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Journal of Public Health

Socio-demographic correlates of alcohol consumption in the Danish general population

Kim Bloomfield, Ulrike Grittner, Hanna Barbara Rasmussen and Hans Christian Petersen
Scand J Public Health 2008 36: 580
DOI: 10.1177/1403494808089648

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Scandinavian Journal of Public Health, 2008; 36: 580–588

ORIGINAL ARTICLE

Socio-demographic correlates of alcohol consumption in the Danish

general population

KIM BLOOMFIELD1,2, ULRIKE GRITTNER2, HANNA BARBARA RASMUSSEN1 & HANS

CHRISTIAN PETERSEN3
1
Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark, 2Institute for Biometrics and
Clinical Epidemiology, Charité – University Medicine Berlin, Germany, and 3Department of Statistics, IMADA, University
of Southern Denmark, Odense, Denmark

Abstract
Aims: Little is known about specific Danish drinking patterns. This paper investigates how various socio-demographic
factors are related to Danish alcohol consumption with special focus on age and sex. Methods: Data come from a national
telephone survey of the Danish general population conducted in 2003 with a final sample size of 2,030 cases. Measures of
beverage specific current drinking, overall drinking, daily drinking, heavy episodic drinking, mean consumption, volume per
drinking occasion and frequency of drinking were analysed. Results: A little over 5% of the population are abstainers.
Fourteen per cent of men and 9% of women are heavy drinkers; 38% of men and 18% of women are heavy episodic
drinkers. Youth of both sexes drink heavily, and especially in a binge drinking style. Regular, more temperate drinking is
associated with increasing age. Multivariate analyses suggest that other than age and sex, classical socioeconomic factors do
not play a great a role in determining drinking patterns. Social integrative factors in particular influence women’s drinking.
Conclusions: With respect to the rest of Europe and North America, Danes consume high levels of alcohol with
a large percentage of youth drinking in a binge pattern. Classical socioeconomic factors play a lesser role in
determining drinking patterns compared to other Western countries. Longitudinal studies and studies of
alcohol-related consequences in the Danish general population should be conducted to better formulate alcohol
and public health policy.

Key Words: Alcohol drinking, binge drinking, Denmark, drinking patterns, general population

Introduction Research on socio-demographic correlates of alcohol use

Danes have been characterized as in a ‘‘league of
their own’’ when comparing their drinking style to
that of Nordic counterparts [1]. Denmark is among
the highest alcohol consuming countries in Europe
and Danish teens rank at the top for frequency of
drunkenness [2]. Although such facts are known,
little research has examined actual drinking patterns
and correlates of drinking outcomes in the general
population. The purpose of this paper is to describe
Danish drinking patterns and examine how various
socio-demographic factors relate to them.
Alcohol survey research has a long tradition of
examining the socio-demographic correlates of
alcohol use [3–5]. North American research has
found that household income, education, and
employment status are positively associated with
current drinking status and frequent drinking, but
are negatively correlated with measures of heavier
drinking [5,6]. Recent European research shows
more complicated relations, where, for example,
higher education and employment status tend to be
associated with heavy drinking among women [7–9].

Correspondence: Kim Bloomfield, Dr.P.H., Department of Health Promotion Research, University of Southern Denmark, Niels Bohrs Vej 9, 6700 Esbjerg,
Denmark. Tel: +45 65504111. Fax: +45 65504283. E-mail: kbl@health.sdu.dk

(Accepted 26 September 2007)

