Australian Drug and Alcohol Review 1986; 5:215-224

Understanding. the Alcoholic in the Context of Commumty Consumption Patterns

Margaret Hamilton Department of Social Studies, University of Melbourne,

Parkville, Victoria

Abstract: Community alcohol consumption in the Queensland mmmg town of Mt. Isa was studied m an attempt to establish drinking patterns and associated problems. Data were collected via morbidity and mortality records, surveys of general practitioners and hospital patients, a review of coroner's records, and case studies. Baseline data were established through a postal survey. Ten per cent of the population were considered to be drinking heavily or very heavily. An attempt was made tounderstand the place of alcohol in the social and cultural life of Mr. Isa. Keywords: Alcohol drinkmg; alcoholic beverages; alcoholism.

Introduction In 1980 I was approached by the ANU North

Australian Research Unit in Darwin and asked if I would be interested in, and prepared to do, some preliminary work with the Mount Isa community regarding a concern they had about drinking problems in the city. On my first exploratory visit to this remote Australian mining town in the north west of Queensland I was struck by the dominance of the mine, the heat and humidity, the easy-going atmosphere and the omnipresence of hotels. I did not initially plan to undertake an ongoing research project but merely to assist the local Welfare Council think about the apparent alcohol problem there was in town.

During my first visit I asked where all the people with alcohol problems were. The answer was "all over the place". Many of the health and welfare people of the town could relate anecdotes of people they had treated or seen who had caused trouble (either directly by disrupting services or indirectly by the high proportion of service time and resources they consumed). This became a familiar picture. During the visit to the local hospital I saw some problem drinkers in a ward and recognised many of the familiar features of staff frustration, uncertainty and patient familiar- ity with the routine of hospital visits, admissions and contact. I went to the local AA meeting where I met four members. They had been going for six years - - and had only managed to recruit one new

member in the previous two years. They com- mented that it was hard to be anonymous in Mount Isa. I spoke to a group of health, education, welfare and other people who had formed a group to do something about drinking, who had run some seminars and who had set up a contact and counselling service at the local Community Advice Bureau on Saturday morn- ings. They said, with disappointment, that they had had only one customer and so had eventually stopped the service. Quite clearly it was going to be hard to locate the alcoholics and problem drinkers and "do something about them". This had been tried and it had not worked.

While in Mount Isa I stayed at a central hotel. I went to a community reception for visiting dignitaries from Brisbane and to an evening barbecue. The information that I collected on these occasions from direct observation and from discussion suggested that there was a general concern about alcohol consumption overall in the community; that the town sees itself as having a big-drinking image and that some are concerned about this (just as some are proud of it). This experience, together with an increasing awareness on my part, after teaching about alcohol and drugs for some time, led me to think about the need to understand more about so-called "normal" or usual drinking practices and to try to understand the link between them and the drinking practices which are associated with problems.

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In this paper I shall present a rationale for studying community consumption patterns and shall discuss some of the issues and dilemmas associated with this kind of research. I will intersperse aspects of the study with results as I proceed and hope to present some idea of the place of the substance alcohol in the community life of Mount Isa. I have done some replication of this study in Frankston in Victoria and, as with any research effort, this focus has heightened my awareness of drinking practices in the contexts in which I move. From this replication and from my general observations and work, I do think there are some idiosyncratic differences between Mount Isa and other Australian communities and that consumption levels might be slightly higher in the north of Australia than down here in the south. I would not, however, want you to conclude that Mount Isa is a particularly unusual Australian community with regard to alcohol and I suggest that the features which are seen there are also observable elsewhere.

