Exploring the behaviours and lifestyles of young non-drinkers A mixed method approach Linda Ng Fat

Why focus on Non-drinkers? 1.In order to understand drinking behaviour it is important to understand all aspects of drinking including the reasons why people dont drink 2. Drinking behaviour is heavily influenced by social norms. But there is often a discrepancy between perceived norm and actual behaviour.

Estimated alcohol consumption on heaviest drinking day in the last week among 18 to 34 years olds Source: Health Survey for England 2008

3. Non drinkers have been shown to have worse health then moderate drinkers, having greater risk of coronary heart disease and all cause mortality (Carrao et al 2000) Fig 1: Relative risk of coronary heart disease against alcohol consumption

Further Criticisms of the J-shaped relationship There is methodological problem in the way non-drinkers are defined e.g. 52.9% of those who said they never had a drink, reported drinking in previous surveys (Rehm, 2008) Non-drinkers may have poorer health behaviours which confound the relationship between non-drinking and greater cardiovascular disease (Naimi, Brown et al. 2005) Could poor health precede non-drinking even at an early age? The J-shaped relationship has been shown to exists even in young drinkers in various outcomes such as mental health and limiting illness (Power 1998)

Questions 1.What are the health behaviours of non- drinkers compared to drinkers? 2.What characteristics predict being a non- drinker? Methods: Analysis on Health Survey for England 2008 (Base: 3, to 34 year olds)

Social Inequalities in Non Drinking Base size n Non Drinkers646 Not had a drink in the past week590 Light699 Medium476 Heavy1,001 Source: Health Survey for England 2008

Health Behaviours Source: Health Survey for England 2008

Health

Next steps Preliminary results seem to suggest that poor health behaviours of non drinkers start at a young age. Poor health and limiting illness also appears to be higher among non drinkers Next steps: To investigate what are the predictors (including poor health) of being a non-drinker compared to drinkers. Methods: Regression analysis using HSE 2008

References Corrao, G., L. Rubbiati, et al. (2000). "Alcohol and coronary heart disease: a meta- analysis." Addiction 95(10): Green, C. A. and M. R. Polen (2001). "The health and health behaviors of people who do not drink alcohol." American Journal of Preventive Medicine 21(4): Naimi, T. S., D. W. Brown, et al. (2005). "Cardiovascular risk factors and confounders among nondrinking and moderate-drinking U.S. adults." American Journal of Preventive Medicine 28(4): Power, C., B. Rodgers, et al. (1998). "U-shaped relation for alcohol consumption and health in early adulthood and implications for mortality." The Lancet 352(9131): Rehm, J., H. Irving, et al. (2008). "Are Lifetime Abstainers the Best Control Group in Alcohol Epidemiology? On the Stability and Validity of Reported Lifetime Abstention." American Journal of Epidemiology 168(8): Linda Ng Fat