Gender differences in attitudes toward alcohol use

Gender Differences in Attitudes to Alcohol Use

Alcohol use is virtually as old as mankind, and billions of people around the world enjoy the conviviality and relaxation that are associated with drinking. There have also been some proven medical benefits associated with moderate alcohol consumption. In many cases, though, the casual and social use of alcohol leads to its abuse, and the enormous adverse effects of alcoholism on Western societies have been well-documented time and again. Furthermore, dependence and abuse is highest among young adults aged 17 to 29 years which can lead to profound health and psychosocial problems later in life. While the research into the causes and effects of alcohol use and abuse continue, the fact remains that there are some important differences in how the practice is viewed by men and women that can provide some valuable insights into developing effective interventions in the future. To this end, this study examines the current research to identify what factors contribute to a higher incidence of alcohol use and abuse in general and among younger drinkers in particular. A critical review of the peer-reviewed and scholarly literature is followed by an analysis of a survey instrument administered to 30 volunteer respondents from the United Kingdom (n=16 females; 14 males) who attend a university located in a coastal city in England. Salient findings and recommendations are provided in the concluding chapter.

Chapter 1: Introduction

Statement of the Problem

Purpose of Study

Rationale of Study

Overview of Study

Chapter 2: Review of Related Literature

Chapter 3: Methodology

Chapter 4: Data Analysis

Chapter 5: Summary, Conclusions and Recommendations

An Analysis of Gender Differences in Attitudes Related to Alcohol Use in the United Kingdom Today

Chapter 1: Introduction

Despite its increasingly negative reputation among clinicians, the use of alcohol plays an important role in many social activities, ranging from the "business lunch" and parties to special occasions. The potential benefits of alcohol consumption during such social occasions are heavily influenced by culture, the setting in which drinking occurs, and expectations about alcohol's effects (Leigh & Stacey, 1991). In this regard, there have been commonly reported results of stress reduction, mood elevation, increased sociability, and relaxation associated with drinking alcohol; however, when alcohol consumption transcends these social settings, it can create some of the most profound problems facing modern societies. In fact, substance abuse in general and alcohol abuse in particular represent some of the most challenging problems facing Western society in the 21st century. The incidence of substance use and abuse is staggering, and alcohol consumption is becoming increasingly commonplace, even among very young people (Briggs, Love & Mcveity, 2000).

Statement of the Problem

The use and abuse of alcohol has been a problem for mankind since time immemorial, but today, alcohol abuse by young people in the United Kingdom has assumed critical levels in some regions, and the problem appears to be getting worse. The consequences of alcohol abuse are well-known but do not seem to dissuade current and potential drinkers from indulging to excess; however, the association between alcohol abuse and acute and chronic health problems, vehicle-related injuries and deaths, poor work performance and attendance, psychosocial maladjustment, and involvement in criminal activity has been shown by study after study in the past (Ammerman, Ott & Tarter, 1999). Furthermore, the societal costs associated with alcohol abuse are enormous, and include additional costs for the national health care system, additional law enforcement, an increased presence of the criminal justice system, and lost economic efficiency (Ammerman et al., 1999). Excessive alcohol consumption can also have a wide range of adverse health effects (Chaloupka, Grossman, & Saffer, 2002). Indeed, among young people, long-term heavy alcohol use has been identified as an important risk factor for stroke (You, McNeil, O'Malley, Davis, Thrift & Donnan, 1997). Very recent alcohol drinking, particularly drinking to intoxication, has been also been linked with a significant increase in the risk of ischemic stroke in both men and women aged 16 through 40 years (Health risks and benefits of alcohol consumption, 2000).

