Abstract
Objectives
The aim of this paper is to examine whether there is an underlying multidimensional typology of drinking according to gender among a population presenting heterogeneous drinking profiles in Canada.
Methods
Latent class analysis was chosen to analyze the degree of statistical relationship among three indicators of drinking practices: patterns of drinking–i.e., frequency and quantity; contexts; and motivations to drink. Multivariate multilogistic regressions were conducted to explore the composition of each typology by age and education. Participants were selected from the Canadian GENACIS survey (Gender, Alcohol, and Culture: An International Study) and comprised 871 men and 843 women (N = 1,714) aged between 18 and 77 years and being regular alcohol drinkers (consumption at least once a month). Respondents to the GENACIS questionnaire completed questions on use, contexts and reasons to drink as well as socio-economic questions (age and education), adjusted by Canadian province of residence.
Results
Six profiles were distinguished among men and five among women. Men and women share four drinking patterns but present distinctive characteristics of drinking. We also observed variability in the relationship according to socio-economic status and gender.
Conclusion
Our results confirmed the complexity and variability of drinking practices according to gender in Canada and the necessity to focus on gender and social dimensions in order to enhance our understanding of alcohol use. This study also reinforces the idea of adapting promotion strategies and interventions in public health by gender and social status in order to make them more efficient.
Key Words: Drinking profiles; typology; gender; context; motivation; social status La traduction du résumé se trouve à la fin de l’article.
Résumé
Objectifs
L’objectif de cette étude est d’examiner la configuration typologique multidimensionnelle de la consommation d’alcool selon le genre au sein de la population canadienne ayant des pratiques de boire hétérogènes.
Méthodes
L’approche d’analyse par classe latente a été choisi afin d’analyser le degré de relation statistique entre les indicateurs de consommation d’alcool, soit l’usage–c.a.d. fréquence et quantité–, les contextes et les motivations à boire. Des analyses de régressions multilogistiques ont ensuite été réalisées afin d’explorer la composition de chacune des typologies selon l’âge et l’éducation. L’échantillon de 871 hommes et 843 femmes buveurs et buveuses réguliers ayant rapporté boire au moins une fois par mois et âgés entre 18 et 77 ans (n = 1 714) provient de l’enquête GENACIS Canada (GENder, Alcohol, and Culture: an international study). Dans le questionnaire GENACIS, les répondants ont répondu à des questions d’usage d’alcool, de contextes et de raisons associées à leur usage, et rapporté certaines caractéristiques socioéconomiques (âge et éducation). Les analyses ont été ajustées selon la province de résidence.
Résultats
Six profils de consommation d’alcool ont été identifiés chez les hommes et cinq chez les femmes. Hommes et femmes partagent quatres pratiques de consommation d’alcool mais présentent certaines caractéristiques distinctives associées au boire. Nous avons également observé une variabilité dans la relation entre les caractéristiques socioéconomiques et les profils selon le genre.
Conclusion
Nos résultats confirment la complexité et la variabilité des pratiques de boire selon le genre et la nécessité de considérer le genre et les dimensions sociales dans les analyses afin d’optimiser notre compréhension des modes d’alcoolisation au Canada. Cette étude renforce l’idée d’adapter les stratégies de promotion et d’interventions en santé publique en fonction du genre et du statut social afin de les rendre plus efficaces.
Mots Clés: profils de consommation d’alcool, typologie, genre, contexte, motivation, statut social
Footnotes
Sources of Funding: Funding for this research was provided by the Canadian Institutes of Health Research (CIHR) to Katryn Graham (PI) and Andrée Demers (Co-PI) (Application no. 108626). Marilyn Fortin received a Doctoral research award (no 182174) from the CIHR. English editing was funded by the Public Health Research Institute of the University of Montreal.
Disclaimer: The content of this study is solely the responsibility of the authors.
Conflict of Interest: None to declare.
