KAP STUDY. NATIONAL INFORMATIONAL CAMPAIGN REGARDING REDUCTION OF ALCOHOL CONSUMPTION Phase I and Phase II May 2014 Table of content 3 EXECUTIVE SUMMARY .................................................................................................................................. 7 INTRODUCTION ........................................................................................................................................... 11 i.1 Purpose and objectives................................................................................................................................. 12 i.2 Applied methodology ................................................................................................................................... 12 i.2.1 Interviewing population. Plan of sampling .......................................................................................... 12 i.2.4 Questionnaire ...................................................................................................................................... 13 i.2.5 Pilot research ....................................................................................................................................... 13 i.2.6 Interviewing and data quality .............................................................................................................. 13 i.2.7 Data analysis ........................................................................................................................................ 13 i.3 Characteristics of the sample ................................................................................................................. 13 i.4 Limits and barriers ........................................................................................................................................ 13 CHAPTER II: KNOWLEDGE AND ATTITUDE REGARDING EXCESSIVE ALCOHOL CONSUMPTION ....................... 28 CHAPTER III: SOCIAL-DEMOGRAPHIC PROFILE OF THE ALCOHOL CONSUMER ............................................... 34 CHAPTER IV: MULTIVARIATE ANALYSIS ........................................................................................................ 36 CONCLUSIONS ............................................................................................................................................. 40 Table of content 4 Charts: Fig. 1A: Have you ever consumed alcoholic beverage (an entire shot, not just a sip)?, %.................................... 16 Fig. 1C: Types of alcoholic drinks, consumed more often, % ................................................................................ 16 Fig. 2A: Have you consumed any alcoholic drinks in the last month?, % .............................................................. 16 Fig. 2C: How often did you have this quantity in the last month?, %.................................................................... 17 Fig. 2D: Number of portions consumed depending on the average consumption frequency, % ......................... 18 Fig. 3A: In the last 3 months, where there days when you consumed more alcohol than usually?, % ................ 18 Fig. 3B: How many portions of alcohol have you consumed in the days when you drank more than usual, in the last 3 months?, % .................................................................................................................................................. 19 Fig. 3C: How often do you drink this quantity?, % ................................................................................................ 19 Fig. 3B and 3C: How many portions of alcohol you consumed during days when you drank more than usual, in the last three months?, How often did you consume this amount?,% ................................................................. 20 Fig. 4A: How often did you have an alcoholic drink during the last year?, %........................................................ 20 Fig. 4B: How many portions of alcoholic drinks did you consume in a normal day, when you consumed alcoholic drinks during the last year?, % .............................................................................................................................. 21 Fig. 4D: How often, during the last year, it happened to you that once you started drinking, you could not stop?, % ............................................................................................................................................................................ 21 Fig. 4E: How often in the last year you failed to do what was normally expected from you, due to alcohol consumption?, % ................................................................................................................................................... 22 Fig. 4F: How often in the last year you felt the need to drink in the morning in order to recover after a session of excessive alcohol consumption?, % .................................................................................................................. 22 Fig. 4G: How often during the last year have you felt guilt or remorse after you had been drinking?,% ............. 22 Fig. 4J: Has it ever happened that a relative, friend, doctor or nurse were worried about your alcohol consumption suggesting you consume less?,% ..................................................................................................... 23 Fig. 8A: If compared to 30 days ago, are you presently drinking more or less, or the same quantity? (question for alcohol consumers), % ..................................................................................................................................... 24 Fig. 8B: In the last 30 days, how often, in general, …? (question for the alcohol consumers), % ......................... 24 Fig. 8C: Have you tried to diminish the alcohol consumption in the last 30 days?, % .......................................... 25 Fig. 8D: In the last 30 days, did someone from your family try to convince you to reduce the quantity of alcohol consumed? (question for the alcohol consumers), % ........................................................................................... 