# 2008 the Nordic Societies of Public Health
DOI: 10.1177/1403494808089648

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 Socio-demographic correlates of alcohol consumption
Additionally, age is for the most part negatively
correlated with drinking measures in North America
while in Europe it is positively correlated with
drinking frequency and also with current drinker
status in some countries [5,10]. Men consistently
drink more and more frequently in almost all
societies [11].
Previous research on Danish alcohol use
Two major general population studies on alcohol
consumption were conducted in the 1980s. Sælan
[12] analysed alcohol consumption data collected in
1976/77 from a representative 40-year-old cohort
residing in Copenhagen. He found that on average,
per week, men drank 17 standard drinks and women
consumed seven drinks. Education and economic
status were positively correlated with increased
frequency of drinking among women while for men
having a family and employment were negatively
associated. Hansen and Andersen [13] conducted a
national survey on drinking habits in 1985 and
compared their results to national data from 1976. A
major indicator was consumption of 11 or more
standard drinks per week. They found a decrease in
this measure as well as less social differences related
to consumption by 1985.
More recently, in a 2002 national postal survey on
a representative sample of Danes, Laursen et al. [14]
found that only 2% reported having been abstainers
in the last 12 months. Six percent of women and
11% of men drank over the national guidelines for
risky drinking (> 14 standard drinks per week for
women; > 21 for men. A Danish standard drink
contains 12 grams pure alcohol (pure alcohol (or
ethanol) can be defined as 99.9% v/v)). With regard
to age groups, those between 18 and 20 years had
the highest percentage of drinking above this limit.
No differences in consumption distribution could be
found with regard to education or urbanization.
A study on national drinking trends reported that
the distribution of consumption changed little
between 1994 and 2000, except for those aged 16
to 24 years whose heavy drinking increased. It also
reported on young persons between 16 and 20 years
in 2001. Over 25% of young men and 8% of young
women consumed more than five standard drinks
(i.e., 60 grams of pure alcohol) on an occasion in the
last 30 days. About 24% of young men and 14% of
young women had drunk above the national guide-
lines in the previous week [15].
With regard to international research, Mäkelä et al
[1] compared drinking indicators in Denmark,
Finland, Norway and Sweden with data collected
in 1996/1997. Annual consumption, overall drinking
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581
frequency and the frequency of drinking six or more
drinks on an occasion were the highest in Denmark,
and 12 month abstinence rates were the lowest.
Among women, Danes reported the highest quan-
tities consumed per occasion.
In the 2003 European School Survey Project on
Alcohol and other Drugs (ESPAD) conducted
among 15- and 16-year-olds, Danish teenagers
ranked number one among 35 European countries
and the USA for frequency of alcohol consumption,
quantity at the last drinking occasion (boys: 69
grams pure alcohol; girls: 48.4 grams) and frequency
of drunkenness [2].
In total, adult Danes drink more heavily in
comparison to their Nordic counterparts and also
have more of a tendency for heavy episodic drinking.
Young Danes have a marked profile for heavy
episodic drinking, drunkenness and heavy consump-
tion. Given this background of earlier research, the
present paper investigates how such drinking
habits are currently associated with particular
socio-demographic factors. This is useful for provid-
ing up-to-date information for identifying which
subgroups might be prone to risky drinking behaviour.
Methods
The sample
The data come from a national survey of the Danish
general population conducted with random digit
dialling (RDD) and computer-assisted telephone
interviewing (CATI) in August and September
2003. Sampling within households was done with
the last birthday method [16]. A total of 2,030
respondents completed the interview, producing a
cooperation rate of 50% (AAPOR formula 3) [17].
The age of respondents ranged from 15 to 99 years,
56% were women, 44% men. Data were weighted
according to age, sex and regional distributions in
the Danish general population. This research was
conducted with approval from the Danish Data
Protection Agency (Datatilsynet).
Alcohol measures
Alcohol consumption was measured with beverage-
specific quantity-frequency questions. An additional
question (separate from the quantity-frequency
series) asked about frequency of heavy episodic
drinking (HED). We constructed the following
indicators as our main dependent variables.
Volume (per day) is the summary of beverage-
specific volume measures. These come from quantity-
frequency questions for beer, wine, strong wine, spirits
582 K. Bloomfield et al.
