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Recommended Alcohol Questions - National Institute On Alcohol Abuse and Alcoholism (NIAAA)

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9/23/2016

RecommendedAlcoholQuestions|NationalInstituteonAlcoholAbuseandAlcoholism(NIAAA)

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InthisSection
RecommendedAlcoholQuestions
AdministeringAlcoholinHumanStudies
ClinicalTrialRegulations,PoliciesandGuidance
DataandSafetyMonitoringGuidelines
EpidemiologicData

RecommendedAlcoholQuestions
TheTaskForceonRecommendedAlcoholQuestions,ataskforceofNIAAA'sCouncilmetonOctober15and16,
2003inBethesdaMarylandtodeveloprecommendedminimumsetsofdownwardcompatiblealcoholconsumption
questions,forresearchersinotherfieldswhoonlyhaveresourcestoaskalimitednumberofalcoholrelated
questions.Therecommendedsetsof3,4,5and6itemspresentedhereresultedfromtheworkofthattaskforce.
WhatIsTheMinimumNumberofQuestionsWhichShouldBeRecommended?
Researchhasshowntheimportanceoflearningaboutpeople'spatternsofalcoholconsumption,notjusttheiraverage
levelsofconsumption(e.g.,averagenumberofdrinksconsumedinaweek).Patternsofalcoholconsumption(that
mayincludefrequentregulardrinkingofsmallamounts,orinfrequentepisodesofconsumingverylargequantitiesall
atonetime)cannotbeadequatelydescribedordifferentiatedbyaskingonlytwoquestionsaboutdrinking.Two
questionscanmeasureonlyaverages(basedonquestionsabouttypicaldrinkingfrequenciesandquantities)or
extremepatterns(suchasabstinenceandheavyepisodicdrinking).Tomoreadequatelycapturetherangeofdrinking
patternsrequiresaminimumofthreequestions.Specifically,ameasureoffrequencyofheavydrinking(5ormore
standarddrinkswithinatwohour*periodformen(4ormoreforwomen),andstandardquestionsaboutfrequencyof
alcoholuseandtypicalnumberofdrinksperdaywhenalcoholisused,arenecessarytoadequatelydescribedrinking
patternsandtotalvolumeofalcoholconsumed.
ThisrecommendationisconsistentwiththoseintheInternationalGuideforMonitoringAlcoholConsumptionand
RelatedHarm(WHO,2000,pg57).Itisalsobasedonrecentepidemiologicalstudiesonalcoholintakeandrisks
whichhavedemonstratedthatforestimatingriskofmortality,morbidity(includinginjuries)andotherproblems
includingdrunkdrivingandsocialharms,itisessentialtoassessheavyquantityconsumptioninadditiontousual
frequencyandquantityofconsumption.Themostwidelyused,patternmeasureofheavyconsumptionis"binge"
definedbyaWorkingGroupofNIAAA'sCouncilasapatternofdrinkingalcoholthatbringsbloodalcoholconcentration
(BAC)to0.08gramspercentorabove.Forthetypicaladultthispatterncorrespondstoconsuming5ormoredrinks
(male)or4ormoredrinks(female)inabout2hours.
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RecommendedAlcoholQuestions|NationalInstituteonAlcoholAbuseandAlcoholism(NIAAA)

