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Population Health Metrics
Published in: Population Health Metrics 1/2016

Open Access 01-12-2016 | Research

Estimating average alcohol consumption in the population using multiple sources: the case of Spain

Authors: Luis Sordo, Gregorio Barrio, María J. Bravo, Joan R. Villalbí, Albert Espelt, Montserrat Neira, Enrique Regidor

Published in: Population Health Metrics | Issue 1/2016

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Abstract

Background

National estimates on per capita alcohol consumption are provided regularly by various sources and may have validity problems, so corrections are needed for monitoring and assessment purposes. Our objectives were to compare different alcohol availability estimates for Spain, to build the best estimate (actual consumption), characterize its time trend during 2001–2011, and quantify the extent to which other estimates (coverage) approximated actual consumption.

Methods

Estimates were: alcohol availability from the Spanish Tax Agency (Tax Agency availability), World Health Organization (WHO availability) and other international agencies, self-reported purchases from the Spanish Food Consumption Panel, and self-reported consumption from population surveys. Analyses included calculating: between-agency discrepancy in availability, multisource availability (correcting Tax Agency availability by underestimation of wine and cider), actual consumption (adjusting multisource availability by unrecorded alcohol consumption/purchases and alcohol losses), and coverage of selected estimates. Sensitivity analyses were undertaken. Time trends were characterized by joinpoint regression.

Results

Between-agency discrepancy in alcohol availability remained high in 2011, mainly because of wine and spirits, although some decrease was observed during the study period.
The actual consumption was 9.5 l of pure alcohol/person-year in 2011, decreasing 2.3 % annually, mainly due to wine and spirits. 2011 coverage of WHO availability, Tax Agency availability, self-reported purchases, and self-reported consumption was 99.5, 99.5, 66.3, and 28.0 %, respectively, generally with downward trends (last three estimates, especially self-reported consumption). The multisource availability overestimated actual consumption by 12.3 %, mainly due to tourism imbalance.

Conclusions

Spanish estimates of per capita alcohol consumption show considerable weaknesses. Using uncorrected estimates, especially self-reported consumption, for monitoring or other purposes is misleading. To obtain conservative estimates of alcohol-attributable disease burden or heavy drinking prevalence, self-reported consumption should be shifted upwards by more than 85 % (91 % in 2011) of Tax Agency or WHO availability figures. The weaknesses identified can probably also be found worldwide, thus much empirical work remains to be done to improve estimates of per capita alcohol consumption.
Appendix
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Metadata
Title
Estimating average alcohol consumption in the population using multiple sources: the case of Spain
Authors
Luis Sordo
Gregorio Barrio
María J. Bravo
Joan R. Villalbí
Albert Espelt
Montserrat Neira
Enrique Regidor
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Population Health Metrics / Issue 1/2016
Electronic ISSN: 1478-7954
DOI
https://doi.org/10.1186/s12963-016-0090-4

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