COMMUNITY HEALTH STUDIES VOLUME X, NUMBER 1, 1986 ADULT CONSUMPTION OF ALCOHOL IN VICTORIA,

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COMMUNITY HEALTH STUDIES VOLUME X, NUMBER 1, 1986 ADULT CONSUMPTION OF ALCOHOL IN VICTORIA, 1967-83 John Ross Health Department Victoria, Box 4057, GPO, Melbourne, Victoria, 3001 Introduction The

1 COMMUNITY HEALTH STUDIES VOLUME X, NUMBER 1, 1986 ADULT CONSUMPTION OF ALCOHOL IN VICTORIA, John Ross Health Department Victoria, Box 4057, GPO, Melbourne, Victoria, 3001 Introduction The misuse of alcohol in Australia has been recognized as a problem of epidemic proportions. The Senate Select Committee on Social Welfare reported that between 1965 and 1976 per capita consumption of alcohol had increased by 41 per cent.' In particular the consumption of beer had increased by 27 per cent; wine by 122 per cent; and spirits by 50 per cent. These data have greatly influenced community attitudes in regard to alcohol-related problems and most State governments accepted the premise that overall consumption of alcohol was on the increase. Recent theoretical arguments and survey data suggest that annual per capita alcohol consumption (APCAC)* is linked with heavy drinking as proposed by Ledermann many years ag~.~.~ Ledermann considered that the distribution of consumption of alcohol in any population is lognormal and that there are strong grounds for believing that the distribution is determined by APCAC as a single parameter. This is by no means universally accepted, but it does appear that most authorities agree that APCAC has some relevance to health. The implications of such opinions are of considerable importance to Governments because of their potential to alter APCAC by fiscal and other means. It was therefore considered of interest to examine the State data which might be used to measure APCAC in Victoria over as a long a period as reasonably reliable statistics have been available. Methods The first requirement for this study is a time series for quantities of alcoholic beverages consumed. In Victoria, the Liquor Control Commission is responsible for control of the sale, disposal and consumption of liquor and excellent data exist to show the sales of bulk beer in *In this paper APCAC refers to persons 15 years of age and over. hogsheads and packaged beer as dozen packs from However, State wine and spirits figures have only been assembled since so that time-series data needed to compute APCAC for Victoria are incomplete. There are other methodological problems in regard to wine. For example, in 1983 the Victorian Treasurer reduced the tax discrimination in favour of wine by increasing the licence fee on wine from 9 per cent to 20 per cent. This provided an incentive to large purchasers of wine to look to interstate merchants and may have affected the quality of State data.' In other words, time-series data for wine and spirits consumption are not available for Victoria on a retrospective basis and collections recently started are not entirely valid, especially for wine. In order to overcome this dearth of State data on wine and spirits consumption over the period of this study, it was necessary to adopt an indirect measure of State consumption of these goods. The Australian Bureau of Statistics (ABS) regularly publishes estimates of the apparent consumption of alcoholic beverages for Australia and in the present study ABS data on the apparent consumption of wine and spirits were disaggregated to approximate Victorian con~umption.~ For excise duties, ABS have specifically warned that although State tables are available, the State in which duty was paid is not necessarily the State in which consumption or usage occurred.6 However, the rationale behind the present approach is based on the ABS finding that consumption across Australia comprised various beverage combinations which showed an homogenous trend for the most populous States.' In particular, there was a good correspondence between national consumption data and that for Victoria which is shown in Table 1. The components of the total quantity of alcohol consumed from year to year are seen by considering its relationship with sales in the ith category of liquor. The relationship may be ROSS 41 COMMUNITY HEALTH STUDIES

TABLE 1 Per Cent Distribution of Type of Alcoholic Beverage Consumed by Adult Persons in Previous Week Australia-wide and for Victoria, February, 1977 NationlState None Beer Beer & Beer & Every Other

