There have been many variations on the theme of "wet" versus "dry" patterns of alcohol consumption. "Wet" and "dry" ideal types, primarily based on the extent to which alcohol customs are integrated and consistent with or antithetical to societal norms, can be located at opposite ends of a continuum and include distinctive patterns of consequences of drinking as well as different assumptions regarding societal responses to drinking. The "dry" proponents primarily focus on medical issues, the long-term consequences of alcohol consumption, while the "wet" proponents are far more concerned with the social disruptiveness associated with drinking. These correlate with very different types of drinking patterns or habits: sporadic bouts of intoxication for the "drys" and chronic heavy consumption for the "wets." Canada, England, France and Sweden were selected for comparison because the variation between their "wet"/"dry" status exemplifies the extent to which the "wet"/"dry" paradigm is capable of accounting for each country's history of alcohol consumption and its regulation. Seventeen alcohol-specific characteristics are analysed within five main categories: popular movements and the politicisation of alcohol; consumption statistics; drinking patterns and cultural meanings of alcohol; alcohol-related problems; and alcohol policy. Largely ignored in the formal evaluative literature, most of what currently exists on the subject has been collected piecemeal and presented ad hoc. This thesis examines whether cultural influences, particularly the "wet"/"dry" paradigm, influence the effectiveness of alcohol control policies. The purpose then is to contribute to the state of knowledge and theorising regarding the nature and explanation of variation between "wet" and "dry" cultures as archetypes, both in terms of the cultural position of alcohol and policy preferences and about the processes of change in a "wetter" or "dryer" direction; integral to this is the provision of alternative modes of conceiving the resolution to specific alcohol problems.

Background: Among middle-aged and older adults, light-to-moderate drinkers appear to have better physical functioning than non- and heavy drinkers. The cross-sectional association may be confounded by former drinking. Longitudinal evidence on alcohol consumption and future changes in physical functioning is sparse. Objective: To investigate the role of alcohol consumption and physical functioning in Central and Eastern Europe (CEE), a region characterised by relatively poor health status and high alcohol consumption. Study design: Cross-sectional and longitudinal analyses of a study of 28,783 men and women aged 45–69 years randomly selected from population registers in Novosibirsk (Russia), Krakow (Poland) and seven towns of Czech Republic, with approximately 10 years of follow-up. Methods: At baseline, alcohol consumption in the past 12 months was measured by a graduated frequency questionnaire, and problem drinking was assessed by the CAGE questionnaire. In the Russian cohort, past drinking behaviour was also assessed. Physical functioning at baseline and at three subsequent occasions was measured by the PF-10 subscale of the Short-Form-36 (SF-36) instrument. Results: In cross-sectional analyses of the baseline data, the odds of physical limitations (PF-10 score<75% of maximum) were highest among non-drinkers, decreased with increasing drinking frequency, drinking volume and average drinking quantity, and were not associated with problem drinking. In the Russian cohort with data on past drinking, increased odds of physical limitations were found in subjects who stopped or reduced drinking for health reasons. In longitudinal analyses, using 10-year follow-up data, alcohol consumption and problem drinking at baseline was not consistently associated with the rate of decline in physical functioning. Conclusions: The excess risk of physical limitations in non-drinkers at baseline was partly explained by ‘sick quitters’, and the apparently protective effect of heavier drinking was partly due to less healthy former heavy drinkers moving to lower drinking categories. The lack of longitudinal association between alcohol consumption indices and the rate of decline in physical functioning may be due to methodological limitations; however, the possibility cannot be excluded that my findings reflect a genuine absence of an effect.

