Journal of Public Health | Vol. 32, No. 4, pp. 512 –518 | doi:10.1093/pubmed/fdq008 | Advance Access Publication 3 March 2010
Why do people drink at home?
John Foster1, Donald Read2, Sakthidaran Karunanithi3, Victoria Woodward4
1
Family and Mental Health, Greenwich University, London, UK
NW School of Public Health, NHS Cumbria, UK
3
NW School of Public Health, North Lancs PCT and North West Strategic Health Authority, Lancaster LA1 1QD, UK
4
Addictive Behaviour, Glyndwr University, Wrexham, UK
Address correspondence to John Foster, E-mail: [email protected]
2
A B S T R AC T
trend for adults to consume alcohol “at home”. To date this is a development that has received little research attention.
Participants and Methods Four focus groups (FG) of current drinkers who drank at home and reflected the views of both genders, differing
age bands and living arrangements were conducted. The setting for the study was an economically deprived seaside resort in the North-West
of England. Each focus group had two facilators and was taped, transcribed and subject to thematic analysis. FG A: (n¼15; 9 males, 6 females)
young people aged 13–21. FG B (n¼4, 1 male, 3 female) volunteers aged 30–50 some of whom had children and were in relationships. FG C
(n¼15, 6 males, 9 females) recruited from a residents association-aged 25–70. FG D (n¼4, 1 male, 3 female), aged 20–30 recruited through a
local Lesbian and Gay Group.
Results The principal reasons for drinking at home concerned convenience, these included cost, safety, social occasions, fear of under age
drinkers, child-care, relief of stress. Lesser themes such as the smoking ban also emerged.
Conclusions These findings provide data of import to researchers and public health professionals to allow them to produce and target public
health messages that take into account that the majority of drinking now takes place “at home”.
Keywords alcohol consumption, public health, young people
Introduction
In a recently conducted systematic review, it was estimated
that alcohol consumption was responsible for 31 000 deaths
in the UK in 2005 and that the cost of alcohol consumption
in 2005 – 06 was £3.0 billion.1 Furthermore, Sir Liam
Donaldson2 outlined a number of harms caused by ‘passive
drinking’. These were crime, family breakdown, fetal alcohol
syndrome, sexual assault and rape, noise and disruption,
over burdened NHS, problems at work, unemployment, intimidation, marital problems and drink driving. One of his
recommendations to tackle this after similar developments
taking place in Scotland was to introduce a minimum price
of 50p per unit of alcohol, following the results of a report
from the University of Shefﬁeld.3 This has also been one of
a number of recommendations made in a recent report by
the British Medical Association with the aim of reducing
512
drinking in young people.4 The rationale for the 50p cut-off
is that this would have a signiﬁcant impact upon heavy drinkers and young people whilst increasing the cost of alcohol
for ‘controlled drinkers’ only a few pence per week. The
importance of Donaldson’s proposal is that it posits a
general population approach towards the costs of tackling
alcohol-related harm that would involve a paradigm shift in
UK alcohol policy as illustrated by this quote from Gordon
Brown (the UK prime minister) the morning following
the release of Donaldson’s report. ‘We don’t want the
John Foster, Principal Research Fellow
Donald Read, Speciality Registrar Public Health
Sakthidaran Karunanithi, Consultant, Public Health
Victoria Woodward, Senior Lecturer
# The Author 2010, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.
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Background The past 30 years have seen a shift in the culture concerning the consumption of alcohol in the UK. One of these is the increasing
W H Y P E O P L E D R I NK AT H O M E
Participants and methods
The study received ethical approval from the Middlesex
University School of Health Studies-Heath Ethics
Sub-Committee. The research governance department for
Blackpool Primary Health Care Trust (PCT) approved this
on the proviso that no participants were recruited through
the PCT and that PCT premises could not be used when
conducting the research. Blackpool has a population of
150 000, is one of the most densely populated areas of
the England outside of London and was once the most
popular seaside resort in the UK. However, over time, the
resort has gone into steep economic decline and is now
heavily reliant on stag and hen parties to maintain it as a
viable 12-month destination.11 It has far higher than
national/regional average alcohol mortality and morbidity
rates and these tend to be concentrated in the most deprived
areas of the town.12
The current project employed a qualitative methodology;
in this case, four focus groups (FGs) to explore the reasons
why the participants elected to drink at home. All the participants were current drinkers who drank both within and
outside the home. The aim was to collect a sample that
could reﬂect the views of both genders and differing age
bands. Attempts were made to collect more precise data
relating to age, educational marital/employment status and
income but there was some reluctance to provide these data
in three of the four groups and thus a broad sketch of the
proﬁle of each group is provided only. All the participants
agreed to take part in the FGs after having been shown a
participants information sheet and signed a consent form to
the effect the proceedings would be taped and transcribed.
