Surveys of our drinking habits have made grim reading ... but now experts have discovered they have been wildly underestimating our thirst for alcohol.
The level of alcohol consumption in Scotland could be twice as much as previously estimated because of the trend towards stronger drinks and bigger measures. Experts have reviewed how surveys of drinking are carried out amid concerns the alcoholic strength and serving size of certain drinks such as wine have been underestimated.
And they have warned that taking into account other factors such as evidence from sales figure and people underestimating or under-reporting how much they drink, the true scale of the alcohol problem Scotland is likely to be far more serious than previously thought.
The latest survey, carried out in 2003, found on average men drank 17.2 units of alcohol per week and women drank 6.5 units. But the NHS Health Scotland report How Much Are People In Scotland Really Drinking?, published tomorrow, suggests people could be drinking up to twice this amount.
Report author Sonnda Catto, public health surveys manager at NHS Health Scotland, said there had been a growing discrepancy between the survey estimates of alcohol consumption and evidence on alcohol-related harm, which had led to questioning of the validity of data collected.
"We found there had been some changes over time in the way people drink and those changes had crept up on us," she said. "With drinks getting stronger and people becoming used to larger drink sizes, the alcohol challenge faced by Scotland appears to be more serious than we thought.
"This piece of work shows we are probably capturing around 50% (of alcohol consumption) in surveys and much of that is likely because drinks have become bigger and stronger."
Detailed data on alcohol consumption is collected through the Scottish Health Survey, which has been conducted three times in 1995, 1998 and 2003. But the measurements on how much people were drinking have been based on calculations used when surveys on drinking were first carried out, when one glass of wine - equivalent to 125ml at a strength of 8% ABV (alcohol by volume) - was counted as one unit of alcohol.
Now wines typically range from 11.5% to 14.5% in alcoholic strength and 175ml and 250ml glasses are more common in licensed premises, which add up to between 2 and 3.6 units of alcohol. And while a pint of beer has been classed as having two units of alcohol, many popular beers now contain three units per pint. Men are advised not to regularly drink four or more units a day and women should not exceed three.
In addition, the researchers point out what people are drinking at home has been substantially underestimated, with the average glass of home-poured spirits more than twice the size of a single pub measure.
CATTO agreed that people were confused about how many units they were drinking. "If you take a large glass of wine at the upper end of that limit - at 14.5% ABV - a single glass will contain over 3.5 units," she said. "That is going to take a woman over the daily recommended maximum and it practically takes a man up to that level.
"I think there is need for further clarity about the alcoholic content of drinks. All drinks contain information on percentage of alcohol by volume, but perhaps it would be more helpful if they contained the number of units to help people monitor their drinking more closely."
The Office of National Statistics published UK-wide figures last year that reviewed survey figures to take into account of stronger and larger drinks. The average women's intake in 2005 was recalculated at 9.4 units - an increase of 45% from the old figure, mainly because women tend to drink more wine. The average intake for men went up by 26% to 19.9 units a week. Similar re-calculations for Scotland will be published by the government on Tuesday, and are also expected to show an increase.
Catto said the new methods would also be used for the next Scottish Health Survey, which is currently being carried out and is due to be published in 2009.
"Instead of just assuming one glass of wine has one unit in it, researchers now ask people whether they usually drink small, medium or large glasses of wine, so we are able to take account of some of that diversity and the increase in sizes," she said.
"We will also be applying new conversion factors, when people tell you they drink x volume of wine or x volume of beer, then that needs to be converted into number of units so we have upped those as well to take account of greater strength."
Evelyn Gillan, project director of the Scottish Health Action on Alcohol Problems (Shaap), said the findings from NHS Scotland echoed work that it had previously carried out, which showed there was twice as much alcohol being sold as people were reporting drinking.
"The alcohol industry has frequently said if you look at the survey data most people are drinking responsibly - but we did that research because we didn't think that actually stood up," she said.
GILLAN agreed that factors such as changes in sizes of wine glasses were a major factor in increasing alcohol consumption. "There has been various inducements and enticements - such as it is cheaper to buy a bigger glass of wine than two small ones, it is cheaper to buy four bottles of wine instead of one or 10 cans of lager instead of two," she said. "They are specific marketing activities that are designed to get us to drink more. Yes we have been drinking more, but we have been encouraged to do so."