BriefOverviewofthe3,4,5And6ItemSetsofRecommendedQuestions
The3itemsetasksaboutthefrequencyofpast12monthdrinking,thenumberofdrinksconsumedonatypical
drinkingdayinthepast12monthsandaboutthefrequencyofbingedrinkinginthepast12months,inorderto
captureinformationaboutbothlevelofconsumptionanddrinkingpatterns,asrecommendedabove.The4itemset
addsaquestionaboutthemaximumnumberofdrinksconsumedina24hourperiodinthepast12months.This
questionisimportantbecauseitprovidesadditionalinformationaboutdrinkingpatternsandbecauseitishighly
correlatedwithalcoholusedisorders.Itisinsertedbeforethebingedrinkingquestionwhichthenbecomesquestion4
inthe4itemset.The5itemsetaddsaquestionaboutmaximumdrinksina24hourperiodintherespondent's
lifetime,asthelastquestionintheset.Andfinally,the6itemsetadds,asthefourthquestionimmediatelyfollowing
theitemaboutmaximumdrinksina24hourperiodinthepast12months,anitemwhichasksaboutthefrequencyof
consumingthismaximumnumberofdrinksinthepast12months.
TheChoiceofthePast12MonthTimeframe
Itwastheconsensusofthetaskforcethataskingaboutalcoholconsumptionoverthepast12monthswasthebest
choiceoftimeframe,takingintoaccounttheissuesofrecallovertheperiodandofinfrequentdrinkers,manyofwhom
wouldbemissedwithashorttimeframe.Missinginfrequentdrinkerscouldbeespeciallyproblematicforstudyingthe
relationshipbetweeninfrequent(whichisoftenlighttomoderate)drinkingandgeneralhealthoutcomes,arelationship
whichisthefocusofmanylargeepidemiologicalstudiesofadults.
However,whenstudyingalcoholconsumptionamongadolescents,otherfactorsneedtobeconsidered.Duetothe
moresporadic,oropportunistic,natureofalcoholconsumptionamongyouth,andthepossibilityofgeneralizingfrom
recentdrinkingepisodes,a30daytimewindowisfrequentlyusedforunderagesubjects.Usinga30daytimewindow
forunderagesubjectswillalsofacilitatecomparisonswithmanyothernationalsurveystudiesofyouth,whichemploy
thattimeframe.
Keyreferences(selected):
Caetano,R.,Tam,T.,Greenfield,T.K.,Cherpitel,C.J.andMidanik,L.T.(1997)DSMIValcoholdependenceand
drinkingintheU.S.population:Ariskanalysis.AnnalsofEpidemiology7,542549.
Cherpitel,C.J.,Tam,T.W.,Midanik,L.T.,Caetano,R.andGreenfield,T.K.(1995)Alcoholandnonfatalinjuryinthe
U.S.generalpopulation:Ariskfunctionanalysis.AccidentAnalysisandPrevention27,651661.
Greenfield,T.K.andRogers,J.D.(1999)Alcoholicbeveragechoice,riskperception,andselfreporteddrunkdriving:
effectsofmeasurementonriskanalysis.Addiction94,17351743.
Midanik,L.T.,Tam,T.W.,Greenfield,T.K.andCaetano,R.(1996)Riskfunctionsforalcoholrelatedproblemsina
1988U.S.nationalsample.Addiction91,14271437.
Rehm,J.andBondy,S.(1996)Riskfunctions,lowriskdrinkingguidelines,andthebenefitsofmoderatedrinking.
Addiction91,14391441.
Rehm,J.,Greenfield,T.K.andRogers,J.D.(2001)Averagevolumeofalcoholconsumption,patternsofdrinkingand
allcausemortality.ResultsfromtheU.S.NationalAlcoholSurvey.AmericanJournalofEpidemiology153,6471.
Room,R.,Bondy,S.andFerris,J.(1995)Theriskofharmtooneselffromdrinking,Canada1989.Addiction90,499
513.
ThreeQuestionSet
Question1(asksaboutfrequencyofpast12monthdrinking)
Duringthelast12months,howoftendidyouusuallyhaveanykindofdrinkcontainingalcohol?Byadrinkwemean
halfanounceofabsolutealcohol(e.g.a12ouncecanorglassofbeerorcooler,a5ounceglassofwine,ora
drinkcontaining1shotofliquor).Chooseonlyone.
Everyday
5to6timesaweek
3to4timesaweek
twiceaweek
onceaweek
2to3timesamonth
onceamonth
3to11timesinthepastyear
1or2timesinthepastyear
(IFRESPONDENTGIVESANYOFTHEABOVERESPONSES,GOTOQUESTION2)
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RecommendedAlcoholQuestions|NationalInstituteonAlcoholAbuseandAlcoholism(NIAAA)