Early work on alcohol problems focused especially on identifying and describing indi- viduals suffering negative consequences of alcohol consumption and making a detailed study of them in an attempt, on the one hand, to explain the cause(s) of their condition and, on the other, to make a retrospective construction of the history of the development and progression of symptoma- tology. There followed a movement from this to include broader health and other consequences such as costs to the community in loss of income, social security benefits, utilization of institutions such as hospitals, courts, goals, and then some consideration of others directly affected by the drinkers behaviour (especially family members) followed. ,-2 More recently work has expanded to include consideration of earlier points of interven- tion and resultant programs such as drink-driver education, industry based projects and alcohol and drug education schemes. An interest in sub-populations such as Aborigines has always been present and this had more recently expanded to include young people, women, children of alcoholics, migrant groups and so on.

A parallel development of community based, epidemiological studies has received attention; some, in part, prompted by a number of official enquiries, and since the early 70's, incorporating other drugs as well as alcohol. 3-~ Australian studies have predominantly been of populations of already identified "problem drinkers" or "alcoho- lics". As writers from other countries have commented, "far less is known about "normal" drinkers than about alcoholics known to treat-

ment agencies",' and Sir Phillip Phillips' com- mented in 1965:

"It is curious to reflect that, apart from literary differences, there does not exist very much modern social and psychological examination of the place and effect of the moderate use of alcoholic liquor upon normal members of modern communities as distinguished from excessive and immoderate uses. Normal social psychiatry tends to limp behind the study of pathological aspects." An expansion of view beyond the identified

alcoholics undergoing treatment emerged, and some understanding of "usual practices" with regard to alcohol consumption began to be identified. Much of this material came from questions about alcohol consumption and related problems in broad, epidemiological studies of general health and mental health in specific populations. Examples include the surveys of local communities or towns that were conducted by the (then) Victorian Mental Health Authority. 8'° There are increasingly broad based attempts to collect useful alcohol related data at a national level, for example the surveys by the Australian Bureau of Statistics in 1974-5" and 1977'2; the National Health and Medical Research Council in 1975"; the Department of Health, 1979'~; and various household expenditure sur- veys.

There have now been a small number of studies here in Australia of specific communities, but as various writers have indicated, satisfactory com- parisons and comprehensive descriptions of Au- stralian drinking patterns are difficult, with little comparability of data collection, contributing to considerable confusion, disagreement and uncer- tainty about conclusions that might be drawn. Drew *', for example, suggests that many data that have been accumulated refer to only one part of the whole picture and that "because of the limitations o f available means of data collection - - surveys of opinion, personal reporting of habits, anecdotes and impressions - - the reliability of much of the data is open to question".

The focus of the present study was on the context of drinking, the patterns of drinking and, like Cahalan and Room, '6 the "patterns of association of variables in a general population segment especially rich in drinking problems." An attempt was made to describe what O'Connor" refers to as the "images of drinking" - - "those expectations, attitudes and particular patterns of behaviour in relation to drinking". She suggests that: In looking at the use of alcohol in a culture it is necessary to have both an appreciation of the

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socio-culmral climate in which drinking takes place, i.e. knowledge and understanding of the social meaning, norms and functions of alcohol in the society, as well as the knowledge of the complications associated with the level of con- sumption on both a societal and individual level."

Numerous writers support this orientation. 1.2° Bacon, in his introduction to the Cahalan and Room 16 work on problem drinking says, "Man in society using alcoholic beverages and having attitudes about the use, is the basis in this field. All too frequently this core, this essential and crucial precondition to all questions and answers, has been forgotten". Edwards et al. TM suggest a rationale: "If as seems likely, problem drinking that leads to personal or social distress is none other than an extrapolation of normal drinking, then study of normal drinking is likely to give useful insights to the roots of a problem of wide social importance".

Given the apparent logic of this position, it is necessary to say that this is not a universally held view, and much of the work of the 60's, for example, was based on an assumption that there

was an intrinsic difference between "normal", "social" drinkers and "alcoholics". This is exem- plified in the following quote, cited by Schmidt et al.2*: "Alcohol and alcoholism are two entirely different subjects . . . . Just as sugar is not the cause of diabetes, alcohol is not the cause of alcoholism". Much research of the past has been guided by single factor explanations of drink related problems and alcoholism. Various cultu- ral, sociological, psychological and physiological perspectives have been adopted in an attempt to explain the etiology of alcohol-related problems. Interest in broadly based explanations of drinking problems and a search for indirect measures of alcoholism prevalence resurfaced after some dis- illusionment with earlier approaches achieved by encouraging "civilized" drinking: such healthy drinkin.g habits would be introduced as a kind of immumzation against irresponsible drinking behaviour?