2 TABLE 1 Per Cent Distribution of Type of Alcoholic Beverage Consumed by Adult Persons in Previous Week Australia-wide and for Victoria, February, 1977 NationlState None Beer Beer & Beer & Every Other Only Wine Spirits Combination Australia Victoria Source: Australian Bureau of Statistics Special Tabulation. stated formally as follows: Qt = iai,xbit,i=1,2,3... (1) where Q, = the total quantity of alcohol consumed in period t; Ai, = the proportion of alcohol contained in the ith beverageduring period t; and, Bit = the quantity of the ith beverage sold during period t; i = 1 (beer), 2 (wine), 3 (spirits) The proportion of alcohol contained in each beverage category is not static from year to year because the overall market is comprised of numerous lines each having a different content of alcohol. For example, the wine market has a marked bi-modal distribution with respect to alcohol content and over the past 17 years the relative production and sales positions of fortified and flavoured wines viz-a-viz sparkling and table wines have reversed.* One reason for this is the considerable increase in sales of bulk and packaged wines containing less than 12 per cent alcohol by volume. The mean alcohol content of the conglomerated wine market has steadily declined as a consquence of the greater proportion of medium alcohol content varieties being produced and sold. Using ABS data on the market shares of wine variations a computer algorithm was used to estimate the mean alcohol content for all wines in each respective year. For the purpose of computing APCAC in Victoria it was assumed that liquor sold within particular periods was consumed without undue delay. Therefore, all results are based on current but not lagged values for consumption. This assumption is more tenuous for fine wines; however, modern packs such as wine casks and flagons have contributed substantially to increased wine consumption in recent years and such products are not intended to be stored. The Australian Wine and Brandy Producers Association Incorporated believe that approximately 51.9 per cent of total wine consumption and 64 per cent of table wines is in the form of cask, flagon or other bulk wine products which are usually consumed within a reasonable time of being purchased. To compute APCAC the drinking age population was defined as persons 15 years and older and relevant denominator data from 1967 to 1983 were obtained from census and intercensus estimates of population published by ABS. This definition represents broad judgement applied to published studies for Australia and is consistent with work done overseas. Results A time-series of beer sales which is comparable in terms of measurement criteria is available for Victoria from 30 June, Hogsheads* and bottles are the two main segments of the retail beer market and comprise draught beer consumed on the premises of licensed victuallers and clubs, as distinct from beer bought at, but usually consumed away from ordinary licensed premises. The quantities of beer comprising these market segments have been calculated for the period and are shown in Figure 1. As can be seen, total beer sales reached a maximum in Thereafter, bulk sales declined while packaged beer sales increased. The shift in market preference for packaged over bulk beer is continuing, and, for the year ended 30 June 1983, there was a further decline in the comparative purchases of bulk beer against packaged beer. The purchases of packaged beer for the year ended 30 June, 1982 amounted to 70.9 per cent of total beer purchases and rose to 71.6 per cent *Hogshead contains litres of beer. ROSS 48 COMMUNITY HEALTH STUDIES

IIIII Packaged Beer Bulk Beer 400 300 200 100 0 Year FIGURE 1 83 Annual Sales of Bulk and Packaged Beer in Relation to Total Beer Sales for Victoria, 1967 to 1983 in 1983.

