Sociodemographic determinants of alcohol consumption frequency

236
Probl Hig Epidemiol 2016, 97(3): 236-240
Sociodemographic determinants of alcohol consumption
frequency amongst medical university students
Uwarunkowania społeczno-demograficzne częstości spożycia alkoholu wśród studentów
uniwersytetu medycznego
Krystyna Kowalczuk 1/, Aneta Klimberg 2/, Elżbieta Krajewska-Kułak 1/
1/
2/
Zakład Zintegrowanej Opieki Medycznej, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Białymstoku
Zakład Higieny, Katedra Medycyny Społecznej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu
Wprowadzenie. Alkoholizm i jego konsekwencje zdrowotne i społeczne
stają się jednym z głównych wyzwań dla zdrowia publicznego w XXI w.
Introduction. Alcoholism and its health and social consequences are
becoming one of the principal public health challenges of the 21st century.
Cel. Ocena wpływu czynników społeczno-demograficznych na częstość
konsumpcji alkoholu wśród studentów Uniwersytetu Medycznego
w Białymstoku.
Aim. To analyze the influence of sociodemographic factors on the frequency
of alcohol consumption amongst the students of the Medical University
of Bialystok.
Materiały i metody. Badaniem przeprowadzonym w marcu 2011 r. objęto
grupę 504 studentów Uniwersytetu Medycznego w Białymstoku. Wszyscy
uczestnicy wypełniali wystandaryzowany anonimowy kwestionariusz
dotyczący ich kontaktu oraz opinii na temat napojów alkoholowych.
W niniejszym opracowaniu uwzględniono dane dotyczące częstości spożycia
trzech różnych rodzajów napojów alkoholowych w okresie 12 miesięcy
poprzedzających badanie. Rozkład tych danych analizowano w zależności
od charakterystyk społeczno-demograficznych respondentów.
Material & Method. The study performed in March 2011 included a group
of 504 students from the Medical University of Bialystok. All participants
completed a standardized anonymous questionnaire dealing with their
contact with alcohol and opinions about alcoholic beverages. Our analysis
included the data on the frequency of alcohol consumption within the last
12 months prior to the survey. The distributions of those characteristics
were analyzed depending on the sociodemographic characteristics of the
responders.
Wyniki. W ciągu ostatnich 12 miesięcy poprzedzających badanie ok. 80%
respondentów przynajmniej raz spożywało wino i napoje spirytusowe,
a ponad 90% piwo. W tej grupie znalazła się stosunkowo duża frakcja
studentów, którzy zadeklarowali 40 i więcej epizodów spożycia napojów
alkoholowych, co wskazuje na możliwość regularnej konsumpcji alkoholu.
Wykazano znamienny wpływ płci respondentów na częstotliwość spożycia
piwa i napojów spirytusowych. Na częstotliwość spożywania piwa wpływało
natomiast miejsce zamieszkania podczas studiów. Rok studiów okazał
się czynnikiem wpływającym istotnie na częstotliwość konsumpcji wina.
Results. Approximately 80% of the responders consumed wine and
spirits at least once during the last 12 months prior to the study and
more than 90% declared at least one episode of beer consumption. The
responders’ gender significantly influenced the frequency of beer and
spirit consumption. Additionally, the frequency of beer consumption was
significantly modulated by the place of residence during studies, and the
frequency of spirit consumption was influenced by the level of parental
income. The year and the field of the study were revealed as significant
determinants of the frequency of wine consumption.
Wnioski. Czynniki społeczno-demograficzne mają istotny wpływ na
częstość spożywania alkoholu przez studentów uczelni medycznej. Wśród
zidentyfikowanych determinantów konsumpcji alkoholu przez młodzież
akademicką, z punktu widzenia profilaktyki najistotniejszymi wydają się
zmienne związane z kontrolą rodzicielską.
Conclusion. Sociodemographic factors exert a significant effect on the
frequency of alcohol consumption amongst the surveyed students. In terms
of prevention, the variables associated with parental control were found
to be the most important determinants of alcohol consumption among
university students.