This thesis focuses on an analysis of the social meaning that skid row has for-homeless alcoholics and social control agents. From a sociological perspective the study of skid row in Britain as a specifically social phenomenon has for the most part remained unexplored. Most accounts of contemporary vagrancy and its attendant problems have been handled either in a journalistic fashion, or from the standpoint of professionals concerned with the amelioration of the problem or the treatment and rehabilitation of individuals living on the row. The way in which society reacts to, and seeks to control, the skid row problem has not been systematically investigated. This work seeks to redress the imbalance by paying equal attention to both deviancy and social control aspects of the phenomenon. Skid row is shown to be made up of a particular set of institutions manned or used by persons who bring to them particular beliefs and styles of action. In this study an attempt is made to go beyond traditional approaches to understanding one section of the overall skid row population, namely the skid row alcoholic. The reader will soon appreciate that any notion of the derelict alcoholic as someone exclusively suffering from some kind of individual or. social pathology is absent from these pages. The spot-light has been taken off the alcoholic as if he stood in isolation from society's endeavours to bring him into line. Instead, attention is focused on the social relationships that have unfolded amongst alcoholics, and between alcoholics and deviancy workers concerned with punishing, treating or rehabilitating them. Firstly, then, the analysis extends beyond any one single typical skid row institution, such as a common lodging house, government reception centre, prison or rehabilitation hostel. The homeless derelict inebriate leads a nomadic life within our urban centres; he is continuously on the (ix) move, stopping temporarily in institutions on a closed circuit which he rarely moves out of. His definition of these institutions and life in them informs our understanding of how he confronts his homelessness, poverty, unemployment, and alcohol addiction. Secondly, insofar as society's response to vagrancy and alcoholism is examined, three levels of that response are spelled out: the interpersonal, in which professionals comment on their daily encounters and'work with homeless alcoholics; the institutional, in which the basic ideological and objectives of skid row establishments are articulated; and the political, in which contemporary social policy is analysed. In contrast to the dominant positivist or structural functional interpretation of deviant phenomena - perspectives in which the deviant is understood in terms of psychological or environmental factors inevitably pushing him into aberrant and asocial behaviour - the thesis attempts to utilise a sociological perspective, namely symbolic interactionism, with the object of demonstrating the essentially social and purposive character of both the deviant and correctional enterprise. Participant observation was the research technique employed to gather empirical data throughout the study. The concepts of social control, subculture, and deviant identity are employed as a framework within which to locate the empircal findings and analysis.

Background: While the overall proportion of young people who report drinking alcohol in the UK appears to have decreased over the past fifteen years, those who do drink are consuming in larger quantities, and drinking more frequently. An association between industry-driven alcohol marketing and young people’s drinking behaviour has been demonstrated in a number of cross-sectional, longitudinal and qualitative studies, but less is known about how young people are affected by alcohol marketing and how marketing processes knit with other widely studied influences on young people’s drinking behaviour. This study aimed to investigate the influence of industrydriven alcohol marketing processes (price, promotion, product branding and placing) on young people’s drinking choices and behaviour. Methods: A mixed-methods approach underpinned by a critical realist perspective was adopted. A systematic review examined empirical studies concerning the impact of industry-driven price and other marketing techniques on young people’s drinking behaviour. Qualitative interviews were conducted with young people aged 14-17 from NE England (n=31) to explore accounts of when, why, where and how they drink alcohol. Q methodology was used to derive ‘factors’ underlying alcohol choices, based on the results of a card sorting procedure undertaken with young people aged 14-17 from NE England (n=28). Findings: The systematic review identified 32 papers which were predominantly crosssectional in design, and focused on the impact of alcohol promotion on young people’s alcohol use. Although industry-driven alcohol marketing appeared to influence young people’s drinking behaviour, studies reported on a variety of populations, study designs, exposure measures and outcome measures, making synthesis and extrapolation difficult, as well as underlining a shortage of longitudinal work establishing the effect of alcohol marketing over time. The review highlighted a paucity of studies conducted in the UK as well as a lack of research examining the influence of price for those under the legal drinking age only and exploring the impact of digital or social media marketing on young people’s drinking behaviour. Young people interviewed in the qualitative study appeared to make micro-level choices about alcohol (between products and brands), positioning themselves as autonomous agents and unaffected by overt forms of alcohol marketing. However, the majority of participants were able to recount brands and slogans, did not recognise less visible aspects of promotion (e.g. sponsorship, viral and digital marketing) and did not associate the pricing of alcohol as a form of marketing. Therefore, advertising and other promotional activity seemed to play a role in building recognisable imagery linked to alcohol products, as well as associations and expectancies related to drinking. The advisability of drinking per se did not appear to have been questioned by participants and was considered an acceptable and normal practice. Participants reported that they were not exclusively price-led and choices were made in conjunction with other criteria (e.g. taste, availability, strength and image). Q factor analysis revealed three accounts: Factor one illustrates a sense of individuality, autonomy, and maturity in alcohol choices; factor two is price-led, choosing to drink whatever is most accessible, cheapest or on special offer; and factor three is an account of bounded adventure, pleasure and hedonism. Conclusions: Bourdieu’s concept of ‘habitus’ is drawn on to illustrate that young people’s alcohol choices are influenced by structural predispositions (including industry processes and alcohol marketing) but that ‘taste’, social norms and interpersonal relationships (recognised as agency) can also play a role in reinforcing, normalising and driving behaviour. Deeply embedded social norms and industry processes culminate in ‘political economies of health’ where health behaviours are governed by historical traditions and the logic of advanced capitalism (the need to make a profit), and choices constrained into seemingly free, naturalised directions. Thus, a description of young people as individual, rational agents, who can make the ‘correct’ choices about alcohol use, minimises structural and cultural factors that are, in part, shaped by the alcohol industry in conjunction with other influences such as inter-personal relationships and social norms, and which constrain health choices and behaviours of young people. Public Responsibility Deals and voluntary self-regulation of alcohol marketing may be inadequate to counter this. Instead, it needs to be identified that young people are being subtly bombarded and further work is required to ‘unravel’ this impact. Nevertheless, tighter restrictions on the marketing of alcohol, such as a policy resembling France’s Loi Evin should be given consideration. The current alcohol strategy for England and Wales includes a commitment to implementing an alcohol minimum unit price. However, findings from this doctoral work demonstrate that it is difficult to disentangle the four elements of the marketing mix. Price encompasses just one facet of alcohol marketing and makes up only a small part of the external world in which young people are becoming acculturated. The effect that price changes alone could have on young people’s alcohol use should not be overemphasised. Thus, as well as examining the impact of price on young people’s drinking behaviour pre and post legislative change, further work should also explore the changing nature of industry-driven alcohol marketing processes. In particular, the influence of digital and social media marketing on young people’s drinking behaviour needs to be examined further, as well as the combined contribution that alcohol marketing, long-standing social norms and inter-personal relationships (‘the alcohol habitus’) all can make towards a ubiquitous culture of alcohol consumption.

