Socio-Economic, Lifestyle, and Availability Factors in the Stabilization of AlcoholConsumption in CanadaAuthor(s): REGINALD G. SMARTSource: Canadian Journal of Public Health / Revue Canadienne de Sante'e Publique, Vol. 78, No.3 (May/June 1987), pp. 176-180Published by: Canadian Public Health AssociationStable URL: http://www.jstor.org/stable/41989360 .

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Socio-Economic, Lifestyle, and Availability

Factors in the Stabilization of

Alcohol Consumption in Canada

REGINALD G. SMART*

In 1975-83, per capita alcohol consumption stablized and even slightly declined in Canada . This followed a long period of increasing consumption . A wide variety of economic , demographic and availability variables were associated with the increase in consumption. However , these same variables do not relate to the stabilization in 1975-83 . Increasing unemployment and the proportion of population aged 60 and over were highly associated with declines in consumption. The stabilization period also involved changes in lifestyle toward consumption of lower cholesterol foods , less tobacco consumption and increased physical exercise . The stabilization in alcohol consumption may relate to significant changes in emphasis given to health in Canada.

De 1975 à 1983 , la consommation d'alcool par habitant s ' est stabilisée , et elle a même légèrement décliné à l'issue d'une longue période de croissance. Cette dernière a été associée à une vaste gamme de variables économiques et démographiques. Or, ces mêmes facteurs ne touchent pas la stabilisation. L'augmentation du chômage et de la population de 60 ans et plus a été associée à la baisse de consommation. La période de stabilisation reflète également l'évolution du mode de vie vers des aliments moins riches en cholestérol, vers une diminution du tabagisme et une augmentation de l'exercice physique. Il se peut que la stabilisation soit liée à la nouvelle importance accordée à la santé au Canada.

From experienced about 1950

a large to

increase 1975, most

in per western

capita countries

alcohol experienced a large increase in per capita alcohol consumption.1 Canada experienced one of these so-called "long waves" of increased per capita consumption,2 3 rising from about 5.9 litres of absolute alcohol in 1950 to 1 1 .4 litres in 1975. However, in the mid 1970s, various countries, including Austria, Denmark, Great Britain, Finland, Iceland, Norway and Canada2 experienced either a stabilization or a small decline in the rate of alcohol consumption. In Canada, consumption per adult declined to 10.82 litres in 1983 (the last year for which data are available). During this period the OPEC oil crisis developed, unemployment rates increased, and disposable income dropped or stabilized after long periods of growth and affluence. Economic factors are believed to be the main reason for the declines in alcohol consumption4 but changes

♦Director, Prevention Studies, Addiction Research Foundation, 33 Russell St., Toronto, Ontario M5S 2S1. The views expressed in this paper are those of the author and do not necessarily reflect those of the Addiction Research Foundation. The author thanks Dr. Norman Giesbrecht and Mr. Edward Adlaf.

toward more healthy lifestyles and reduced availability may also be important.

The reasons for the declines in alcohol consumption have not been well studied in any country, including Canada. The International Study of Alcohol Control Experiences Group2 pointed out declines in consumption in several countries and speculated that "the levelling off is not solely an interlude related to economic recession". Mention was made of changes in "occupational structure and technology" and "urbanization". However, no analysis was made of the relative contribution of these variables. Most analyses of declines in alcohol consumption have involved serious economic depressions5 or wartime situations,6 which are not relevant here. However, Skog3 found that, during 1895-1905, alcohol use fell in Norway while buying power remained steady but alcohol prices increased and availability decreased. Also, Kendell et al.7 found that economic declines resulted in decreased alcohol consump- tion in Scotland in the early 1980s.

Although economic conditions have worsened in Canada

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since 1975, other factors may also account for declines in consumption. For example, the population is aging and this should reduce overall consumption as older people typically drink less. Also, availability may have decreased in areas where legal drinking ages were increased. Lifestyle changes are also striking as there is more interest in fitness, healthy lifestyles and better eating habits as people avoid foods high in cholesterol. No examination has been made of the contribution of these factors to the stabilization in alcohol consumption in Canada.

I have examined the reasons for the stabilization and decline in alcohol consumption in Ontario in 1975-1983 by studying a wider range of changes than are usually considered. I have examined how declines in alcohol consumption relate to changes in economic variables (unemployment, disposable income); demographic variables (the proportion of the population aged over 60 and under 20); availability factors (advertising expenditure, number of drinking establishments, cost of alcohol); and a number of consumption variables assumed to be related to lifestyle (consumption of butter, eggs, coffee etc.).