3 IIIII Packaged Beer Bulk Beer Year FIGURE 1 83 Annual Sales of Bulk and Packaged Beer in Relation to Total Beer Sales for Victoria, 1967 to 1983 in Conversely, purchases of bulk beer which amounted to 29.1 per cent of total beer purchases for the year ended 30 June, 1982 fell to 28.4 per cent the next year. This represents an all time high in respect of packaged beer sales, and an all time low for the comparative percentage purchases of bulk beer. The alcohol content of Victorian beer falls about the middle of the generally narrow range of alcohol strengths of popular beer produced around the World." The alcohol content, according to labels, ranges from 3.3 per cent by volume for Carlton and United Breweries Ltd. Light Ale, to 4.9 for the market leaders such as Carlton Draft, Fosters and Abbotts Lager, Melbourne and Victoria Bitter. Reduced alcohol beers enjoy between 8 and 11 per cent of the national market according to seasonal fluctuation and are in heavier demand in New South Wales and the Northern Territory; in Victoria, low alcohol beer now holds 8.2 per cent of the beer market.i2 Because of the volumetric format of tabulated consumption data it is convenient to accept the Australian average alcohol content of standard beer as 4.8 per cent by volume and that for local low alcohol beer as 3.3 per cent (Light Ale as labelled)". However, low alcohol beer is a recent innovation in Victoria and it was not a major factor during the long period to which this study relates. The composite alcohol content of Victorian beer for 1982 was 4.68 per cent by volume. Information on the market composition for wine is obtained directly from wine makers by means of a mail collection administered by the ABS. Data relates to wineries with wine sales of 250,000 litres or more in the previous financial year and accounts for approximately 97 per cent of total wine sales. The figures include all sales by wine makers, net of exports, sales for ships' stores and interwinery sales, the latter exclusion being necessary to avoid duplication in the published figures. All data are collected on an Australia-wide basis only and State figures are not available. Again, it is convenient to accept the Austra- ROSS 49 COMMUNITY HEALTH STUDIES

lian average alcohol content of table, sparkling and carbonated wines as 11.5 per cent by volume; and, fortified and flavoured wines and vermouth as 18.

4 lian average alcohol content of table, sparkling and carbonated wines as 11.5 per cent by volume; and, fortified and flavoured wines and vermouth as 18.5 per cent by volume and use a market share algorithm to compute the composite alcohol content for total wine sales on a year-by-year basis. ) The time series thus obtained for the alcohol content of wine was then used to compute the contribution of wines to APCAC in Victoria. In aggregate, as a result of changes in the composition of the wine market, the alcohol content of all wines consumed has fallen by 2.7 per cent during the past 17 years and in 1983 was per cent by volume. The amount of absolute alcohol sold Australia-wide in the form of spirits is directly excisable by the Commonwealth Government and figures are available from ABS publications.6 Where appropriate, the estimated litre consumption of spiritous products may be approximated by applying a factor of 2.5 to the litres alcohol consumption. In this paper Victorian wine and spirits consumption were computed by pro rata disaggregation of national data using Australian and Victorian populations aged 15 years and over for the respective years. Notional time series data obtained with this method are shown for Victoria in Table 2. As already mentioned, the Victorian Liquor Control Commission has tabulated wine and spirits sales for Victoria for the years to and these data are compared with values calculated by disaggregation and shown in Table 3. The information collected by State authorities on the volume of wine purchased since are incomplete and, for reasons already mentioned, the situation may not improve. However, the missing data should not affect the ratio of the purchases of these products within the State: therefore it is possible to present the percentages by volume of beer, wine and spirits purchased by various categories of liquor licences for the years ended 30 June 1982 and Percentage purchases of beer, wine and spirits derived from licensing data are useful because they may be used as a benchmark to compare whether computed values of beer, wine and spirits consumption in Victoria are in reasonable proportion. Remember, the ABS Alcohol and Tobacco Consumption Survey did not show any dramatic differences in consump- TABLE 2 Victorian Annual Pro Rata Consumption of Wine and Spirits Calculated from National Data and Populations Fifteen Years and Over for Years Ended 30 June 1967 to 1983 Year Wine Spirits* ( OOO litre) ( OOO litre) ,102 6, ,872 7, ,449 7, ,263 8, ,384 9, ,783 9, ,624 11, ,424 11, ,700 11, ,803 10, ,591 11, ,386 12, ,080 10, ,138 9, ,390 10, ,878 11, ,543 11,809 *The estimated litre consumption was calculated by applying a factor of 2.5 to the litres alcohol consumption. Source: Australian Bureau of Statistics, Catalogue Nos , tion patterns of wine and spirits viz-a-viz beer, between the most populous Australian states. Therefore on the evidence available, national consumption of wine and spirits (imports and production net of exports) can be used to approximate Victorian consumption. Figure 2 shows APCAC of beer, wine, spirits and total absolute alcohol contained in each product category for Victoria from to Data contained in Tables 2 and 3 for 1981 to 1983 when combined allow pro rata allocations of wine and spirits consumption to be expressed as percentages of a notional total volume of liquor sold in Victoria and to be compared with real State data on the ratios of purchases of the corresponding products. The respective notional product shares obtained in this way for the years ended 30 June 1981 to 1983 have been compared with State data, shown in Table 4. ROSS 50 COMMUNITY HEALTH STUDIES