and ‘‘alcopops’’. For frequency, the categories (refer-
enced to the past 12 months) were: ‘‘every day or
nearly every day’’, ‘‘4–5 times a week’’, ‘‘2–3 times a
week’’, ‘‘approximately once a week’’, ‘‘2–3 times a
month’’, ‘‘approximately once a month’’, ‘‘a few times
during the last 12 months’’, ‘‘once in the last 12
months’’, and ‘‘never’’. ‘‘Current drinkers’’ are
defined as those who consumed alcohol at least once
during the last 12 months. Heavy consumption is
average pure alcohol intake of more than 20 grams per
day for women and more than 30 grams per day for
men [18]. This cut-off is representative of several
thresholds now commonly cited in the literature
[19,20] and used by other researchers [20,21].
Heavy episodic drinking was dichotomized into
respondents who had drunk approximately the
equivalent of six (ca. 72 grams pure alcohol) or more
drinks on one occasion once a month or more often,
and into those who had not. Because the data for this
study are also part of a larger Nordic collaborative
project on alcohol tax changes, the amount of alcohol
defined in HED was made to agree with that in the
Swedish component of the collaborative study. Daily
drinking is defined as drinking alcoholic beverages
daily or almost daily.
Bivariate analyses
Chi-square tests were used for testing prevalences of
consumption variables between men and women,
between age groups, and between categories of
income, education and occupation. Differences in
quantity and frequency measures between age
groups, categories of education, income and occu-
pation and by sex were tested via Mann-Whitney
tests and one-way ANOVA.
Multivariate analyses
Multiple logistic regression with SPSS version 14.0
[22] was used to analyse heavy drinking, heavy
episodic drinking and daily drinking; similarly,
multiple linear regression was used to analyse mean
alcohol consumption per drinking day. Independent
variables were age, marital status (being married or
in registered partnership vs. not), living alone vs. not,
having children vs. not, personal monthly income
(five categories), employment status (farmer/self
employed/employee; retired; student; unemployed/
housewife/househusband/other), education (no voca-
tional training/semi-skilled worker training/EFG
basic vocational course; completed apprentice or
EFG training; short higher education 1–2 years;
3–4 years higher education; 5 years or longer higher
education), being religious (member of a church) vs.
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not, church attendance (more than three times per
year vs. not). Age was centred by subtracting the
mean. Also a quadratic term for age was included,
allowing for distinction between linear and nonlinear
influences of age.
In a first step, age (centred) was included in the
model. Then a squared term for age, education,
occupation and income was introduced in separate
steps into the model by using the likelihood ratio
criterion. In a last step all other covariates were
included by using a stepwise forward procedure
[23].
Results
Prevalences and mean values of drinking variables
for the entire sample and for men and women
separately are presented in Table I. Five and a half
per cent of respondents reported not drinking at all
in the last 12 months. Based on the total sample,
wine is the beverage consumed by the largest
proportion of respondents with little difference
between sexes. Beer has the second largest propor-
tion of consumers, and more men than women drink
this. Spirits are ranked last with a similar gender
difference. Ten per cent of the sample consists of
daily drinkers; 11.6% are heavy drinkers. Twenty-
eight per cent drink in a heavy episodic fashion at
least monthly. Daily average volume is about 13
grams among drinkers, but the average on a drinking
day is four times higher. That means the Danes
drink on average more than 50 grams on one
drinking occasion. Fifty grams pure alcohol are
equivalent to three-fourths of a bottle of wine or four
bottles of beer (0.33l) or four glasses of spirits
(0.04l). Significant sex differences (pv0.001) are
found for all these drinking indicators except for
current wine consumption.
Table I also displays these results by age and sex.
For both sexes, age patterns of beverage-specific
drinking are similar: the proportions engaging in
current drinking and wine drinking remain stable
across age groups, the proportions drinking wine and
engaging in weekly drinking increase across age
groups and the proportions drinking spirits decline
across age groups. Daily drinking and age are
positively correlated, but heavy drinking and heavy
episodic drinking are negatively associated with age.
Mean frequency of drinking days per month also
increases with age while mean consumption per day
is highest for the youngest age group and does not
change substantially across the middle and older age
groups. Mean quantity per drinking day is negatively
associated with age.
 Table I. Self-reported drinking patterns among Danish men and women and by age (weighted).