Based on previous research125, the decline in alcohol consumption should be related to depressed economic conditions, reduced availability, an increase in the proportion of the population aged 60 and over and under 20, as they are less frequent and lighter drinkers. It was also expected that general trends toward more healthy consumption patterns were importantly associated with declining alcohol consumption. That is, there should be less consumption of coffee and the high cholesterol foods (butter, eggs and beef) and more consumption of the healthier low cholesterol foods (fruit, vegetables, fish poultry, margarine). The analysis employs Ontario data, which were selected, in part, because the reduction in alcohol consumption closely resembles Canada as a whole. In addition, I have examined economic and demographic factors associated with changes in per capita consumption in various Canadian provinces during 1974-1983.

METHOD

All data used were for 1963 to 1983 and were obtained from a variety of government reports (Table I). Per capita alcohol consumption of alcoholic beverages was expressed as litres of absolute alcohol per person aged 15 years and over in all provinces, the Northwest Territories and the Yukon. Unemployment rates were expressed as rates per total adult population. Disposable income was expressed as dollars per capita. Demographic variables included the proportions of the total population of Ontario aged under 20 and over 60 years. The cost of alcohol was given as the cost of 10 litres of absolute alcohol as a percentage of disposable income per person aged 15 and over. The number of drinking establishments was the total number of licenced drinking places in Ontario each year; it was not expressed as i rate. The number of drinking establishments was not

TABLE I Correlations of Alcohol Consumption (Litres Per Adult 15 and Over) and Other Variables in Ontario, 1963-19831

Change in

Direction of

1963-74 1975-83 Correlation 1963-83 Year ^96* TŤl Yes .93* Unemployment .60* .55 .63* Disposable Income .98* -.32 Yes .80* Prop, over 60 .95* -.36 Yes .80* Prop, under 20 -.97* .28 Yes -.88* Advertising Expend. .91* -.33 .75* Coffee Consumption .08 .44 .32 Cost 10L Ale. as % Disp. -.98* -.47 -.99*

Inc. No. of Drinking Establs. .98* .30 .84* Per Capita Butter Cons. -.95* .16 Yes -.95* Per Capita Fruit Cons. .18 .03 -.60* Per Capita Veget. Cons. .61* .00 Yes .79* Per Capita Egg Cons. -.75* -.13 -.91* Per Capita Fish Cons. -.55* -.19 .34 Per Capita Beef .94* -.08 Yes -.35 Per Capita Poultry Cons. .88* -.09 Yes .89* Per Capita Margarine Cons. .84* -.46 Yes .83* *p < .05 (one-tail) 'Sources: Addiction Research Foundation. Statistics on Alcohol and Drug Use in Canada and Other Countries. Volumes I and II. Data available as of September 1984. Toronto: Addiction Research Foundation, 1985.

Addiction Research Foundation. Annual Reports. (1964-1981). Toronto: Addiction Research Foundation.

Ministry of Treasury and Economics. Ontario Statistics. (1982 and 1984). Toronto: Ministry of Treasury and Economics.

Single E, Giesbrecht N. Rates of Alcohol Consumption and Patterns of Drinking in Ontario, 1950-1975. Substudy No. 961. Toronto: Addiction Research Foundation, 1978.

Statistics Canada. Apparent Per Capita Food Consumption. (1964-83). Ottawa: Statistics Canada. Cat. 32-226 to 32-230.

obtainable for all provinces and hence has only been used in the analysis for Ontario.

Some data, such as those for advertising expenditures and per capita consumption of coffee, butter, fruit, vegetables, eggs, fish, beef, poultry and margarine, could not be obtained for Ontario separately. Hence the rates used were those for the whole of Canada. Regional variations in consumption of various products may be important but it is unlikely that Ontario's consumption relative to that in other provinces changed much in 1975-1983.

RESULTS Factors Associated with Alcohol Consumption in Ontario

The results for Ontario are shown in Figures 1 to 6 and the analysis in Table I. Alcohol per capita consumption rose from 8.5 litres in 1963 to 11.2 litres in 1974. However, in 1975, consumption began to stabilize with 1 1 .4 litres in 1976 and 1 1 .2 litres in 1983. In 1963-1983, alcohol consumption is positively related to unemployment (Figure 1), disposable income (Figure 2); the proportions of the population aged over 60 (Figure 3); advertising expenditures (Figure 4); the number of drinking establishments (Figure 5); per capita consumption of vegetables, poultry and margarine (Figures 6 and 7)). However, alcohol consumption in 1963-1983 is negatively associated with the proportion of the population

(Continued on page 179)

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Figure 1. Per Capita Alcohol Consumption and Unem- ployment Rate: 1963-1983.

Figure 2. Per Capita Alcohol Consumption and Disposa- ble Income and Cost of Alcohol: 1963-1983.

Figure 3. Per Capita Alcohol Consumption and Propor- tion of the Population Aged 20 Years and Under and Aged 60 Years and Over: 1963-1983.

Figure 4. Per Capita Alcohol Consumption and Advertis- ing Expenditures (in thousands): 1963-1983.