An evolutionary development of the single distribution of consumption theory first proposed by Ledermann ~ in the mid 50's, especially by the Ontario research group, 2''2'-~ led to a focus on

Table 1: M o u n t I s a - - Alcohol consumpt ion and associated problems

The env ironment (place) - - the pe_ople

ALCOHOL CONSUMPTION PATI'ERNS ]

POSTAL SURVEY School survey.~ Attitudes (drink, [ drunk, gender). Group interv. | Consumption. School / Drink/Abstain, Community Stated reason, I Location, Teacher survey~ Company, I Time of day, Observation ] Frequency, Amount. (Beer, wine, spirits) (Container) Problems MAST Demographic Age, sex, mar. stat. country birth, eml~loyment, accom, i n c o m e , e c l u c a t l o n ,

time of residence in MI I

[ GROUPS SURVEY. I

I INDIRECT MEASURES. ) eg: AIc sales. |

/ I

IHOTEL & CLUB SURVEY~

[ ALCOHOL ASSOCIATED PROBLEMS[

General morbidity mortality.

I I GPs survey

I Hospital survey.

1 Coroner's records.

1 "Visitlng" nurses.

Agency case [ survey.

I "Gatekeepers"

I survey ] SW, Clergy, ~Teachers, [Police.

I I ~ of Commerc~

I Mt. Isa Mines Health Screening Accidents Absences MAST

I Uniform stats] ]

[Court records~ I

Probation & [ Parole case survey.

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alcohol control policies in preference to attempts to change individual attitudes and behaviour in relation to drinking. ~~ Ledermann concluded that a lognormal distribution describes consump- tion and that the dispersion of alcohol consump- tion can be predicted by the mean. From this, it followed that the proportion of heavy drinkers in any population actually depends on the mean of consumption; so that, if the mean per capita consumption in a population could, for example, be lowered there would be fewer heavy drinkers and, (from linkages between this and "damage") reduced drinking problems.

There have now been numerous persuasive arguments challenging the Ledermann model on a variety of grounds, ~" but although somewhat discredited as a mathematical model, this theory remains a potent influence on the development of public policy in this field. It has served to facilitate a broadening of focus away from the particular perspective of the clinician. By challenging old assumptions that "alcoholics" are a distinct and unique group, it has led to a consideration of total consumption and the influence that the drinking culture or environment has on an individual's drinking behaviour.

The study reported here has attempted a consideration of both drinking patterns and associated problems. To consider, on one hand, only those identified as alcoholics, or overall consumption on the other, would be insufficient. As Colon et al." suggest: "It appears futile to develop a prevention strategy that touches only on alcohol consumption without addressing atti- tudes, social conditions and urbanization fac- tors".

Subjects and Methods

Multiple methods were used in data collection and analysis. They are shown diagramatically in Table 1, which gives some indication of the size of the task undertaken and the wealth of the data collected. There are two major "streams" of interest: one being alcohol consumption patterns and the "culture" of alcohol; the other, evidence and expression of problems associated with alcohol in the four major areas where patients, clients or customers (or their friends, relatives or associates) are likely to be noticed: health, welfare, employment and crime. For each of these target segments a variety of data collection methods and instruments were used. For the health area they included general morbidity and mortality data; a survey of general practitioners; a survey of the hospital patients (casualty, in- patients and out-patients); a review of coroner's

records for the year of the study; and contact and case study of patients of the visiting nursing service.

