Understanding stability and change in British drinking using 16 years of market research data

从2001年到2016年，英国经历了酒精消费量的历史高峰，随后急剧下降。这些趋势与一系列跨部门的酒类战略、许可证改革、酒吧禁烟、关于酒精税和最低价格的辩论、媒体关注“狂欢英国”和“小姐”文化以及以节制饮酒而闻名的新一代年轻人相一致。有人认为，我们国家的饮酒文化发生了根本性的变化，但迄今为止，这些变化都没有得到充分的记录和理解。例如，虽然我们有关于饮酒量如何变化的良好数据，但我们对人们在何处、何时、为何、与谁以及如何饮酒的变化知之甚少。这一点很重要，因为更好地了解与健康有关的行为改变的社会和环境背景对改善公众健康和福祉的努力日益重要。《柳叶刀》杂志、医学研究委员会、社会流行病学家和复杂系统理论家都强调了对微观层面的社会、文化和地理环境缺乏关注，而与健康相关的行为和干预措施正是在这些环境中发生的。这限制了我们就卫生行为与更广泛的文化和结构变化之间的关系提供专家评论、预测和应对未来趋势以及为公共政策和辩论提供信息的能力。酒精研究就是一个很好的例子。尽管这一主题在健康和社会科学领域有着悠久的历史，但研究人员往往难以描述并提供令人信服的解释，解释饮酒文化的变化。造成这种情况的一个关键原因是，大多数定量证据将饮酒视为一种单一行为，取决于人们喝了多少酒。在现实中，饮酒的场合有很多种，其特点是饮酒发生的背景（例如，酒吧午餐，在家放松，晚上外出），场合的类型通常是非专业话语和政策辩论的焦点。根据这些观点量身定制的定量证据可以让人们了解英国饮酒文化是如何变化的，在哪里进行干预以促进积极的趋势，减少消极的趋势，以及哪些预防政策有效地解决了最令人担忧的饮酒类型。这个项目的回应是将人们的注意力从饮酒者转移到饮酒场合。该研究预计，通过分析2001年至2016年期间由25.5万人报告的785,000次大型国际独特数据集，我们对酒精使用的理解将发生阶段性变化。这项工作分为三个工作包（WP）： WP1将探索2001年至2016年英国饮酒的变化。它将根据诸如场合的目的、地点、时间、参与者、饮酒的数量和类型以及饮酒时进行的其他活动（例如进食）等特征，确定所见的主要饮酒场合类型。我们将研究是否出现了新的饮酒类型，哪些场合变得更常见或更不常见，场合的特征是如何变化的，以及这些变化与总体消费趋势的关系。WP2和WP3将测试一系列的假设，这些假设试图解释饮酒场合的趋势，用饮酒场合来解释消费的人口趋势，并检查三个主要的社会变化对饮酒场合的影响，即2008年的经济衰退，2003年的许可法案和禁止在酒吧吸烟。在解释观察到的趋势和变化时，我们将重点关注研究不足和与政策相关的主题，如家庭饮酒和女性饮酒的增加、中老年饮酒、不同地理区域饮酒文化的差异、年轻人饮酒的减少、酒精危害悖论以及饮酒与父母和就业等社会角色之间的关系。

From 2001 to 2016, Great Britain experienced a historic peak in alcohol consumption followed by a sharp decline. These trends coincided with a series of cross-departmental alcohol strategies, licensing reforms, a smoking ban in pubs, debates about alcohol duty and minimum prices, media focus on 'Binge Britain' and 'Ladette' culture, and a new generation of young adults noted for their abstemious approach to alcohol. It has been argued that fundamental changes in our country's drinking culture have resulted but these are, as yet, poorly documented and understood. For example, whilst we have good data on how the amount consumed has changed, we know far less about changes in where, when, why, with whom or how people drink.This is important as achieving a better understanding of the social and environmental context of health-related behavioural change is increasingly central to efforts to improve public health and well-being. The Lancet, the Medical Research Council, social epidemiologists and complex systems theorists have all highlighted the lack of attention given to the micro-level social, cultural and geographic contexts in which health-related behaviours and interventions to address them take place. This has limited our ability to provide expert commentary on how health behaviours relate to wider cultural and structural shifts, to anticipate and respond to future trends, and to inform public policy and debate.Alcohol research is a case in point. Despite the subject's long history in the health and social sciences, researchers often struggle to describe, and offer convincing explanations of, changes in drinking culture. A key reason for this is that most of the quantitative evidence treats alcohol use as if it was a single behaviour defined by how much people drink. In reality, there are many different types of occasion in which drinking occurs, characterised by the context in which they take place (e.g. pub lunch, relaxing at home, a night out), and types of occasions are often the focus of attention in lay discourse and policy debate. Quantitative evidence tailored to such perspectives can deliver understanding of how British drinking culture is changing, where to intervene to promote positive trends and curtail negative ones, and which preventative policies effectively tackle the types of drinking causing most concern.This project responds by shifting attention from drinkers to the drinking occasion. It anticipates delivering a step-change in our understanding of alcohol use by analysing a large internationally-unique dataset of 785,000 occasions reported by 255,000 individuals between 2001 and 2016. The work is divided into three work packages (WP): WP1 will explore how British drinking changed from 2001 to 2016. It will identify the predominant types of drinking occasions seen, based on characteristics such as the occasion's purpose, location, timing, participants, amount and type of alcohol drunk, and other activities undertaken while drinking (e.g. eating). We will examine if new types of drinking have emerged, which occasions became more or less common, how the characteristics of occasions changed and how these changes relate to the overall consumption trend.WP2 and WP3 will test a series of hypotheses which seek to explain trends in drinking occasions, use drinking occasions to explain population trends in consumption, and examine the impact of three major societal changes on drinking occasions, namely the 2008 recession, the 2003 Licensing Act and bans on smoking in pubs. In developing explanations for observed trends and variations, we will focus on under-researched and policy-relevant topics such as increased home drinking and drinking among women, drinking in middle- and older-age, variation in drinking cultures across geographic areas, the decline in young adults' drinking, the alcohol harm paradox and relationships between drinking and social roles such as parenthood and employment.