Alcohol content variation in the assessment of alcohol consumption
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Addictive Behaviors, Vol. 16, pp. 555-560, 1991 Printed in the USA. All rights reserved.
0306-4603/91 $3.00 + .OO Copyright e 1991 Pergamon Press plc
ALCOHOL CONTENT VARIATION IN THE ASSESSMENT OF ALCOHOL CONSUMPTION
CHRISTOPHER S. MARTIN and TED D. NIRENBERG Brown University and Substance Abuse Treatment Center,
Roger Williams General Hospital, Providence, Rhode Island
Abstract - Most investigators have not adequately accounted for the alcohol content of different beverages when assessing alcohol consumption. Considerable research has assessed consumption in terms of the number of standard drinks. A problem with standard drink measures is that differ- ent distilled spirits, wines, and malt beverages vary considerably in alcohol content. State-to-state and brand-to-brand variations in the strength of different malt beverage brands are provided, as malt beverage alcohol contents are not contained on labels due to federal and state regulations. Ignoring alcohol content variation when estimating consumption can produce a large amount of error. Alcohol consumption should be assessed in terms of the number, size, and alcohol content of beverages.
The effects of alcohol consumption on health and responses to alcoholism treatment have been major issues in the alcohol field. While it is widely acknowledged that chronic heavy use adversely affects health (Turner, Mezey, & Kimball, 1977a, 1977b), the effects of more moderate levels of consumption are less clear (Popham & Schmidt, 1978). To as- certain the differential effects of varying levels of consumption, it is essential to have valid and reliable measures that can accurately detect alcohol consumption in a given time period.
Assessment of alcohol consumption is complicated by the fact that the major classes of alcoholic beverages have different concentrations of alcohol and are usually consumed in different volumes. This issue has been addressed by reference to the concept of alcohol equivalency. Alcohol equivalency refers to the fact that drinks that differ in alcohol con- tent are usually consumed in different volumes, such that the total amount of absolute alcohol consumed is similar for a typical drink of distilled spirits (e.g., gin, rum, whis- key), wine, and malt beverages (e.g., beer, ale, malt liquor). Thus, many researchers have assessed the number of standard drinks consumed by subjects in measures of the quantity of consumption (Sobell, Sobell, & Nirenberg, 1988).
Many different definitions of the standard drink measure have been used in the litera- ture. These definitions specify both the amount and alcohol content of malt beverage,
The authors thank the following institutions for providing information used in the preparation of this article: Virginia Department of Alcoholic Beverage Control; Bureau of Alcohol, Tobacco, and Fii; Health Educa- tion Foundation; Alcoholic Beverage Medical Research Foundation; Beer Institute; Anheuser-Busch, Inc.; Coors Brewing Company; G. Heileman Brewing Company, Inc.; Miller Brewing Company. Thanks also to Professor Robert Borkenstein and Drs. Fred Ellis and Dwight B. Heath.
Parts of this manuscript were presented as a poster session at the joint meeting of the Research Society on Alcoholism and the Inte.mational Society for Biomedical Research on Alcoholism in Toronto, Canada, June 17-22, 1990.
Requests for reprints should be sent to Dr. Christopher Martin, Center for Alcohol and Addiction Studies, Brown University, Box G, Providence, RI 02912.
556 CHRISTOPHER S. MARTIN and TED D. NIRENBERG
wine, and distilled spirits that contain the same or similar amount of absolute al- cohol. In the United States, these absolute alcohol values range from 0.4 to 0.6 oz of absolute alcohol, with most falling close to 0.5 oz of absolute alcohol (e.g., Brandsma, Maultsby, & Welsh, 1987; Sobell, Sobell, Maisto, & Cooper, 1987; Sobell, Sobell, & Nirenberg, 1988).
Researchers should be aware of a major methodological issue in the use of standard drink measures. Alcohol content varies widely within the major classes of alcoholic bev- erages. Because standard drink definitions assume some typical alcohol content value in defining standard units (e.g., that malt beverages contain 4% alcohol), actual consump- tion may be overestimated for subjects who drink beverages with lower concentrations of alcohol and underestimated for subjects who drink beverages with higher concentrations of alcohol. Therefore, it is more accurate to measure the actual alcohol content of bever- ages when estimating alcohol consumption.