Figure 5. Per Capita Alcohol Consumption and Number of Drinking Establishments.

Figure 6. Per Capita Consumption of Alcohol and Other Products: 1963-1983.

Figure 7. Per Capita Consumption of Alcohol and Other Products: 1963-1983.

Figure 8. Per Capita Consumption of Alcohol and Other Products: 1963-1983.

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under 20 years of age; the cost of alcohol; and per capita consumption of butter, fruit and eggs. There are essentially no relationships between alcohol consumption and the consumption of coffee, fish or beef in 1963-1983.

Table I shows that the relationships between the economic, social, availability, and consumption variables are almost identical in 1963-1983 and 1963-1974, the years of increasing consumption. However, when the same variables are examined for their association with per capita consumption in 1975-1983, the years of stabilization, none of them are significant. Of course, the series of years is shorter for the stabilization period and higher correlations would be needed to establish significance than in the 1963- 1983 period. Surprisingly, the size of the correlations decreased in almost all cases for 1975-1983. For many variables, the actual direction of the correlation changed (e.g. disposable income, proportion of population over 60, proportion under 20, advertising expenditures, butter, beef, poultry and margarine consumption). Clearly, different economic, demographic, availability and food consumption variables explained alcohol consumption in 1975-1983 and the explanatory variables for 1963-1974 are not very helpful.

The main problem is to show how the years of increasing alcohol consumption (1963-1974) and the years of stabilization differ. An examination of the figures shows that some variables are different in the years of stablization than in the earlier years. Unexpectedly, alcohol advertising expenditures and the number of drinking establishments increased greatly, while the real cost of alcohol actually decreased slightly. Demographic changes were as expected with more 60+-year-olds and fewer 20-year-olds in the population. The unemployment rate was also much higher during the period of stabilization but disposable income

went up compared to the earlier years. Consumption of some foods showed little change in the two periods (e.g. beef, coffee, fish); however, there was a significant increase in consumption of low cholesterol foods such as poultry, vegetables and margarine and a large decline in butter consumption.

Ideally, a multivariate analysis should be made to determine which variables contribute most to our understanding of alcohol consumption and its associated changes. Unfortunately, auto-correlations for such data frequently occur, thereby posing methodological con- straints. Moreover, time series analyses requires a longer data series than is available.

Variations in Alcohol Consumption Across Provinces Changes in per capita alcohol consumption varied greatly

from one province to another in 1974 to 1983 (Table II). For example, Alberta showed a 9.5% increase in consumption while Newfoundland posted a 1.4% increase. In contrast, all other provinces showed declines, with the largest in Quebec (-1 1.8%) and the Yukon and Northwest Territories (-9.9%) and the smallest in British Columbia (-1.3%) and Nova Scotia (-1.5%). The average reduction across the country was 2.8%, Ontario being close to that with a 2.5% reduction in alcohol consumption.

Product-moment correlations (significance determined by one-tail tests) based on all 11 regions (not shown) indicated that the percentage change in alcohol consump- tion was positively correlated with the percentage change in the unemployment rate (r = .59; p < .05) and negatively correlated with the percentage change in the proportion of people aged over 60 (r = -.63; p < .05). The correlations for changes in the cost of alcohol, disposable income and in the

TABLE II Changes in Consumption of Alcohol (Litres Per Person) and

Economic and Demographic Changes in Canadian Provinces 1974 to 19831

% Change in % Change % Change in in

% Change % Change %Increase Proportion of Proportion Per Capita in in in of

Alcohol Cost of Rate of Population Population Disposable 10L

Province 1974 1983 Consumption of Alcohol Unemployment Aged Under 20 Aged 60+ Income Newfoundland 10.45 10.60 +1.4 -3.6 93.8 -16.3 +22.1 158 P.E.I. 10.05 9.57 -4.8 -18.8 25.8 -15.6 +8.5 193 Nova Scotia 10.00 9.85 -1.5 -14.0 36.1 -18.0 +15.3 164 New Brunswick 8.95 8.80 -1.7 -11.8 52.3 -17.4 +14.0 159 Quebec 10.27 9.19 -11.8 -2.2 90.4 -20.4 +21.8 156 Ontario 11.45 11.16 -2.5 -7.8 153.7 -17.7 +19.2 155 Manitoba 11.36 10.85 -4.9 -9.8 235.7 -15.1 +15.3 158 Saskatchewan 10.41 9.98 -4.1 -4.0 164.3 -14.2 +8.4 147 Alberta 11.82 12.94 +9.5 -15.2 285.7 -18.6 -0.1 172 British Columbia 13.00 12.83 -1.3 -4.6 130.0 -18.2 +16.1 147 Yukon and N.W. 18.28 16.65 -8.92 -24.0 N/A -21.7 +22.5 191 Territories Sources as in Table I.