These patterns of alcohol abuse generally develop during adolescence; unfortunately, a significant percentage of these adolescents will develop serious problems with drugs and alcohol throughout their adulthood. According to Ammerman and his colleagues, "As with many social ills, treatment of affected individuals is expensive and has a limited rate of success" (p. 3). Therefore, it has been widely recognized that the most effective approach to decreasing alcohol abuse is prevention; by preventing the full-blown incidence of alcoholism later in life, scarce resources can be allocated to treatment and other forms of intervention such as law enforcement (Ammerman et al., 1999). This point is also made by Chaloupka, Grossman, and Saffer (2002) who report that fatal motor vehicle accidents remain the leading cause of death of people under the age of 35 years, with alcohol being involved in more than one-half of these fatal crashes. In fact, fatalities per car miles of travel of people between the ages of 16 and 24 were more than twice as large as those of people ages 25 and over in 1995 (Dee & Evans, 2001). In addition, the abuse of and dependence on alcohol are highest among people between the ages of 18 and 29 (Chaloupka et al., 2002). Finally, targeting younger people for such educational interventions has assumed increasing importance today because alcohol abuse in adolescence appears to be associated with alcohol abuse in later life; as a result, governmental policies designed to reduce alcohol abuse by younger people could represent the most effective approach to reduce its incidence in all segments of the population (Chaloupka et al., 2002). In particular, the use and abuse of alcohol by university students has emerged in recent years as a matter of great concern (Cox, Inderhaug, King, Klinger, Man, Schippers, Skutle, & Stuchlikova, 2002). In fact, many college students drink excessive quantities of alcohol and their common pattern of heavy episodic drinking can result in severe negative outcomes. As a result, it has become increasingly important today to identify the factors that determine which students will drink problematically, and how these factors might place them at risk for greater drinking problems in the future (Cox et al., 2002).

Purpose of Study

The purpose of this study is to identify those gender-related differences that exist among a sampling of university students in the United Kingdom concerning alcohol use and abuse to determine if these findings can be integrated into a best practices approach to intervention and educational initiatives.

Rationale for the Study

The examination of the particular lifestyle characteristics of people who consume either no alcohol or varying amounts of alcohol can provide researchers with other factors that might account for different health outcomes; for instance, gender, age, education, physical fitness, diet, and social involvement are among the factors that may be taken into account in determining relative risk of disease (Health Risks and Benefits of Alcohol Consumption, 2000).

Overview of Study

To develop as much insight into the perplexing issues surrounding alcohol use and abuse, this study employed a hybrid methodology comprised of a critical review of the peer-reviewed and scholarly literature in Chapter 2 followed a more detailed explanation of the study methodology in Chapter 3. A survey of a sample of university students in the United Kingdom who agreed to participate in this research by completing the survey instrument at Appendix A is examined in Chapter 4 and the results of these surveys were analyzed using SPSS 11.0 (Student Version), and the findings interpolated through a series of trended graphs and narrative interpretations. The concluding chapter provides a summary of the research, conclusions that can be drawn, and relevant recommendations.

Chapter 2: Review of Related Literature

Background and Overview.

According to Anderson, Bjarnason, Choquet, Elekes, Morgan, and Rapinett (2003), alcohol abuse can result in serious short-term and long-term health risks and is an accurate predictor of future problem drinking and drug use. Furthermore, alcohol abuse has been associated with a wide range of other negative behavioral consequences, including accidents, violent behavior and victimization and suicidal tendencies, as well as earlier sexual encounters and an increased incidence of unprotected sex (Anderson et al., 2003)). Furthermore, frequent and heavy alcohol by young people has been associated with personal problems with family, friends, employers, school authorities and law enforcement authorities (Anderson et al., 2003). While the likelihood of casual or social drinking evolving into problem drinking may in part be attributable to various biological and genetic factors, such problematic behavioral patterns are developed within in a multilevel social context, ranging from interpersonal relationships to societal-level structural constraints and cultural traditions (Anderson et al., 2003).

Gender Differences in the Perception of Alcohol Use.

There are some profound differences in how alcohol use is perceived by men and women today, but these views have some important basis in European history. According to Martin (2001):

Given the connection between drink and sexual activity and a similar connection between drink and unruly behavior, the patriarchal constraints on the consumption of alcohol by women seem weak. Men believed that a drinking woman was more likely than a sober woman to engage in illicit sex; they feared the sexuality of sober women, and the fears increased with each cup of wine or jug of beer. Nonetheless, women had their cups and their jugs. Some historians have failed to recognise the strong connection between drink and sexual activity in traditional Europe and have as a consequence attributed certain phenomena, such as the association between drinking establishments and prostitution, to other developments. (Martin, 2001, p. 136).