25 Fig. 8E: Which of the following statements expresses the best your opinion on your consumption of alcoholic drinks? (question for the alcohol consumers), % .................................................................................................. 25 Fig. 8F: How likely is it that you will reduce alcohol consumption forever? (question for the alcohol consumers), % ............................................................................................................................................................................ 26 Fig. 9I: During the last appointment at the doctor / health check, I was asked about my drinking habits, % ...... 26 Fig. 9A: To what extent you agree or disagree with the following statements, % ................................................ 28 Fig. 9B: From what you know, does alcohol provoke the following …?, % ........................................................... 29 Fig. 9C: Are you worried about the fact that alcohol will harm your health in the future and if yes, to what extent? (question only for consumers), %............................................................................................................. 29 Fig. 9D: What do you think is the statement: ”Alcohol consumption during the pregnancy can lead to serious disabilities to the child” true or not?, % ................................................................................................................ 30 Fig. 9F: What do you think, is it true or nor that the effects determined by alcohol consumption during the pregnancy will disappear together with the growing child?, % ............................................................................ 30 Fig. 9G: Have you ran across some information about the effects of alcohol over the child during the pregnancy?, % ....................................................................................................................................................... 30 Fig. 9H: Regarding effects of alcohol over the foetus, what do you think, how safe is to have the following quantities of alcoholic drinks?, % (2014) ............................................................................................................... 31 Table of content 5 Tables: Table i.1: General sample, N=1505, % ................................................................................................................... 13 Table 1B: How old were you when you had your first full portion of alcohol?, years .......................................... 16 Table 2B: How many portions did you have usually in the days when you had alcohol?, portions ...................... 17 Table 5.1: Social-demographic profile of the alcohol consumer comparing with the profile of a non-consumer, % ............................................................................................................................................................................... 34 Table 5.1: Attitudes ............................................................................................................................................... 36 Table 5.2: Knowledge ............................................................................................................................................ 37 Table of content 6 Executive summary EXECUTIVE SUMMARY This report presents data collected from the survey conducted after the national informational campaign regarding reduction of alcohol consumption was launched, on a sample of 1505 respondents from rural and urban areas, in the Republic of Moldova, during March-April 2014. Data were collected by means of PAPI face to face, using probabilistic sampling method with mechanical step. The report presents the key results of this study. 7 Executive summary 8 EXECUTIVE SUMMARY This report contains data collected from the survey on a sample of 1505 respondents from urban and rural areas in the Republic of Moldova, during March-April 2014. Data were collected by means of face-to-face PAPI using stratified random sampling method. However, the report includes data similar to the research conducted on a 1501 respondents during May-June 2012. Habits of alcohol consumption • As compared to the year of 2012, share of those people who have ever drunk an alcoholic beverage (an entire shot, not just a sip) has increased by 11 p.p. • Average age when the first time an entire shot was consumed according to the results of 2014 research was 18 years. • Wine is the most consumed alcoholic beverage (68%, which is by 10 p.p. more than in 2012), on the second place one finds beer with 20% (- 6 p.p. compared to the previous time period), spirits represent the main alcoholic beverage for 7% of the respondents. • Share of people who have consumed any type of alcoholic beverage during the last month has decreased by 9 p.p. as compared to 2012. • Average number of shots consumed at an occasion during the last month has decreased from 3 in 2012 to 2.2 in 2014. • Every third consumer mentioned that during the last 3 months there were days when he or she consumed more than usual, and in such days 50% of them drank up to 5 shots. A promising trend is that share of people who mentioned that they drank more than usual with a frequency of ”daily” or ”almost daily”, has decreased (share of both responses in 2012 was of 6% and now it is 1%). • Majority of consumers at one occasion consume not more than 1 or 2 shots (71% of consumers), and one fourth consume at one occasion 3-4 shots. • There might be observed a trend of decrease of the share of those who once they have started could not stop drinking (from 14% of the consumers in 2012 to 8% in 2014). • Share of those consumers, who because of the alcohol did not manage to do was waited from them, decreased (from 18% to 13% in 2014). • A decrease may be observed in case of those who during the last year have felt the necessity to drink in the morning after