Br. J. Addict., 1976, Vol. 71, pp. 23-29. Longman. Printed in Great Britain.

Public Attitudes towards Alcoholism in a Scottish Gity*t Keith J. B. R « , B.Med.BioI., M.B., Ch.B., A.I.BioI., A.I.H.E. Director, Clapham House Research Unit, 1 Merchant Street, London, E.3.

Margaret Bayers, R.G.N., R.F.N. Research Worker, Clapham House Research Unit, 1 Merchant Street, London, E.3.

Summary A sample of the population of Aberdeen City was interviewed, and attitudes towards alcohotism determined. White they were generally in agreement with the experts on eight of the nine factors there were inconsistencies in their attitudes. They held opposite opinions to the experts in regarding alcoholism as a sign of moral weakness. These findings have been discussed in the context of the Scottish culture. Recommendations have been made concerning future programmes cf alcoholism education and their evaluation in Scotland.

Introduction Although studies have been carried out in the U.S.A. (Haberman and Sheinberg, 1969; Linsky, 1970; Coe and Smith, 1972) and New Zealand (Blizard, 1970, 1971) to determine the attitudes of the public towards alcoholism, little is known of Scottish attitudes towards alcoholism. The purpose of this paper is therefore to describe a study of attitudes Xo\fa.Tdi'& alcoholism in a Scottish city. A report in 1965 recommended that the "public should be informed about the grave risks inherent in the excessive consumption of alcohol, and that alcoholism is an illness, and the alcoholic is a sick person in need of treatment" (H.M.S.O., 1965). Since that recommendation was made educational campaigns have been mounted at the national (Macrae, Ratcliif, and Liddle, 1972) and the local level (Brown, Frame and Thomas, 1973; Rix, 1974) with the purpose of increasing public awareness of alcoholism. In 1971 a regional council on alcoholism was established in Aberdeen and the present study wjis intended to establish the attitudes held by Aberdeen citizens in the summer of 1973 before the Council opened its Alcoholism Information Centre and embarked on a more extensive educational programme. Rix (1974) has suggested that "The Alcoholism Questionnaire" (Marcus, 1963) might prove a suitable instrument for measuring attitudes towards alcoholism before and after an educational programme and this paper describes base-line measurements made using this instrument. •Part of this report was prepared by K. J.B.R. during the tenure of a W. R. Henderson Trust (Edinburgh) Travelling Scholarship at the New York State Department of Mental Hygiene, Research Institute on Alcoholism, Buffalo, N.Y., U.S.A. fReprint requests to: Dr. K. J. B. Rix, Department of Physiology, Marischal College, Aberdeen, AB9 IAS, Scotland.

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Keith J. B. Rix and Margaret Buyers

Methods Questionnaire "The Alcoholism Questionnaire" comprises 40 statements about alcoholism. A subject can obtain a score from 1 to 7 on each ofthe items: " 1 " if the subject completely agrees with the statement, " 7 " if he is in complete disagreement, etc. Thirty-six ofthe items relate to nine factors (defined in Table 1) and a mean score from 1 to 7 can be computed for each factor for any subject. The statistic of interest, however, is the Mean Factor Score (MFS) for a group of individuals. Positive attitudes towards alcoholism are indicated by a high score on factors 1, 2, 4 and 9, and a low score on factors 3, 5, 6, 7 and 8. Positive attitudes are those which are in agreement with the staff of the Addiction Research Foundation of Ontario (Marcus, 1963). Table 1. Factor 1. Emotional difficulties

2. Loss of control 3. Prognosis for recovery 4. The alcoholic as a steady drinker

5. Alcoholism and character defect 6. Social status of the alcoholic 7. Alcoholism as an illness 8. Harmless voluntary indulgence

9. Alcohol dependence producing

Factor Definitions* A high score indicates the belief that emotional difficulties or psychological problems are an important contributing factor in the development of alcoholism. A high score indicates the belief that the alcohoUc is unable to control his drinking behaviour. A high score indicates the belief that most alcoholics do not, and cannot, recover from alcoholism. A high score indicates the belief that periodic excessive drinkers can be alcoholics. A low score indicates the belief that a person must be a continual excessive drinker in order to be classified an alcoholic. A high score indicates the belief that the alcoholic is a weak-willed person. A high score indicates the belief that alcoholics come from the lower socio-economic strata. A high score indicates the belief that alcoholism is not an illness. A high score indicates the belief that the alcoholic is a harmless heavy drinker whose drinking is motivated only by a fondness for alcohol. A high score indicates the belief that alcohol is a highly dependence producing substance.