There are some other important gender-related distinctions found in the historical record as well. For example, historians have maintained that the beliefs regarding alcohol use were gender-specific, with men supposedly being less susceptible to the erotic effects of drink than their female counterparts. "True, misogyny or at least fear of female sexuality inspired some of the authors who condemned drinking women, but misogyny and the fear of female sexuality also led some authors to warn men to observe moderation in drink and thereby to preserve their chastity.... Men also feared insubordinate women and their tendency to become disorderly. As in sex, so in disorder, men believed that alcohol increased these tendencies" (Martin, 2001, p. 136).

In 1996, a study was conducted by members from European Union (EU) countries of female and male drinking patterns, and their acute and chronic consequences, for nine European countries (Finland, France, Germany, Great Britain (Scotland), Italy, the Netherlands, Sweden, Switzerland, and the Czech Republic); the researchers investigated whether European women's and men's drinking patterns were becoming more similar following the reasoning of the "convergence" hypothesis. According to Wilsnack and Wilsnack, the researchers determined that any such convergence has been small, inconsistent, and statistically uncertain in the majority of these European countries, with the sole exception of Finland (where until recently women were exceptionally likely to be abstainers or very infrequent drinkers). "In none of the European countries studied did women's drinking frequencies or quantities exceed those of men" (Bloomfield et al., 2001 cited in Wilsnack & Wilsnack, 2003).

The EU researchers also studied the extent to which recent shifts in women's roles, especially increased education and additional compensated employment outside the home, had resulted in increased drinking by women following the "emancipation" hypothesis. The results of this component of the study suggested that women with higher levels of education were more likely to drink at least occasionally (i.e., not to abstain completely) (Allamani et al., 2000 cited in Wilsnack & Wilsnack, 2003); however, a more rigorous analysis determined that paid employment, in isolation of consideration of other factors such as the roles such as marriage and parenthood, did not consistently increase the chance that women would drink heavily (defined as 12 or more drinks per week) (Wilsnack & Wilsnack, 2003).

The EU study also addressed the question of how survey measures of drinking behavior could be made more gender-sensitive. The investigators concluded that oversimplified questions (e.g., questions that are not beverage-specific, do not specify drink sizes, and do not ask about atypical drinking occasions) should not be used in such investigations because they tend to underestimate female drinking more than male drinking, resulting gin overestimation of gender differences; the researchers concluded that the evaluation of cultural effects on the reliability and validity of drinking measures required additional research (Wilsnack & Wilsnack, 2003).

Interventions and Initiatives Targeted at Reducing Alcohol Abuse among Younger Drinkers.

Unfortunately, adolescents and young adults who may be experiencing problems with their alcohol consumption are frequently unwilling to discuss their substance use with clinical professionals (Bukstein, Clark, Cornelius, Delbridge, Donovan, & Kelly, 2003). Furthermore, alcohol abuse and full-blown alcoholism remain conditions better described in the literature than they are understood. Despite the paucity of available "cures" for alcohol abuse, though, there are some solid steps that can be taken by community leaders, educators, law enforcement officials and policymaker at all levels to help reduce the incidence of overindulgence by young drinkers. For example, owners and managers of establishments that serve alcoholic beverages can implement policies that instruct staff members on how best to prevent younger patrons from becoming intoxicated and can refuse sales to obviously intoxicated customers; these same steps can be used to help prevent illegal alcohol sales to underage students (Toomey & Wagenaar, 2002). The results of a recent study determined that fully 79% of establishments that serve alcohol will continue to serve it to patrons who appear obviously intoxicated in spite of laws that prohibit such practices; some examples of policies that management can implement are serving alcohol in standard sizes, limiting sales of pitchers of alcohol, cutting off service of alcohol to intoxicated patrons, promoting alcohol-free drinks and food and eliminating last call announcements (Toomey & Wagenaar, 2002). While some of the existing server training programs have resulted in interventions such as offering food and alcohol-free beverages, training in isolation from other elements has resulted in reduced sales of alcoholic beverages to intoxicated individuals to date (Toomey & Wagenaar, 2002).

