary analyses showed that
there were no significant differences between participants with and without this data. Given the concentration on risky drinking in the current study, non-drinkers were also removed from study analyses. This resulted in a total sample of 292 current drinkers for the current study and Table 1 provides detailed information on their characteristics. Measures
Alcohol Consumption: AUDIT-C The Alcohol Use Disorders Identification Test Consumption (AUDIT-C) was used to assess typical alcohol consumption in the previous 12 months. It includes the following three consumption items from the original 10-item AUDIT (Bush, Kivlahan, McDonell, Fihn, & Bradley, 1998): (Q1) typical frequency of drinking, (Q2) typical quantity of alcohol consumed, and (Q3) frequency of
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RISKY DRINKING AND KNOWLEDGE OF SAFE DRINKING GUIDELINES IN OLDER ADULTS
drinking six drinks or more. Each question is scored from 0–4 giving a possible summary score of 0–12. An indication of risky drinking is provided when a specific cutoff value is applied to the total AUDIT-C score. A threshold of ≥4 for women and ≥5 for men was selected based on previous research (Dawson, Grant, Stinson, & Zhou, 2005; Bradley et al., 2007; Rodriguez-Martos & Santamarina, 2007). Responses to the third question (Q3) on the AUDITC were used to form a risky drinking category of binge drinkers; a score of ≥1 on this question identified drinkers who consumed six or more drinks on any day in the past year. Risky Drinking Subgroups Based on Quantity and Frequency (Guideline Criteria) Three subgroups of self-reported risky drinking were formed using responses to AUDIT-C Q1 and Q2. These subgroups were based on the recommended guideline criteria, and included: (1) drinking more than seven drinks per week (in relation to the NIAAA older-specific recommendations), (2) drinking in excess of two drinks per drinking day, at least once a month (based on NHMRC daily guidelines for long-term risk), and (3) drinking more than 14 drinks per week (NHMRC guidelines for daily limits calculated per week). Two indicators of low-risk drinking were also created, (1) drinking one to seven drinks per week, which falls within the NIAAA guidelines, and (2) drinking one to two drinks a day, which falls within the NHMRC guidelines. Knowledge of Safe Drinking Guidelines Knowledge of safe drinking guidelines was investigated by asking participants, if they knew the maximum number of drinks recommended by the Australian NHMRC per day: To decrease your risk of harm from alcohol-related disease or injury, what is the maximum number of drinks you should drink per day? Response options ranged from 0 to 5 drinks or “don’t know” and responses were used to form categories of “within guidelines,” “greater than guidelines,” and “don’t know.” Data Approach A purely descriptive approach was taken because of the research aims and exploratory nature to the study. All descriptive data frequencies are analyzed by gender using SPSS (v20).
RESULTS Alcohol Consumption
The mean AUDIT-C score was 3.10 (SD = 2.16). For men, this was 3.90 (SD = 2.49) and 2.50 (SD = 1.64) for women. The distribution of AUDIT-C scores for men and women is shown in Table 2. Given that older adults are considered more frequent drinkers than younger adults, drinking quantity was examined in different drinking frequencies by gender. Participants who consumed alcohol on a monthly or less frequent basis mainly reported one to two drinks per typical drinking day (96.7% of men, 97.3% of women). Participants who reported drinking two to three times a week reported a greater number of drinks per typical day (AUDIT-C Q2) compared to those who drank less frequently. In those who drank two to three times a week 34.5% of men and 44.8% of women reported three to four drinks per drinking day, and a further 17.2% of men reported to consume ≥5 drinks. Among those who drank ≥4 times a week, a substantial number of men drank heavily, with 36.6% reporting three to four drinks and 22% drinking ≥5 drinks; in contrast, 69.4% of women consumed one to two drinks per drinking day. Risky Drinking Subgroups Based on the Quantity and Frequency of Alcohol Consumption (Guideline Criteria) A cutoff score of ≥4 for women and ≥5 for men on the AUDIT-C identified 31.7% of women and 33.6% of men as risky drinkers. Chi-square tests showed that no significant difference was evident in the prevalence of risky drinking between men and women when the AUDIT cutoff score was applied. Responses to the third question on the AUDIT-C (AUDIT-C, Q3) that assessed binge drinking showed significant differences between men and women, 39.2% of men, and 10.8% of women from the entire sample reported an episode of binge drinking in the past 12 months. Further significant gender differences were also highlighted: 28.8% of men compared with 9% of women binge drank monthly or less, and 10.4% of men compared with 1.8% of women binge drank weekly or more frequently (daily). Applying the NHMRC criteria for risky drinking showed that 40.8% of men and 16.2% of women drank more than two drinks on any one drinking day, and 21.6% of men and 6.6% of women exceeded 14 drinks per week. Applying the NIAAA criteria of more than seven drinks per week showed that 44.8% of men and 27.5% of women engaged in risky drinking. Investigating the prevalence of
