Spożycie napojów alkoholowych w Polsce w 1985 r. Część I: Wzory zachowań
Authors: Jerzy Jasiński
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Two consecutive alcohol consumption surveys were carried out in Poland in 1980 and 1985. In both of them quota samples of population 16 years of age and over were used, and the sizes of the samples were 1972 and 1808 respectively. The surveys were sponsored by the Institute of Psychiatry and Neurology which is responsible for funding research on a broad range of topics related to alcohol, its effects, use and misuse. The fieldwork was carried our by specially trained interviewers of the Centre for Public Opinion Survey and Programme studies of the state Committee for Radio and TV in Warsaw, a well established public opinion poll institute working already for more than 30 years.
The majority of items included in the questionnaires used in each survey were identical, only some were altered, dropped entirely, or substituted for by other formulations. The preliminary part of both questionnaires concerned the relations of the respondents with other people. This was followed by a group of several questions related to the last drinking occasion: place and company of drinking, kind and amount of alcohol consumed, and the reason for drinking. In the 1985 survey more detailed information on the last occasion of drinking was collected, viz. separate questions were asked in relation to the last occasion of consumption of spirits and that of the consumption of wine, as well as on the duration of these occasions. The persons who had not consumed alcohol during the twelve months preceding the interview were asked whether they had ever drunk before, and what the reasons were for their being teetotallers.
All the respondents were requested to tell about their pleasant and unpleasant experiences with alcohol, and whether alcohol helped them or caused trouble in some situations listed in the questionnaire, and pertaining to their social and professional life. Apart from that, the respondents were asked to express their approval or disapproval of several statements concerning good and bad consequences of drinking. In this part of the questionnaire, in the 1985 survey several alterations were introduced in comparison with the former survey. What remained unchanged in the questions were those on being victimized during the last twelve months while drunk, or by a drunk person.
The questions on drinking in excess or more often than desired, or binge drinking-asked in the 1980 survey - were replaced in the 1985 survey by questions forming the CAGE questionnaire. Other questions asked in both surveys concerned the consumption of moonshine alcohol and drinking at work. The concluding part of the questionnaires was designed to obtain information on the respondents age, sex, education, place of residence, kind of work, etc.
In the above surveys, the-last-occasion approach was applied in order to estimate the size and the pattern of alcohol intake by the respondents. This approach is adopted in the majority of Polish alcohol consumption surveys, following the example of a Finnish researcher P. Kuusi.
Both surveys were carried out in mid-September, i.e. after-summer holidays, during a normal working month, without any important religious or national festivities, which would have changed to some extent the ordinary drinking practices.
During the years 1980-1985, the size of the apparent consumption of alcoholic beverages changed considerably. According to the official data derived from the statistics on sales of commodities, in 1980 the per capita consumption amounted to 8.4 litres of pure alcohol, of which 71 per cent was drunk in spirits,15 per cent- in wine, and 14 per cent -in beer. The 1985 figures were: 6,8 litres, 67, 15 and 18 per cent respectively. It looks as if the total consumption decreased substantially (by 19 per cent), but the structure of beverages consumed remained fairly stable. However , according to the opinion shared by the majority of specialists on the subject, the drop in the officially recorded consumption was associated with a marked increase in moonshine alcohol, which resulted in raising the total consumption to at least the 1980 level.
The results of the survey seem to support this assertion. The per capita self-reported consumption of alt alcoholic beverages amounted to 5.6 and 5,9 litres of pure alcohol in 1980, and 1985 respectively. Thus, instead of the 1985 drop, a slight increase occurred (by 5 per cent). Moreover, while. the self-reported consumption of the majority of the beverages remained stable a large increase was noted in the home-made beverages: the illegally distilled moonshine alcohol (spirits) and the legally made fruit wine. The consumption of moonshine spirits was in 1985 higher than that in 1980 by 130 per cent and the consumption of fruit wine was higher by 60 per cent. In1985,one-scventh of all alcoholic beverages consumed were home-made, while in 1980 - only one-thirteenth. As a result, the share of spirits in the total amount of alcohol consumed – whether legally or illegally distilled in 1985 exceeded the 71 per cent level of 1980.
