Young binge drinkers may get most of the newspaper headlines, but alcohol consumption in middle-aged men and women is an increasing concern. In the UK over the past couple of decades, alcohol-related death rates have doubled for both men and women aged 35 to 54.
The drinks industry tends to characterise excessive drinking as a problem only for a tiny minority, seeing everyone else as responsible drinkers. But about one quarter of men in their thirties and forties report having drunk more than eight units (four pints) in a day in the past week – anything beyond which is seen as binge drinking.
Research we recently co-authored explores how men and women in mid-life view alcohol consumption, and their attitudes and experiences of drinking to excess. We conducted discussions with 15 groups of friends or colleagues aged 30 to 50 years, amounting to 60 people in total. Our intention was to use this information to come up with pointers for how government health campaigns around alcohol could improve in future.
In the zone
Most participants were able to draw on their experiences of drinking over at least a decade or two. They described themselves as being “in the zone” when they felt they had drunk enough to feel relaxed and sociable, but not so much that they couldn’t function properly. They described their enjoyment of being with friends who were drinking at a similar rate.
Rather than counting units of alcohol, participants described monitoring changes in their body as ways of moderating their drinking. This way they could slow down or stop drinking before they felt they had passed the point of no return. Women described a range of sensations in their bodies more clearly than men when they reached a certain level of intoxication, and were more likely to say they stopped drinking as a result.
Really older and wiser?
Participants talked about planning their drinking around responsibilities to their jobs and families, as well as when they would next need to drive. This meant that drinking in mid-life was often more home-based and often curtailed during the week.
Our research challenges the notion that peer pressure only applies to young people. Participants described how their intention to stop drinking was sometimes not accepted by friends and colleagues. This was illustrated through repeated chants of phrases such as, “go on, go on, go on”, “one for the road” and “just leave the car” when they tried to decline a drink.
The people in our study discussed times when they made sure that they had an “acceptable” reason for not drinking, such as having the car or detoxing, as simply declining another drink was otherwise often ignored by their peers. This suggests that heavy drinking in the UK, at least at weekends and holidays, is associated with sociability in mid-life. Indeed, not drinking is the behaviour which requires explanation.
Drinking and male friendships in mid-life
For the men in our study, drinking pints of beer together in the pub was seen as an important part of making and maintaining male friendships. Buying rounds – where each man in turn bought drinks for the group – was part of pub etiquette, and sometimes led to excessive drinking.
The jokes and insults involved in many male drinking sessions were frequently retold in the interview context. What was particularly surprising was that men spontaneously discussed the role that drinking in the pub played in maintaining their mental health. Although participants were aware that alcohol was a depressant, laughing and joking with friends while relaxing over a drink was described as uplifting. This was seen as particularly important for men, given their poorer mental health compared to women.
As one man said: “If you go out with your mates, have a few drinks, it’s great for your mental health. You don’t feel lonely, you don’t feel sad or depressed, it always cheers you up … You need your mates to keep you sane.”
This suggests that viewing drinking as an “act of friendship” can lead to both potentially health-damaging excess but also potentially health-promoting behaviour in the form of sharing emotions and supporting friends.
Sensible drinking campaigns
Government drinking campaigns tend to treat excessive drinking as irrational and caused by lack of self-control, while focusing almost entirely on negatives. But as we found in our study, middle-age drinkers view their drinking as a rational and often enjoyable activity within the context of busy lives. They make time for drinking sessions as a way of winding down and giving themselves a reward. In their eyes, it is the binge-drinking youths that are the irrational ones. Unless campaigns acknowledge this viewpoint, they are unlikely to be heard.
None of this will be news to the drinks industry, it must be said. Their advertising messages targeting what they claim to be the vast majority of responsible drinkers regularly link drinks to relaxation and reward. So long as public health planners make finger-wagging their priority, they are missing a trick here. The rates of alcohol-related damage in middle-age may well keep rising as a result.