13 march 2017

The country-level effects of drinking, heavy drinking and drink prices on pre-drinking: An international comparison of 25 countries

INTRODUCTION AND AIMS: The practice and adverse consequences of pre-drinking have been documented within a dozen countries, but little remains known about the differences between countries or the country-specific determinants of pre-drinking. This study aims to estimate the percentage of pre-drinkers in different countries and the impact of country-level indicators such as the price of alcohol and the prevalence of drinkers and of heavy drinkers.

DESIGN AND METHODS: Using data from the Global Drug Survey, the percentage of pre-drinkers was estimated for 25 countries from 65 126 respondents. Bivariate and multivariate multilevel models were used to model the impact of the on-premise/off-premise drinks price ratio, the prevalence of current drinkers and of heavy drinkers on the percentage of pre-drinkers.

RESULTS: The estimated percentage of pre-drinkers per country ranged from 17.7% (Greece) to 85.4% (Ireland). Across all countries, the higher the prevalence of current drinkers, the higher the percentage of pre-drinkers. In addition, an interaction between the prevalence of heavy drinkers and the price ratio was found. In countries with a low price ratio, the higher the prevalence of heavy drinkers, the higher the percentage of pre-drinkers. The opposite effect was observed in countries with high price ratios.

DISCUSSION AND CONCLUSIONS: Pre-drinking appears to be a worldwide phenomenon. The significant effects of all three indicators demonstrate the role of country-level determinants underpinning the prevalence of pre-drinking across countries. Policy makers could use the reported findings for initiating campaigns to reduce pre-drinking behaviour.

[Labhart F, Ferris J, Winstock A, Kuntsche E. The country-level effects of drinking, heavy drinking and drink prices on pre-drinking: An international comparison of 25 countries. Drug Alcohol Rev 2017;00:000-000]

Additional Info

  • Authors

    Labhart F.; Ferris J.; Winstock A.; Kuntsche E.
  • Issue

    Drug Alcohol Rev. 2017 Mar 13. doi: 10.1111/dar.12525. [Epub ahead of print]
  • Published Date

    13 march 2017