Women
Variable Total n52030 Men n5895 n51135 Men Women
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All All 15–29 30–49 50+ 15–29 30–49 50+

Age groups (years)
(n5168) (n5350) (n5376) (n5188) (n5388) (n5559)
Current drinking (%) 94.5 96.8 92.3*** 96.8 97.3 96.5 90.9 94.0 91.4
Current beer drinking (%) 80.3 92.2 68.9*** 90.8 95.4 90.0* 69.6 73.0 65.3
Current wine drinking (%) 86.8 87.5 86.1 73.9 90.3 92.0*** 76.0 89.1 88.2***
Current spirits drinking (%) 72.3 79.8 65.1*** 83.0 82.8 75.2* 81.7 68.1 55.3***
Weekly drinking (%) 60.4 73.4 48.0*** 67.4 69.4 80.3*** 38.9 46.9 52.9**

Socio-demographic correlates of alcohol consumption

Daily or almost daily drinking (%) 10.3 14.4 6.4*** 1.8 8.8 26.3*** 0.0 3.5 11.6***
Heavy drinking (drinking more than 20/30 11.6 14.0 9.2*** 29.8 9.1 10.0*** 14.4 7.4 8.6*
grams of pure alcohol for women/men) (%)
Heavy episodic drinking once or more often 27.9 38.0 18.2*** 67.7 42.6 17.5*** 45.9 16.3 7.3***
monthly (one bottle of wine, 24 cl spirits, 6
bottles of beer) (%)
Mean/median frequency in days per month 8/4 10 / 11 6 / 4*** 7/4 9/9 13 / 11*** 4/3 6/3 8 / 4***
(drinkers only)
Mean/median volume in grams of pure alcohol 13.0 / 8.0 17.8 / 12.1 8.1 / 4.9*** 26.4 / 17.5 15.0 / 10.7 15.6 / 11.2*** 11.6 / 7.6 7.0 / 4.2 7.4 / 4.3***
per day (drinkers only)
Mean/median quantity per drinking day in grams 56.0 / 39.6 63.3 / 45.1 48.6 / 36.5*** 109.8 / 92.2 60.6 / 47.4 40.5 / 34.1*** 87.5 / 74.2 46.5 / 39.1 33.1 / 28.1***
of pure alcohol (drinkers only)

* pv.05, ** pv0.01, ***pv.001 (Chi-Square tests/Mann-Whitney tests were used to compare percentages/continuous drinking measures of both sexes and of age groups for men and
women separately).

583
584 K. Bloomfield et al.
A very strong negative age gradient can be seen for
both men and women with regard to both heavy
episodic drinking and quantity consumed per drink-
ing day: almost twice the average amount (some-
times more) is consumed among those aged 15–29
years compared to the sex-specific average. That is,
68% vs. 38% for young men and 46% vs. 18% for
young women regarding HED, and 110 vs. 63 grams
pure alcohol for young men and 88 vs. 49 grams
pure alcohol for young women for mean quantity per
drinking day.
Table II presents prevalences for heavy drinking,
heavy episodic drinking, daily drinking and mean
consumption per drinking day by categories of
income, education and occupation and for men
and women separately. Regarding heavy drinking
among men, no differences are seen by income
category. Heavy drinking is more prevalent among
lower than among higher educated men. Almost one
third of men currently occupied as students are
regular binge drinkers in contrast to only 8.8%
among retired men. Among women there are no
significant differences in the prevalences of heavy
drinking between different levels of income, educa-
tion and different occupational groups. Regular
heavy episodic drinking among men does not vary
by income but is much more common in the lowest
educational group than among other levels of
education. With regard to occupational groups,
almost three-fourths of the male students binge
drink. Among women, heavy episodic drinking is
associated with low income, low educational
achievement and with being a student. Among the
various socioeconomic indicators, retirement is the
only characteristic to be significantly associated with
daily drinking for both men and women. Mean
consumption levels per drinking day are associated
with low income for women, and with low educa-
tional achievement as well as student status for both
sexes.