Welfare data were more difficult to collect and included an attempted case finding exercise over a one week period through all agencies, and a survey of those responsible for delivering welfare services. In the employment sector a major study was undertaken with the cooperation of Mount Isa Mines Limited, the major employer in town. This included a sample of all employees' health and accident records (which included information relating to alcohol consumption, though spasmo- dically recorded); and the use of the Michigan Alcohol Screening Test (MAST) in the Occupa- tional Health Section.

With all the weaknesses of a postal survey in mind and after much consideration (and following an initial data collection period in the town) it was decided to proceed with this in an effort to establish some baseline data against which other material might be compared. The electoral roll was used as the sampling frame since we were most interested in those 18 and over. Some groups were therefore under or un-represented - - mig- rants who were not naturalised; unregistered adults; Aboriginals for whom voting is not compulsory and all those who had recently moved to the area.

Using Slonim's criteria ~5 a sampling procedure was adopted aiming to get at least 214 responses for an adult population of approximately 14,500. Three times that many were posted in the hope that at least a one-third response rate would be obtained. At the same time a comprehensive demographic profile of the community was completed so that we had good knowledge of the bias in the sample of respondents. This bias, as it turned out, was minimal. Slightly more women responded and fewer recent arrivals in the town did so than would be expected given the population profile. The response rate was 37%. The questionnaire covered four major areas: attitudes to drinking, drunkenness and to men's and women's drinking; consumption of alcohol; problems; and demographic data. Consumption of alcohol variables considered included: drinker status, stated reasons for drinking, location of drinking, company when drinking, time of day, frequency of drinking occasions, amount con- sumed on those occasion and beverage preference.

Results Half of the respondents were male and half

female; 82% were married and 75% were Australian born (with another 10% coming from

English speaking countries); 58% were employed full time, 10% part-time and 22% were in home duties. Of those who were employed, 30% were employed by Mount Isa Mines Ltd. above ground and 12% below ground (total of 42% of those employed); 25% were employed in the private sector and 13% were self-employed with 12% employed in government positions. Over a third of the respondents were in an income bracket of $20-30,000 per year which is higher than for Queensland or for Australia overall.

The respondents' drinking habits are presented in Tables 2-10. Some 90% of men and 75% of

Table 2: Drinker status x sex

Male Female No. % No. %

DRINKER 105 90 86 75 ABSTAINER 12 10 28 25

117 100 114 100 231

51% 49%

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women drank alcohol (Table 2). Drinkers were spread fairly evenly over all age groups (Table 3). The only exception was for women aged 46-55 when 28% were abstainers. From Table 4 it can be seen that men preferred beer and women were more likely to drink spirits, and wine (with beer as

Tab~4: Beveragepreference x sex

Male Female No. % No. %

BEER 79 77 23 29 SPIRITS 15 14 30 38 WINE 9 9 26 33

Total 103 79 182

their third preference). Beer was, however, less popular in the younger age groups where spirits were equally popular (Table 5).

No respondent admitted to morning drinking, though some did answer the MAST question relating to before noon drinking positively (Table 6). This apparent discrepancy is thought to be

Table 6: Usual time of drinking

No. %

Mornings 0 0 Lunch time 1 1 Afternoon 12 6 After work 63 33 At dinner or tea 51 27 After dinner or tea 62 33

Total 189 100

Table 3: Drinker status x age

18-25 26-35 36-45 46-55 56 & over No. % No. % No. % No. % No. %

DRINKER 39 87 52 80 55 86 28 72 15 94 ABSTAINER 6 13 12 20 9 14 11 28 1 6

45 100 65 100 64 100 39 100 16 100 229

Table 5: Beverage preference x age

18-25 26-35 36-45 46-55 56 & over No. % No. % No. % No. % No. %

BEER 15 39 28 55 30 58 17 61 12 93 102 56% SPIRITS 19 50 12 23.5 11 21 2 7 1 8 45 25% WINE 4 11 11 21.5 11 21 9 32 0 0 35 19%

Total 38 51 52 28 13 182

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explained by the nature of shift work and the proportion of morning drinkers consuming after work (though still in the morning). Given the more socially acceptable category - - drink after work - - it is likely that this would have been the chosen one for those drinkers. The most common times for drinking alcohol were after work (33%), with dinner or tea (27%) and after dinner or tea (33%).