Between the years 1980 and 1985 the proportion of consumers of fruit wine and spirits within the population remained stable, and that of other beverages increased. In particular, the number of those who drank moonshine spirits doubled. With the exception of fruit wine drunk in 1985 by nearly one-third of men as well as women 16 years of age and over, other beverages were consumed by far more men than women. This was particularly the case as regards beer which was drunk by 70 per cent of men and only 20 per cent of women, and moonshine spirits which were drunk by 30 per cent of men and 11 per cent of women. Spirits, which in Poland means mostly vodka, were consumed by 85 per cent of men and 62 per cent of women, and wine by 46 and 39 per cent respectively.
FREQUENCY AND AMOUNT
The-last-occasion approach adopted in the surveys consists not only in asking the respondents of how much and of how long ago they had drunk for the last time each of, the alcoholic beverages enumerated in the questionnaire, but also in assuming that the occasions reported were typical for the ways the respondents drank.
Frequency of drinking depends heavily, among other things, on the kind of' beverage. In the Polish culture, wine is the less frequently drunk alcoholic beverage. Two-thirds of its consumers drink it at most once a month, and half of all its consumers - at most once every three months. Home-made fruit wine is being drunk even less often. Only one in five or six wine consumers drink it once a week or more often.
The consumers of spirits seem to be divided into two distinct groups, one formed by occasional drinkers (at most once a month) and the other by frequent drinkers (several times a month or even several times a week). The first group consists of one-third, and the other one of more than half of all spirits drinkers. One in five of them drinks spirits several times a week.
Most evenly distrributed on the frequency scale of drinking were the consumers of beer. Nearly as many drank it every day, every week, every month or every three months.
Similar picture emerges in respect of the amount drunk on one occasion. Regardless of the beverage, most consumers drink small quantities only. But there are also heavy drinkers who consume on one occasion at least a quarter of a litre of spirits, one litre of wine or more than one litre of beer. Those drinkers constituted one in five of spirits' consumers, even one in two of moonshine spirits consumers, and one in five of wine or beer consumers, less heavy drinkers are only among home-made fruit wine drinkers (one in ten).
The information concerning the frequency of drinking and the amount of alcohol consumed makes it possible to separate four patterns of drinking: heavy and frequent, heavy and infrequent, moderate and frequent, moderate and infrequent. Among consumers of different beverages, the group of persons drinking moderately and infrequently was the most numerous particularly as regards the consumers of wine, and smaller degree the consumers of spirits and moonshine spirits, and to the smallest degree-the consumers of beer. Also the group of persons drinking heavily and infrequently were relatively numerous, apart from consumers of beer, among whom the second most numerous group was that of persons drinking moderately and frequently. Every fourth or fifth consumer of beer, every seventh consumer of home-made frit wine drank much and frequently. As regards persons, who drank any two of the above-mentioned beverages, a convergence of their drinking parents could be noticed which consisted in the following regularity: if one of the beverages was consumed according to one of the patterns, the other beverage was generally also consumed according to the same pattern.
The above results were very similar in both surveys. However, in the 1985survey, a slight shift towards greater concentration of consumption could be noticed.
One of the effects of drinking alcohol, and for some consumers probably also one of the aims of drinking, is to get drunk. Using the information from the 1985 survey on such factors as the kind and amount of beverages consumed, the duration of the drinking occasion, and the sex and weight of the respondent, the blood alcohol concentration was estimated for every drinking occasion reported. In about one quarter of drinking occasion this estimate could not be done due to the lack of some of the necessary data, most often that of the weight of the respondents.
Only one in every five events of drinking spirits and one in three events of drinking wine have not caused a rise in blood alcohol concentration above the physiological level of 0,2 per mille. Getting drunk, i. e. overstepping the blood alcohol concentration of 1.5 per mille, occurred in 13 per cent of incidents of drinking spirits, 7 per cent of drinking wine, and 5 per cent of drinking home-made fruit wine. If related to the total number of drinking occasion of the above beverages this means that in Poland every day about 600 thousand persons would get drunk.
Persons getting drunk were significantly more numerous among men than women, and as far as men are concerned among young (up to 40 years of age), less educated, blue-collar workers describing themselves as non-believers or non-worshiping believers. Among women only those who felt to be better off than average would drink significantly more often than others.