References
- 1.Bird CE, Riecker PP. Gender and Health: The Effect of Constrained Choices and Social Policies. New York, NY: Cambridge University Press; 2008. [Google Scholar]
- 2.Keyes KM, Grant BF, Hasin DS. Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population. Drug Alcohol Depend. 2008;93:21–29. doi: 10.1016/j.drugalcdep.2007.08.017. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Paradis C, Demers A, Nadeau L, Picard E. Parenthood, alcohol intake, and drinking contexts: Occasio Furem Facit. J Stud Alcohol Drugs. 2011;72:259–69. doi: 10.15288/jsad.2011.72.259. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Wilsnack RW, Vogeltanz ND, Wilsnack SC, Harris TR, Ahlström S, Bondy S, et al. Gender differences in alcohol consumption and adverse drinking consequences: Cross-cultural patterns. Addiction. 2000;95:251–65. doi: 10.1046/j.1360-0443.2000.95225112.x. [DOI] [PubMed] [Google Scholar]
- 5.Bloomfield K, Grittner U, Kramer S, Gmel G. Social inequalities in alcohol consumption and alcohol-related problems in the study countries of the EU concerted action ‘Gender, Culture and Alcohol Problems: A Multinational Study.’. Alcohol and Alcoholism. 2006;41(Suppl.1):26–36. doi: 10.1093/alcalc/agl073. [DOI] [PubMed] [Google Scholar]
- 6.Graham K, Bernards S, Demers A. Gender differences by province in alcohol consumption and consequences: Results of the GENACIS Canada study. In: Poole N, Greaves L, editors. Highs & Lows: Canadian Perspectives on Women and Substance Use. Toronto, ON: Centre for Addiction and Mental Health; 2007. [Google Scholar]
- 7.McPherson M, Casswell S, Pledger M. Gender convergence in alcohol consumption and related problems: Issues and outcomes from comparisons of New Zealand survey data. Addiction. 2004;99:738–48. doi: 10.1111/j.1360-0443.2004.00758.x. [DOI] [PubMed] [Google Scholar]
- 8.Wilsnack RW, Wilsnack SC, Kristjanson AF, Vogeltanz-Holm ND, Gmel G. Gender and alcohol consumption: Patterns from the multinational GENACIS project. Addiction. 2009;104:1487–500. doi: 10.1111/j.1360-0443.2009.02696.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Bailly RC, Carman RS, Forslund MA. Gender difference in drinking motivations and outcomes. J Psychol. 1991;125(6):649–56. doi: 10.1080/00223980.1991.10543327. [DOI] [PubMed] [Google Scholar]
- 10.Demers A, Kairouz S, Adlaf EM, Gliksman L, Newton-Taylor B, Marchand A. Multilevel analysis of situational drinking among Canadian undergraduates. Soc Sci Med. 2002;55(3):415–24. doi: 10.1016/S0277-9536(01)00258-1. [DOI] [PubMed] [Google Scholar]
- 11.Kairouz S, Gliksman L, Demers A, Adlaf E. For all these reasons, I do drink: A multilevel analysis of contextual reasons for drinking among Canadian undergraduates. J Stud Alcohol. 2002;63:600–8. doi: 10.15288/jsa.2002.63.600. [DOI] [PubMed] [Google Scholar]
- 12.Kairouz S, Greenfield T. A comparative multi-level analysis of contextual drinking in American and Canadian adults. Addiction. 2007;102:71–80. doi: 10.1111/j.1360-0443.2006.01655.x. [DOI] [PubMed] [Google Scholar]
- 13.Adlaf E, Blackburn J, Demers A, Kellner F, Single E, Webster I. Social Determinants, Alcohol Consumption and Health: A Secondary Analysis of Canada’s Alcohol and Other Drugs Survey 1994. Ottawa, ON: Canadian Centre on Substance Abuse; 1997. [Google Scholar]
- 14.Grittner U, Kuntsche S, Graham K, Bloomfield K. Social inequalities and gender differences in the experience of alcohol-related problems. Alcohol and Alcoholism. 2013;47(5):597–605. doi: 10.1093/alcalc/ags040. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.GENACIS. The European Commission (contract QLG4-CT-2001-0196): “Gender & Alcohol — A Multinational Study”, the U. S. National Institute on Alcohol Abuse and Alcoholism (grants R01AA04610 and R21AA12941), the Swiss Federal Office of Education and Science (contract 01.0366) the German Ministry of Health and Social Security, and the World Health Organization (WHO) 2005. [Google Scholar]
- 16.CCSA. Canadian Addiction Survey, 2004: Microdata eGuide. Ottawa: CCSA; 2007. [Google Scholar]