Table 7: Usual location of drinking

No. %

Own home 101 53 Home of friends or relatives 16 8.5 Restaurant 10 5 Hotel 16 8.5 Club 28 15 Out of town (Outdoors) 2 1 Other 17 9

Total 190 100

The most usual location for drinking was at home (53%) (Table 7). Given the climate and social life of the community the Australian barbecue is a feature of town life. From observa- tion and discussion it is apparent that a number of social norms and customs surround these occa- sions with regard to alcohol consumption. It is expected that you take alcohol to consume. It is

~ oled and you are not expected to consume more an you take. The common expectation of what

constitutes a 'reasonable' amount to take along is a least six "stubbies". It was also observed that many homes had a second refrigerator located, usually, in the barbecue area and there predomi- nantly and often exclusively for alcohol storage. It is worth pointing out that Mount Isa has a stabilising population profile with more people remaining for longer periods, more married people and families and fewer single men than was the case some fifteen and more years ago. This is a factor in moving drinking locations to homes and away from the public drinking locations.

The second most popular location for drinking was a club: 15% usually drink there. Hotels were less popular with only 8.5% indicating this was the usual venue for drinking. Clubs are generally more congenial environments for members since they have lower prices for alcohol, longer trading hours and whilst exclusion on the grounds of race, gender or any other feature is not possible and not apparently practiced, the very nature of clubs and

their geographic location together with minimum dress requirements and other structural factors effectively mean that the compositon of the patrons/members in somewhat different to that of most hotels. The most popular club in the city has a membership of approximately 7,500 adults who pay an annual membership of $10.00. The facilities offered are comprehensive and of a high standard with comfortable seating, meals service, games areas, special events and a large screen television. As one of the administrators said: "We have better facilities, better prices, better be- haviour and better people."

Three of the four corners of the central block of the city are dominated by hotels. Three other hotels are located in surrounding areas. They vary in size, quality and patronage. All have large drive-in bottle shop sections which, given the popularity of drinking at home, constitute an important part of their sales. Much of the beer is sold in cartons, that of 2 dozen stubbies being the most common. The bottle shops have a wide range of exotic liquors reflecting, in part, the broad ethnic background of the population. In the bars and lounges of these hotels one can obtain counter meals (and competition being acute, the quality is generally good). The practice of "shouting", especially in "rounds" in these settings contributes to significant alcohol con- sumption with, for example, someone in a "school" of four, drinking stubbles, going two rounds consuming eight drinks. When one calculates this quantity in standard drink measures however, the amount consumed is closer to fifteen drinks than to eight. This is a point that we need to address in our community education programs.

Some drinking was done outdoors other than at barbecues, for example at the two lakes associated with the city and at sporting functions. It was noted that following the weekly run of some of the running clubs, the participants congregated around a source of alcohol ("to replenish the liquid which had just been run off"). The other noteworthy feature of outdoor drinking was the consumption by aboriginal groups in the local dry riverbed and surrounds. It is apparent that aborigines are identified by the local people as being the "problem group" with regard to alcohol. They are more likely to drink in public places and outdoors where they are most obvious and visible to the community. Their practice of sharing drinks is also different to the white

drinking. For example, it is common a group of, say, eight aboriginal men to buy a

flagon of wine (sold and advertised actively in all the bottle shops) and proceed to the fiver bed

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where they sit in a circle and pass the flagon around. Many whites regard this as a deviant practice and an indicator of problem drinking. It is worth pondering the comparison with the group of four men, standing in a bar drinking in a round only some short distamce away. I believe that much of what is identified as the "'problem of aboriginal drinking" in this community is related to issues of different practices and different cultures as it might be to dramatically different consumption levels over time. A previous paper on this subject has been published elsewhere, s

The other major occasion for outdoor drinking in the town was the annual rodeo. Sponsored by the local Rotary Club, it represents a high point in the social life of the city and many come from afar to join in the three day event. Alcohol sales in hotels and clubs increase during this weekend as well as the sales at the rodeo itself. Beer sales from the Rotary booths in 1982 were 1,900 cartons (of2 dozen stubbies), and an additional amount of alcohol was sold in the form of rum and whisky.