Table II. Prevalences of heavy drinking (20/30 grams per day), heavy episodic drinking (6+ at one occasion at least monthly), daily drinking
and mean consumption per drinking day (log) for categories of income, education and occupation among men and women.*

Mean consumption
Heavy episodic per drinking day
n Heavy drinking (%) drinking (%) Daily drinking (%) (log, drinkers only)

Men Women Men Women Men Women Men Women Men Women

Income (personal monthly

income)
Up to 7.000kr 114 148 12.7 11.4 39.2 30.9 13.3 4.0 3.89 3.88
7.000–13.999 152 275 17.0 9.6 32.1 13.5 15.1 7.0 3.89 3.61
14.000–20.999 234 304 12.6 8.7 37.4 12.0 16.5 6.9 3.85 3.60
21.000–27.999 185 153 12.2 9.4 36.9 20.6 14.0 6.9 3.85 3.66
28.000 or more 142 108 14.2 8.0 48.0 16.0 15.0 8.1 3.91 3.48
Significance p50.681 p50.901 p50.091 pv0.001 p50.912 p50.736 p50.908 pv0.001
Education
No vocational training /semi- 293 380 21.2 11.2 44.3 24.3 11.0 4.6 4.04 3.79
skilled worker training/EFG
basic vocational courses
Completed apprentice or 250 189 9.2 7.5 37.6 11.8 16.7 8.0 3.79 3.62
EFG training
Short higher education for 1– 80 178 15.6 9.1 24.4 14.6 14.3 9.1 3.87 3.65
2 years
Middle-range higher 141 307 10.6 7.5 37.7 15.4 13.9 5.4 3.85 3.58
education for 3–4 years
Long higher education for 5 131 81 8.3 10.6 32.1 18.5 18.9 9.2 3.75 3.55
years or more
Significance pv0.001 p50.480 p50.005 p50.002 p50.167 p50.194 pv0.001 p50.002
Occupation
Farmer, self employed/ 520 555 11.1 9.2 38.9 19.1 11.3 5.2 3.88 3.69
employee
Retired 199 331 8.8 7.7 12.8 3.8 32.5 13.0 3.44 3.34
Student 83 113 30.1 13.0 71.8 46.1 0 0 4.59 4.34
Unemployed/housewife/ 93 136 25.7 8.7 49.5 18.8 10.9 4.3 4.09 3.62
househusband/other
Significance pv0.001 p50.419 pv0.001 pv0.001 pv0.001 pv0.001 pv0.001 pv0.001

*Significance tests were calculated by using Chi-square tests and one-way ANOVA for mean consumption per drinking day.