but their anonymity would be maintained. All four groups
were recruited through Blackpool-based voluntary sector
organizations or residents groups via personal contacts of
the research group. The ﬁrst group were young people
(n ¼ 15; 9 males, 6 females) aged 13 –21. Some were still
living at home but none had children. A group of volunteers
(1 male, 3 females) aged 30– 50, some of whom had children and were in relationships from a Blackpool-based
charity comprised the second group. Another large group
(n ¼ 15; 6 males, 9 females) were recruited from a residents
association of what they themselves described as a workingclass housing estate. The age of the participants ranged
from 25 to 70 with the majority being clustered at 50þ.
The ﬁnal group (n ¼ 4; 1 male, 3 females) (age range 20 –
30) were recruited through a Lesbian and Gay Group. All
were currently working, in relationships and one of the
women had a child.
Each FG was conducted with two facilitators, one who
predominantly observed and took notes and the other who
facilitated the discussions. A series of themes/prompts were
provided for each group as follows:
†
†
†
†
†
Why do you drink at home?
On what occasions do you drink in licensed premises?
What are your beliefs concerning home drinking?
Who makes the decision to drink in your household?
What are some of the rituals that surround the drinking
that takes place at home?
The discussions were free-ﬂowing and organic, and in practice, this structure was rarely followed in a linear fashion.
This paper predominantly reports discussions that emanated
from the ﬁrst and second bulleted themes. Each group was
taped and subsequently transcribed. Thereafter, it was analysed by the ﬁrst and second authors independently who
agreed the themes that emerged. A procedure was in place
for the third author to act as an arbitrator in the case of a
dispute. In the event this was not required.
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responsible sensible majority of moderate drinkers to have
to pay more or suffer more as a result of the excesses of
the minority’.5 The British have been heavy episodic/binge
drinkers for many centuries,6 though Foster7 has pointed
out that there have been a number of signiﬁcant changes in
drinking culture in the UK over the past 30 years. One of
these is the shift towards drinking away from licensed premises. Despite this, the original Alcohol Harm Reduction
Strategy for England8 (AHRSE) did not refer to drinking
away from licensed premises. This omission was rectiﬁed in
the second national strategy document—‘Safe, Supportive
and Social’,9 which recognized that home drinkers do
present a signiﬁcant health burden.
To date, the reasons why adults elect to drink in nonlicensed premises are largely speculative and anecdotal. It is
thought that cost and convenience are two of the key variables, particularly in those individuals who have young children. There also may be certain activities which have
become increasingly linked to home drinking, such as family
parties and barbecues. Research has also shown that a
number of key local authority personnel believe that for
older people by which they mean 30þ and those with
young families, town centres are becoming increasingly unattractive to visit as they are perceived to be overwhelmed by
young binge drinkers.10
This paper uses a qualitative methodology to examine
some of the reasons put forward for drinking away from
licensed premises by male and female participants in the age
range 13 – 75.
513
514
J O U RN A L O F P U B L I C H E A LTH
Table 1 Themes for drinking away from licensed premises by gender and age
Theme
Number of
Gender, n (%)
Age bands, n (%)
Males
Females
15
times discussed
16 –25
26– 35
36– 45
46– 55
56– 65
.65
Convenience
36
20 (55)
16 (45)
1 (3)
6 (17)
12 (33)
6 (17)
10 (27)
1 (3)
0
Cost
34
21 (61)
13 (39)
2 (6)
5 (15)
12 (35)
3 (8)
9 (26)
2 (6)
1 (4)
Safety
33
20 (60)
13 (40)
3 (9)
3 (9)
7 (21)
3 (9)
8 (25)
6 (18)
3 (9)
Social occasions
29
11 (38)
18 (62)
1 (4)
9 (30)
10 (34)
2 (8)
5 (16)
1 (4)
1 (4)
Child care
18
4 (22)
14 (78)
0
3 (16)
9 (52)
3 (16)
3 (16)
0
0
Stress/reward
13
5 (39)
8 (61)
0
1 (8)
6 (46)
3 (23)
3 (23)
0
0
Fear of under-age drinking
11
3 (27)
8 (73)
0
0
4 (36)
6 (54)
1 (10)
0
0
Smoking ban
6 (60)
4 (40)
1 (10)
3 (30)
4 (40)
1 (10)
1 (10)
0
0
4
1 (25)
3 (75)
0
0
2 (50)
2 (50)
0
0
0
Drink driving
4
2 (50)
2 (50)
0
0
0
1 (25)
3 (75)
0
0
Pre-loading
4
0
4 (100)
0
1 (25)
2 (50)
1 (25)
0
0
0
The data for the age bands have been assigned retrospectively after consultation with the facilitators of the FGs (D.R. and S.K.).