Ididnotdrinkanyalcoholinthepastyear,butIdiddrinkinthepast
(GOTOQUESTION1A)
Ineverdrankanyalcoholinmylife
(GOTOQUESTION1B)
1ADuringyourlifetime,whatisthemaximumnumberofdrinkscontainingalcoholthatyoudrankwithina24hour
period?(askedhereonlyofthosewhodidnotdrinkanyalcoholduringthepast12months)
36drinksormore
24to35drinks
18to23drinks
12to17drinks
8to11drinks
5to7drinks
4drinks
3drinks
2drinks
1drink
(DONEWITHALCOHOLQUESTIONS)
1BSoyouhaveneverhadadrinkcontainingalcoholinyourentirelife.(askedonlyofthosewhosaytheynever
drankalcoholintheirlives)
Yes,Ineverdrank.
(DONEWITHALCOHOLQUESTIONS)
No,Ididdrink
(GOBACKTOQUESTION1ANDREPEAT)
Question2(asksaboutnumberofdrinksontypicaldrinkingdayinpast12months)
Duringthelast12months,howmanyalcoholicdrinksdidyouhaveonatypicaldaywhenyoudrankalcohol?
25ormoredrinks
19to24drinks
16to18drinks
12to15drinks
9to11drinks
7to8drinks
5to6drinks
3to4drinks
2drinks
1drink
Question3(asksaboutfrequencyofbingedrinkinginpast12months)
Duringthelast12months,howoftendidyouhave5ormore(males)or4ormore(females)drinkscontaininganykind
ofalcoholinwithinatwohourperiod?[Thatwouldbetheequivalentofatleast5(4)12ouncecansorbottlesofbeer,
5(4)fiveounceglassesofwine,5(4)drinkseachcontainingoneshotofliquororspiritstobeprovidedby
interviewerifasked.]Chooseonlyone:
Everyday
5to6daysaweek
3to4daysaweek
twodaysaweek
onedayaweek
2to3daysamonth
onedayamonth
3to11daysinthepastyear
1or2daysinthepastyear
FourQuestionSet
Question1(asksaboutfrequencyofpast12monthdrinking)
Duringthelast12months,howoftendidyouusuallyhaveanykindofdrinkcontainingalcohol?Byadrinkwemean
halfanounceofabsolutealcohol(e.g.a12ouncecanorglassofbeerorcooler,a5ounceglassofwine,ora
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RecommendedAlcoholQuestions|NationalInstituteonAlcoholAbuseandAlcoholism(NIAAA)

drinkcontaining1shotofliquor).Chooseonlyone.
Everyday
5to6timesaweek
3to4timesaweek
twiceaweek
onceaweek
2to3timesamonth
onceamonth
3to11timesinthepastyear
1or2timesinthepastyear
(IFRESPONDENTGIVESANYOFTHEABOVERESPONSES,GOTOQUESTION2)
Ididnotdrinkanyalcoholinthepastyear,butIdiddrinkinthepast
(GOTOQUESTION1A)
Ineverdrankanyalcoholinmylife
(GOTOQUESTION1B)
1ADuringyourlifetime,whatisthemaximumnumberofdrinkscontainingalcoholthatyoudrankwithina24hour
period?(askedhereonlyofthosewhodidnotdrinkanyalcoholduringthepast12months)
36drinksormore
24to35drinks
18to23drinks
12to17drinks
8to11drinks
5to7drinks
4drinks
3drinks
2drinks
1drink
(DONEWITHALCOHOLQUESTIONS)
1BSoyouhaveneverhadadrinkcontainingalcoholinyourentirelife.(askedonlyofthosewhosaytheynever
drankalcoholintheirlives)
Yes,Ineverdrank.
(DONEWITHALCOHOLQUESTIONS)
No,Ididdrink
(GOBACKTOQUESTION1ANDREPEAT)
Question2(asksaboutnumberofdrinksontypicaldrinkingdayinpast12months)
Duringthelast12months,howmanyalcoholicdrinksdidyouhaveonatypicaldaywhenyoudrankalcohol?
25ormoredrinks
19to24drinks
16to18drinks
12to15drinks
9to11drinks
7to8drinks
5to6drinks
3to4drinks
2drinks
1drink
Question3(NEWQUESTIONFOR4ITEMSETNOTEORDERCHANGENEWQUESTIONIS#3)(asksabout
maximumdrinksina24hourperiodinpast12months)
Duringthelast12months,whatisthelargestnumberofdrinkscontainingalcoholthatyoudrankwithina24hour
period?
36drinksormore
24to35drinks
18to23drinks
12to17drinks
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RecommendedAlcoholQuestions|NationalInstituteonAlcoholAbuseandAlcoholism(NIAAA)

8to11drinks
5to7drinks
4drinks
3drinks
2drinks
1drink
Question4(asksaboutfrequencyofbingedrinkinginpast12months)
Duringthelast12months,howoftendidyouhave5ormore(males)or4ormore(females)drinkscontaininganykind
ofalcoholinwithinatwohourperiod?[Thatwouldbetheequivalentofatleast5(4)12ouncecansorbottlesofbeer,
5(4)fiveounceglassesofwine,5(4)drinkseachcontainingoneshotofliquororspiritstobeprovidedby
interviewerifasked.]Chooseonlyone.
Everyday
5to6daysaweek
3to4daysaweek
twodaysaweek
onedayaweek
2to3daysamonth
onedayamonth
3to11daysinthepastyear
1or2daysinthepastyear