TABLE 3 Victorian Liquor Control Commission (LCC) Wine and Spirits Sales Data, Compared with Populationbased Disaggregations of Similar National Data for Years ended 30 June 1981 to 1983 Year Wine

5 TABLE 3 Victorian Liquor Control Commission (LCC) Wine and Spirits Sales Data, Compared with Populationbased Disaggregations of Similar National Data for Years ended 30 June 1981 to 1983 Year Wine ('OOO litre) Spirits*('000 litre) Pro Rata LCC Pro Rata LCC ,390 52,311 10,815 8,861 75,878 67,712 11,535 11,053 79,543 74,414 11,809 11,669 *The estimated litre consumption was calculated by applying a factor of 2.5 to the litres of alcohol consumption.2 Sources: Australian Bureau of Statistics, Catalogue No Liquor Control Commission (Vic). Reports and Statements of Accounts, Years ended 30 June 1981 to c M Wine IIIII Beer I Spirits '69 E '71 '73 Year FIGURE 2 '79 '81 '83 Annual Consumption of Absolute Alcohol Per Head of Population Aged Fifteen Years and Over in Relaton to Beverage Type for Victoria, ROSS 51 COMMUNITY HEALTH STUDIES

TABLE 4 Victoria Per Cent Purchases of Beer, Wine and Spirits Obtained by Disaggregation of Australian Data and Compared with Real State Data in Parentheses for 1981 to 1983 Year Beer Wine Spirits

6 TABLE 4 Victoria Per Cent Purchases of Beer, Wine and Spirits Obtained by Disaggregation of Australian Data and Compared with Real State Data in Parentheses for 1981 to 1983 Year Beer Wine Spirits (87.30) (10.80) 2.14 (1.80) (84.01) (13.75) 2.31 (2.24) (83.14) (14.58) 2.29 (2.28) Source: Table 2 and Figure 1. Discussion With regard to drinking behaviour, the trends in the data are consistent with the view that Victorians are consuming more wine and less beer per adult with spirits occupying a fairly constant but small share of the market. Of beer sales, hotel bar sales have declined at a remarkable rate with Victorians showing a greater preference for packaged beer than ever before. The patterns of retail sales of packaged beer have also changed, with the increasing variety of premises such as supermarket annexes and drive-ins which are generally more accessible to ordinary shoppers. Since the early 70s the increasing popularity of wine and packaged beer has been significantly correlated with a steady decline in draft beer sales. State sales of hogsheads and packaged beer for the period are based on local data and show a distinct variation in regard to implicit hotel drinking over the 17 years of this study. The findings of the Senate Select Committee on Social Welfare in 1977 and fears expressed for the future do not appear to hold in Victoria. Certainly between 1966 and 1974 there was some increase in APCAC in this State but on all the available evidence there has been no remarkable change over the past decade. The main finding is that the mean consumption of base alcohol was (SD) litres per head of population 15 years and over during the past 17 years. Of perhaps even more interest is the finding that despite phenomenal changes of behaviour shown by Victorians in regard to their preferred type of beverage and place of drinking, that APCAC has not increased significantly and the picture has been one of quite stable consumption in Victoria over many years. The method of this study is limited mainly by the lack of available time series data on State consumption of wine and spirits and a method of disaggregating national data was used to overcome this difficulty. However, testing the method against independently assembled data from ABS and State statistics on wine and spirits consumption and the proportional sales of beer, wine and spirits (Table 3 refers) shows that a pro rata estimate of the consumption of those goods from national data seems reasonable. In reading this paper it should be remembered that ABS and the Commonwealth Department of Health define per capita consumption as apparent consumption divided by the mean population for that period and acknowledge that an effective per capita consumption for certain commodities.may be higher than official figures indicate. This is almost certainly true of liquor and APCAC is defined in this paper as being equal to the apparent consumption divided by the drinking population of persons aged 15 years and over as tabulated by ABS. The distribution of consumption argument which arose out of Ledermann s work states that the health of a population is inversely related to the overall consumption of alcohol in the population. The argument is based on two premises: first, the higher the mean of alcohol consumption, the higher is also the number of heavy drinkers in the population; and second, heavy drinkers have an increased risk of death This argument has far-reaching implications for health policies and a recent World Health Organisation document concludes that any reduction in APCAC will be accompanied by a significant decrease in alcohol-related problems.18 The results pinpoint a relevant and quantifiable policy objective and one which is linked with health status and other drink-related social problems. For those concerned with developing strategies to prevent alcohol-related problems and to reduce associated costs, the finding should stimulate some reflection on what has been achieved over the past 17 years in Victoria ROSS 52 COMMUNITY HEALTH STUDIES

7 and whether a quantitative target for APCAC within a nominated time frame should be a community health policy objective. Acknowledgement Publication is by authority of the Health Department Victoria. References 1. Senate Select Committee on Social Welfare. Drug Problems in Australia: An Intoxicted Society? Canberra: Australian Government Printing Service, Skog OJ. Liver cirrhosis epidemiology: some methodological problems. Br JAddict 1980; 75: Ledermann S. Alcool, alcoolismel & alcoolisation. Paris: Presses Universitaires de France, Cited by Miller GH and Agnew N. The Ledermann model of alcohol consumpion: Description: implications and assessment. Q J Stud Alcohol 1974; 35: Victoria Parliament. Budget speech Budget Paper 1, Melbourne: Government Printer, Australian Bureau of Statistics. Apparent Consumption of Foodstuffs and Nutrients. Canberra: Australian Government Printing Service (Catalogue No ). 6. Australian Bureau of Statistics. Customs and Excise Revenue Australia. Canberra: Australian Government Printing Service (Catalogue No ). 7. Australian Bureau of Statistics. Alcohol and Tobacco Consumption Patterns, February Canberra: Australian Government Printing Service (Catalogue No O). 8. Australian Bureau of Statistics. Sales and Stocks of Australian Wine and Brandy by Winemakers. Canberra: Australian Government Printing Service (Catalogue No ). 9. Australian Bureau of Statistics. Estimated Resident Population by Sex and Age:. States and Territories of Australia. Canberra: Australian Government Printing Service (Catalogue No ). 10. McIntosh ID. Population consumption of alcohol and proportion drinking. Br J Addict 1981; 76: Australian Associated Brewers. Submission to the Senate Standing Committee on Social Welfare. Canberra, Australian Wine and Brandy Producers Association. Submission to the Treasurer of the Commonwealth of Australia. Canberra, Commonwealth Department of Health. Alcohol in Australia. Canberra: Australian Government Printing Service, Australian Wine and Brandy Corporation. Second Annual Report. Year ended 30 June, Lelback WK. Quantitative aspects of drinking in alcoholic liver cirrhosis. In: Khanna JM, Israel Y and Kalant H, eds. Alcoholic Liver Pathology. Toronto: Addiction Research Foundation, Pequignot G, Tuyns AJ and Berta JL. Ascitic cirrhosis in relation to alcohol consumption. Int J Epidemioll978; 7: Poikolainen K. Increased alcohol consumption correlated with hospital admission rates. Br J Addict 1983; World Health Organisation. Alcohol - related problems; the need to develop further the WHO initiative. Geneva: WHO 1978 (Document EB 63/23.) ROSS 53 COMMUNITY HEALTH STUDIES

FACTORS DETERMINING UNITED STATES IMPORTS OF COFFEE

12 November 1953 FACTORS DETERMINING UNITED STATES IMPORTS OF COFFEE The present paper is the first in a series which will offer analyses of the factors that account for the imports into the United States