A new study by the US Centers for Disease Control and Prevention (CDC) shows that three quarters of American adults who binge on alcohol prefer to drink beer. The researchers recommend tightening up control of sales and marketing and raising tax on beer to bring it in line with the policies that apply to other alcoholic beverages.

The study is to be published in the September issue of the American Journal of Preventive Medicine and is available as an online pre print edition.

Binge drinking, defined as drinking five or more drinks at one sitting, is an important public health problem in the United States, and little is known about the types of drinks consumed by binge drinkers, said the authors in the background information to the study.

Data on what binge drinkers drink could help guide decisions aimed at curbing the problem, especially since beer, wine and liquor are taxed, marketed, sold and distributed differently, they added.

Lead author, Dr Timothy Naimi, a medical epidemiologist with the CDC’s Division of Adult and Community Health said that:

“This study isn’t looking at alcohol consumed by people drinking responsibly, or moderately; this is alcohol consumed by people drinking five or more drinks in a sitting, so almost all of them are going to be impaired, if not overtly intoxicated.”

“This is exactly the kind of drinking behavior that leads to so many deaths and secondhand problems that inflict real pain and costs on society, not just the drinker,” added Naimi.

Naimi and colleagues analysed data from 14,150 adult binge drinkers across 18 states who participated in the Behavioral Risk Factor Surveillance System binge-drinking survey in 2003 and 2004. This included information on the amount and type of alcohol each participant consumed during their most recent binge session.

The overall results showed that:

  • Beer was the predominant or exclusive alcoholic beverage consumed by 74.4 per cent of binge drinkers.
  • 80.5 per cent of binge drinkers drank some beer.
  • Of all binge drinks consumed, beer accounted for 67.1 per cent, liquor for 21.9 per cent, and wine for 10.9 per cent.
  • Beer also accounted for most of the alcohol consumed by those participants at highest risk of becoming harmed or causing harm as a result of drinking alcohol.

Naimi said that some of the most dangerous groups are the underage drinkers, people who drank eight or more drinks in one session, and those who drove while drinking or just afterwards.

The researchers found that among those at highest risk of causing or incurring harm as a result of drinking alcohol:

  • For the 18 to 20 year olds, beer accounted for 67 per cent of the drinks consumed.
  • For those who had three or more binge sessions a month, beer accounted for 70.7 per cent of drinks consumed.
  • For those who drank eight or more drinks per binge session, beer accounted for 69.9 per cent of drinks consumed.
  • For those who binge drank in public places, beer accounted for 64.4 per cent of drinks consumed.
  • For those who drove during or within 2 hours of a binge session, beer accounted for 67.1 per cent of drinks consumed.

Naimi and colleagues concluded that:

“Beer accounted for two thirds of all alcohol consumed by binge drinkers and accounted for most alcohol consumed by those at greatest risk of causing or incurring alcohol-related harm.”

Speculating on what might lie behing these statistics, they said that:

“Lower excise taxes and relatively permissive sales and marketing practices for beer as compared with other beverage types may account for some of these findings.”

And they suggested one way to curb the problem of excessive drinking would be to equalize “alcohol control policies at more stringent levels”.

“Sadly, there’s lots of binge drinking going on with all kinds of drinks, and there are lots of effective polices that haven’t been widely adopted,” said Naimi.

“And there are other laws, like those related to selling alcohol to minors or selling to those who are already drunk, that aren’t reliably enforced,” he added.

In the US, beer enjoys favourable treatment compared to liquor and wine said the authors. As Naimi explained:

“Beer is sold in far more locations, especially outlets like convenience stores and gas stations, where impulse purchases are common. Beer taxes at the state and federal level are low and beer is king in terms of aggressive marketing to young adults, who are especially likely to drink and get drunk.”

However, the authors were keen to point out these factors are probably only part of the explanation. Choosing a drink is a complex psychological decision, of which policies surrounding access and availablity is only one factor. There are social factors too, like family habits, culture, country of origin. The authors said this was probably the biggest limitation of their study.

“But from a public health standpoint, it doesn’t make sense that beer is marketed, taxed and distributed in a more permissive way than other beverages,”said Naimi.

“What Do Binge Drinkers Drink? Implications for Alcohol Control Policy.”
Timothy S. Naimi, Robert D. Brewer, Jacqueline W. Miller, Catherine Okoro, Chetna Mehrotra.
Am J Prev Med 33(3), 2007.

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Written by: Catharine Paddock