Irish Attitudes Towards Alcohol and its Effects on Alcohol Consumption

1. Irish Attitudes Towards Alcohol and its Effects on Alcohol Consumption Ashley Galloway

2. Background Binge Drinking=consuming alcohol in a manner that raises an individual’s BAC to a level equal to or greater 0.08 To prevent alcohol use disorder (AUD) the National Institute on Alcohol Abuse and Alcoholism recommends that men not drink more than 4 drinks in a single day with no more than 14 drinks per week

3. Background • Worldwide, Irish identity has historically been associated with heavy drinking patterns, even for those who do not live in Ireland • 58 Out of 100 drinking events for Irish men result in binge drinking • Rates of alcoholism have at times been higher for Irish-Americans than they have for the Irish in Ireland • Studies have concluded that second-generation Irish Americans have heavier drinking patterns than first generation immigrants

4. Background: Public Health Impact • Studies have suggested the association between violence and alcohol • The full magnitude of alcohol related deaths have begun to be better understood by studying the potential years of life lost due to alcohol, even for moderate drinkers • Heavy drinking in one sitting, and over time has been shown to have significant health impacts including: damage to the heart (stroke, high blood pressure, arrhythmias), liver (cirrhosis, fibrosis, alcohol related hepatitis), pancreas, immune system, and can increase the risk of cancers of the mouth, esophagus, throat, liver and breasts

5. Choosing Qualitative Methods: Conceptual/Theoretical Framework • Interested in understanding the perceptions of typical alcohol consumption, and to see if those perceptions offer explanations for the excessive alcohol consumption among this population. • Due to the fact that norms, and perceptions of those norms cannot be accurately measured or understood empirically, qualitative methods are most appropriate • Using phenomenology as a framework allows one to study experiences that relate to emotion, social activity, and to thought. Phenomenology can be defined as: a way of understanding how people “make sense of an experience and transform it into consciousness both individually and as shared meaning”. • An individual cannot reflect on experience without being a part of that experience, therefore phenomenology requires methods that fully capture and depict how people experience, perceive, judge and describe some phenomenon.

6. Sample • Snowball/Chain Sampling & Convenience (minimal amounts) • Male 21-35 • Irish- Immigrant or Irish-American (at least one parent or grandparent who was born in Ireland ) • Married/ Cohabitating or Single

7. Sample Demographics

8. Data Collection • Open-ended structured Interviews • Irish-born interviewed Irish-born and American born interviewedIrish-Americans • One observation conducted in a local pub, but data not used in analysis

9. Data Collection: Interview Questions • What are your thoughts about how much your (e.g. friends/family/significant other) drink? • Prompts: • Reasons why thy drink, How much they drink • Do they drink a lot? • Do your parents drink (a lot?)? Did your parents drink as you grew up – in what context? Do you drink with your parents now? • What would they drink? • What kind of effect has your current relationship status had on your alcohol consumption? • Single: do you think you would drink less if you were in a relationship? • What does being Irish mean to you? • How do you think your identity as Irish influenced the answers you gave to these questions? • Do you think being Irish(-American) and drinking is different to being (non-Irish-)American and drinking? • What aspect of your identity plays the biggest role in how you think about your own drinking? • In your opinion what kinds of attitudes does the typical Irish person have about drinking compared to people who aren’t Irish? • What should I have asked you that I didn’t think to ask? • If I was to hang out with you on a typical night drinking, what would we do? • Prompts: • Where would we go? If they say pub or bar- What kind? • Who would we go with? • Where are your friends from? • What would we drink? • Would we eat somewhere? • How much alcohol in one sitting and how often is typical for the average guy your age to drink? • be careful describing what a typical night out is – don’t lead • So, if you went above x, would you consider that too much? • What do you think is very little to drink? • What do you think about people who usually don’t drink or who drink very little? • How do you feel when you are the only person not drinking? • How does alcohol make you feel? • Do you feel different when drinking compared to when you aren’t? • When or for what reasons are you most likely to drink? • Do you think it is the same for your friends/family?

10. Analytic Procedures • Content analysis is thought of as a subjective way to quantify the results of qualitative data and consists of three separate methods: conventional, directed, and summative. • Conventional content analysis was used: codes developed directly from the data without any predetermined categories or theoretical viewpoints • Investigators separately transcribed the interviews, reconvened and created a final code list.

11. Findings: “Drinking Problem” • There was one overarching finding from this project which was centered around the concept of what does not constitute a “drinking problem”. • A specific question was not asked on this topic, yet all 4 participants brought up the term “drinking problem” at least once in the interviews. • It was used to clarify that neither the interviewees themselves, members of their family, or their friends had a “drinking problem”, • Did not to define what would be considered a “drinking problem”. • Also used as a reason why some people may abstain from drinking or choose to drink very little • Used to explain drinking habits of Americans.

12. Excessive as Typical All of the men stated that it was typical for themselves and their friends: • To consume alcohol 3-4 times a week • To have somewhere between 8-12 drinks in one day/night at least once a week. • The amount of alcohol consumed might vary depending on the day of the week or if they had to drive home, but it was common to drink 7-10 beers/drinks 2-4 times a week Mark: Well, like, for me I’m thinking time span, like are you saying from six in the evening to midnight, ten beers is too much? That’s like a beer and a half an hour. I don’t think that’s unreasonable by any means.