excessive alcohol consumption prior to that (from 19% to 13%). • As compared to the research from 2012, share of those who during the last year could not remember what had happened at night prior to that, because of alcohol consumption, decreased. • There might be observed a decrease of the share of people who had situations when they or someone else have been injured because of the fact that the interviewed consumer drank alcoholic beverages (from 13% to 5%). • As compared to the 2012 research, share of those who in comparison with 30 days ago has consumed less, has increased (from 18% in 2012 to 36% in 2014). • Every fifth consumer tried to diminish alcohol consumption during the last 30 days (which is 4 p.p. more than in 2012). Knowledge and attitudes regarding excessive alcohol consumption • As compared to the 2012 research, share of those people who do not agree with the following statement alcohol consumption cannot be that harmful: a lot of people drink alcoholic beverages their entire life and live till ripe old, has increased (from 73% to 79%). • Share of those people who do not agree with the statement alcohol consumption can cause serious health problems has increased (from 80% to 96%). • Share of those who consider that their health would improve if they reduce amount of alcohol they consume, has increased (from 29% to 35%). Executive summary 9 • Share of respondents, whose close people consider they should decrease the amount of alcohol consumed, has diminished (from 29% to 18%). • Level of information of both – consumers and non-consumers has improved in the area of the harms provoked by alcohol consumption. • As compared to the previous research, share of consumers worried that alcohol will harm their health in the future has decreased by 13 p.p. • Great majority of respondents are informed that in case that the woman consumes alcohol during pregnancy, this might lead to disabilities in children ( 93% as compared to 64% in 2012). • As compared to the previous research, there might be observed a decrease (from 20% to 5%) of the share of those people who consider that the negative effects in child determined by alcohol consumption during pregnancy disappear when the child grows up. Executive summary 10 Introduction 11 INTRODUCTION This report is based on the research, carried out by Magenta Consulting for World Health Organization. Introduction 12 INTRODUCTION This report is based on a research, carried out by Magenta Consulting for World Health Organization. i.1 Purpose and objectives The main objective of this project is to determine the level of knowledge, attitudes and practices regarding alcohol consumption among the population of Moldova. This report presents the results of the survey conducted after the launch of the national informational campaign regarding reduction of alcohol consumption among the population of Republic of Moldova – ”With a sober mind”, launched in February 2014. Main objectives of the study are: 1. Assessment of the drinking habits of the alcohol drinkers; 2. Measuring the awareness level and level of understanding of the negative impact of alcohol drinking on health; 3. Measuring, in dynamics, the predisposition level of alcohol drinkers to quit this habit. i.2 Applied methodology This research was conducted according to the methodology of KAP study, where knowledge, attitudes and practices are analysed. This approach provides a diagnosis of the community level of knowledge of the population - on the understanding of the subject matter (the damage caused by alcohol consumption); attitude - on both, public empathy for a phenomenon or topic and preconceptions about them; practice - on how people demonstrate their attitudes and knowledge through actions. Understanding KAP level allows initiation of awareness of the problem in a more efficient way. This approach demonstrated its theoretical and methodological efficiency in similar studies. The study was based on primary quantitative data. Taking into account the purpose and objectives of this study, the methodology applied in the project complies with the methods and techniques used in the scientific world and consultancy services, being adapted to local conditions. i.2.1 Interviewing population. Plan of sampling Quantitative data were collected through interviews conducted with 1505 persons throughout the country, excluding Transnistria. This number of interviews provides an error margin of ± 2.6% at a confidence level of 95%. Data were collected between 08/03/2014 - 29/03/2014. Data source for sampling: National Bureau for Statistics of the Republic of Moldova. Characteristics of the sampling: systematic random sampling. No quotas applied. At the first level, districts were combined in groups, from these groups localities were randomly selected, and interviews were conducted, thus offering the chance for all communities to participate in the survey. Moreover, the number of interviews conducted in each group depended on the number of inhabitants and the number of localities (by size). Three level randomization was applied, taking into consideration groups of districts, households and respondents: 1. Locality– randomly selected for each level as it is described above and using a table with random figures; 2. Household - for each locality, based on routes according to the existent streets, designed depending on the number of interviews per locality. Household selection was based on a starting point and mechanical step; 3. Person/respondent – when selecting the respondent, the method of last birthday was used. 13 Introduction i.2.4 Questionnaire The used questionnaire is a complex one and includes both closed and open questions. The questionnaire was provided by the client, adapted and tested by Magenta Consulting research team, in close collaboration with the customer, according to the research objectives. The questionnaire was translated into Romanian and Russian, the interview was conducted in the language requested by the respondent. i.2.5 Pilot research Pilot – research’s aim is to validate