An alternative that has been shown to be more effective has been to reduce the overall availability of alcohol by restricting the flow of alcohol at parties and other events on and off campus. "Many policies for preventing underage access to alcohol at parties can also be used to decrease the amount of drinking among older students. Overlapping community policies include banning beer kegs and prohibiting home deliveries of large quantities of alcohol" (Toomey & Wagenaar, p. 194). Overlapping policies for campus events include limiting the quantity of alcohol per person and monitoring or serving alcohol rather than allowing self-service. At one fraternity party, Geller and Kalsher (1990) found that attendees who obtained beer through self-service consumed more beer than those who got alcohol from a bartender. Event and party planners could also be required to serve food and offer a large selection of alcohol-free beverages. Another strategy is to serve low-alcohol content beverages. Geller et al. (1991) found that students attending a fraternity party where only low-alcohol content drinks were served consumed the same number of drinks but had a lower blood alcohol concentration (BAC) than did students at parties where regular alcohol content beer and mixed drinks were served.

Current and Future Trends.

While many observers might believe that people in the United Kingdom are drinking more alcohol than ever before, the fact remains that average alcohol use in the U.K. has declined from the late 17th seventeenth century. At that time, English excise records indicated a daily consumption of about one pint per person; however, this estimate might understate the consumption of ale and beer by 50% (Martin, 2001). "To help put these figures in context, in 1995 the annual per capita consumption of wine in France was 63.5 liters and in Italy 60.4; the daily per capita consumption of beer in the United Kingdom was not quite a half pint (102.7 liters per person per year)" (Martin, 2001, p. 30). There are also some commonalities in alcohol use among young people in both the United States and Canada; alcohol use decreased between the late 1980s to the mid 1990s in these countries but during the late 1990s alcohol use stabilized among U.S. adolescents, while it increased among students in Ontario, Canada (Effendi, Hill & White, 2003). Alcohol use increased between the late 1980s and mid 1990s among younger students in the United Kingdom, then decreased again in the late 1990s to levels comparable to those at the turn of the 20th century (Boreham & Shaw, 2001).

Nevertheless, the problems associated with alcohol use and abuse have not changed during the intervening centuries, but they have been more fully investigated and are better understood today. For example, in their essay, "Environmental Policies to Reduce College Drinking: Options and Research Findings," Toomey and Wagenaar (2002) report that "Concern over drinking practices among college students has grown recently, in part because of well-publicized, alcohol-related tragedies that have occurred on campuses in the last few years" (p. 193). As a result of this publicity, many observers have asked, "What has happened to our college campuses? Why are we seeing so many alcohol-related deaths?" (Toomey & Wagenaar, p. 194). In fact, the primary shifts in drinking patterns today may not be related to actual drinking levels or patterns among college students but rather modern society's increasing recognition of the role alcohol plays in many problems, both on campus and off. "Alcohol has been an integral part of many campuses for years -- playing a role in campus celebrations, social functions and academic activities," the authors report. "Until recently, however, we had not quantified the contribution of alcohol to dropout rates, assaults, property damage and deaths and injuries occurring on and around campus. Colleges and universities are now struggling to identify effective strategies to address college drinking in an attempt to reduce alcohol-related problems among this population" (Toomey & Wagenaar, p. 194). This goal is exceedingly important given that heavy consumption of alcohol represents a major problem for the physical, psychological and social well-being of young people today.