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 Socio-demographic correlates of alcohol consumption
Multivariate analyses
In order to simultaneously introduce additional
covariates and also to control for potential con-
founders to the bivariate relationships shown in
Table II, multivariate analyses were undertaken.
Table III summarizes the results of multiple logistic
regressions and multiple linear regression. The
regression of mean consumption per drinking day
was restricted to drinkers only. Because of the
skewed distribution of the values for mean con-
sumption the natural log of this variable was taken
before analysis.
Heavy drinking. For men, age, having children and
being religious are negatively associated with heavy
drinking. But attending church three or more times
per year is positively associated with heavy drinking.
The significant coefficient for age-squared indicates
that younger men are more likely to be heavy
drinkers than middle-aged and older men. Among
women, age and having children are negatively
associated with heavy drinking.
Heavy episodic drinking (at least once a month). Among
men, only age is negatively associated with heavy
episodic drinking. Other factors are not significant,
which implies that HED is mainly a youth
phenomenon regardless of other socio-demographic
background variables. Age, having children,
religiosity, attending church, and income are
negatively associated with HED among women.
Daily or almost daily drinking. Age is positively
associated with being a daily drinker among men.
Age and being married or in a partnership are
positively associated with being a daily drinker
among women. The odds ratio for age-squared
indicates a nonlinear relationship between age and
daily drinking: middle-aged and older women and
men are more often daily drinkers than their younger
counterparts.
Mean consumption per drinking day. Age and having
children are negatively associated with mean
consumption for men. For women, age, being
married or in a partnership, living alone, having
children, religiosity and income are negatively
associated with mean consumption. For both men
and women there is also a nonlinear age effect: the
association with mean consumption declines
exponentially.
An additional model was run that included
interaction terms between age and the predictor
variables as well as between income and education.
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585
These results (not shown) did not substantially
modify the findings reported above.
Discussion
Almost all adult Danes are drinkers and especially
younger Danes drink in a concentrated, episodic
manner. It is striking that, regardless of age and sex,
the average amount consumed by a Dane on a
drinking day is 50 grams of pure alcohol. Danish
men drink more and more frequently than Danish
women, but the two sexes display similar age
patterns. Other socio-demographic factors appear
to operate differentially between sexes. Those factors
that influence women’s drinking the most could be
seen as related to ‘‘community’’: having children,
being married, being religious and attending church
are negatively associated with drinking. The only
classical socioeconomic variable to have an effect on
women’s drinking was income, and this effect was
negative for mean consumption and u-shaped for
HED. Surprisingly, living alone was associated with
lower mean consumption, while marriage was
positively associated with daily drinking and nega-
tively associated with mean consumption. The
effects of these two variables suggest that many
women probably engage in frequent but moderate
drinking with their partners.
For men, family variables and religiosity were not
as consistent as for women. Marriage did not
influence men’s drinking, as is often the case in
developed countries, (eg. [8]). Having children was
negatively associated with both heavy drinking and
mean consumption. Income had surprisingly no
significant effect on any of the drinking indicators
and in the multivariate analyses the significant
bivariate associations of education and occupation
on drinking disappeared. The religious variables
were only associated with heavy drinking and in
opposite ways: being religious was negatively asso-
ciated while attending church had a positive effect.
In sum, no clear relationships between socio-
demographic variables and drinking behaviour could
be discerned, suggesting that drinking is a highly
accepted and widespread phenomenon among
Danish men.
An outstanding finding of our research is the
remarkably high prevalence of regular heavy episodic
drinking behaviour of younger people. This is not a
phenomenon exclusive to Denmark; previous studies
[24,25] have shown that youth binge drinking is
common in Europe. However, our research corro-
borates the especially high rates of binge drinking
among Danish youth found in other Danish surveys.
We have estimated that among those 16 to 20 years
 586
Table III. Summary of significant results of multiple logistic regression (odds ratios, 95% CI) and multiple linear regression (betas, 95% CI).a

K. Bloomfield et al.
Mean cons./drinking
Heavy drinking Heavy episodic drinking Daily drinking day (grams, log consumption, drinkers only)

Men Women Men Women Men Women Men Women

2
R 0.12 0.06 0.26 0.23 0.18 0.16 0.26 0.23
Age (centred, 0.98 0.98 0.94 0.95 1.07 1.11 20.02 20.017
continuous) (0.96–0.99) (0.96–0.99) (0.93–0.95) (0.94–0.96) (1.05–1.09) (1.06–1.16) (20.023–20.019) (20.02– 20.015)
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Age (centred) squared 1.001 – – – 0.999 0.998 1.5*1024 1.6*1024