questionnaires. Thus, the questionnaire is pre-tested on a sample of 10 people in rural and urban areas, seven - in Romanian and 3 - in Russian. i.2.6 Interviewing and data quality Interviews were carried out by the team of Magenta Consulting interviewers, who have prior participated in numerous similar projects. At the beginning of the project, the team was informed about the subject of the study, its objectives and the method of data analysis. To ensure data quality, 40% of the questionnaires were checked on the phone. During examination, questions were randomly selected from the questionnaire. i.2.7 Data analysis Data interpretation was performed using the specialized program - SPSS 18 with descriptive and multicriteria statistical interpretation. The questionnaires were processed using specialized scan recognition software thus excluding the possibility of human error in creating database. i.3 Characteristics of the sample Interviews were conducted face to face by a team of operators, based on structured questionnaires. All operators were trained for this project and the questionnaires were pre-tested. The interviews took place at home. Sample segmentation was done according to area of residence (rural / urban), data which collected from the National Bureau of Statistics. Other characteristics of the sample were not determined. Population aged 1655 years was included in the research. Table i.1: General sample, N=1505, % Total, N=1505 Gender Age Education Marital status Area Region Male Female Average age Without education / primary Vocational school Higher education NA Single Married / Living together NA Rural Urban North Centre South Total 47 53 35,9 9 54 36 0 31 69 0 55 45 27 52 21 100 i.4 Limits and barriers During this study, no major obstacles were encountered. Alcohol consumers, N=1189 50 50 35,9 9 54 36 0 30 70 0 54 46 27 53 20 100 Nonconsumers, N=316 37 63 35,8 11 54 34 1 34 66 1 60 40 28 46 26 100 Introduction 14 Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation CHAPTER I: HABITS RELATED TO THE ALCOHOL CONSUMPTION. ALCOHOL CONSUMPTION CESSATION This chapter presents information on habits related to alcohol consumption and alcohol consumption cessation. 15 Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 16 CHAPTER I: HABITS RELATED TO THE ALCOHOL CONSUMPTION. ALCOHOL CONSUMPTION CESSATION This chapter contains information about alcohol consumption habits and alcohol consumption cessation, compared with the study in 2012. Currently, 89% of the population aged 16-55 years indicated they have consumed at least one full portion of alcoholic beverage in their life, which is with 11 p.p. higher compared with 2012 (78%). Fig. 1A: Have you ever consumed alcoholic beverage (an entire shot, not just a sip)?, % Overall, in 2014, respondents indicated that on average, they consumed for the first time a full portion of alcohol at age 18. In 2012, the average age was 17 years. Table 1B: How old were you when you had your first full portion of alcohol?, years Age 2012 Nr. of Average respondents value 1165 17 2014 Nr. of Average respondents value 1322 18 Majority of respondents who consumed alcohol at least once indicated that most often they drink wine (68%). 20% of the participants most often drink beer, 7% - spirits and 5% - other drinks. Fig. 1C: Types of alcoholic drinks, consumed more often, % 2 of 3 respondents who had ever consumed a full portion of alcohol, consumed alcoholic beverages during the last month (66%). This share is 9 p.p. smaller than back in 2012. Fig. 2A: Have you consumed any alcoholic drinks in the last month?, % Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 17 Respondents indicated that during the last month they consumed on average 2.2 portions of alcohol in the days when they had alcohol, which represents an almost one portion of alcohol decrease. Table 2B: How many portions did you have usually in the days when you had alcohol?, portions Shots N 837 2012 Average value 3.0 N 882 2014 Average value 2.2 Most (75%) of those who consumed alcohol during the past month drank with a frequency of 1-2 times per week and less often (43% - once a month and 32% - 1-2 times a week). Compared with the situation in 2012, in 2014 the quota of those who consumed the given quantity 2-3 times a week increased (from 13% to 18%) and so did the share of those who consume alcohol 1-2 times a week (at 27% up to 32%). The quota of respondents who consume daily and almost daily decreased compared with 2012. Fig. 2C: How often did you have this quantity in the last month?, % Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 18 To see the number of portions consumed depending on the average consumption frequency, the following cross-tab was executed (see Fig. 2D). Among those consumers who drink alcohol beverages once a month, every other uses to drink 2-4 portions per occasion. Share of those, who are used to drink one portion of alcohol and less, increases (47%, higher by 13 p.p. compared to 2012). Among those consumers who drink alcohol one or two times per week, most of them (69%) drink usually 2-4 portions – an 11 p.p. increase from 2012. This happened on account of the decline of high and very high level of consumption (which went down from 13% to 4% in 2014). Respondents who consume alcoholic beverages more often (2-3 times per week) are used to drink, in 74% of cases, 2-4 portions per occasion. In case of consumers who drink daily, share of those who drink not more than 4 portions has increased (from 81% to 88%). This increasing trend is happening on the account of the decline of high level consumption shares – from 16% to 13% for those who consume 5-10 portions and from 3% to 0 for those who consume more than 10 portions per occasion. In this way, there is a noticeable evidence of diminution of high level of consumption in favour of low level of consumption. Fig. 2D: Number of portions consumed depending on the average consumption frequency, % 33% of respondents indicated that during the last three months they had days when they consumed more