Forty-one percent ot respondents usually drank with their spouse and thirty-six percent with their

Table 8: Usual drinking company

No. %

Alone 14 7 With friend(s) 69 36 With spouse 77 41 With other relatives 9 5 With work mates 13 7 Other 8 4

Total 190 100

friends (presumably not necessarily mutually exclusive categories!) (Table 8). Only 7% re- ported usually drinking alone.

In the inquiry about the gender of drinking companions (Table 9), there was a significant difference between the response to the respon- dent's "usual" practice and the "last time they drank": 78% said that their usual companion group comprised both sexes, while only 56% actually drank in mixed company on the last occasion. From observation I would suggest that the last occasion is a more accurate reflection of practices that the "usual" statements. The diffe- rent could reflect some social sensitivity to the questions.

In categorising the quantity and frequency of drinking we used the scheme suggested by the Commonwealth Health Department": Light : less than 50ml. per day Medium : at least 50ml. per day but less than

100ml. per day Heavy : at least 100ml. per day but less than

150ml. per day Very Heavy: at least 150ml. per day.

From Table 10 it is evident that 10% were in the heavy and very heavy consumption groups. It is worth noting that this is likely to be an underestimate as there is considerable evidence that people understate their alcohol consumption on questionnaires and also worth noting that this sample was slightly skewed in the direction of those who are the lower drinking groups in the community (women). Many who drank beer did so directly from stubbies which contain 375 ml. and are not, therefore, "standard drinks" of 200 ml. We thought it important to account for this in the survey, as it made a significant difference to the calculation of consumption for individuals.

Table 9: Gender of drinking companions

Usual drinking companions x last occasion drinking companions

LAST With men With women Men &: Women

USUAL only only together Total

Alone No. %

With men only 15 2 4 4 25 13 With women only 0 4 1 0 5 3 Men and women together 29 16 100 5 150 78 Alone 0 0 1 10 11 6

Total No. 44 22 106 19 191 % 23 11.5 55.5 10

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Table 10: Amount and frequency of alcohol consumption

* Calculated with consideration of container size for beer, wine, spirits. Adjusted accordingly.

Less than 5 or more 5 or more 5 drinks/ less than at least occasion, once/month once/month

No. % No. % No. %

5 or more at least

once/week No. %

Total

No. %

NIL 45 21.8 0 0 0 0 0 0 45 19.1 LIGHT 128 62.1 2 67 1 50 7 29.2 138 58.8 50 mls. or less/day MEDIUM 21 10.2 1 33 1 50 6 25 29 12.3 51 mls. - - 100 mls/day HEAVY 9 4.4 0 0 0 0 3 12.5 12 5.1 101 mls. - - 150 mls/day VERY HEAVY 3 1.5 0 0 0 0 8 33.3 11 4.7 151 mls. or more/day

Total 206 3 2 24 235

In interviews with residents the most common- ly suggested reasons for their preference for stubbies was size and ease of "handling". One resident explained: "in a climate like this, you have to drink little bottles because if you tried to drink a large bottle the second half would be too hot before you got to the bottom!" The advertising poster featured on a large billboard just out of town on one of the main roads also suggests the use that these features are put to in promoting beer. A stubby is being held and drunk, with the caption reading: The drink that comes in its own container".

The scores for the MAST (Table 11) have been categorised according to the original method of Seizer. From this table it is apparent that 23% of

Table 11: Problem(s) with alcohol consumption

M.A.S.T. Scores

No. %

No apparent problem (Normal) 147 62.6 Possible alcohol related problem(s) ('Suspect Alcoholics') 33 14 "Probable" alcohol related problem(s) ('Alcoholics') 55 23.4

Total 235 100

the respondents were in the group we have called "probable alcohol related problems". The correla- tion between alcohol consumption and the MAST score was not strong though, with 24% of the "probable alcohol related problems" group in the heavy and very heavy drinking groups.