* Adapted from Marcus (1963). Sample The sampling method used was that of "quota sampling" in which the interviewer has to find a certain number of subjects of various age groups, social class and sex.

Scottish Attitudes towards Alcoholism

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The "quota" of 62 persons was based on the social class, age, and sex distribution of the population of the city of Aberdeen. Interview technique

Interviews were carried out by one ofthe authors (MB) who had previous experience of market research and opinion poll surveys. If the subject agreed to participate, each of the 40 statements were read to the subject who responded with one of the seven responses printed on an answer card (i.e. completely agree, mostly agree, etc). Results Empty houses and refusals

There were three empty houses and ten persons refused to be interviewed. The interviewer regarded the number of refusals and reasons for refusal as similar to that encountered by her in other public opinion surveys. Mean Factor Scores

The MFS are shown in Table 2 where they are compared with the MFS of the staff of the Addiction Research Foundation of^ Ontario ("Expert") and the MFS of a sample of Toronto citizens (from Marcus (1963)). T a b l e 2> Comparison of Mean Factor Scores of the Expert, Aberdeen and Toronto Groups Factor

i 2 3 4 6

r

Expert

Aberdeen

Toronto

5-20 5-35

4-90 5-12 3-32 4-03 4-40 2-56 3-36 3-55 4-41

5-16 5-03 2-99 3-18* 3-51* 2-88 3-07 3-22 4-60

2-llt 5-23t 3-18t 2-68 2-68* 2-54t 4-35

'

8 9 *MFS differs from the Aberdeen MFS by more than 0-50 and less than 1-0. fMFS differs from the Aberdeen MFS by more than 1 -0. It has been suggested by Marcus (1963) that MFS differences of less than 0-5 should be ignored, and attention directed to differences greater than 1-0. Thus, there are no important differences between the attitudes of the Aberdeen and the Toronto citizens. Except for Factors 4 and 5, the MFS differences are less than 0-5. On Factor 4 the difference was 0-85 and on Factor 5 the difference was 0-89 but these are not great enough to deserve comment according to Marcus. There were important differences between the Aberdeen attitudes and the experts' attitudes on several factors. MFS differences of less than 0-50 were found on four factors (1, 2, 6, 9), indicating agreement about emotional difficulties and loss of control in alcoholism, that alcohol is a dependence-producing drug, and that alcoholism affects all social classes. The difference of 0-68 on Factor 7 indicates that

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Keith J. B. Rix and Margaret Buyers

the Aberdeen citizens were slightly less favourable towards the illness concept of alcoholism. Differences of greater than 1 -0 were found on Factors 3, 4, 5 and 8. On Factors 3, 4 and 8 the opinions were in the same direction as the experts (i.e. on the same side of the neutral MFS of 4'0) but the large MFS differences of 1'21 (Factor 3), 1-20 (Factor 4) and 1-01 (Factor 8) indicate that the Aberdeen citizens were much less convinced than the experts that alcoholism has a good prognosis (Factor 3), that periodic excessive drinkers can be alcoholics (Factor 4), and that the alcoholic is not a harmless voluntary heavy drinker (Factor 8). On Factor 5, the Aberdeen sample held opinions opposite in direction and considerably different to the experts, i.e. they saw the alcoholic as a weak-willed person (Factor 5, MFS difference 1-22). Relationship of age to MFS Ferneau (1967) has used "Student's" t-test to compare MFS before and after a period of expected attitude change. In this study, it was used to study the relationship between age and attitudes towards alcoholism. For this purpose the MFS of two sub-groups comprising those under forty-five and those aged forty-five years and over were compared. The results indicate that the older subjects were more likely to believe that the alcoholic is unable to control his drinking (p< 0-001, Factor 2) and they were also more likely to believe that periodic excessive drinkers can be alcoholics (p

Public attitudes towards alcoholism in a Scottish city.

Br. J. Addict., 1976, Vol. 71, pp. 23-29. Longman. Printed in Great Britain. Public Attitudes towards Alcoholism in a Scottish Gity*t Keith J. B. R «...
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