alcohol than usual. Compared with 2012, the situation remained about the same. Fig. 3A: In the last 3 months, where there days when you consumed more alcohol than usually?, % Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 19 34% of respondents who consumed more alcohol than usual during the last three months have been drinking at least 6-10 portions, 41% - 3-5 portions and 9% - 1-2 portions. Overall, the number of portions increased in comparison with 2012 and the share of people who indicated they "do not know" number of portions, has decreased. Fig. 3B: How many portions of alcohol have you consumed in the days when you drank more than usual, in the last 3 months?, % Regarding the frequency of consumption, the share of people who drink the indicated number of portions daily decreased – from 2% to 1%, and the share of those who do it almost daily disappeared. At the same time, the share of those who consume the indicated amount of alcohol 2-3 times per week and less often increased: share of those who consume alcoholic beverages once per week – once per month has increased by 6.6 p.p. and share of those who consume alcohol 1-2 times in 3 months has increased by 12 p.p. Fig. 3C: How often do you drink this quantity?, % Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 20 In order to see the number of portions of alcohol depending on the frequency of consumption (in the days when respondents drank more than usually) the following cross-tab was created. There were noticed important structural modifications al the level of each consumed quantity. So, there is no share of those who drink more than 10 portions with a daily or almost daily frequency. A similar trend can be observed in the frequency of consumption by the number of portions consumed: there are no more shares of those who drink large amounts of alcohol with a daily or almost daily frequency. Quantity of 1-2 portions remains an exception – a larger share consumes this amount 2-3 times a week and daily (24% as compared to 10% in 2012). Fig. 3B and 3C: How many portions of alcohol you consumed during days when you drank more than usual, in the last three months?, How often did you consume this amount?,% The comparative chart below shows than within 2 years the share of respondents who drink once a month and less often increased with 7 p.p., as well as the proportion of those who consume alcoholic beverages 2-3 times per week (+ 5 p.p.). This growth was produced due to the reduction by 4 p.p. of the share of consumers who drink alcoholic beverages 2-4 times a month, while daily or almost daily consumers’ share remained stable (4%). Fig. 4A: How often did you have an alcoholic drink during the last year?, % Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 21 During the last year, 71% of respondents used to consume 1-2 portions of alcohol per regular day of consumption. Per total, within 2 years, the share of reduced portions consumers went up: a growth of 3 p.p. for 1-2 portions consumers and of 5 p.p. for 3-4 portions consumers. It is important to mention though that mainly this change happened due to a decrease of the share of those who did not give any answer. Fig. 4B: How many portions of alcoholic drinks did you consume in a normal day, when you consumed alcoholic drinks during the last year?, % Most respondents who consumed alcohol in the last year indicated that they did not have more than five portions of alcohol on one occasion in the past year (64%). 24% of respondents who consumed alcohol in the last year have drunk the indicated quantity less often than once per month, 8% - once a month, and 3% weekly. Thus, there might be observed a decrease of the shares of consumers together with the increase of the frequency, and in 2014 there lack consumers who drink daily or almost daily 5 or more portions of alcohol. Fig. 4C: How often did you consume 5 or more portions of alcohol on one occasion during the last year?, % Among persons who consumed 5 or more portions per regular occasion, share of those who could not stop drinking reduces from 13% in 2012 to 8% in 2014. At the same time, the quota of those who maintain selfcontrol after a significant amount of alcohol went up from 73% in 2012 to 90% in 2014. Fig. 4D: How often, during the last year, it happened to you that once you started drinking, you could not stop?, % Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 22 In 2014 the share of those who failed to honour their responsibilities because of alcohol abuse decreased. This share was 13% in 2014, compared to 18% in 2012. Fig. 4E: How often in the last year you failed to do what was normally expected from you, due to alcohol consumption?, % 8% of respondents who happened to consume more than five portions of alcohol on one occasion in the last year, at least once a month felt the need to drink in the morning to recover after a session of excessive alcohol consumption. This share din not change significantly from 2012 (8% while in 2012 it equalled 7%). Instead, an essential growth of the share of those who did not have such a necessity during the last year (from 66% to 83%) can be observed and mainly because of the decrease of the share of those who did not answer the question. Fig. 4F: How often in the last year you felt the need to drink in the morning in order to recover after a session of excessive alcohol consumption?, % The proportion of those who had qualms after an abusive alcohol consumption session remained maintained the same as in 2012 – 24%. And share of those who did not have any remorse has increased, while share of those who did not answer to this question – decreased. Fig. 4G: How often during the last year have you felt guilt or remorse after you had been drinking?,% Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 23 The share of those who could not recall the last night’s events because of abusive alcohol consumption (5 portions and more) reduced from 19% (2012) to 15% (2014). Among them, 4% (compared to 3% in 2012) admitted they went through this more often than once a month. Fig. 