(1.00– (0.998–1.00) (0.996–0.999) (1.5*1025– (1.4*1025–
1.001) 2.8*1024) 3.1*1024)
Marital status Married or registered – – – – – 2.35 – 20.17
partnership (1.19–4.63) (20.28– 20.06)
Living alone Alone – – – – – – – 20.17
(20.31– 20.03)
Having children Yes 0.35 0.31 – 0.52 – – 20.22 20.18
(0.20–0.61) (0.18–0.56) (0.34–0.80) (20.31– 20.13) (20.28– 20.08)
Occupation (reference: Retired – – – – – – – –
farmer/self empl/ Student
Employee) Unempl./housewife/
househusband/other
Educational level Completed apprentice – – – – – – – –
(reference: no or EFG training
vocational 1–2y. higher education
training / 3–4y. higher education
semi-skilled 5y. or more higher
worker training / education
EFG basic course)
Income (personal 7.000–13.999 Kr – – – 0.43 – – – 20.04
monthly) (reference: (0.24–0.78) (20.08– 20.004)
up to 7.000 Kr) 14.000–20.999 Kr 0.38 (0.22–0.66)
21.000–27.999 Kr 0.70 (0.39–1.26)
28.000 Kr or more 0.63 (0.29–1.39)
Religion Being religious 0.56 – – 0.57 – – – 20.14
(0.35–0.88) (0.36–0.89) (20.25– 20.04)
Active religious Attend church more 1.65 – – 0.50 – – – –
than 3 times per year (1.01–2.69) (0.29–0.86)
a
Variable selection was conducted by a stepwise forward procedure using the likelihood ratio criterion. Only significant variables in final models are displayed.
 Socio-demographic correlates of alcohol consumption
of age 74% of men and 59% of women drink six or
more drinks on one occasion at least once per month
(data not shown). These values are similar to those
reported by the Danish National Board of Health for
the period of 2000 to 2003 in which 76% of men and
62% of women of the same age had drunk at least
five standard drinks on at least one occasion in the
previous 30 days [15]. Given that the binge drinking
measurement for the National Board of Health is
slightly lower than ours, these estimates lie in close
agreement to each other.
Our study also provides more details of drinking
patterns in the Danish general population. There has
been a tendency to believe that socio-demographic
correlates function similarly across developed socie-
ties, but recent research has shown that differences
exist [8]. Moreover, these results confirm and
elaborate the Danish drinking patterns described
by Mäkelä et al. [1]. For example, we also found that
drinking frequency increases with age, something
Mäkelä et al did not find in the other Nordic
countries, but is a pattern that Denmark shares with
continental Europe [10]. Thus, Danish drinking has
a Nordic character with its frequent heavy episodic
consumption, but also resembles Europe with its
higher and regular total consumption.
A limitation of our study is the modest coopera-
tion rate. It is well known that willingness to
cooperate in surveys is declining and telephone
surveys are especially affected [26–28]. Reassuring,
though, is the fact that our survey estimates of heavy
drinking (total population: 11.6%, men: 14.0%,
women: 9.2%) agree very closely with those esti-
mated from a large national health monitoring
survey conducted in 2000 (total population:
11.7%, men: 14.8%, women: 8.7%) by the Danish
National Institute of Public Health. This study, the
Danish Health and Morbidity Survey, collected data
by personal interview, covered the same age range as
our survey and used probability methods for a
sample size of 16,690 respondents with a response
rate of 74.2% [29]. Its heavy drinking measure is 24
grams pure alcohol per day for women and 36 grams
for men, and thus, slightly higher than our heavy
drinking definition (20 grams pure alcohol per day
for women, 30 grams per day for men). Also, as
mentioned earlier, our binge drinking measures are
in close agreement to those of the survey of the
Danish Board of Health and the Danish Cancer
Society which employed a self-administered postal
questionnaire and obtained a response rate of 68%
[30]. This leads us to believe that our estimates are
acceptably robust, even though these other surveys
have had higher response rates and used data
collection methods known to yield more information
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587
than telephone interviews on sensitive questions,
such as drinking behaviour [31].
Another limitation is that our data are cross-
sectional; thus causal relations cannot be inferred.
Yet, this socio-demographic profile can offer a point
of departure for needed longitudinal studies that can
more confidently describe relations between age and
drinking, and the acquisition of certain social roles
and their influence on drinking behaviour. Further,
trajectory analyses would be useful, especially for
mapping problematic youthful drinking careers and
factors contributing to worsening or maturing out of
such behaviour. Such information would aid in
concretely informing Danish alcohol policy and
public health planning.
Acknowledgements
This study was supported by the Danish Medical
Research Council (contract no. 22-02-374), the
Danish Health Insurance Foundation (journal nrs.
2003B195, 2004B195, 2005B093) for the data
collection and the Nordiska samarbetsnämnden för
samhällsforskning (project no. 20071). The authors
wish to thank Dr Gerhard Gmel for his careful
comments on earlier drafts of this paper, Anne
Vagner Pedersen and Thim Prætorius for their
help in formatting the manuscript, and two
anonymous reviewers. An earlier version of this
paper was presented at the 31st Annual Alcohol
Epidemiology Symposium of the Kettil Bruun
Society for Social and Epidemiological Research
on Alcohol, Riverside, CA, USA, 30 May–3 June
2005.
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