Research article
The Intensity of Binge Alcohol Consumption Among U.S. Adults

https://doi.org/10.1016/j.amepre.2009.09.039Get rights and content

Background

Binge drinking (consuming five or more drinks during a drinking occasion) is responsible for more than half of the 79,000 annual deaths due to excessive drinking in the U.S. Although studies show a strong dose–response relationship between the intensity of binge drinking (i.e., the number of drinks consumed per binge episode) and adverse outcomes, there are no population-based studies assessing this measure.

Purpose

This study aims to analyze population-based data from a module of questions on binge drinking among U.S. adults to assess the number of drinks consumed by binge drinkers and the associated independent risk factors for consuming more drinks.

Methods

Data were analyzed from 14,143 adult binge drinkers who responded to the Behavioral Risk Factor Surveillance System binge drinking module in 2003 and 2004. Total drinks were calculated by summing the total number of beer, wine, and liquor-containing drinks consumed during a respondents' most recent binge drinking episode.

Results

Binge drinkers consumed an average of 8.0 drinks (median 6) during their most recent binge drinking episode; 70.0% of binge drinkers consumed six or more drinks, and 38.4% consumed eight or more drinks. Men consumed more drinks during their last binge episode than women (M=8.3 vs 7.0, median=7 vs 6), and those aged 18–34 years consumed more drinks than those aged >34 years for both men and women. Independent risk factors for consuming eight or more drinks included being male; being aged <35 years; being other than white race/ethnicity; having less education; not being married; binge drinking three or more times in the past 30 days; and drinking mostly beer.

Conclusions

Most adult binge drinkers drink in excess of the five-drink threshold defining this risky behavior. The intensity of binge drinking should be monitored regularly by health agencies to improve surveillance and to better assess the impact of interventions designed to reduce binge drinking and its consequences.

Introduction

Excessive alcohol consumption is a leading preventable cause of death1 that causes approximately 79,000 deaths annually in the U.S., and it shortens the lives of those who die by approximately 30 years.2 Binge drinking, often defined as the consumption of five or more drinks on an occasion, typically results in acute impairment and is responsible for more than half of these deaths.2, 3 Binge drinking is also a leading risk factor for a variety of health and social outcomes, such as unintentional injuries, violence, unintended pregnancy, and cardiovascular disease.4, 5, 6, 7, 8

Studies have demonstrated that the risk of alcohol-related harms increases with the intensity of binge drinking—that is, with an increased number of drinks consumed per binge episode and with higher blood alcohol concentrations.9, 10, 11, 12 However, we are unaware of prior studies that have characterized the number of drinks consumed per binge episode on a population basis. Such information is crucial for characterizing the risks associated with binge drinking and for evaluating the impact of strategies to prevent this behavior. This study used population-based data from a module of questions on binge drinking among U.S. adults to assess the number of drinks consumed by binge drinkers and independent risk factors for consuming more drinks during a person's most recent binge drinking episode.

Section snippets

Methods

Data for this study came from the CDC's Behavioral Risk Factor Surveillance System (BRFSS). Extensive detail about the BRFSS and its methods are available at www.cdc.gov/brfss/. In brief, the BRFSS includes state-based random-digit-dial telephone surveys of people aged ≥18 years, which are conducted monthly in all states, the District of Columbia, and some territories; survey instruments contain questions on a variety of health risk measures, including alcohol consumption. Data are weighted to

Results

The study population was 75.1% male, with 52.7% aged ≤34 years, 59.4% with at least some college education, and 72.8% of white non-Hispanic race/ethnicity. Overall, binge drinkers consumed an average of 8.0 (median=6) drinks during their most recent binge drinking episode (Table 1). Groups that consumed a significantly higher number of binge drinks included those who were male; aged 18–34 years; belonged to racial/ethnic groups other than white non-Hispanic (data not shown); had no college

Discussion

To our knowledge, this is the first study to examine the intensity of binge drinking, that is, the total number of drinks consumed during a discrete binge drinking episode. It was found that adult binge drinkers in the U.S. consumed an average of eight drinks per binge episode, and that 70% of binge drinkers consumed six or more drinks, including almost 40% who consumed eight or more drinks. Although drinking just five drinks on one occasion is associated with adverse outcomes in epidemiologic

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