4H: How often during the last year you have not been able to remember what happened the night before because you consumed alcohol?,% The share of those who stated that it happened to them that they or someone else was injured as a result of their alcohol consumption has decreased (from 13% to 5%). At the same time share of those who did not offer any answer to this question decreased as well. Fig. 4I: Have you or someone else been injured due to the fact that you consumed alcohol?,% 6% of respondents who drank at least a portion of alcohol said that it happened at least once that a relative, friend, doctor or nurse were concerned about his alcohol consumption, suggesting to consume less. In 2012, this share was 8%. Fig. 4J: Has it ever happened that a relative, friend, doctor or nurse were worried about your alcohol consumption suggesting you consume less?,% Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 24 Being asked about the amount consumed now compared to 30 days ago, 49% indicated they consume the same amount (compared to 43% in 2012). Also, there was noticed a strong growth – 18 p.p.- among those who reduced the alcohol amount consumed compared to 30 days ago. Fig. 8A: If compared to 30 days ago, are you presently drinking more or less, or the same quantity? (question for alcohol consumers), % In 2014, the problem of reducing the alcohol consumption was a frequent topic for 13% of the consumers, compared to 10% in 2012. Less often this topic was approached by 29% in 2014, compared to 21% in 2012. In 2014, 17% of the alcohol consumers have frequently thought of the damage caused to those around. This proportion exceeded with 5 p.p. the share of 12% recorded in 2012. This issue was sometimes considered a problem by 33% of consumers in 2014, compared to the correspondent share of 20% in 2012. Bad influence of alcohol on personal health was often an issue for 21% of respondents in 2014. In comparison with 2014, this share is bigger with 4 p.p. than the correspondent share in 2012. At the same time, this concern was treated sometimes by 42% in 2014, which is by 10 p.p. more than the corresponding share in 2012. Home discussions about alcohol and its harm were carried sometimes by 44% in 2014, this share being 10 p.p. bigger than in 2012. For 27% of respondents this topic was often a matter of thinking in 2014, compared to 10% recorded in 2012. Fig. 8B: In the last 30 days, how often, in general, …? (question for the alcohol consumers), % Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 25 In 2014, 20% of the alcohol consumers tried in the last 30 days to drop alcohol consumption. In 2012, this quota was 16%. Fig. 8C: Have you tried to diminish the alcohol consumption in the last 30 days?, % 9% of alcohol drinkers indicated that during the last 30 days someone in the family has tried to convince them to reduce the amount of alcohol consumed. Fig. 8D: In the last 30 days, did someone from your family try to convince you to reduce the quantity of alcohol consumed? (question for the alcohol consumers), % In terms of plans to reduce alcohol consumption, we see a prominent positive trend, compared to 2012. Once the number of portions consumed by drinkers increases, quota of those planning to reduce alcohol consumption goes up. 51% of respondents who used to eat 5-10 servings indicated that they have no plans to reduce alcohol consumption, 7% - plan to reduce the amount consumed later, but not in the next 12 months, 5% - plan to reduce it in the next 6 -12 months, 9% - in the next six months and 19% - during the next month. Fig. 8E: Which of the following statements expresses the best your opinion on your consumption of alcoholic drinks? (question for the alcohol consumers), % Chapter I: Habits Related to the Alcohol Consumption. Alcohol Consumption Cessation 26 32% of consumers planning to reduce alcohol consumption are absolutely sure that they will reduce alcohol consumption forever, 21% - very likely will reduce and 18% - perhaps will reduce. Sum of the respondents quota who are absolutely sure and very likely to reduce alcohol consumption is by 8 p.p. higher compared with the answers of respondents in 2012 (53% compared with 45%). Fig. 8F: How likely is it that you will reduce alcohol consumption forever? (question for the alcohol consumers), % During the last appointment at the doctor / health check, 11% of all respondents were asked regarding the habit of drinking alcohol. Quotas did not differ significantly neither when comparing alcohol drinkers with nondrinkers, nor when comparing them to 2012. It is worth mentioning that there was recorded a growing share of non-consumers who were asked about drinking alcohol habits. This share constitutes 16% in 2014, which is 4 p.p. bigger than the correspondent share in 2012. Fig. 9I: During the last appointment at the doctor / health check, I was asked about my drinking habits, % Chapter II: Knowledge and Attitude regarding Excessive Alcohol Consumption 27 CHAPTER II: KNOWLEDGE AND ATTITUDE REGARDING EXCESSIVE ALCOHOL CONSUMPTION This chapter presents information on knowledge and attitudes of the respondents regarding excessive alcohol consumption. Chapter II: Knowledge and Attitude regarding Excessive Alcohol Consumption 28 CHAPTER II: KNOWLEDGE AND ATTITUDE REGARDING EXCESSIVE ALCOHOL CONSUMPTION This chapter contains information about the knowledge and attitudes of Moldovans regarding alcohol abuse. Data collected in 2014 are analysed in comparison with the results from 2012. 