Słowa kluczowe: nadużycie, alkohol, determinanty, czynniki ryzyka, młodzież
Key words: abuse, alcohol, determinants, risk factors, youths
© Probl Hig Epidemiol 2016, 97(3): 236-240
Adres do korespondencji / Address for correspondence
www.phie.pl
Nadesłano: 15.05.2016
Zakwalifikowano do druku: 20.08.2016
dr n. med. Krystyna Kowalczuk
Zakład Zintegrowanej Opieki Medycznej
Uniwersytet Medyczny w Białymstoku
ul. Marii Skłodowskiej-Curii 7A, 15-096 Białystok
tel. 663 80 02 32, e-mail: [email protected]
Introduction
Alcoholism and its health and social consequences are becoming one of the principal public health
challenges of the 21st century [1]. Aside from many
negative health effects [2], excessive consumption of
alcohol can bring an array of harmful social conse-
quences [3, 4]. Chronic alcohol abuse, particularly
associated with other risk factors (including genetic
predisposition), promotes the development of alcoholism – a disorder associated with the loss of control
over the volume of consumed alcohol [1].
Kowalczuk K i wsp. Sociodemographic determinants of alcohol consumption frequency amongst medical university students 237
Adolescents constitute one of the risk groups for
alcoholism [1, 5]. The results of many studies suggest
a gradual decrease in the age of alcohol initiation
[5, 6]. This detrimental phenomenon’s risk factors
include passive acceptance by parents and the fear
of being excluded from the peer group [7, 8]. In the
case of young people, the effects of these factors can be
strengthened by independence associated with the beginning of higher school education. Frequently, young
people study outside the place of their permanent
residence that lacks parental control, and moreover
the accommodation in student dormitories constitutes
an additional factor promoting alcohol abuse [9].
In recent years, due to the alarming data on the
early age of alcohol initiation, a number of studies
dealing with alcohol consumption amongst school-age
adolescents have been conducted [10-12]. Besides
a few exceptions [13-15], the problem in question has
not been analyzed in detail in regards to university
students – mostly as a result of their maturity and
associated organizational and legal problems. Due to
their future job and the specificity of academic subjects, the exposure to alcoholic beverages constitutes
a specific threat in the case of medical university students [16‑19]. Despite this, the problem of alcohol
consumption by this group has not been analyzed in
detail thus far, particularly with regards to its determinants. Yet, the identification of characteristics of
young people that predispose them to alcohol abuse
can play a key role in the prevention of alcoholism.
Aim
To analyze the influence of sociodemographic factors on the frequency of alcohol consumption amongst
the students of the Medical University of Bialystok.
Material and method
The study performed in March 2011 included
a group of 504 students from the Medical University of
Bialystok. This representative sample, corresponding
to 10% of the entire student population, was selected
by means of stratified sampling taking into account
the department, field of study, year of study, and participant’s gender. The group consisted of students aged
from 18 to 27 years with 22.2% of males. Most of them
(34.7%) were residents of cities with the population
of above 200 000 inhabitants and 15.5% resided in
villages. The protocol of this study was approved by the
Local Bioethical Committee of the Medical University
of Bialystok (ref. no. R-I-002/143/2011). All participants were familiarized with the study objectives and
protocol and gave their written consent to participate.
All participants completed a standardized anonymous questionnaire dealing with their contact with
alcohol and opinions about alcoholic beverages. The
questionnaire was prepared and kindly provided by
the PBS DGA Sp. z o.o. Research Agency (Sopot, Poland). The participants were asked to complete the
questionnaire during their academic classes.
Our analysis included the data on the frequency
of consumption of three various types of alcoholic
beverages (beer, wine, and spirits) within the last 12
months prior to the survey. The distributions of those
characteristics were analyzed depending on the sociodemographic characteristics of the responders: gender,
age, place of permanent residence and the place of
residence during the studies, marital status, number
of children, receiving a social or scientific scholarship,
income of the student and his/her parents, parental
educational level, and the field and year of study.