The themes were derived by two reviewers afﬁxing codes
with reference to the transcripts and ﬁeld notes and as a result
identifying similar phrases and identifying them as themes
according the principles outlined by Miles and Huberman.13
The group facilitators (D.R. and S.K.) were able to
provide information from the transcripts that allowed the
group to construct Table 1, which provides an age and
gender split for the comments made.
Activities that involved drinking at home which were also
discussed, each time by male interviewees—these were,
drinking games, listening to music and playing computer
games. Also included in this theme is the fact, predominantly discussed by women, that there was no need to order
taxis.
Cost
Results
There were a number of themes that emerged from the FG
discussions. A summary of the themes and the gender and
age distribution of the comments are shown in Table 1.
They are presented in order of the most frequently mentioned theme ﬁrst etc. and each theme is accompanied by an
illustrative quote. There was a discussion in FG 1 concerning street drinking that largely related to under-age drinking
and this is qualitatively different from other forms of home
drinking, thus it is not reported here. A fuller presentation
of the data is available in a report published on the Alcohol
Education and Research Council website www.aerc.org.uk.14
Convenience
The theme of convenience was common for both genders
and for individuals aged 16– 55. It is illustrated by a quote
from a woman in her mid-50s from a residents association.
You can relax more at home. You don’t have to wait at the bar to be
served; you can just go and get yourself a drink. You sit down and you
are pretty much there for the rest of the night.
There was a strong link between convenience and many of
the other themes. Cost was discussed most frequently by
males and individuals aged 26 –35 and 46– 55. The majority
of alcohol purchased was bought in supermarkets or local
off licences as illustrated by the following quote from a male
in his mid-30s in a relationship but having no children.
I have found this week that I have brought more alcohol than I have
ever brought in my life because it was cheap. It was a heck of a lot of
more than I with normally buy. It was two litre bottles for £20 last
week and this week it is 7 pound a bottle. I end up buying double or
triple I would normally buy because I’m saving some money on it.
Young people under the age of 18 displayed a very different
type of drinking. It was a common place for them to club
together their monies to buy more alcohol as illustrated by
the following quote.
When you are out with your mates if there are 10 or 15 of you, if you
all put in a tenner that’s £150 between 15 of you to spend on booze
so when you’re out and everyone buys booze just with that £10. Say
like. . . how much is a bottle of vodka now, about £10 or something?
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10
Accompany to food
W H Y P E O P L E D R I NK AT H O M E
Safety
Also linked to the idea of convenience was the belief that
drinking at home was safer than going out. This tended to
manifest itself in different ways and was discussed more
often by men and individuals in the age ranges 26 –35 and
46 –65. The majority of comments related to a belief that
pubs were often unpleasant and violent. There were some
speciﬁc concerns: younger women believed they were often
short-changed in terms of measures of spirits in pubs or
they were watered down. Another perceived the danger
from pubs was having your drink spiked—again this was an
issue for both genders. The quote relating to this is from a
young gay man.
theme that was more likely to be discussed by young
women and is also linked to convenience. The quote below
is made by a woman in her early 30s with no children.
I think if I have had a particularly stressful day at work. I will get in
the bath and open a bottle of wine.
Fear of under-age drinkers
This was a theme that tended to be discussed by females
and those aged 46 –55. The quote below is from a male in
his mid-50s. Most of these comments came from members
of the residents association. They perceived that a lack of
safety in consequence of the amount of under-age drinking
and the subsequent public nuisance that the police were
either unable or unwilling to tackle. As a result, a number of
this group did not want to leave their ﬂats after dark.
Gangs of youths drinking and smashing bottles and when you phone
the police they come out but they come back again. Loads of time you
wake up in the morning and you see all the broken bottles, so they are
getting it from somewhere.