Barbara O'Donnell, director of services at Alcohol Focus Scotland, said the research reinforced the view that people underestimate the amount of alcohol they actually drink.
"Since the introduction of the unit system the strength of alcoholic drinks has increased," she said. "When people are out for an evening they are drinking much more than they realise.
"Home drinking is another area of concern, since people do not measure wine or spirits and therefore do not really know what they have drunk."
Thirty years ago, most wines being drunk in Britain were from cooler climates such as Germany and had a lower alcohol content of around 9%. During the 1980s and 1990s there was a rise in popularity in much stronger wines from hotter regions such as Australia, South Africa and America.
Gavin Partington, spokesman for the Wine and Spirit Trade Association, said most wines were now around 12.5% ABV on average and there had been little change in this over the past decade. He argued there was an increasing demand among consumers for lower alcohol wines, which the industry was responding to by seeking a change in European regulations to allow certain alcohol reduction processes to be used for trade within the EU.
"At the moment ,these alcohol reduction processes are permitted for sale and distribution in France and Spain on an experimental basis, but unfortunately because of the regulations they are not permitted for general trade around and within the European Union," he said. "In view of what consumer taste is demanding, it is in the interests of the industry to be able to provide people with low alcohol wine if that is what they choose."
Partington also pointed to a recent survey of bars and clubs, which found the standard glass size used was 175ml, with 23.5% serving 250ml as an option and 30% still serving wine in 125ml glasses.
"This does run slightly counter to the common perception that somehow bars and restaurants have only got this large glass size available for use," he added.
David Poley, chief executive of the Portman Group, which promotes responsibility in the drinks industry, said surveys showed the number of Scots men who drank more than the recommended limits every week had fallen from 34% in 1998 to 29% in 2003, although he acknowledged there had been a rise in women's drinking.
"Scots are drinking less than virtually anywhere else in Great Britain," he said. "We should focus on educating the minority who continue to ignore the risks associated with their heavy drinking."
A spokesman for the Scottish government said a new alcohol strategy would be published in the summer. "It is examining all areas, taking a wide ranging look at possible measures that might tackle Scotland's alcohol problem," he added.
A night on the town ... Do you know how much you're drinking? IT'S a scene that is repeated countless times across the country every Friday night - a group of friends gathering in a pub to wind down after a week's work. But do they have any idea of how much they are drinking?
In Glasgow's city centre, 24-year-old Alison is enjoying her first glass of wine for the evening. Offered a choice of small (175ml) or large (250ml) sizes at the bar, she goes for the latter, which is only £1 more expensive than the smaller measure, without hesitation.
"At home I've got huge fishbowl wine glasses that hold half a bottle at a time, and I would easily have one of them," she says. "So I don't think of this as being a particularly big glass."
When asked to guess how much units are in the glass, she underestimates it at "about two" and is surprised to learn it could be more than three.
But, she quickly points out she doesn't drink every day. "I can easily go Monday to Friday without having a drink at all," she says.
"But then I will have a lot to drink at the weekend - I guess I am more of a weekend binge drinker."
Her friend Suzanne, 32, believes there is a bigger problem with people drinking at home.
"I know plenty of people who don't think they are big drinkers because they don't go out much," she says.
"But they go home at night and don't think twice about having a bottle of wine with their partner - each, not between them.
"Because they talk to their friends and everyone is drinking that much, it kind of normalises it, so no-one thinks much about it."
She adds: "I think when you are drinking in the pub, you will have the amount you drink limited by the price, having to fight your way to the bar and when the pub shuts.
"When you are drinking at home, you are far more tempted to just open a bottle and then finish it, or be constantly topping it up, and it's easy to lose track of how much you have actually had to drink."
Within the space of a few hours, the group has drunk its way through a large 250ml glass of wine and two 175ml glasses each, adding up to around seven units.
A binge is described as six or more units for a women, but according to Louise, 30, this isn't even a big drinking session. "If I go out on a big Saturday night out, I'll probably have a bottle of wine and then at least couple of shots of vodka or something on top of that," she says.
"I know roughly how many units are in a glass of wine, but to be honest I don't really think much about it.
"I would only ever really count what I was drinking if I had to drive later on or early in the morning."
"The only time I ever really think I have drunk too much is when I have a killer hangover the next day."
Sunday Herald