The statistical analysis of the results was carried
out using Statistica 10 (StatSoft, Tulsa OK, USA)
package. The statistical characteristics of discrete
variables were presented as frequency distributions.
Normal distribution of continuous variables was
verified with the Shapiro-Wilk test and the characteristics of those variables were presented as arithmetic
means and standard deviations (SD). The influence
of grouping variables on the distribution of alcohol
consumption frequencies was analyzed with the Pearson’s chi-square test and Fisher’s exact test. The level
of statistical significance was established at p=0.05.
Results
Approximately 80% of the responders consumed
wine and spirits at least once during the last 12 months
prior to the study and more than 90% declared at least
one episode of beer consumption. This group included
a relatively high fraction of individuals (29% of the
responders) who declared at least 40 episodes of alcoholic beverage consumption; this may correspond
to regular consumption of alcohol.
The responders’ gender significantly influenced
the frequencies of beer and spirit consumption. The
female students (17.6%) declared moderate consumption of beer (6-9 times per year) during the last 12
months preceding the study significantly more frequently than the males (6.4%); an inverse relationship
was revealed in the case of frequent consumption of
this beverage where 22.7% of the females and 44.5%
of the males declared consumption at least 20 times
per year. In contrast, the female students (46.9%)
declared complete abstinence or very low frequency
of consumption of spirits (once or twice during the
last 12 months prior to the study) significantly more
frequently than the male students (22.7%), while the
latter group significantly more frequently (22 vs. 40%)
admitted moderate consumption of such beverages
(6-19 times per year).
The year of the study was revealed to be a significant determinant of the frequency of wine consumption. The proportion of individuals who declared
238
abstinence from this type of beverage was the highest
amongst the 4th year students; whereas, its consumption was the most frequent amongst the 3rd and 6th
year students.
The frequency of beer consumption was significantly modulated by the place of residence during
studies. The responders who resided with their parents
(28.1%) declared complete abstinence from this beverage or a very low frequency of its consumption (once
or twice per year) within the last 12 months prior to
the study markedly more frequently than the other
students (13.9%).
Furthermore, the level of parental income had
a significant influence on the frequency of spirit consumption. The individuals who judged the income of
their parents as insufficient to cover basic needs much
more frequently (47.1%) declared low (once or twice
per year) consumption of spirits during the last 12
months preceding the study. In contrast, the students
who assessed their parental income as sufficient to cover more than basic needs significantly more frequently
(16.2%) admitted to a fairly high frequency of spirit
consumption (10-19 times per year).
The field of the study was revealed as an important
determinant of the frequency of wine consumption
in the examined group. Students of the Faculty of
Pharmacy disclosed complete abstinence from this
beverage significantly more frequently than the other responders. In contrast, students of the Faculty of
Health Sciences declared moderate consumption of
wine (6-9 times per year) significantly more frequently than individuals studying other disciplines.
Other grouping variables analyzed in this study
did not have a significant impact on the frequency of
consumption of various alcoholic beverages amongst
university students.
Discussion
This study revealed that the frequency of alcoholic
beverage consumption amongst medical university
students is not high and does not differ markedly
from population-based average value for this age group
[13‑16]. Nevertheless, responses of approximately
10% of our subjects suggest regular alcohol consumption and those individuals can be qualified as risky
drinkers according to the WHO criteria [1]. Also, the
qualitative distribution of alcoholic beverages consumed by the participants appears disadvantageous
as the surveyed students declared a relatively high
consumption of spirits and quite low consumption of
wine.
Our analysis identified several sociodemographic
variables that had a significant impact both on the
quantitative and qualitative characteristics of alcohol
consumption amongst medical university students.