One of the characteristic features of drinking alcohol in Poland is using the existing occasions or inventing them. Alcohol happens to be drunk in order to celebrate such events as family festivities (like name-days or birthdays), religious ceremonies (like baptism, confirmation or - in particular - wedding), national holidays, government ceremonies (like opening a factory, a museum'' new railway station or a bridge), other happy events (tike winning a match by a favourite soccer team, passing important examinati.ons by the son or daughter, their entrance to the high school or the university). Drinking occasion may be called for while looking for some comfort caused by losing a march by a favourite soccer team a set-back at work, or misfortune in personal matters. Alcohol is served and drunk in order to show hospitality, to emphasize the importance of a guest or an unusual, lofty, or particular character of the meeting, etc. This list could be easily extended, but it does not seen necessary as its aim is only to show that drinking alcoholic beverages - probably with the exception of beer only – is perceived as an event calling for special justification. This justification should not be equated with causes of drinking, deeply rooted and often not understood and realized clearly by the person in question. Therefore, the justification for drinking provides an insight not so much into the reasons of drinking as into its cultural context.
Using the information on the kind and amount of alcohol drunk, on the place of drinking, character of the occasion, and, in the 1985 survey, also on the duration of the drinking incidence, three main types of spirits and wine consumption occasions were distinguished: a family celebration, a friendly social meeting, and a drinking-for-purpose event.
The family celebration comprised nearly half of all drinking occasions described in the replies of the respondents. These occasions lasted longer than others, namely about 4 to 5 hours, with many persons taking part, the amount of alcohol drunk was smaller by half than the average amount and in more than 90 per cent of cases they took place in private quarters.
The friends-meeting social type of drinking occasions were less numerous, they comprised about one-third of the total number of the last occasions reported. Half of them occurred in friends appartments, one-fourth on the respondents flats, and one in seven in a bar or restaurant. The meeting lasted about 2-3 hours, and the amount of spirits or wine drunk was somewhat larger than the average. Most often 4 to 5 persons took part in these encounters.
One in five of the last occasions described by the respondents was of the drinking-for-purpose type. The most often stated justification for such a drinking occasion was that ,,it just happened this way" or ,,without any special reason, and the second in the row was that the drinking tock place in order to handle some business which made it necessary to have a drink’’. These occasions lasted usually l-2 hours and the company consisted of about 3-4 persons. Most often the meeting took place in a bar or a restaurant at work; relatively rarely in private appartments, and occasionally in a park or another commonly frequented place. Persons drinking on these type of occasions consumed twice as much alcohol as the average.
The types and characteristics of drinking occasions did not change between 1980 and 1985; only few exceptions were noted, such as those with more alcohol drunk in private apartments and less in bars and restaurants. The same types of drinking occasions were fund in respect of consumption of spirits and wine, only home-made fruit wine did not seem to be drunk ,,for purpose’’
DRINKING AT WORK
One of the special features of drinking practices in Poland is the consumption of alcohol at work. It takes place against the provisions of the labour law and in some circumstances also against criminal law. Every few years the authorities launch a campaign against drinking at work only to learn that it brings about temporary results. In order to understand the reasons for limited effects of such endeavours a closer look at a socialist enterprise is necessary' fn a state-controlled economy, a socialist enterprise is not. only a place where employees provide work in order to produce some commodities or services. One of the Polish leading sociologists described such an enterprise as a combination of an industrial plant, an office, and charity. Its peculiar social life stems from all the above factors, and it is only against this background that an appraisal of the data on drinking at work can be made.
The 1980 survey revealed that two of every three respondents employed in the state-owned enterprises and offices had in the course of the last year prior to the interview drunk alcohol while at work. The results of the 1985 survey were markedly different since the affirmative answers to the question of drinking at work was given by one in every two such respondents. On the assumption of the last occasion approach an attempt was made at amount of drinking events at work. The numbers of such events in1980 and 1985 were 14.6 and 7.3 per one employee respectively. It seems to be a marked decrease, but is has to be seen whether it will be a lasting one.
Drinking at work seems to be very common also in another respect. When looping at the characteristics of the consumer of alcohol at work they correspond closely to the characteristics of all drinking persons.
