Binge drinking has traditionally been more common in Anglo-Saxon and northern European countries, known as "dry drinking cultures," than it has been in Mediterranean countries. However, a study of drinking among adults in the Madrid region of Spain indicates that binge drinking is on the rise.
"In Mediterranean countries, alcohol consumption -- particularly in the form of wine -- has very strong social and historical roots," said José Lorenzo Valencia-Martín, a medical doctor at the Universidad Autónoma de Madrid and corresponding author for the study.
"Wine is a component of the so-called 'Mediterranean diet' and is typically consumed almost every day in moderate amounts, during meals with family and friends. This is typical of countries with 'wet drinking cultures.' Although many people in Anglo-Saxon countries share this drinking pattern, there is also a tradition of drinking with no meal, and particularly after meals and alone, without the company of family or friends."
Both Valencia-Martín and Joan R. Villalbí, deputy director at the Agència de Salut Pública de Barcelona observed that historical patterns of drinking seem to be changing, as binge drinking appears to be on the rise in Mediterranean countries.
"Although traditionally, southern European countries had a pattern of higher per capita consumption, most of which was derived from daily consumption of wine with meals," said Villalbí, "this is changing. For example, daily consumption with meals is decreasing in Spain, and beer is the most consumed alcohol. Binge drinking, particularly among youth on weekend nights, has become a health and social issue in Spain, a process mirrored in other countries of southern Europe."
For this study, researchers examined data gathered during 2000 to 2005 through telephone interviews of 12,037 persons (5,850 males, 6,187 females) considered representative of the adult population (18 to 64 years of age) in the Madrid region. Binge drinking was defined as consumption of eight or more standard units of alcohol (e 80g) for men, and six or more (e 60g) for women during any one drinking session during the previous 30 days.
Results indicate that the prevalence of binge drinking is high in Madrid -- 30.8 percent among men and 18.2 percent among women aged 18-24 years -- and is particularly notable among younger men with a higher education.
"In Spain, the frequency of binge drinking declines with age much more quickly than in Anglo-Saxon countries, where it is relatively frequent until old age," said Valencia-Martín. "And, in Spain, as in most other Western countries, binging is more frequent among those with higher education levels. This latter finding might be related to the absence of family duties among university graduates until a later age than blue-collar workers. It allows young graduates to spend more weekend nights drinking."
"Although drinking to drunkenness is not socially acceptable in Spain," observed Villalbí, "binge drinking is becoming acceptable, especially among youth. However, this is considered to be a fairly new phenomenon for which little empirical data existed. This data would have been extremely useful earlier in 2007 when there was an attempt to develop point-of-sale and publicity regulations on alcohol."
Another key finding of the study was that most of the alcohol consumed by the binge drinkers was in the form of spirits rather than beer or wine (the latter two comprise most of the alcohol consumed in Spain).
"Binge drinking seems to be an 'imported drinking pattern,' based on spirits -- such as gin, whisky, vodka, etc. -- which are not culturally rooted in Spain," said Valencia-Martín. "We think that spirits are mainly used in binging because drinkers may seek the psychoactive effects of alcohol in a relatively short time."
"Spirits and liquor combined with coke or other sodas are popular among the young," added Villalbí. "The liquor industry has been very active in marketing its products among youth, particularly 'alcopops,' and circumventing the current ban on TV publicity of drinks of more than 23 percent alcohol. Their marketing is directed explicitly to the younger age groups, linking drinking with fun and social and sexual success. There is data documenting an extreme growth in alcohol publicity expenditures and its related impact in Spain over the last few years."
Both Valencia-Martín and Villalbí believe that binge drinking is part of an evolving pattern of alcohol consumption across European countries, another consequence of what Valencia-Martín calls the globalization of drinking.
"Obviously it is a very risky consequence," he said, "because binge drinking is associated with traffic crashes, hazardous driving behavior, and injuries resulting from violent behavior. In Mediterranean countries, we must increase the social awareness of this problem, so that families and the government work together to control binge drinking among the youth."
Villalbí concurs. "If drinking is becoming a social and health problem, with important negative effects involving also non-drinkers, it cannot be left to individual options and industry initiatives," she said. "Governments must also be involved and take action. These results provide the framework for an increasing interest in European Union policies in this field."
Results are published in the October issue of Alcoholism: Clinical & Experimental Research.
The study was funded in part by a grant from the Dirección General de Salud Pública y Alimentación, Comunidad de Madrid.
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