Klaus Mäkelä

Relationships between characteristics of drinking occasions and negative and positive experiences related to drinking.

The relationships between characteristics of drinking occasions and experiences related to drinking were studied. Interviews were conducted in 1992 with a representative sample of the Finnish population between 15 and 69 years of age. The analyses were based on 10,039 drinking occasions of 1,483 male and 1,373 female drinkers. Intake of alcohol and the frequency of drunkenness were the most important predictors of both negative and positive experiences related to drinking. Characteristics of the drinking situations contributed significantly to the explanatory models, but their predictive power was small. Public and large-group drinking situations tended to increase and private and intimate situations tended to decrease the number of both negative and positive experiences related to single drinking occasions. The same situations that lead to increased positive experiences with drinking also increase the risk for negative experiences.

The reward structure of drinking among younger and older male drinkers.

In discussions of addictive processes, the arguments presented often imply that the reward structure of drinking changes over time: most benefits are immediate, but many adverse effects are delayed (Skog, 1996). That people continue to drink at a certain level despite increasing adverse consequences is best explained by saying that they become, in various degrees, addicted to alcohol. Seen from this perspective, age can be used as an indirect measure of the length of the drinking career, and the overall reward structure should be more positive among young drinkers than among old. A recurrent finding in drinking surveys is, however, that young drinkers report more adverse consequences than older drinkers even when overall intake of alcohol is held constant (Bondy, 1995; Bongers et al., 1995; Casswell et al., 1993; Makela & Simpura, 1985; Midanik, 1995; Midanik & Clark, 1995; Room et al., 1995). There are good common-sense explanations for this phenomenon: the drunken comportment of young people may be more reckless, they may still be learning to hold their liquor, they may be under stricter social control, and smaller economic and social resources may aggravate the negative consequences of their drinking. One important question remains, however: Why do young people continue to drink? That is, what outbalances the fact that they experience more negative consequences than older drinkers? In discussing the reward structure of drinking, it is obviously not enough to study negative consequences. The perceived benefits of drinking have also to be taken into account. In this report, our aim is to analyze the overall reward structure of drinking at various levels of intake in two different age groups. We pay particular attention to how the reward structure changes as a function of increasing intake. Our data come from a Finnish general population survey. We focus on male drinkers 20-29 years old and 40-49 years old. The choice of the age groups is based on the following considerations: The older respondents have consumed alcohol, on the average, 20 years longer than the younger respondents. Men 20-29 years old have, on the average, passed the experimental phase but are still in the early stages of their drinking career. Those in the older age group have had time to experience some of the delayed adverse consequences of drinking, but relatively few have died or turned abstinent because of them. Survey data provide information on the probability of occurrence of each consequence of drinking at different levels of consumption, but we have no yardstick for the utility or disutility of each consequence. There is no way of relating the utility of receiving a small reward with a high probability to the disutility of suffering a serious loss with a low probability. Moreover, our survey questions cover only a small and rather trivial selection of the possible benefits and disadvantages of drinking. To interpret our results, we have to apply indirect reasoning. Earlier analyses (Makela & Mustonen, 1988) show that the incidence of negative effects of drinking increases more rapidly than that of beneficial effects as a function of annual intake of alcohol. Perceived benefits of drinking continue to increase even among those with the highest consumption levels, but the differences in growth rates can be interpreted as indicating that the cost-benefit balance is more favorable at lower levels of consumption. Applying the same reasoning, we may also compare the reward structure in different groups of respondents as a function of overall intake of alcohol. Material and methods In September-October 1992, interviews were performed with a representative sample of the population between 15 and 69 years of age in Finland (for sampling operations and data collection, see Makela, 1971; Simpura, 1987; Simpura et al., 1995). The overall response rate was 87% and the number of completed interviews was 3,446. …