96% of the total sample knew about the fact that alcohol can cause serious health problems, and the quota of these respondents increased with 16 p.p. compared with 2012 results. Currently, 35% of drinkers agree with the statement My health would improve if I reduce the amount of alcohol consumed – and this share is bigger with 6 p.p. than in 2012 - and 18% - with the statement People important to me believe that I should reduce the amount of alcohol consumed – which is a 11 p.p. decline from 2012. Fig. 9A: To what extent you agree or disagree with the following statements, % *In order to get the total answer ”yes”, the answer categories ”fully agree” and ”agree” were united, and for a ”no” answer, the answers ”fully disagree”, ” disagree” and ”none” were united. In 2012, N=1501 in cases when all respondents answered the question and N=1165 when only those who consume alcohol answered the question. In 2014, N=1505 for all respondents and N=1189 for consumers. Chapter II: Knowledge and Attitude regarding Excessive Alcohol Consumption 29 With reference to what alcohol can cause, in 2014 respondents indicated a higher level of knowledge of diseases and injuries caused by alcohol consumption. Both drinkers and non-drinkers indicated to a greater extent liver cancer, hypertension, foetal brain damage, mental retardation and low weight at birth. Fig. 9B: From what you know, does alcohol provoke the following …?, % The degree of anxiety regarding alcohol influence of personal health in the future reduced since 2012. The share of 26% of those extremely and very worried recorded 2 years ago dropped to 13% in 2014. Fig. 9C: Are you worried about the fact that alcohol will harm your health in the future and if yes, to what extent? (question only for consumers), % Chapter II: Knowledge and Attitude regarding Excessive Alcohol Consumption 30 The statement according to which alcohol consumption during the pregnancy can lead to serious disabilities to child is supported by the great majority of respondents (93%). A noticeable evolution is recorded from 2012, when only 64% of respondents agreed with this statement. Fig. 9D: What do you think is the statement: ”Alcohol consumption during the pregnancy can lead to serious disabilities to the child” true or not?, % In 2014 there were recorded 5% of respondents who believed that effects related to alcohol consumption during pregnancy disappear when the child grows up. In 2012 this category of people consisted of 20%. Within 2 years it can be noticed a serious structural change: there appears a significant share of those hesitant toward this statement, Therefore, is recorded a migration of responses from the supportive side toward the reticent side. Fig. 9F: What do you think, is it true or nor that the effects determined by alcohol consumption during the pregnancy will disappear together with the growing child?, % 45% of Moldovans stated that they ran across some information about the effects of alcohol over the child during the pregnancy, which is a raise of 5 p.p., if compared to 2012. Fig. 9G: Have you ran across some information about the effects of alcohol over the child during the pregnancy?, % Chapter II: Knowledge and Attitude regarding Excessive Alcohol Consumption 31 Regarding the effects of alcohol on the foetus, 23% of the population considered completely safe to have 1-2 portions of alcohol during pregnancy. As the amount suggested for analysis goes up, the quota of respondents who consider it safe decreases and the quota of respondents, who consider that alcohol consumption during the pregnancy is very dangerous increases. However, non-consumers consider alcohol consumption being hazardous during pregnancy to a greater extent, compared to consumers, regardless of the amount and frequency of use. Fig. 9H: Regarding effects of alcohol over the foetus, what do you think, how safe is to have the following quantities of alcoholic drinks?, % (2014) Chapter II: Knowledge and Attitude regarding Excessive Alcohol Consumption 32 Chapter III: Social-demographic Profile of the Alcohol Consumer 33 CHAPTER III: SOCIAL—DEMOGRAPHIC PROFILE OF THE ALCOHOL CONSUMER This chapter presents information regarding the socio-demographical characteristics of the alcohol consumers. 34 Chapter III: Social-demographic Profile of the Alcohol Consumer CHAPTER III: SOCIAL-DEMOGRAPHIC PROFILE OF THE ALCOHOL CONSUMER This chapter includes the profile data of consumers and non-consumers of alcohol, compared with the total population profile. Per general, 70% of respondents watch television on a daily basis, 11% - 4-6 times a week, and 9% - 2-3 times per week. Habits of consumers and non-consumers do not vary significantly, compared to the total sample. 26% of Moldovans noted that they listen to the radio daily and 9% - 4-6 times a week. Reading newspapers or magazines occurs less frequently than watching TV and listening to radio. Most respondents skim them once a week and less often than once a week. Every second respondent uses the Internet daily and a greater share of alcohol-consumers surfs the internet than non-consumers, the difference between them being 6 p.p. Both consumers and non-consumers of alcohol go to cinema less often than once a week. Childre n in familie s Going to cinema Using Internet Reading newspapers / journals Listening to radio Watching TV Table 5.1: Social-demographic profile of the alcohol consumer comparing with the profile of a non-consumer, % Daily 4-6 times a week 2-3 times a week Once a week Less often than once a week Never I do not remember No answer Daily 4-6 times a week 2-3 times a week Once a week Less often than once a week Never I do not remember No answer Daily 4-6 times a week 2-3 times a week Once a week Less often than once a week Never I do not remember No answer Daily 4-6 times a week 2-3 times a week Once a week Less often than once a week Never I do not remember No answer Daily 4-6 times a week 2-3 times a week Once a week Less often than once a week Never I do not remember No answer Yes No Alcohol consumer, N=1189 70 11 10 3 5 1 0 0 26 9 11 5 23 25 1 0 3 3 6 18 39 29 1 0 58 7 5 3 5 22 0 0 0 0 0 0 31 68 1 0 67 Non-consumer, N=316 71 12 8 2 6 2 0 0 24 9 13 6 21 25 1 0 5 2 8 17 38 26 3 0 54 6 4 2 6 28 0 0 0 0 0 0 26 71 3 0 59 33 41 Total, N=1505 70 11 9 3 5 1 0 0 26 9 11 6 23 25 1 0 4 3 7 18 39 29 1 0 57 7 5 3 5 23 0 0 0 0 0 0 30 68 1 0 66 34 Chapter IV: Multivariate analysis 35 CHAPTER IV: MULTIVARIATE ANALYSIS This chapter presents multivariate analysis that was carried out in order to analyse the impact of the exposure to the campaign on the level of knowledge of the alcohol consumers and of those who do not drink regarding harms caused by excessive consumption of alcoholic beverages. 