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proportion of those aged under 20, with per capita consumption were not statistically significant.** A regression analysis was attempted with the data but the small number of cases (n=ll) and collinearity made significant results difficult to interpret.

DISCUSSION Because the stabilization period (in Ontario) involved

increases in alcohol availability, decreases in the cost of alcohol as well as economic, demographic and dietary changes, a complex explanation for the changes is required. It is interesting to note that alcohol consumption stabilized although alcohol outlets and advertising budgets increased, while real costs of alcohol actually decreased. Availability of alcoholic beverages per se may not be as important as earlier works claim unless associated with other factors contributing to increased consumption.

The changes in food consumption towards low cholesterol foods suggest that the stablization in alcohol consumption was related to lifestyle and health-oriented changes of a fundamental nature. Indeed, some other health-related behaviours are also growing in popularity. For example, 47% of adult Canadians were cigarette

♦♦Correlations based on percentage change measures did not vary substantively when provinces with increasing consumption (Alberta and Newfoundland) were deleted from the analysis. Although correlations changed in magnitude, their direction remained unchanged. The correlation between percentage change in alcohol consumption with percentage change in unemployment was .27, and with the percentage change in the proportion of the population aged 60 years and over was -.50. Received: February 17, 1986. Accepted: May 29, 1986.

smokers in 1975 compared with 41% in 1983. Also, there have been large increases in sports and exercise levels. For example, in Canada, 54% of adults participated in sporting activities in 1974 in contrast to 77% in 1984.8 Unfortunately, it is impossible to obtain yearly data on many health-related behaviours such as exercise and recreational activities. Hence, detailed analyses cannot be made.

Perhaps during periods of social change, where health concerns predominate, the usual economic variables affecting alcohol consumption are less important. Stabilization in alcohol consumption is an unusual experience for Canadians and for many other nations in this century. We are just beginning to understand the factors involved in this important change.

REFERENCES 1 . Bruun K, Edwards G, Lumio M, Makela K, Pan L, Popham RE, Room

R, Schmidt W, Skog OJ, Sulkunen P, Osterberg E. Alcohol Control Policies in Public Health Perspective. Helsinki: Finnish Foundation for Alcohol Studies, 1975.

2. Makela K, Room R, Single E, Sulkunen P, Walsh B. Alcohol, Society and the State. Toronto: Addiction Research Foundation. 1981. 3. Skog OJ. An Analysis of Divergent Trends in Alcohol Consumption and Economic Development. Oslo: Statens Institutt For Alkohol-

forskning, 1984. 4. Kendell R. The beneficial consequences of the United Kingdom's

declining per capita consumption of alcohol in 1979-82 Alcohol and Alcoholism 1984; 19: 271-276.

5. Brenner MH. Trends in alcohol consumption and associated illnesses; some effects of economic changes. Pub Health , 1975; 65: 1279-1292.

6. Smart RG. The effect of licencing restrictions during 1914-1918 on drunkenness and liver cirrhosis deaths in Britain. Brit J Addict 1974; 78: 365-379.

7. Kendell RE, de Roumanie M, Ritson EB. Effect of economic changes on Scottish drinking habits - 1978-82. Brit J Addict 1983; 78: 365-379. ». Canadian Health Facts. Some Indicators of Lifestyle Change in Canada Ottawa: Health Promotion Directorate, 1985.

PROCHAINEMENT: À Ottawa, Canada, du 27 au 30 octobre 1987, se tiendra la

CONFÉRENCE INTERNATIONALE SUR LA PROMOTION DE LA SANTÉ MENTALE

DES ENFANTS ET DES ADOLESCENTS Parrainée conjointement par Santé et Bien-être social Canada, l'Organisation mondiale de la santé, l'Organisation panaméricaine de la santé, l'Unicef, l'Association canadienne pour la santé mentale et l'Association canadienne de la Santé publique, la conférence traitera des facteurs qui influent sur la santé mentale des enfants et des adolescents et notamment les facteurs de vulnérabilité des jeunes et des familles et les facteurs de protection, de la violence et du stress, et des carences affectives. Chacun de ces trois thèmes sera abordé dans le cadre général de la promotion de la santé : mise au point de stratégies d'adaptation, incluant les initiatives personnelles et l'entraide; création d'environnements favorables à la santé; et adoption de politiques publiques favorables à la santé. Les participants seront invités à appliquer les connaissances qu'ils auront acquises au cours de la conférence et par le truchement des réseaux établis à cette occasion dans leur propre travail ou dans leur situation personnelle. Pour plus d'information, veuillez communiquer avec les organisateurs de la conférence :

Association canadienne de Santé publique, Division des conférences 1335, avenue Carling, suite 210 Ottawa (Ontario) Canada K1Z 8N8 Téléphone : (613) 725-3769; Téléfax : (613) 725-9826; Télex : 053-3841

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