No description available.

Excessive alcohol consumption in university students in the UK has been identified by Government agencies and health care providers as significant problem. Social norms research suggests students evaluate and regulate their own alcohol consumption through social comparison with peers. However, students are prone to misperceptions, inaccurately estimating others’ alcohol consumption to be higher than their own. The over estimation of normative peer alcohol consumption has been associated with higher personal alcohol consumption. Unitcheck is an online alcohol resource available to university students in the UK (www.unitcheck.co.uk). Using a social norms approach this online alcohol intervention provides instant personalised normative feedback to students, directly comparing reported individual alcohol consumption with normative peer alcohol consumption. This comparison is designed to correct students’ overestimation of normative peer drinking and encourage moderate alcohol consumption. Currently, Unitcheck feedback is labelled as comparing personal alcohol consumption to normative alcohol consumption of the typical University of Leeds student. There is a paucity of research exploring student responses to personalised normative feedback on an individual level. The aim of this study was to evaluate how students reporting alcohol consumption above recommended weekly limits at the University of Leeds, respond to instant, online personalised normative feedback presented as part of a study version of Unitcheck. A between subjects experimental design employing qualitative think-aloud methodology, plus a semi-structured interview was used. Participants were 21 Undergraduate students in their first or second year of study at the University of Leeds, 67% female, mean age 19.3 years (range 18-21), meanalcohol consumption over the previous week 38.4 units (range 10-150). Participants were randomised to one of two study groups and asked to work through the Unitcheck resource whilst thinking their thoughts aloud. Group A (n=11) used a same-sex referent group in the personalised normative feedback for University of Leeds students. Group B (n=10) used typical University of Leeds student as the normative referent group. All participants then completed a semi-structured interview assessing how believable and personally relevant they found the feedback. Findings from thematic analysis of the transcripts suggest that personalised feedback prompts participants to actively consider their personal value judgements regarding acceptable drinking behaviour. Students responded directly to the normative feedback component. Justifications of ratings of believability of normative feedback were based on personal observations of student drinking behaviour and perceived credibility of the normative data. The current manipulation focussed on gender as a salient comparison group, participants suggested year of study and age as alternative salient normative comparison groups.

This research analyses a binge drinking night out of women aged 25-55. The research method is a thematically structured phenomenological analysis utilising Structured Existential Analysis (SEA) (Deurzen 2010) and Fractions of the Lifeworld (Ashworth 2003) as overlapping heuristic devices. The thematic structure allows a strong narrative flow, which ensures that the voices of co-researchers are maintained throughout. These voices are analysed with SEA, which generative process unveils a greater number of sub themes and an increased complexity that is then analysed using the Fractions of the Lifeworld heuristic. Emotional movement across the night out is tracked and many interwoven themes emerge including gender, sexuality, resistance, freedom, self worth and power. The night out is found to have a ritual structure of time that allows co-researchers a temporary transcendence of their pallid mood as a satiated tedium. The night out is in turn experienced as satiated fullness and is transcended by the release of the next day and the return to work. It is suggested that this ontological movement of the emotions is a possible key-underpinning factor in the initiation of the process of ritual, addiction and of all motivational movement.