Social occasions
Home drinking was also common as a result of social
occasions such as birthdays and having friends or family
over for a visit. This was a theme that tended to be discussed by females and those aged 16 –35 and a quote from
a woman in early 30s with a family is shown below.
I would say birthdays, anniversaries or anything like that. Anything
to do with my family where we are all together we always end up
having a couple of bottles of wine, special occasions.
Child care
An issue that was largely pertinent to the young women in
their 20s and 30s (though not exclusively) was drinking at
home because they had young children to look after or
avoiding the cost of babysitters. This clearly has a link to
cost and convenience. The illustrative quote comes from a
male in his early 30s with a young child. It also illustrates
how those participants who had young children had there
own self-imposed rituals around drinking in this
environment.
When I have a drink, I have a nine-year-old son and we don’t make
a habit of having a drink when he is up. So we will make sure he
goes to bed at nine o’clock, then we will have a drink.
Stress/reward
Having a drink generally at home ‘to wind down’ was
another theme that emerged from the data. It too was a
Miscellaneous adult themes
There were a number of other themes that encouraged
home drinking discussed by the adult groups. Any trends
are shown in parentheses. These were: ﬁrst, the inconvenience resulting from the introduction of the smoking ban in
licensed premises ( predominantly discussed by males and
individuals in the age range 16– 35). The quote below is
from a male in his mid-30s.
I found in the past two years, because I am also a smoker, and you
can’t smoke in pubs, I go into one of the local bars and they have a
little shelter at the back and you can’t see in front of you from all the
cigarette smoke. I am a smoker but I don’t want to be gasping for air
continuously. So I stay at home and have a glass of wine and a
cigarette.
Secondly, drinking alcohol as an accompaniment to food
(this was predominantly discussed by females and individuals in the age range 26 – 45). The following quote is from a
woman in her mid-40s with a family.
For me and my situation. I do a lot of entertaining at home so I like
to cook. So I usually have a glass of wine with it.
Thirdly, drinking at home to prevent drink-driving (discussed equally by both genders, all comments from individuals in the 36– 55 age range); the illustrative quote comes
from a woman in her early 40s who is employed with a
family.
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Spiking of drinks is also an issue I am really careful about, if I am
going to buy a drink it comes in a bottle with a lid on rather than
leave my glass there when I go to the loo I will ask someone to watch
it for me. Though sometimes this can go wrong, you have somebody
watching it for you, what they are doing is putting a pill in their hands
and reaching over to get something else, and as they do they drop it
into your glass, and they think it’s funny.
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516
J O U RN A L O F P U B L I C H E A LTH
If you are a driver it is safer to drink at home because then you don’t
have to worry about driving.
Finally, the practice of ‘pre-loading’, this is drinking at home
before going out for the evening and was only discussed by
females aged 16 –45. The ﬁnal quote is from a woman in
her early 20s who has no family and was working.
We never ever go straight out we always meet up at someone’s house
before we go out and if I’m being completely honest it’s to get drunk
before we go out so that we don’t have to pay extortionate prices when
we get out.
Discussion
Main findings of the current study
What is already known on this topic?
International research has shown for some years that the
majority of drinking takes place outside of licensed premises.15 In the UK, ﬁgures from the British Beer and Pub
Association have found that more than 80% of all wine purchases in 2007 were off-sales—equivalent ﬁgures for spirits
were more than 70% and beer/ciders were more than
40%.7 Generally, there has been very little empirical research
into the reasons why ‘adults’ elect to drink in non-licensed
premises. But gender has been identiﬁed as an important
demographic factor. The alcohol purchasing patterns of
men and women differ. Men are more likely to buy drinks
in bars and women are more likely to purchase alcohol in a
supermarket. Between 16 and 24 years of age, 45% of
women purchase alcohol in bars; after this the ﬁgure drops
to 26%.16 More recently, research has shown that the
increased level of harmful drinking among women aged
45– 64 has been linked to greater home drinking.17
However, most of the research thus far concerning drinking outside licensed premises has been directed at examining
the behaviour and motivations of young people.
Coleman and Cater18 found that the most common
venues for young people to drink (excluding pubs and bars)
were ‘at a friends home when parents away’, ‘own home
What this study adds?