FiveQuestionSet
Question1(asksaboutfrequencyofpast12monthdrinking)
Duringthelast12months,howoftendidyouusuallyhaveanykindofdrinkcontainingalcohol?Byadrinkwemean
halfanounceofabsolutealcohol(e.g.a12ouncecanorglassofbeerorcooler,a5ounceglassofwine,ora
drinkcontaining1shotofliquor).Chooseonlyone:
Everyday
5to6timesaweek
3to4timesaweek
twiceaweek
onceaweek
2to3timesamonth
onceamonth
3to11timesinthepastyear
1or2timesinthepastyear
(IFRESPONDENTGIVESANYOFTHEABOVERESPONSES,GOTOQUESTION2)
Ididnotdrinkanyalcoholinthepastyear,butIdiddrinkinthepast
(GOTOQUESTION1A)
Ineverdrankanyalcoholinmylife
(GOTOQUESTION1B)
1ADuringyourlifetime,whatisthemaximumnumberofdrinkscontainingalcoholthatyoudrankwithina24hour
period?(askedhereonlyofthosewhodidnotdrinkanyalcoholduringthepast12months)
36drinksormore
24to35drinks
18to23drinks
12to17drinks
8to11drinks
5to7drinks
4drinks
3drinks
2drinks
1drink
(DONEWITHALCOHOLQUESTIONS)
1BSoyouhaveneverhadadrinkcontainingalcoholinyourentirelife.(askedonlyofthosewhosaytheynever
drankalcoholintheirlives)
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RecommendedAlcoholQuestions|NationalInstituteonAlcoholAbuseandAlcoholism(NIAAA)

Yes,Ineverdrank.
(DONEWITHALCOHOLQUESTIONS)
No,Ididdrink
(GOBACKTOQUESTION1ANDREPEAT)
Question2(asksaboutnumberofdrinksontypicaldrinkingdayinpast12months)
Duringthelast12months,howmanyalcoholicdrinksdidyouhaveonatypicaldaywhenyoudrankalcohol?
25ormoredrinks
19to24drinks
16to18drinks
12to15drinks
9to11drinks
7to8drinks
5to6drinks
3to4drinks
2drinks
1drink
Question3(asksaboutmaximumdrinksina24hourperiodinpast12months)
Duringthelast12months,whatisthelargestnumberofdrinkscontainingalcoholthatyoudrankwithina24hour
period?
36drinksormore
24to35drinks
18to23drinks
12to17drinks
8to11drinks
5to7drinks
4drinks
3drinks
2drinks
1drink
Question4(asksaboutfrequencyofbingedrinkinginpast12months)
Duringthelast12months,howoftendidyouhave5ormore(males)or4ormore(females)drinkscontaininganykind
ofalcoholinwithinatwohourperiod?[Thatwouldbetheequivalentofatleast5(4)12ouncecansorbottlesofbeer,
5(4)fiveounceglassesofwine,5(4)drinkseachcontainingoneshotofliquororspiritstobeprovidedby
interviewerifasked.]Chooseonlyone.
Everyday
5to6daysaweek
3to4daysaweek
twodaysaweek
onedayaweek
2to3daysamonth
onedayamonth
3to11daysinthepastyear
1or2daysinthepastyear
Question5(asksaboutmaximumdrinksin24hoursinlifetime)
Duringyourlifetime,whatisthelargestnumberofdrinkscontainingalcoholthatyoudrankwithina24hourperiod?
36drinksormore
24to35drinks
18to23drinks
12to17drinks
8to11drinks
5to7drinks
4drinks
3drinks
2drinks
1drink

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RecommendedAlcoholQuestions|NationalInstituteonAlcoholAbuseandAlcoholism(NIAAA)

