The Scottish Government

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Background

Tackling alcohol misuse and eliminating smoking have long been regarded as essential components in the campaign to improve Scotland's health. Both have been the focus of renewed attention from politicians in Scotland and the rest of the UK in recent years. The current political agenda reflects evidence on negative trends in alcohol consumption (particularly among women and younger age groups) and on the effects of passive smoking (or 'second-hand smoke'), as well as interest in policy developments in other countries, particularly the smoking bans introduced in the Republic of Ireland, New York and elsewhere.

This report presents findings from the 2004 Scottish Social Attitudes Survey on a module of questions designed to improve understanding of attitudes towards alcohol and second-hand smoke in Scotland.

Methods

The Scottish Social Attitudes ( SSA) survey was launched by ScotCen¹ (part of the National Centre for Social Research) in 1999. It aims to improve understanding of public opinion over time to inform policy making in Scotland.

The SSA involves 1,600 interviews annually, with respondents selected using random probability sampling to ensure that the results are robust and representative of the Scottish population. The survey involves face-to-face interviews and a self-completion questionnaire. In any one year it will typically contain four or five modules. The module of questions on drinking and smoking on which these findings are based was developed by ScotCen in liaison with the Effective Interventions research team ².

Findings

Alcohol and Scottish Culture

• Alcohol misuse is widely perceived as a problem for Scotland. Forty-six per cent of respondents thought that alcohol caused more harm than other drugs to Scotland as a whole. There was little variation in this view by gender, age or rurality.
• However alcohol is also seen as a central part of Scottish culture - 64% agree that 'Drinking is a major part of the Scottish way of life'.
• Men are more likely than women to view alcohol as a 'social lubricant' - 47% of men compared with 27% of women agree or strongly agree that 'It's easier to enjoy a social event if you've had a drink'.

Alcohol, stigma and social acceptability

• Getting drunk and binge drinking attract more stigma than acceptance among the population as a whole - just 18% agree that 'Getting drunk at the weekends is a perfectly acceptable thing to do', while 83% think someone who binge drinks has a very or fairly serious problem.
• However, 18-24 year-olds hold a more permissive attitude towards getting drunk in general and binge drinking in particular. Fifty-seven per cent of 18-24 years olds agree that getting drunk at the weekends is acceptable, compared with 30% of 25-39 year-olds and 8% of 40-64 year-olds. They are less likely to view binge drinking as a serious problem or as something to be embarrassed about.
• Men also tend to hold more permissive attitudes than women towards getting drunk and binge drinking.
• People in Scotland are divided over whether problem drinkers can be held 'morally responsible' for their own situation. While 34% agree or strongly agree that people with drinking problems have only themselves to blame, 40% disagree.
• There is some stigma (or a perception of stigma) attached to not drinking in Scotland. Thirty-four per cent of current drinkers agree that other people would think it odd if they stopped drinking altogether, while 42% of tee-totallers agree that other people do view their not drinking as odd.
• The majority of people in Scotland think that drinking alcohol should probably or definitely not be allowed in public parks (82%), football matches (83%), in the street (90%) and on trains (76%).

Alcohol and health

• Alcohol and tobacco are not seen as causing as much harm to individual frequent users as heroin or crack cocaine. After cannabis, they are the drugs most people think cause least harm to users.
• Respondents were asked their views of a hypothetical binge drinker and a hypothetical chronic drinker. A majority of people thought that both the binge drinker and the chronic drinker were very or fairly like to seriously damage their long-term health. However, people were much more likely to think the chronic drinker was very likely to damage their long-term health compared with the binge drinker (94% compared with 43%).
• Younger people, aged 18-24, were much less likely than older people to think binge drinking will have serious long-term health effects - 69% of 18-24 year-olds thought the hypothetical binge drinker was very or fairly likely to damage their long-term health, compared with 94% of those aged 65 and over.
• Chronic drinking appears to be viewed within a 'medical model' of alcoholism, as an illness which requires professional help, while binge drinking appears to be viewed more as a 'social problem'. This suggestion is supported by the fact that the most commonly suggested source of help for the chronic drinker was a doctor or GP, while for the binge drinker it was family and friends.

• Most people (74%) think it would be very or fairly easy for someone with a drink problem to find help in the respondent's local area, though respondents in the most deprived areas of Scotland were somewhat less likely to say this.