TABLE 2. Distribution of raw AUDIT-C scores across gender AUDIT-C raw response range Men (n = 125) % Women (n = 167) %
1
2
3
4
5
6
7
8
9
10
11
12
27 (21.6) 69 (41.3)
15 (12) 30 (18)
19 (15.2) 15 (9)
22 (17.6) 33 (19.8)
13 (10.4) 15 (9)
7 (5.6) 3 (1.8)
9 (7.2) 1 (0.6)
5 (4) 0 (0)
5 (4) 0 (0)
2 (1.6) 1 (0.6)
1 (0.8) 0 (0)
0 (0) 0 (0)
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TABLE 3. Summary of risky drinking subgroups
Risky drinking subgroup 1–2 drinks on any day (low risk) 1–7 drinks/week (low risk) Greater than 2 drinks on any day∗ Greater than 7 drinks/week Greater than 14 drinks/week Risky drinking (AUDIT-C ≥4 for women and ≥5 for men) Binge drinking∗∗
Men Women (n = 125) (n = 167) p (%) (%) value∗∗∗ 59.2
83.8
ORIGINAL ARTICLE
Exploring Risky Drinking and Knowledge of Safe Drinking Guidelines in Older Adults Kim-Michelle Gilson1 , Christina Bryant2 and Fiona Judd3 1
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; 2 School of Psychological Sciences, University of Melbourne, Melbourne, Australia; 3 Centre for Women’s Mental Health, Royal Women’s Hospital, Melbourne, Australia BACKGROUND
Background: Risky drinking criteria in older adults lack consistency across the literature. The variable definitions of risk have contributed in part, to widely differing prevalence estimates for risky drinking, ranging from 1% to 15%. Objectives: (1) To identify the prevalence of different types of risky drinking by applying several different criteria, (2) To investigate whether older adults have knowledge of the National Health and Medical Research Council recommended guidelines for safe drinking. Methods: The study population consisted of community dwelling past-year drinkers (n = 292) aged ≥60 years. Participants completed a postal survey on alcohol consumption using the AUDIT-C. Results: Applying multiple risky drinking criteria indicated that 6.6% to 31.7% of women and 21.6% to 44.8% of men were risky drinkers. Men were more likely than women to have inaccurate knowledge of the NHMRC guidelines, and nearly 59.2% of men who exceeded 14 drinks per week reported either not knowing the recommended limits or reported limits that exceeded the guidelines. Conclusions/Importance: A substantial number of older men drank at risky levels and overestimated safe drinking limits. Greater education on the vulnerability to alcohol-related harm together with greater screening practice by health professionals and service providers is recommended. Findings illustrate how different risky drinking criteria vary in their average AUDIT-C scores, with the NHMRC criteria showing greater average scores compared to other criteria. Results also imply that cutoff scores of ≥4 for women and ≥6 for men are consistent with a range of risky drinking criteria in older adults.
It is estimated that 1% to 15% of older adults consume alcohol at a level that constitutes “risky drinking” (Blow & Barry, 2002; Moore et al., 2006) and older adults have been found to drink more frequently than younger age groups (Australian Institute of Health and Welfare [AIHW], 2011). With the proportion of people over the age of 65 years within Australia estimated to reach 20.5% by 2026 (Australian Bureau of Statistics, 2000), there is a great need to better understand and define risky drinking in older adults. In late life, the ability to metabolize alcohol decreases as a result of age-related physiological changes that increase the sensitivity to alcohol and increase the chance of alcohol-related harm (Blow & Barry, 2002). Older adults are also likely to take multiple medications that have adverse interactions with alcohol (Moore et al., 2009; Rakshi, Wilson, Burrow, & Holland, 2011). This greater sensitivity to alcohol affects the appropriateness of applying standard criteria for risky drinking to older adults, because modest levels of alcohol can have adverse consequences on health (Blow & Barry, 2002). Despite this, there is much confusion over what consumption criteria constitute risky drinking in old age, with different consumption-based criteria commonly cited. The absence of any “gold standard” definition of risky drinking makes it very difficult to carrying out screening and compare the prevalence of risky drinking in older adults. Research on risk-related harm is far from consistent and definitions of risk that account for both preexisting health and medication use are recommended (Fink et al., 2002; Moore et al., 1999); however, it can be difficult to attain the depth of this information in both research and clinical contexts. Guidelines from the National Institute on Alcohol Abuse and Alcoholism (NIAAA, 1998) in the United
Keywords older adults, risky drinking, alcohol, guidelines, prevalence, AUDIT-C
Address correspondence to Dr Kim-Michelle Gilson, PhD, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; E-mail: [email protected].