Drinking at home is growing faster than drinking in pubs,
clubs, cafes and restaurants. The off-trade consumption of
alcoholic drinks is forecast to rise by 15%, from 2008 to
2010, with women being the key growth factor in this
trade.25 Despite this, the portrayal of alcohol-related harm is
concentrated upon binge drinking6 and the visible consequences presented by problematic drinkers. Furthermore,
policy responses tend to be a reaction to the visible problems presented by binge drinking. Public health professionals should provide messages/information that take
into account the fact that the majority of drinking now takes
place in the home and seek to understand some of the
reasons for this change. It is important to recognize that
drinking at home is uncontrolled and unregulated. In other
data that we intend to publish in future from these FGs, it
is clear that one of the attractions of home drinking is ‘lack
of scrutiny’. However, it was equally clear that the participants were aware that there were inherent dangers in drinking at home; these were mainly in the form of acute harms,
such as getting into ﬁghts, arguments and accidents. Home
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This paper has used a qualitative methodology to investigate
the reasons why people chose to drink at home. Although a
number of subthemes emerged and have been described,
the reasons adults give for electing to drink at home concerned convenience. Included in this are issues such as
price, safety, fear of under-age drinkers, availability of child
care, immediate relief of stress, family occasions, the
smoking ban and not having to drink and drive. To our
knowledge, this is the ﬁrst attempt to consider home drinking in such a way.
when parents away’ and lastly parks and the streets.
Drinking in the park and the street was also related to other
high-risk behaviours such as illicit drug use, getting into
trouble with the police and unprotected sex. Work from the
USA conducted over 15 years ago has conﬁrmed that
under-age drinkers had little difﬁculty in obtaining alcohol
from on- or off-premises.19 There has been a body of
research that has conﬁrmed the importance of social
context in predicting the level of young people’s drinking.20
Research from New Zealand21 has pointed to different
gender effects, in particular that adolescent females can be
key in either encouraging or discouraging heavy drinking in
their peer groups. The role of parents in this area is unproven, though recent research from North-West England
found that alcohol-related harms and consumption were lessened in young people15,16 whose parents provided alcohol
at home.22
In the context of drinking in young people,18 – 24 recent
data from the Scottish Executive23 has documented a behaviour concerning home drinking mainly in young adults
16– 24 (though not exclusively) known as ‘front loading’ or
‘pre-loading’. This is consuming alcohol purchased from a
supermarket or off licence and thereafter going out to a pub
or night club. This behaviour has been associated with
greater alcohol consumption, a higher likelihood of being a
victim or perpetrator of violence and greater at risk sexual
behaviour.24
W H Y P E O P L E D R I NK AT H O M E
drinking is generally portrayed as being safe and responsible.
Indeed, the ﬁrst author has been engaged in debates with
local large supermarkets in his locality. Their response to the
suggestion that by selling alcohol cheaply, they may be
adding to alcohol-related problems is talk in terms of providing a service for ‘responsible consumers’. In order to
tackle this vested interest in addition to campaigning for
minimal pricing health professionals should be agitating for
a ﬁfth licensing objective for England and Wales—the promotion of public health, so that new licensing applications
could be refused/challenged on public health grounds. The
shortly to be enacted Scottish Licensing legislation has ‘protecting and improving public health’ as a licensing
objective.26
517
groups we would like to interview in future would be students, young people with disposable income and individuals
from middle class occupations. The gender and age spread
in relation to the themes make intuitive sense, for example,
that the majority of those who felt child care was an important reason for them to drink at home were young women.
However, these may be a function of the make-up of the
FGs and how the discussions ensued, thus they should be
regarded as indicative only. Our ultimate aim is to use this
study to devise a tool to allow for a rigorous epidemiological
general population survey with a view to teasing out gender,
living arrangements, class, age and ethnic differences in
‘home drinking’.
‘Pre-loading’ i.e. drinking at home before going out to a
pub or night club is a topic that has been of increasing
research interest and was the subject of a recent set of
comment articles in ‘Addiction’.27 In the current study, it
was not discussed in the depth that we expected it would
be. There are a number of possible explanations for this.
Most of our group were either older, working or with
families. The young people we interviewed tended to be
unemployed. ‘Pre-loading’ seems to be an activity largely
conﬁned to young people without dependents who have disposable income. If there had been a greater number of
these or students in our sample, this might have become a
more prevalent issue. A recently published paper conﬁrmed
a perception on the part of female students that the student
culture encourages heavy/binge drinking, though no discussion of home drinking or pre-loading was reported.28 There
is another possibility; that pre-loading has become so
common place that individuals do not make the distinction
between drinking at home and then going out.
This study was supported by the small grants scheme of the
Alcohol Education and Research Council (SG 08/09 101).
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