- 17.Cooper ML, Russell M, Skinner JB, Windle M. Development and validation of a three-dimensional measure of drinking motives. Psychol Assess. 1992;4:123–32. doi: 10.1037/1040-3590.4.2.123. [DOI] [Google Scholar]
- 18.Cox WM, Klinger E. A motivational model of alcohol use. J Abnorm Psychol. 1998;97:168–80. doi: 10.1037/0021-843X.97.2.168. [DOI] [PubMed] [Google Scholar]
- 19.Kuntsche E, Knibbe R, Gmel G, Engels R. Why do young people drink? A review of drinking motives. Clin Psychol Rev. 2005;25:841–61. doi: 10.1016/j.cpr.2005.06.002. [DOI] [PubMed] [Google Scholar]
- 20.Collins LM, Lanza ST. Latent Class and Latent Transition Analysis. With Applications in the Social, Behavioral, and Health Sciences. Wiley series in probability and statistics. Hoboken, NJ: John Wiley & Sons, Inc.; 2010. [Google Scholar]
- 21.Lanza ST, Collins LM, Lemmon DR, Schafer JL. PROC LCA: A SAS procedure for latent class analysis. Struct Equation Modeling. 2007;14(4):671–94. doi: 10.1080/10705510701575602. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Agresti A, Yang M. An empirical investigation of some effects of sparseness in contingency tables. Computational Statistics Data Anal. 1986;5:9–21. doi: 10.1016/0167-9473(87)90003-X. [DOI] [Google Scholar]
- 23.Nylund KL, Asparouhov T, Muthén BO. Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equat Model: Multidisciplinary J. 2007;14(4):535–69. doi: 10.1080/10705510701575396. [DOI] [Google Scholar]
- 24.Paradis C, Demers A, Picard E. Alcohol consumption: A different kind of Canadian mosaic. Can J Public Health. 2010;101(4):275–80. doi: 10.1007/BF03405286. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.Health Canada. Enquête de surveillance canadienne de la consommation d’alcool et de drogues. Faits saillants. 2011. [Google Scholar]
- 26.Cole-Harding S, Wilson JR. Ethanol metabolism in men and women. J Stud Alcohol. 1987;48:380–87. doi: 10.15288/jsa.1987.48.380. [DOI] [PubMed] [Google Scholar]
- 27.Hugues SO, Power TG, Frances DJ. Defining patterns of drinking in adolescence: A cluster analytic approach. J Stud Alcohol. 1992;52:40–47. doi: 10.15288/jsa.1992.53.40. [DOI] [PubMed] [Google Scholar]
- 28.Cooper ML. Motivations for alcohol use among adolescents: Development and validation of a four-factor model. Psychol Assess. 1994;6(2):117–28. doi: 10.1037/1040-3590.6.2.117. [DOI] [Google Scholar]
- 29.Jayne M, Valentine G, Holloway SL. Alcohol, Drinking, Drunkenness: (Dis) Orderly Spaces. Surrey, England: Ashgate Publishing Limited; 2011. [Google Scholar]
- 30.Midanik LT. Perspectives on the validity of self-reported alcohol use. Br J Addict. 1989;84:1419–23. doi: 10.1111/j.1360-0443.1989.tb03920.x. [DOI] [PubMed] [Google Scholar]
- 31.Grønbæk M, Heitmann BL. Validity of self-reported intakes of beer, wine and spirits in population studies. Eur J Clin Nutr. 1996;50:487–90. [PubMed] [Google Scholar]
- 32.Sommers MS, Dyehouse JM, Howe SR, Lemmink J, Volz T, Manharth M. Validity of self-reported alcohol consumption in nondependent drinker with unintentional injuries. Alcohol Clin Exp Res. 2000;24:1406–13. doi: 10.1111/j.1530-0277.2000.tb02110.x. [DOI] [PubMed] [Google Scholar]
- 33.Gmel G, Graham K, Kuendig H, Kuntsche S. Measuring alcohol consumption - Should the ‘graduated frequency’ approach become the norm in survey research? Addiction. 2006;101(1):16–30. doi: 10.1111/j.1360-0443.2005.01224.x. [DOI] [PubMed] [Google Scholar]
- 34.Greenfield TK, Kerr WC. Alcohol measurementmethodology in epidemiology: Recent advances and opportunities. Addiction. 2008;103(7):1082–99. doi: 10.1111/j.1360-0443.2008.02197.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 35.Alcohol Clin Exp Res. 1998.
- 36.Frohlich KL, Corin E, Potvin L. La relation entre contexte et maladie: une proposition théorique. In: Frohlich KL, De Koninck M, Demers A, Bernard P, editors. Les inégalités sociales de santé au Québec. Montréal, Québec: Les Presses de l’Université de Montréal; 2008. [Google Scholar]