1473
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K.-M. GILSON ET AL.
States recommend that older adults should not exceed one standard drink (14 g) per day or seven standard drinks per week (Blow, 1998). In contrast, the National Health and Medical Research Council (NHMRC) in Australia do not recommend a specific consumption level for older adults. The NHMRC suggest that no more than two standard drinks on any day (1 drink = 10 g) should be consumed in order to reduce the lifetime risk of harm from alcohol-related disease or injury. Interpreting this guideline as a weekly consumption limit might suggest that up to 14 drinks per week is “low risk,” which is significantly more than the NIAAA’s recommendations. Another approach to investigate risky drinking in old age is with the use of screening tools, such as the Alcohol Use Disorders Identification Test-Consumption (AUDITC). Rather than to define risk by quantity and frequency levels, a cutoff value is applied to an overall consumption score based on quantity, frequency, and binge drinking frequency. However, it is currently unclear which cutoff values are best suited to older adults given the little research within this area. Our study intends to highlight the difficulty in selecting risky drinking criteria for older adults and how this can affect the prevalence figures reported across studies. Furthermore, to date, research has not examined whether older adults are aware of the recommended guideline drinking levels; therefore, a focus of the current study is to also establish the proportion of older adults who have accurate knowledge of the safe drinking guidelines (NHMRC) and whether this differed across risky drinkers. Objectives
The study objectives were: (1) to identify the prevalence of different types of risky drinking by applying several different criteria, and (2) to investigate whether older adults have knowledge of the NHMRC-recommended guidelines for safe drinking.
TABLE 1. Characteristics of drinkers Variable Gender Men Women Age 60–69 70–79 80+ Marital status Married Widowed Divorced or separated Single Other Employment status Full-time employed Part-time employed Unemployed Fulltime house duties Retired Financial status Insufficient to meet needs Adequate to meet needs Sufficient to meet needs More than enough to meet needs Ethnicity Australian (% yes) Education Less than high school High school Trade certificate University degree Religious Yes Self-rated health Poor Fair Good Very good Excellent
n (%) 125 (42.8) 167 (57.2) 145 (49.7) 107 (36.6) 40 (13.7) 188 (64.4) 25 (8.6) 26 (8.9) 7 (2.4) 46 (15.8) 40 (13.7) 36 (12.4) 3 (1) 37 (12.7) 175 (60.1) 7 (2.5) 88 (32) 152 (55.3) 28 (10.2) 273 (93.5) 139 (48.8%) 43 (15.1%) 48 (16.8%) 55 (19.3%) 243 (84.4%) 7 (2.4) 42 (14.4) 109 (37.5) 109 (37.5) 24 (8.2)
METHODS Participants and Procedure
Protocol used in this study was fully approved by the Human Ethics Committee of the University of Melbourne, and all participants gave their informed consent. Community-dwelling older adults (aged ≥60 years) were invited to participate in this study. These participants were randomly selected from the electoral rolls of Victoria and New South Wales, Australia, and were part of a larger longitudinal study on health and aging (N = 7,615). Please refer to Murray et al. (2004) for details of this study. Questionnaires were mailed to 1,206 participants who had agreed to be contacted for future waves of data collection and met the age criterion. No exclusion criteria were applied. Valid questionnaire responses were received from 527 participants, resulting in a response rate of 44%. Of those who did response, missing data on age and gender was identified for 106 participants and these were excluded from the study. Subsidiary analyses showed that
there were no significant differences between participants with and without this data. Given the concentration on risky drinking in the current study, non-drinkers were also removed from study analyses. This resulted in a total sample of 292 current drinkers for the current study and Table 1 provides detailed information on their characteristics. Measures
Alcohol Consumption: AUDIT-C The Alcohol Use Disorders Identification Test Consumption (AUDIT-C) was used to assess typical alcohol consumption in the previous 12 months. It includes the following three consumption items from the original 10-item AUDIT (Bush, Kivlahan, McDonell, Fihn, & Bradley, 1998): (Q1) typical frequency of drinking, (Q2) typical quantity of alcohol consumed, and (Q3) frequency of
1475
RISKY DRINKING AND KNOWLEDGE OF SAFE DRINKING GUIDELINES IN OLDER ADULTS
