Perceptions of alcohol health harm among midlife men in England: a qualitative interview study

Abstract

In recent years attention has been directed at harmful levels of alcohol consumption among middle-aged and older people. In England, midlife men are over-represented in the social patterning of risk of alcohol harm. Insights into midlife men’s understandings of alcohol harm are limited, and research suggests poor effectiveness of existing alcohol education messaging and guidance. A better understanding of the ‘lay epidemiology’ of alcohol health harm can inform and thus enhance the effectiveness of public health and alcohol education measures. In-depth individual interviews were undertaken with 42 men aged 45–60 drinking over 240 grams (30 UK units) of alcohol per week. The men’s perceptions reflected three dimensions of how alcohol health harm: 1) is experienced and perceived, 2) is understood to work and 3) is best managed and communicated. The harmful bodily effects from alcohol were recognised in ‘problem drinkers’ and as acute effects. The men understood the effect of alcohol as a poison linked to excessive consumption or when consumption was continuous. Alcohol health harms were understood in relation to wider lifestyle behaviours and the men requested that public health advice should give them choices, and not simply tell them what to do. The men had a limited understanding of how alcohol affected their bodies and, drawing on the medical anthropological concept of ‘explanatory models’, it is suggested that providing clear and accessible explanations of how specific alcohol-related health harms occur may help people to make informed choices of moderation and improve the effectiveness of public health messages.

Keywords:

• Alcohol
• midlife men
• health risk
• risk perceptions
• England

Acknowledgements

We wish to thank the men who agreed to take part in this research and with such richness shared their views and understandings with us. We also thank The Drinkaware Trust and its Board and Research and Impact Committee for their belief in the critical value of research and investment to make this innovative study happen.

Disclosure statement

This research was funded by the UK alcohol education charity The Drinkaware Trust, through the salaried position of Dr. John Larsen as the charity’s Director of Evidence and Impact and payments to independent researchers Dr. Simon Christmas and Amanda Souter. Drinkaware is funded primarily by voluntary and unrestricted donations from UK alcohol producers, retailers and supermarkets, through an agreement between the UK government and the alcohol industry. The charity is governed independently by a Board of Trustees. The funders of Drinkaware had no involvement in or influence over the research.

Additional information

Funding

This work was supported by the The Drinkaware Trust.