Age-specific trends in risky drinking in Germany: collectivity or polarisation?

Introduction According to Skog's collectivity of drinking cultures theory, changes in alcohol consumption in all groups and strata of the population take place as parallel displacement in the distribution of consumption. The aims of the present paper are (1) to illustrate temporal trends in risky drinking and episodic heavy drinking by age and gender and (2) to examine whether the trends are parallel in all age groups ("collectivity") or diverge between age groups ("polarisation"). Methods The data are based on nine surveys of the Epidemiological Survey of Addiction (ESA) between 1995 and 2018. Risky drinking was defined as daily consumption of more than 12 g (for women) or 24 g (for men) of pure alcohol and episodic heavy drinking as consumption of five or more glasses of alcohol (about 70 g pure alcohol) on at least one day in the past 30 days. Linear regressions were calculated separately for age groups (18-29, 30-39, 40-49, and 50-59 years) and gender to predict the temporal effect on risky drinking or episodic heavy drinking and to test trends for differences. Results The temporal changes of risky drinking by age group show soft collectivity among men and polarisation among women. Trends in episodic heavy drinking indicate polarisation for both genders; while the prevalence increased in the youngest and oldest age groups, it decreased in all other age groups. Discussion In light of a general decrease, the increasing trends in risky drinking in specific groups indicate the need for strengthening behavioural prevention. For the positive development to continue and to avoid a trend reversal, public health measures such as alcohol tax increases and reductions of alcohol availability need to be intensified.