SixQuestionSet
Question1(asksaboutfrequencyofpast12monthdrinking)
Duringthelast12months,howoftendidyouusuallyhaveanykindofdrinkcontainingalcohol?Byadrinkwemean
halfanounceofabsolutealcohol(e.g.a12ouncecanorglassofbeerorcooler,a5ounceglassofwine,ora
drinkcontaining1shotofliquor).Chooseonlyone.
Everyday
5to6timesaweek
3to4timesaweek
twiceaweek
onceaweek
2to3timesamonth
onceamonth
3to11timesinthepastyear
1or2timesinthepastyear
(IFRESPONDENTGIVESANYOFTHEABOVERESPONSES,GOTOQUESTION2)
Ididnotdrinkanyalcoholinthepastyear,butIdiddrinkinthepast
(GOTOQUESTION1A)
Ineverdrankanyalcoholinmylife
(GOTOQUESTION1B)
1ADuringyourlifetime,whatisthemaximumnumberofdrinkscontainingalcoholthatyoudrankwithina24hour
period?(askedhereonlyofthosewhodidnotdrinkanyalcoholduringthepast12months)
36drinksormore
24to35drinks
18to23drinks
12to17drinks
8to11drinks
5to7drinks
4drinks
3drinks
2drinks
1drink
(DONEWITHALCOHOLQUESTIONS)
1BSoyouhaveneverhadadrinkcontainingalcoholinyourentirelife.(askedonlyofthosewhosaytheynever
drankalcoholintheirlives)
Yes,Ineverdrank.
(DONEWITHALCOHOLQUESTIONS)
No,Ididdrink
(GOBACKTOQUESTION1ANDREPEAT)
Question2(asksaboutnumberofdrinksontypicaldrinkingdayinpast12months)
Duringthelast12months,howmanyalcoholicdrinksdidyouhaveonatypicaldaywhenyoudrankalcohol?
25ormoredrinks
19to24drinks
16to18drinks
12to15drinks
9to11drinks
7to8drinks
5to6drinks
3to4drinks
2drinks
1drink
Question3(asksaboutmaximumdrinksina24hourperiodinpast12months)
Duringthelast12months,whatisthelargestnumberofdrinkscontainingalcoholthatyoudrankwithina24hour
period?

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RecommendedAlcoholQuestions|NationalInstituteonAlcoholAbuseandAlcoholism(NIAAA)

36drinksormore
24to35drinks
18to23drinks
12to17drinks
8to11drinks
5to7drinks
4drinks
3drinks
2drinks
1drink
Question4(NEWQUESTIONFOR6ITEMSETNOTEORDERCHANGENEWQUESTIONIS#4)(asksabout
frequencyofmaximumdrinksinlast12months)
Duringthelast12months,howoftendidyoudrinkthislargestnumberofdrinks?Chooseonlyone.
Everyday
5to6timesaweek
3to4timesaweek
twiceaweek
onceaweek
2to3timesamonth
onceamonth
3to11timesinthepastyear
1or2timesinthepastyear
Question5(asksaboutfrequencyofbingedrinkinginpast12months)
Duringthelast12months,howoftendidyouhave5ormore(males)or4ormore(females)drinkscontaininganykind
ofalcoholinwithinatwohourperiod?[Thatwouldbetheequivalentofatleast5(4)12ouncecansorbottlesofbeer,
5(4)fiveounceglassesofwine,5(4)drinkseachcontainingoneshotofliquororspiritstobeprovidedby
interviewerifasked.]Chooseonlyone.
Everyday
5to6daysaweek
3to4daysaweek
twodaysaweek
onedayaweek
2to3daysamonth
onedayamonth
3to11daysinthepastyear
1or2daysinthepastyear
Question6(asksaboutmaximumdrinksin24hoursinlifetime)
Duringyourlifetime,whatisthelargestnumberofdrinkscontainingalcoholthatyoudrankwithina24hourperiod?
36drinksormore
24to35drinks
18to23drinks
12to17drinks
8to11drinks
5to7drinks
4drinks
3drinks
2drinks
1drink
Therearemanyotherimportantareasofinquiryrelatedtoalcoholconsumptionwhicharenotaddressedbythe
recommendedquestions.Researcherswhowantmoredetailedinformationaboutalcoholissuesmaywanttoconsider
askingadditionalquestionsinoneormoreofthefollowingareas:moredetailedand/orbeveragespecificconsumption,
alcoholproblemsincludingabuseanddependence,drinkingcontexts,drinkingexpectanciesandreasonsfordrinking,
concurrentuseofothersubstances,andscreeningforalcoholproblemsasagoalofquestions.
Anotherimportantconsiderationisotherhealthrelatedvariableswhichshouldbecollectedinconjunctionwithalcohol
consumptioninformationwheneverpossible.Theseareheight,weight,smokinginformationandpossiblyameasureof
healthstatus.

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*Althoughquestionson"binge"drinkinghavebeenaskedinmanynationalandpopulationsurveys,the2hourtime
framerepresentsachange.Inthepast,thequestionwastypicallyframedusing"inarow"or"onanoccasion."On
February5,2004,NIAAACouncilapprovedthefollowingdefinition:a"binge"isapatternofdrinkingalcoholthatbrings
bloodalcoholconcentration(BAC)to0.08grampercentorabove.Forthetypicaladult,thepatterncorrespondsto
consuming5ormoredrinks(male),or4ormoredrinks(female),inabout2hours."Thequestionsrecommendedhere
reflectthatdefinition.Furtherinformationaboutthisdefinitionisavailableat:
http://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.htm

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