The collectivity of changes in alcohol consumption revisited

Aims Within-country temporal changes in alcohol consumption in the United States, Finland and Norway were examined to assess (i) whether a change in mean alcohol consumption is accompanied by a change in the prevalence of heavy drinkers, (ii) whether this mean change reflects a collective displacement in the whole distribution of consumption and (iii) whether collective displacement is found for both an upward and a downward shift in mean consumption. Methods We applied repeated cross-sectional survey data on distribution measures for estimated annual alcohol consumption from national population sample surveys covering 30-40-year periods in two countries with increasing trends in mean consumption (Finland and Norway) and one country with decreasing trends (the United States). Results There was a strong positive association (P < 0.001) between changes in mean consumption and changes in the prevalence of heavy drinkers in all three countries. Moreover, a change in mean consumption was accompanied by a consumption change in the same direction in all consumer categories in all three countries, i. e. a collective displacement. The regression coefficients were approximately 1. Conclusions Drinkers at all levels of consumption appear to move in concert, both up and down the consumption scale, in Finland, Norway and the United States, as predicted by Skog's theory of the collectivity of drinking cultures.