Alcohol is the most harmful drug in the UK, with harm extending beyond the individual to affect other people, society and the economy. Interventions effective at reducing alcohol intake are hindered by barriers to delivery. This thesis aimed to explore the use of the Internet for the delivery and evaluation of interventions for reducing alcohol intake, with a view to widening the availability of services. The effectiveness of stand-alone computer-based interventions was determined in the first systematic review in this field to present clinically meaningful outcomes, i.e. grams per week and binge frequency (Chapter 2). A number of limitations of the literature were identified, most of which were subsequently addressed in the Down Your Drink (DYD) online trial. This online trial of an Internet-based intervention provided the context for the exploration of methodological challenges introduced by the Internet setting (Chapter 3). Conventional measures of alcohol intake may not retain their validity when transferred online. An online measure of past-week alcohol consumption was created and validated for use as the primary outcome measure in the DYD trial (Chapter 4). Low rates of follow-up are common in online trials and increase the possibility of bias. Two sequential online trials found low value incentives (e.g. £5) did not improve follow-up in the DYD trial, whereas higher values incentives (e.g. £10) were effective and more cost-effective (Chapter 5). Qualitative interviews with DYD trial participants provided a unique insight into the experiences of a previously unstudied group of hazardous drinkers seeking help online (Chapter 6). The Internet setting was found to mitigate some of the barriers to seeking help in-person, attracting a large group of ‘e-help-seekers’ whose varied needs are unmet by existing services. The implications of these findings on the development of online services were discussed along with directions for future research.

This thesis highlights the complex issues associated with women habitual drunkards and the changing perceptions of such women as sinful, as a social problem, and latterly as a threat to the nation’s health. The national situation is investigated and the perceived relationship between habitual drunkards and insanity is discussed. The local context of Bristol is examined including the emergence of the inebriate institutions the Royal Victoria Homes, Horfield, and Brentry. In addition, the working relationship between the Royal Victoria Homes and the state, philanthropy, and public bodies is analysed. The thesis also examines women habitual drunkards sent to the National Institutions for Inebriates, a network of institutions associated with Bristol. The key workers involved with these institutions and how they contributed to debates and practices are explored. Gendered attitudes and how they affected women’s lives and the way women’s social roles and behaviour were shaped by stereotypes is a central theme of this thesis. The thesis argues that habitual drunkards, particularly women, sent by the courts to inebriate reformatories were often perceived by doctors to be on the borderland of insanity. Such women were considered not sufficiently sane to be in control of themselves, nor sufficiently insane to be certified and sent to a lunatic asylum. The over-arching aim of the thesis is to discover the complex factors, national and local, that had an influence on women habitual drunkards sent by the courts to a certified inebriate reformatory. Finally, why reformatories were viewed by contemporaries as a solution to serious concerns over women and drinking and the reaction of some of the women sent to an inebriate reformatory is considered. The thesis period ends with the Mental Deficiency Act, 1913, which brought habitual drunkards within the meaning of the Inebriates Act, 1898 under its provision.

The thesis analyses the formation of state alcohol policy in contemporary Russia, with particular emphasis on the initiative to reduce consumption initiated by President Medvedev in 2009. The analysis is based on qualitative data gathered from a range of sources: semi-structured interviews conducted during fieldwork in Russia; interviews or extended discussions of alcohol policy already in the public domain; government documents and other official publications; contemporary media articles and opinion polls. I apply a constructivist sociological methodology which views ‘social problems’ as not simply objective states of affairs, but rather the result of competition between different groups in society to establish their interpretation of ‘the problem’ as the dominant discourse. I describe how from the mid-2000s, a small but influential anti-alcohol movement emerged comprised of members of a ‘civil society elite’. This new elite was successful in gaining cultural authority over the definition of the ‘alcohol problem’, and thus setting the anti-alcohol agenda. I interpret changes in alcohol policy in the 1990s and 2000s in the context of broader political and socio-economic trends. I apply the concept of sistema, the informal network-based system of governance in Russia, to explain how state-sponsored vodka interests have affected the development of anti-alcohol policy over the period 2009-2012. The development and passage of the major 2011 law on alcohol is described in detail, including the crucial role played by rival vodka and beer industry lobbyists. The thesis concludes by evaluating to what extent alcohol policy under President Medvedev 2009-2012 can properly be described as an ‘anti-alcohol campaign’. I conclude that while the initiatives cannot be dismissed as mere ‘simulation’ of anti-alcohol policy as some respondents suggested, the word ‘campaign’ gives a false sense of coherence to policies that were pushed by a variety of competing policy actors pursuing their own sectoral interests.