drinking six drinks or more. Each question is scored from 0–4 giving a possible summary score of 0–12. An indication of risky drinking is provided when a specific cutoff value is applied to the total AUDIT-C score. A threshold of ≥4 for women and ≥5 for men was selected based on previous research (Dawson, Grant, Stinson, & Zhou, 2005; Bradley et al., 2007; Rodriguez-Martos & Santamarina, 2007). Responses to the third question (Q3) on the AUDITC were used to form a risky drinking category of binge drinkers; a score of ≥1 on this question identified drinkers who consumed six or more drinks on any day in the past year. Risky Drinking Subgroups Based on Quantity and Frequency (Guideline Criteria) Three subgroups of self-reported risky drinking were formed using responses to AUDIT-C Q1 and Q2. These subgroups were based on the recommended guideline criteria, and included: (1) drinking more than seven drinks per week (in relation to the NIAAA older-specific recommendations), (2) drinking in excess of two drinks per drinking day, at least once a month (based on NHMRC daily guidelines for long-term risk), and (3) drinking more than 14 drinks per week (NHMRC guidelines for daily limits calculated per week). Two indicators of low-risk drinking were also created, (1) drinking one to seven drinks per week, which falls within the NIAAA guidelines, and (2) drinking one to two drinks a day, which falls within the NHMRC guidelines. Knowledge of Safe Drinking Guidelines Knowledge of safe drinking guidelines was investigated by asking participants, if they knew the maximum number of drinks recommended by the Australian NHMRC per day: To decrease your risk of harm from alcohol-related disease or injury, what is the maximum number of drinks you should drink per day? Response options ranged from 0 to 5 drinks or “don’t know” and responses were used to form categories of “within guidelines,” “greater than guidelines,” and “don’t know.” Data Approach A purely descriptive approach was taken because of the research aims and exploratory nature to the study. All descriptive data frequencies are analyzed by gender using SPSS (v20).
RESULTS Alcohol Consumption
The mean AUDIT-C score was 3.10 (SD = 2.16). For men, this was 3.90 (SD = 2.49) and 2.50 (SD = 1.64) for women. The distribution of AUDIT-C scores for men and women is shown in Table 2. Given that older adults are considered more frequent drinkers than younger adults, drinking quantity was examined in different drinking frequencies by gender. Participants who consumed alcohol on a monthly or less frequent basis mainly reported one to two drinks per typical drinking day (96.7% of men, 97.3% of women). Participants who reported drinking two to three times a week reported a greater number of drinks per typical day (AUDIT-C Q2) compared to those who drank less frequently. In those who drank two to three times a week 34.5% of men and 44.8% of women reported three to four drinks per drinking day, and a further 17.2% of men reported to consume ≥5 drinks. Among those who drank ≥4 times a week, a substantial number of men drank heavily, with 36.6% reporting three to four drinks and 22% drinking ≥5 drinks; in contrast, 69.4% of women consumed one to two drinks per drinking day. Risky Drinking Subgroups Based on the Quantity and Frequency of Alcohol Consumption (Guideline Criteria) A cutoff score of ≥4 for women and ≥5 for men on the AUDIT-C identified 31.7% of women and 33.6% of men as risky drinkers. Chi-square tests showed that no significant difference was evident in the prevalence of risky drinking between men and women when the AUDIT cutoff score was applied. Responses to the third question on the AUDIT-C (AUDIT-C, Q3) that assessed binge drinking showed significant differences between men and women, 39.2% of men, and 10.8% of women from the entire sample reported an episode of binge drinking in the past 12 months. Further significant gender differences were also highlighted: 28.8% of men compared with 9% of women binge drank monthly or less, and 10.4% of men compared with 1.8% of women binge drank weekly or more frequently (daily). Applying the NHMRC criteria for risky drinking showed that 40.8% of men and 16.2% of women drank more than two drinks on any one drinking day, and 21.6% of men and 6.6% of women exceeded 14 drinks per week. Applying the NIAAA criteria of more than seven drinks per week showed that 44.8% of men and 27.5% of women engaged in risky drinking. Investigating the prevalence of
TABLE 2. Distribution of raw AUDIT-C scores across gender AUDIT-C raw response range Men (n = 125) % Women (n = 167) %
1
2
3
4
5
6
7
8
9
10
11
12
27 (21.6) 69 (41.3)
15 (12) 30 (18)
19 (15.2) 15 (9)
22 (17.6) 33 (19.8)
13 (10.4) 15 (9)
7 (5.6) 3 (1.8)
9 (7.2) 1 (0.6)
5 (4) 0 (0)
5 (4) 0 (0)
2 (1.6) 1 (0.6)
1 (0.8) 0 (0)
0 (0) 0 (0)
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TABLE 3. Summary of risky drinking subgroups
Risky drinking subgroup 1–2 drinks on any day (low risk) 1–7 drinks/week (low risk) Greater than 2 drinks on any day∗ Greater than 7 drinks/week Greater than 14 drinks/week Risky drinking (AUDIT-C ≥4 for women and ≥5 for men) Binge drinking∗∗
Men Women (n = 125) (n = 167) p (%) (%) value∗∗∗ 59.2
83.8