Female students’ lower frequency of beer and spirit
Probl Hig Epidemiol 2016, 97(3): 236-240
consumption observed in this study is not a surprising
finding. This phenomenon has been confirmed by
the results of numerous previous studies [13-19]. As
a result of physiological differences, women are characterized by a relatively higher susceptibility to the
harmful effects of alcohol, as reflected by the limits of
so-called “safe drinking” that were defined by WHO
[1].
Indisputably, our study has revealed that despite the students’ apparent independence, parental
influences play a key role in the control of alcohol
consumption by university students. Our analysis
confirmed that the level of spirit consumption was
to a large extent determined by the level of parental
income. It is particularly alarming that the frequency
of spirit consumption increased markedly whenever
the parental income was sufficient to cover basic needs
of the family. The important role of parents in the prevention of alcohol abuse amongst university students
was also confirmed by the results of the analysis of the
effect of the place of residence during studies on the
frequency of beer consumption. The latter parameter
was significantly lower amongst the responders who
resided with their parents during university education.
An analysis of factors determining the level of
wine consumption amongst the surveyed students
revealed quite interesting findings. The identified
determinants included variables that were associated
directly with university education, i.e. the year and
field of the study. Our study found that the 3rd and 5th
year students declared markedly higher levels of wine
consumption. Perhaps this finding can be interpreted
in the context of the curriculum. The 3rd year of education corresponds to the completion of the bachelor
degree for health professionals (nurses, emergency
workers, etc.), while the 5th year corresponds to the
final period of study during uniform medical and
other master degree studies. It can be assumed that
the higher frequency of wine consumption amongst
these students resulted from celebrating the end of
education rather than from a consolidated consumption pattern. Consequently, low consumption of wine
amongst the 4th year students may be associated with
their involvement in mastering didactically-intense
clinical subjects present in that year’s curriculum.
Additionally, this study revealed that the pharmacy students consumed wine significantly less
frequently than the students of other medical fields.
This finding is quite surprising because these students
are presumed to possess a relatively comprehensive
knowledge of the composition of various alcoholic
beverages and their resultant harmfulness. Numerous large scale epidemiological studies have revealed
that the moderate consumption of wine, especially
red wine, seems to exert a protective effect on the
cardiovascular system, possibly due to high content of
Kowalczuk K i wsp. Sociodemographic determinants of alcohol consumption frequency amongst medical university students 239
flavonoids, considered to be the so-called free radical
scavengers [20-22]. Unfortunately, this potentially
favorable pattern of alcohol consumption is still not
very popular in our country [23], as confirmed, among
others, by the results of our study.
Despite important findings, this study also has
a number of limitations. First-of-all, when interpreting
the results of questionnaire studies dealing with such
sensitive issues as alcohol consumption one should
consider the possibility of dishonest replies by some of
the responders [24]. Consequently, one can suppose
that the factual rate of alcohol consumption may be
higher than the one revealed by our study. Another
potential interpretative problem that could confound
the results of alcohol consumption frequency analysis
is the size of a single alcoholic “drink”. In our study,
we used the units of consumption that are approved
both by WHO and the Polish State Agency for the
Prevention of Alcohol-Related Problems [1]; this is in
contrast to other authors who have employed varying
definitions for a “drink”. Furthermore, the responders
differed in the understanding in regards to the units
of alcohol volume, which markedly hindered the pos-
sibilities of interpretation [25]. Finally, one should
keep in mind that questionnaire surveys usually refer
to the average consumption of alcohol during a given
time period. Consequently, individuals who drink
alcohol regularly and those who use it compulsively
cannot be distinguished conclusively, thus influencing
the results of this study to a certain extent [26].
In conclusion, this study has revealed that sociodemographic factors exert significant effect on the
frequency of alcohol consumption amongst medical
university students. In terms of prevention, the most
important determinants of alcohol consumption
among university students were found to be the variables associated with parental control.
Conclusion
1. Sociodemographic factors exert significant effect
on the frequency of alcohol consumption amongst
medical university students.
2. In terms of prevention, the variables associated
with parental control are the most important
determinants of alcohol consumption among
university students
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