Do drinking problems in the past affect current consumption?

Harmful use of alcohol ranks among the top five risk factors for disease, disability and death worldwide. However, not all individuals who consume alcohol throughout life are addicted and our premise is that addiction implies a chain of consumption that produces harmful effects. The objective of this study was to evaluate whether self-assessed past drinking problems - our measure of harmful alcohol consumption - affect the current alcohol consumption patterns. We expected that drinking problems in the past could have a positive effect on current alcohol consumption. Using Portuguese data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we applied an ordered probit model, given the ordered nature of the dependent variable. Our dependent variable measures the current consumption using categories listed in ascending order of alcohol intake frequency (from less than once a month to daily consumption). Our results suggest that harmful alcohol consumption in the past is an important determinant of current alcohol consumption. Self-assessed past drinking problems had a positive effect on the first five lower categories of current alcohol consumption frequency - less than once a month to up to six days a week. Therefore, to reduce non-communicable avoidable diseases related to the use of alcohol, policies should consider the individuals’ decisions regarding alcohol consumption during their lifetime, and specific policies should focus on individuals with past drinking problems.

Keywords:
Alcohol Drinking; Alcoholism; Risk-taking; Health Policy

Explanatory variables	Description	Overall mean	Mean (population with past drinking problems)
Drinking problem	Binary variable of a self-assessed drinking problem. 1 - if excessive consumption of alcohol was a problem at some point in the respondent’s life course; 0 - otherwise.	0.036
Age	The number of years that the respondent has lived.	63.8	62.8
Male	Binary variable. 1 - if male; 0 - otherwise.	0.593	0.850
Education	Number of years the respondent has received full-time education.	6.49	8.15
Married	Binary variable. 1 - if married.	0.787	0.600
Unemployed	Binary variable. 1 - if unemployed.	0.071	0.100
Retirement	Binary variable. 1 - if retired.	0.560	0.550
Smoke	Number of years the respondent smoked.	11.1	23.5
Physical activity	Binary variable. 1 - if the individual does physical exercise more than once a month.	0.480	0.400
Depression	Answer to the question: “Was there ever a time or times […] when you suffered from depression symptoms which lasted at least two weeks?”. 1 - if the answer is yes.	0.300	0.475
Income	Value of annual income in the previous year, after taxes.	EUR 9896.03	EUR 10360.13
Diseases	Number of diseases the individual suffers from (of the following list: heart problems; high blood pressure or hypertension; high blood cholesterol; stroke or cerebral vascular disease; diabetes or high blood sugar; chronic lung disease; cancer or malignant tumour; stomach or duodenal ulcer, peptic ulcer).	1.31	1.57
Dependent variable
Frequency	Categorical and ordered variable, according to the self-assessed consumption frequency: 0 - not at all in the last 3 months; 1 - less than once a month; 2 - once or twice a month; 3 - once or twice a week; 4 - three or four days a week (frequent drinker); 5 - five or six days a week (regular drinker); 6 - almost every day (daily drinker).	2.582	4.400

	Drinking problem (%)
	0 (no)	1 (yes)	Total
Frequency
1 - Less than once a month	7.62	0.45	8.07
2 - Once or twice a month	6.35	0.45	6.80
3 - Once or twice a week	12.06	0.45	12.51
4 - Three or four days a week	5.08	0.09	5.17
5 - Five or six days a week	4.53	0.18	4.71
6 - Almost every day	60.74	1.99	62.74
Total	96.37	3.63	100.00
n	1,063	40	1,103

Variables	Ordered probit model parameter	Average marginal effects on probabilities
Variables	Ordered probit model parameter	y = 1	y = 2	y = 3	y = 4 (frequent drinker)	y = 5 (regular drinker)	y = 6 (daily drinker)
Drinking problems	-0.342 * (0.197)	0.046 * (0.038)	0.026 * (0.016)	0.029 ** (0.015)	0.008 * (0.005)	0.004 * (0.001)	-0.117 * (0.071)
Age	0.005 (0.005)	-0.001 (0.001)	-0.000 (0.000)	-0.001 (0.000)	-0.000 (0.000)	-0.000 (0.000)	0.002 (0.002)
Male	0.680 *** (0.088)	-0.091 *** (0.014)	-0.056 *** (0.009)	-0.069 *** (0.010)	-0.017 *** (0.003)	-0.011 * (0.002)	0.232 *** (0.032)
Education	-0.039 *** (0.009)	0.005 *** (0.001)	0.003 *** (0.001)	0.004 *** (0.001)	0.001 *** (0.000)	0.001 *** (0.000)	-0.013 *** (0.003)
Married	0.215 ** (0.090)	-0.029 ** (0.014)	-0.017 ** (0.007)	-0.020 ** (0.008)	-0.005 ** (0.002)	-0.003 * (0.001)	0.074 ** (0.032)
Unemployed	0.079 (0.153)	-0.010 (0.019)	-0.006 (0.011)	-0.007 (0.014)	-0.002 (0.004)	-0.001 (0.003)	0.027 (0.051)
Retirement	-0.044 (0.101)	0.006 (0.013)	0.003 (0.007)	0.004 (0.009)	0.001 (0.003)	0.001 (0.002)	-0.015 (0.034)
Smoke	0.003 (0.003)	-0.000 (0.000)	-0.000 (0.000)	-0.000 (0.000)	-0.000 (0.000)	-0.000 (0.000)	0.001 (0.001)
Physical activity	0.187 ** (0.078)	-0.025 ** (0.011)	-0.014 ** (0.006)	-0.017 ** (0.007)	-0.005 ** (0.002)	-0.003 ** (0.001)	0.064 ** (0.026)
Depression	-0.150 * (0.084)	0.020 * (0.011)	0.011 * (0.006)	0.014 * (0.008)	0.004 * (0.002)	0.002 * (0.001)	-0.051 * (0.029)
Income	-1.16e-06 (1.99e-06)	1.55e-07 (1.49e-07)	8.69e-08 (1.49e-07)	1.08e-07 (1.85e-07)	2.89e-08 (4.95e-08)	1.82e-08 (3.12e-08)	-3.97e-07 (6.78e-07)
Diseases	0.036 (0.033)	-0.005 (0.004)	-0.003 (0.002)	-0.003 (0.003)	-0.001 (0.001)	-0.001 (0.001)	0.012 (0.011)

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[1] Correspondence A. M. Reis European Business School and Research Group of ISAG, Instituto Superior de Administração e Gestão. Rua Central Sul 23, Vilamar, Coimbra 3060-767, Portugal. anamariacpr@hotmail.com