Discussion Most people in Mount Isa drink alcohol. Many

drink heavily. Some have problems with this drinking. It is not possible to present all the results of the study in this paper. I have attempted to present some of the results arising from the postal questionnaire. Recognising the weakness of this methodology and the sample size, it is necessary to consider these data together with those collected from the other sources before drawing broad conclusions or inferences about these figures.

The major value of this study has probably been to attempt to understand the place of alcohol in the social and cultural life of a city; the way it is used and misused or abused and the problems, both acute and longer term, that it might cause for individual residents, their families and the com- munity as a whole. Alcohol is certainly an integral part of the social life of the city. Almost all social events, from civic receptions to sporting events and primary school fetes, are associated with alcohol consumption. Some of the residents of this city are concerned about subtle and obvious shifts in drinking practices and patterns. As one

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said: "In the old days we used to sing and drink, now we just drink".

This work suggests that there is some value and a need for us to understand better the "usual" drinking practices of our community; to better know what the culture of drinking is. This has implications for prevention strategies at all levels; both formal and informal. Community wide programs certainly need to address these issues. From a study such as this it is much easier to identify target groups, behaviours, venues and alternatives.

Intense observation and study of a community produce data which are rich and valuable. There are observations that would not have been gained by one approach to this community: for example, there is only one tap in the city area which is publicly accessible. In a place that is hot and often unpleasant, the need for outlets of drink of various kinds is obvious. That the most apparent and the most accessible outlets are hotels probably contributes to the fact that alcohol is the drink that many groups interviewed are most likely to use, paradoxically, to quench their thirst.

Much evidence from this study and elsewhere suggests that young people are drinking more than their age cohorts in the past. Though trite, it is true that the youth of today will be the adults and parents of tomorrow. We might well spend more time on examining our usual drinking practices and the attitudes and beliefs and culture that we are handing down.

A number of methodological problems emerged in the course of this study. One was the range of beverages and the size of standard containers or measures in common usage in Australia. Especial- ly for beer, this is a problem in the calculation of amounts and what we should portray as safe levels in health education programs. Controversy still surrounds the question of how much alcohol can be safely consumed. In a recent Australian text,

Krivanek ~' says: "Most authorities agree that an intake of 60g per day (about 80 ml) puts the drinker at risk for physical and psycho-social

roblems ' '. More recent evidence suggests that the vels set here might now warrant review in

relation to what might be called heavy and very heavy drinking. Recent suggestions would put these levels lower and thus include more drinkers in these categories. Attempts to develop an acceptable, standardized form of describing and classifying drinking behaviour continue. '~°

There are many difficulties inherent in a study such as this. I have not attempted to address all of them or to present a comprehensive view of the results. What I hope is that we might increasingly take an interest in a range of research methodolo- gies, locations and foci in an effort to expand our view and understanding of the complex jigsaw that, when pieced together, means some people have a lot of trouble with their use of alcohol and this community overall has a lot of trouble with the way in which many drink. I think any research which can contribute to enriching the knowledge we have of distinctive Australian drinking prac- tices is important.

Correspondence and requests for reprints to: Margaret Hamilton, Lecturer, Department of Social Studies, University of Melbourne, Parkville, Vic. 3052.

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Table 12: Alcohol consumption/day x M.A.S.T. score

No apparent problem Possible problem(s) Probable problem(s) No. % No. % No. %

NIL 42 28.6 3 9.1 0 0 LIGHT 82 55.8 28 84.8 28 10.9 MEDIUM 13 8.8 2 6.1 14 25.5 HEAVY 5 3.4 0 0 7 12.7 VERY HEAVY 5 3.4 0 0 6 10.9

Total 147 33 55

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