ALCOHOL CONTENT OF DIFFERENT BEVERAGES
There is a large amount of variation in the alcohol content of different brands of dis- tilled spirits and wine (Leake & Silverman, 1971). It is easy to determine the alcohol content of such beverage brands, because these values are given on bottle labels. Com- mercially available distilled spirits vary from 95% alcohol to 40% alcohol and to 20% alcohol if liqueurs such as schnapps are included in this category. The alcohol content of wine varies from about 8% to 14% alcohol. Fortified wines, made by adding alcohol to wine, vary from about 15% to 25% alcohol.
Alcohol content for malt beverages varies widely by country, by state in the United States, and by brand. Many countries have regulations concerning the permissible alcohol content of malt beverages. There are three classes of malt beverages in Sweden defined by ranges of alcohol content: Class I, 2.25% maximum; Class II, 3.5% maximum; Class III, 5.6% maximum. In Norway, Class I malt beverages have a maximum alcohol content of 2.5%, Class II have a maximum of 4.75%, and Class III have a maximum of 7.0%.
In the United States, it is difficult to obtain information concerning the alcohol content of different malt beverage brands. Federal regulations prohibit alcohol content inforrna- tion about malt beverages in advertisements and on labels, except where required by state law (Federal Alcohol Administration Act, sections 205[e] and 205[fj). Current state laws apply only to beers that have 3.2% alcohol by weight (4% by volume) or less. In these cases, labeling does not give exact alcohol content, but instead simply certifies that the alcohol content of the beverage does not exceed 3.2% alcohol by weight.
State-to-state variation Personal communication from several major U.S. brewers indicates that to comply with
state laws, a malt beverage brand will often have a different alcohol content in different states in the United States. There is a good deal of variation between states concerning the maximum allowable alcohol content of malt beverages (Modem Brewery Age, 1990). State laws concerning maximum allowable alcohol content are summarized in Table 1.
These state-to-state variations are complex. In some states, malt beverages can be over the allowed maximum if they are sold in liquor stores. In other states, malt beverages are
Alcohol content is usually expressed in the United States as percent alcohol by weight for malt beverages, as percent alcohol by volume for wines, and as proof spirits for hard liquor. Proof spirits is exactly twice per- cent alcohol by volume. For malt beverages, percent alcohol by weight is approximately 20% less than percent alcohol by volume. In this article, the alcohol content of different beverages is given as percent alcohol by volume for purposes of comparability, unless otherwise noted.
Alcohol content variation 557
Table 1. Summary of some 1990 state laws concerning maximum allowable alcohol content of malt beverages.
KatiSas Missouri Oklahoma Utah
Alabama California Iowa Mississippi Oregon Texas
Georgia Louisiana Vermont West Virginia
Arkansas Iowa South Carolina Tennessee Wisconsin
Idaho North Carolina Ohio South Dakota
Values are expressed as percent alcohol by volume. Some states have different regulations for ale, malt liquor, or beverages sold in liquor stores; some states have higher taxes and/or licensing fees for malt beverages that are above the maximum.
allowed to be over the maximum value but are then subject to higher taxes and/or licens- ing fees. Some laws concerning maximum content are for beverages that are called beer; higher content is allowed for malt beverages that are called malt liquor or ale. State laws use both the percent by weight and the percent by volume metrics. Clearly, researchers need to be familiar with regulations concerning the alcohol content of malt beverages in the area in which data on consumption are collected.2
Brand-to-brand variation There is a significant amount of variation in alcohol content among malt beverage
brands. Data concerning alcohol content of different brands were obtained from two sources. The first source was several major United States brewers; the second was the Virginia Department of Alcoholic Beverage Control, which has performed chemical tests
*Information about the alcohol beverage control laws of different states can be obtained from Attention: state Laws, Health Education Foundation, Suite 452, 600 New Hampshire Ave., N.W., Washington, DC 20037. The cost is $5 per state.
558 CHRISTOPHER S. MARTIN and TED D. NIRENBERG
on malt beverages seized during alcohol-related arrests. Alcohol content values were in close agreement when reported by both of these sources.
The alcohol contents of some low-alcoholsbeers, light beers, regular beers, and malt liquors/