According to Macmanus (1996), "Government intervention in health-related practices that are viewed as harmful to individuals and society at large, such as smoking and alcohol abuse, does not spark the same intergenerational differences as does government involvement in health issues with a moral dimension" (p. 248). For instance, younger people have been found to be much more supportive than their older counterparts concerning government regulations and programs permitting sex education and condom distribution in the schools and those that promote substance abuse treatment rather than seeking to punish people for their use. In this regard, Macmanus suggests that, "The generational divide in health care policy is likely to widen in the future as health care rationing becomes necessary. When disease-specific funding and care choices are posed to the public, the generational differences will be dramatic -- and each group will become more combative" (p. 248).

Chapter 3: Methodology

The review of the peer-reviewed and scholarly literature was accomplished through consultation of public and university libraries, reliable online sources such as Questia, EBSCO and Medline, as well as governmental and organizational Web sites dedicated to the topic examined herein. According to Wood and Ellis (2003), the following outcomes can be achieved through the use of a well-conducted review of the timely and relevant literature:

It helps describe a topic of interest and refine either research questions or directions in which to look;

It presents a clear description and evaluation of the theories and concepts that have informed research into the topic of interest;

It clarifies the relationship to previous research and highlights where new research may contribute by identifying research possibilities which have been overlooked so far in the literature;

It provides insights into the topic of interest that are both methodological and substantive;

It demonstrates powers of critical analysis by, for instance, exposing taken for granted assumptions underpinning previous research and identifying the possibilities of replacing them with alternative assumptions;

It justifies any new research through a coherent critique of what has gone before and demonstrates why new research is both timely and important.

The survey of U.K. university students was conducted by recruiting 30 volunteer respondents who used alcohol in varying degrees, aged 18 to 35 years, who agreed in advance to participate in this study; in an effort to obtain as many responses as possible within the time parameters involved, there was no effort made at randomization. Thirty (30) surveys were emailed or hand-delivered to these respondents, and all were received in sufficient time for inclusion in the data analysis. A copy of the survey instrument is provided at Appendix A; face validity for the instrument was achieved by having five associates of the author review the instrument to determine if it appeared to collect the type of information intended. Based on the five positive responses received, the instrument was used intact.

Section 1 of the survey instrument consisted of a series of demographic-related questions designed to identify the gender of the respondent, how long the respondent had used alcohol, and the respondents' ages; Section 2 of the survey was comprised of a series of Likert-scaled questions ranging from 1 to 5 as indicated and Section 3 provided space for open-ended comments which are reproduced verbatim below following the analysis of Sections 1 and 2. The results of the statistical analysis are discussed further in Chapter 4 below.

Chapter 4: Data Analysis

Section 1. Demographics

1. Please indicate whether you are a male or female in the space below.

Male ____ Female

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Female

Male

2. Please indicate how long you have been drinking alcohol in years in the space below.

____ years

Males:

Male Mean

Females:

Female Mean

One-Sample Statistics

Overall Mean

Std. Deviation

Std. Error Mean

Years - Males & Females

3. How old are you?

____ years

Frequency

Percent

Valid Percent

Cumulative Percent

Valid

Average Male Age:

Average Female Age:

Average Age of All Respondents:

Sum

Mean

Std. Deviation of Total Sum of Total N

Section 2. Likert-Scaled Questions

Questions in section 2 were analyzed using the chi-square goodness of fit test which is sensitive to sample size (Cheng & Wu, 1994); however, the analysis of the distribution of the respondent scores showed the responses met the normality assumption of the nonparametric chi-square statistics (when appropriate) performed to compare demographic and survey variables for the male and female groups of students.

Please rate how strong your desire was to use alcohol during the last 24 hours?

Not at All Extremely High

Case Summaries

Question

Observed N

Expected N

Residual

Test Statistics

Question

Chi-Square df

Asymp. Sig.

A cells (.0%) have expected frequencies less than 5. The minimum expected cell frequency is 6.0.

Please rate how strong your desire was not to use alcohol during the last 24 hours?

Not at All Extremely High

Case Summaries

Question

Observed N

Expected N

Residual

Test Statistics

Question

Chi-Square df

Asymp. Sig.

A cells (.0%) have expected frequencies less than 5. The minimum expected cell frequency is 6.0.

Please rate your confidence in your ability to resist using alcohol today: