LAUSR

BACKGROUND AND AIMS UK alcohol consumption per capita has fallen by 18% since 2004 while the alcohol-specific death rate has risen by 6%. Inconsistent consumption trends across the population may explain this. Drawing on the theory of the collectivity of drinking cultures and age-period-cohort analyses, we tested whether consumption trends are consistent across lighter and heavier drinkers for three temporal processes: (i) the life course, (ii) calendar time, (iii) successive birth cohorts. DESIGN Sex-specific quantile age-period-cohort regressions using repeat cross-sectional survey data. SETTING Great Britain, 1984-2011. PARTICIPANTS Adult (18+) drinkers responding to 17 waves of the General Lifestyle Survey (total N=175,986). MEASUREMENTS Dependent variable: The 10th , 25th , 50th , 75th , 90th , 95th and 99th quantiles of the logged weekly alcohol consumption distribution (excluding abstainers). INDEPENDENT VARIABLES seven age groups (18-24, 25-34 … 65-74, 75+), five time periods (1984-1988 … 2002-2006, 2008-2011) and 16 five-year birth cohorts (1915-1919 … 1990-1994). Additional control variables: ethnicity and UK country. FINDINGS Within age, period and cohort trends, changes in consumption were not consistently in the same direction at different quantiles of the consumption distribution. When they were, the scale of change sometimes differed between quantiles. For example, consumption among women decreased by 18% (CI95: -32% - -2%) but increased by 11% (CI95: 2% - 21%) at the median and by 28% (CI95: 19%-38%) at the 99th quantile, implying consumption fell among lighter drinkers and rose among heavier drinkers. This type of polarised trend also occurred between 1984-1988 and 1996-2000 for men and women. Age trends showed collectivity but cohort trends showed a mixture of collectivity and polarisation. CONCLUSIONS Countervailing alcohol consumption and alcohol-related harm trends in the UK may be explained by lighter and heavier drinkers having different period and cohort trends as well as by the presence of cohort trends that mean consumption may rise in some age groups while falling in others.