Alcohol and crime

• The vast majority of people in Scotland (88%) do not think that whether a person is drunk or sober should affect the punishment they receive for vandalising a car, suggesting that people do not think alcohol consumption should be seen as either a mitigating or an aggravating factor in determining punishments for crime.

Alcohol and young people

• Attitudes towards underage drinking vary depending on the context and the age of the young drinker. People are most likely to disapprove of underage drinkers in pubs (61% think it is always or mostly wrong for a 17 year-old to drink in a pub with friends) and least likely to disapprove of older teenagers drinking small amounts at home with their parents (just 16% thought it was always or mostly wrong for a 17 year-old to drink in this situation).
• Disapproval of younger teenagers drinking is relatively high, even when this involves small amounts in a 'safe' (and legal) situation - 42% thought it was always or mostly wrong for a 14 year-old to drink a small amount at home with their parents, even if they do not get drunk.
• There is relatively strong support (particularly among 18-24 year-olds) for a 'no proof, no sale' policy to tackle underage drinking (31% thought this was the measure most likely to be effective), but very little support for action to punish parents of underage drinkers (32% thought this was the measure least likely to be effective).

Controlling the sale and purchase of alcohol

• When the survey was conducted in late 2004, there were relatively low levels of support for banning 'irresponsible' drinks promotions like happy hours and two-for-one offers - just 21% favoured an outright ban. However, a further 37% thought these types of offers should be restricted, suggesting there is majority support for some action on cheap drinks promotions.
• People are more likely to think that longer pub opening hours will encourage people to drink more heavily (54%) than to think people will pace their drinking more sensibly (36%).
• There appears to be little support for increasing taxes on alcohol to encourage more sensible drinking.

Second-hand smoke

• Restaurants, pub and bars are the locations where most people in Scotland are regularly exposed to second-hand tobacco smoke. Thirty-six per cent said they were regularly exposed to other people's smoke in restaurants and 55% that they were regularly exposed to second-hand smoke in pubs and bars.
• Thirty-nine per cent of respondents avoid pubs and bars and 46% avoid restaurants at least sometimes because of other people's smoke.
• People were more likely to support a complete ban on smoking in restaurants compared with pubs and bars (53% compared with 25%). However, even among smokers, who were the group least likely to support an outright ban, there was majority support for some action to restrict smoking in pubs and bars.
• Support for a complete ban on smoking in pubs and bars was much higher among employers, managers and professionals (34%) compared with those in routine and semi-routine occupations (17%), suggesting class is a key factor associated with support for a ban.

Conclusions

The 2004 Scottish Social Attitudes Survey provides a clear picture of attitudes towards alcohol and second-hand smoke in Scotland today. The findings confirm many of the key assumptions about public attitudes towards alcohol that have underpinned recent policy initiatives and campaigns - for example, that young people and men are more permissive than older people and women in their attitudes towards binge drinking, and that in general disapproval of underage drinking is high.

However, they also highlight the apparently contradictory or ambiguous attitudes that many people in Scotland have about drinking alcohol. For example, drinking is perceived as both a major problem for Scotland and part of a 'Scottish way of life' and in spite of the high level of publicity surrounding alcohol and tobacco as major causes of death and ill-health in Scotland, most people do not think they cause as much harm to frequent users as other drugs.

Finally, the study also provides robust baseline data on public attitudes towards current proposals on controlling the sale and purchase of alcohol and prohibiting smoking in enclosed public places, including pubs, bars and restaurants. This baseline position is summarised above.

Of course, the real value of the survey will lie in the possibility of tracking all these attitudes over time. Will the current cohort of 18-24 year-olds retain their permissive attitudes towards alcohol in their late 20s or early 30s? And will the next generation of young people exhibit less permissive attitudes? Will the gender-divide in attitudes towards drinking persist? Will support for a ban on smoking in pubs and bars increase or decrease if the ban is implemented? In repeating the drinking and smoking module in future sweeps of the SSA, we will be able to track changes in cultural attitudes towards alcohol and developments in public opinion on the control of drinking and smoking in Scotland.

Footnotes

¹ The Scottish Centre for Social Research (ScotCen) was formed in Feb 2004 as the result of a merger between The National Centre in Scotland and Scottish Health Feedback an independent research consultancy.

³ The Effective Interventions research team are now titled Substance Misuse research team.