The justification for drinking at work is very similar to that described above, only the family celebration and friends-meeting social types seen to merge into one. In 1980 nearly half, and in 1985 one-third the persons who drank at work did it while celebrating name-days or birthdays. One in five of those who drank at work did it ,,with no special reason" or because alcohol was offered by somebody, which corresponds to the drinking-for-purpose type.
Alcohol dependence is a very complex concept and it is debatable whether tackling it in a survey research can produce conclusive results. In the 1985 survey it was approached by means of one of the questionnaires used by medical practitioners. After reviewing several of such questionnaires, like MAST, SMAST, CAGE, MALT, Reich, the CAGE questionnaire was selected as the most suitable, among other things, because of its brevity. A common feature of all the above instruments is that they are in fact screening tests, and their aim is to spot out in a pool of patients those who might have an alcohol problem. These patients are referred afterwards to a qualified specialist for a proper examination and diagnosis.
The use of such a questionnaire in a survey conducted in a general population is an extention of its application far beyond the limits of its original design, because in such a situation it is expected to provide a final ,,diagnosis" instead of pointing to persons suspected of being addicted to alcohol. In the circumstances both the sensitivity and specificity of the questionnaire become of utmost importance.
The low specificity of the CAGE questionnaire makes it impossible to estimate- within the known limits of errors - the size of the group of alcohol dependent persons in the general population because a number of persons likely to be classified on its basis as being alcohol dependent in fact are not dependent. The size of the latter (i. e. those incorrectly classified as alcohol dependent) is partly a function of the size of the group of the alcohol dependent in the general population.
The percentage of respondents who in the 1985 survey said ,,yes" to al1 the four questions of the CAGE questionnaire was 4.4, to three questions - 11.8, to two questions - I2.1, and to one question - 15.1. The results of the previous applications of the CAGE test show that four ,,yes" answers to the questionnaire questions were given only by alcohol dependent persons, and no such answers were given by persons not dependent. Hence it can be assumed that in the cases of all four ,,yes" answers one deals with alcohol dependent persons, without fear of making a serious error. As to the persons who gave three ,,yes" answers) one can assume among them a higher cumulation of alcohol dependent persons, and as regards those who said ,ryes" to two questions it can be hypothesised that there are few such persons among them.
On the basis of the results obtained, the probable number of persons in 1985 in Poland in the age group of 16 years and over, who were alcohol dependent, has been estimated as somewhat higher than number of persons who said ,,yes’’ to all the four questions in the CAGE questionnaire, i. e. approximately 1,500 000, the error limits of this estimate, unfortunately, cannot be specified. The persons who gave a higher number of ,,yes’’ answers to the test questions drank largel quantities of alcohol. More answers of this kond were given by men, middle-aged persons and elderly (but not old), living in villages, not well-off, non-worshipping believers and non-believers.
THE ABSTAINERS AND TEETOTALLERS
Abstainers are referred to here as those who do not drink a particular alcoholic beverage, and teetotalers as those who according to themselves do not drink alcohol at all (1980 survey) or who did not consume alcohol during the last twelve months prior to the interview.
Only 25 per cent of the respondents abstained from drinking spirits, about 25 per cent-from wine, 58 per cent (in 1980)and 50 per cent (in 1985)-from beer, 70 per cent (in 1980) and 64 per cent (in1985)-from home-made fruit wine, and 89 per cent (in 1980) and 79 per cent (in 1985)-from moonshine spirits.
The were 14.8 per cent teetotalers in 1980 and 16.1 per cent in 1985, however, the difference in those percentages is statistically insignificant. In general population the fraction of teetotalers is probably a few points higher because in both the 1980 and 1985 samples the persons aged 16-19 and 60 and more, namely those among whom the non-drinkers are most numerous, were underrepresented.
Less than half of the teetotalers never drank alcohol and the share of those who stopped drinking increased between the years 1980 and 1985. This result would have looked promising were it not for the reasons for not drinking given by the respondents. Most often old age, poor health, lack of money, and similar justification were offered, and only one in seven non-drinking alcohol respondent mentioned that drinking alcohol would interfere with his studies or work, or against his beliefs or cherished values.
Also the social characteristics of teetotalers give reason for worry: among these overrepresented are very young and elderly, women, poorly educated, blue-collar workers, poor-in general those who belong to the lower social strata of the population.
To be a teetotaler in Poland is unenviable.