People who report low social support are significantly more likely to experience heavy drinking and binge drinking than those who feel more supported, a large European study suggests. The researchers also found strong evidence that risky drinking is associated with residential areas. Although alcohol use is known to be linked to social, economic and demographic factors, the research is incomplete; it is not clear to what extent some of these factors, especially environmental factors, predict dangerous drinking. Researchers in Spain designed a study that was unusual in examining both heavy drinking and binge drinking and both individual and contextual (environmental) factors. The study confirmed individual risk factors and uncovered certain environmental factors that may help target interventions for those at risk.
Heavy drinking has declined in Spain and binge drinking has emerged as the leading cause of alcohol-related health damage. Researchers pulled data from Spain's 2011-12 National Health Survey, all collected at a single point in time. They identified samples from more than 20,000 people and examined heavy drinking (in men 40 grams of alcohol per day; in women 24 grams) and binge drinking (in men six or more drinks in 4-6 hours; in women five or more). The data includes individual characteristics, such as gender, age, education level, rural or urban residence, smoking history and perceived social support. Researchers also looked at environmental variables related to education, unemployment and the percentage of local people working in the hospitality industry – an indicator of the density of bars and restaurants. They used statistical analysis to examine associations between risky drinking and factors considered relevant.
The data showed that individuals who viewed their social support as low were twice as likely to report heavy drinking, and nearly twice as likely to report binge drinking, as were those with more social support. This could be because social support is protective, because social isolation is stressful, and/or because risky drinking can harm relationships.
Other individual factors were also relevant. Heavy alcohol use and binge drinking were reported more often by men than by women, and were relatively common among those with higher incomes; higher earnings may facilitate risky alcohol use. Binge drinking was also more common among young people; the risk decreased with each birthday. Being a current or former smoker was a substantial risk factor, but educational achievement was not.
Contextual factors were also substantially associated with hazardous alcohol consumption, although they varied by drinking pattern. Residents of areas with relatively high employment opportunities in the hospitality industry more often reported heavy drinking; this study could not distinguish whether they drank heavily because they had easy access to bars, or whether as heavy drinkers they chose to live near bars. Areas with higher unemployment rates had fewer self-reported heavy drinkers. Heavy drinking was not related to rural versus urban living; binge drinking, on the other hand, was more common among rural dwellers than urban dwellers. The analysis suggested that additional environmental factors not addressed in this study were relevant.