36 Chapter IV: Multivariate analysis CHAPTER IV: MULTIVARIATE ANALYSIS In order to identify the influence of access to advertising / information on knowledge on health of consumers and non-consumers, logistic regression analysis was carried out. The criteria marked in green are a part of a model that has a statistical significance. The cells that are marked in dark green, indicate that whether the person has been exposed to the information campaign or not, it really influences the level of knowledge or his attitude regarding issues related to alcohol consumption, mentioned in the table. Table 5.1: Attitudes Alcohol consumers Attitudes 1 2 3 4 5 6 7 8 9 p Odds Ratio Lower limit Alcohol drinks can cause cancer of the oral cavity, pharynx, larynx, and oesophagus, Chi-squared=44,806, Sig.=0,000 Logistic regression 0,023 1,719 1,079 Alcohol drinks can cause liver cancer, Chi-squared=14,864, Sig.=0,095 Logistic regression 0,353 1,419 0,678 Alcohol drinks can cause breast cancer, Chi-squared=40,094, Sig.=0,000 Logistic regression 0,376 1,184 0,815 Alcohol drinks can cause skin cancer, Chi-squared=54,162, Sig.=0,000 Logistic regression 0,066 1,417 0,977 Alcohol drinks can cause colon/rectal cancer, Chi-squared=31,186, Sig.=0,000 Logistic regression 0,027 1,769 1,067 Alcohol drinks can cause hypertensive diseases, Chi-squared=28,809, Sig.=0,001 Logistic regression 0,407 0,733 0,352 Alcohol drinks can cause diabetes, Chi-squared=29,121, Sig.=0,001 Logistic regression 0,348 1,266 0,774 Alcohol drinks can cause brain damage to foetus, Chi-squared=13,781, Sig.=0,130 Logistic regression 0,787 1,099 0,554 Alcohol drinks can cause low birth weight, Chi-squared=15,966, Sig.=0,068 Logistic regression 0,455 1,324 0,634 Non-consumers Attitudes Upper limit 2,74 2,971 1,722 2,054 2,934 1,526 2,071 2,181 2,765 1 2 3 4 5 6 7 8 9 p Chi-squared=13,286, Sig.=0,150 Logistic regression 0,727 Chi-squared=7,570, Sig.=0,578 Logistic regression 0,490 Chi-squared=33,044, Sig.=0,000 Logistic regression 0,021 Chi-squared=19,472, Sig.=0,021 Logistic regression 0,470 Chi-squared=2,985, Sig.=0,965 Logistic regression 0,878 Chi-squared=18,410, Sig.=0,031 Logistic regression 0,988 Chi-squared=23,217, Sig.=0,006 Logistic regression 0,779 Chi-squared=16,948, Sig.=0,050 Logistic regression 0,995 Chi-squared=11,831, Sig.=0,223 Logistic regression 0,996 Odds Ratio Lower limit Upper limit 1,320 0,278 6,27 0,433 0,04 4,679 1,702 0,746 3,886 0,711 0,282 1,794 1,124 0,252 5,007 0,000 0 . 0,854 0,285 2,564 0,000 0 . 0,000 0 . 37 Chapter IV: Multivariate analysis Table 5.2: Knowledge Alcohol consumers Knowledge 1 2 3 4 p Odds Ratio Lower limit Non-consumers Knowledge Upper limit Alcohol consumption can cause serious health problems, Chi-squared=28,262, sig.=0,001 Logistic regression 0,746 1,101 0,617 1,964 People important to me believe I should reduce the amount of alcohol consumed, Chi-squared=47,736, sig.0,000 Logistic regression 0,237 1,214 0,88 1,676 Alcohol consumption cannot be that bad: many people drink all their lives and live till ripe old, Chi squared=90,467, sig.=0,000 Logistic regression 0,018 1,469 1,069 2,018 My health would improve if I reduced the amount of alcohol consumed, Chi-squared=36,115, sig.=0,000 Logistic regression 0,333 0,881 0,683 1,138 1 p Chi-squared=9,158, Sig.=0,423 Logistic regression 0,517 Odds Ratio Lower limit Upper limit 2,685 0,135 53,275 1,156 0,632 2,116 N/A 3 Chi-squared=24,281, Sig.=0,004 Logistic regression 0,637 N/A Chapter IV: Multivariate analysis 38 Conclusions CONCLUSIONS 39 Conclusions 40 CONCLUSIONS Analysing the results of research that was conducted in 2014 after the national information campaign regarding reduction of alcohol consumption among the population of Republic of Moldova – “With a Sober mind”, was launched in 2014 there might be observed several changes compared to the year of 2012. Particularly, this research included a larger quota of persons who have consumed an alcoholic beverage at least once (89% as compared to 78% in 2012) and also a higher quota of people who mainly consume wine (68% as compared to 58% in 2012). However, the quota of those who consumed alcoholic beverages of any kind during the last month decreased. The quota of those who have found that in the last three months there have been days when they consumed more than usual did not change significantly (33% in 2014). Compared to the previous study, there was a slight increase in the percentage of persons consuming no more than 1-2 portions at a time (+ 3 p.p.). Other consumption indicators also showed positive trends. Thus, the quota of those who have never consumed five or more portions at a time in the last year, increased (from 52% to 64%). The vast majority said that last year it had never happened to them that they were not able to stop once started to consume alcoholic drinks. The current study also recorded a smaller percentage of people who have found out that in the last year there were occasions when they were not able to do what was expected of them normally due to alcohol consumption. A decrease was also in the field of the urge to drink in the morning to recover after a heavy drinking session (from 19% in 2012 to 13% in 2014). Regarding the attitudes also there are some positive trends: there is quota increase of the consumers who discussed with their families about alcohol and its damage to health (+ 27 p.p.), and of those who tried to reduce their alcohol consumption in the last 30 days (+4 p.p.) and there was an increase of those who are sure that they will reduce their alcohol consumption. Knowledge of the population about the harm of alcohol abuse increased if compared to the previous period. The vast majority of respondents are aware that alcohol can cause serious health problems and one third of consumers is also aware that their health would improve if they could reduce the amount of consumed alcohol.
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