13. Excessive as Typical (cont.) None of the participants said that it was typical to not drink, but occasionally they might not drink when they go out if: • they had to drive • were hung-over • had spent too much recently from drinking Others who do not drink/drink very little: • Respect it If someone had a drinking problem • Ok on occasion John: Either personality better make up for it, or if they’re drinking nothing, it means either they have a drinking problem or it means they’ve never drank in their life, and I don’t care … If it was once or twice and I knew the reasons, no worries but if it was all the time, they’d need to have a good damn personality, or they better have a drinking problem.

14. Excessive is the Norm • None of the men thought there was anything wrong with an individual consuming too much alcohol . • Their idea of too much was based on what number of drinks they would have to consume to experience a hangover, to make them not feel well, or to make them feel aggressive. • None of the men stated how many times a week would be considered too often to drink. • It was common to mention that their friends or themselves would drink more than what they classified as excessive Mark: I’ve learned lately that I have either one extreme where I have two beers and walk out the door and go home or I’ll have 15 … These are so funny ‘cos I’m picturing some of my friends and they would drink a hell of a lot more. Some of them might destroy a bottle of Jameson. Luke: Some of my friends drink more to just get drunk- a lot. Not a lot, but when they drink they drink a lot. I mean for the sake of getting drunk

15. Excessive is Justified • All men gave justifications for why many of their friends, family members, or themselves did not have drinking problems Bob: I have some aunts who definitely, are noticeably uh happy when the family gets together, more so than my mom and other aunts and it’s kind of a funny joke, but … they run very productive lives it’s not like they have a problem. But it’s very much accepted within our family … • After stating the amounts of alcohol consumed by friends and/or family they would justify this by saying it wasn’t often or that those people could go a day without drinking

16. Excessive is Justified (cont.) • One of the best examples is when one participant was asked were some of the reasons his friends drank. Even though he was not asked if he thought any had a “drinking problem” this was his response: John: I know for a fact that none of the people I hang out with have drinking problems, and don’t drink to excess frequently … none of those people [his friends] are also getting blackout shit-faced drunk every single night, like there’s no, one of those guys I can look at and go you have a serious drinking problem, you need help … they drink when they are out, but they can also go a day without a beer. They definitely need some psychiatrist’s advice, or they definitely stop over at a psychiatrists, and I know that for a fact. But definitely not alcohol related.

17. American as Excessive • The majority of the men mentioned that Americans drink much more compared to the Irish or to Irish-Americans • The Irish-born men mentioned that the drinking culture is worse in America than it is in Ireland and that Americans drink more than Irish do • A common term used was Americans “drinking to get drunk” and they will do the following when drinking: “blacking out”, puking, fighting, and drunk driving

18. American as Excessive(cont.) • The Irish-born also stated that although a stereotype exists in the US of Irish being excessive drinkers, they felt Americans have more of a drinking problem than the Irish do • Drink a larger amount in a shorter time period, drink more frequently and quickly, and are out more regularly John: Have you heard this stuff about the alcohol enema where they put a tube in their bum … pour alcohol into it because it doesn’t get processed by the liver, so it’s absorbed right into the blood stream and they get drunker faster? They do the stupidest stunts with alcohol that we would never touch. They’re nuts, absolutely nuts. We’d never try to ingest alcohol by putting it into a glass and putting it over your eyeball. The stuff they do over here is crazy. They take it to the extreme in every aspect of life. Mark: (in reference to the Irish drinking stereotype) oh the Irish are great drinkers and alcoholics - and as far as I can see it’s quite the contrary. Absolutely the Americans have much bigger drinking problem in my opinion than the Irish … [For the Irish] it’s a much more social atmosphere and it’s to go out and hang out with friends, not to go out and get as drunk as we can as quick as we can and be puking everywhere

19. Discussion • 7-10 alcoholic drinks 2-4 times a week was considered normal while binge drinking is defined as consuming 5 or more alcoholic drinks on 1 occasion. Therefore, it can be concluded that binge drinking is actually a norm among this group. • Most of the men defined excessive drinking as more than 7 beers or more than 10 beers, yet at other moments in the interview these same men stated that their friends, family and themselves drank above these numbers, one even mentioning consuming up to 15 drinks in a night. Or some friends would drink an entire bottle of alcohol in one night

20. Discussion (Cont.) • Problem drinking has been defined for men as more than four drinks per occasion and more than 14 drinks per week. • Despite this definition, none of these men believed that they fit the definition of a problem drinker, nor did their family or friends. These findings further support the conclusion that an excessive amount of alcohol is considered normal among this group. • In regards to the American vs. Irish drinking patterns one of the greatest distinctions seems to be the amount of time the alcohol is consumed in, or the ways that it is consumed rather than the amount.

21. Reflexivity/Reflection • Comments were made in the interviews such as, “is that a good answer” and another time where he said “this is going to sound bad”. • Knew the first interviewee, may have had an effect on the results • Location of the second interview, the man knew some of the people also eating in the café, we shared a table with another gentleman

22. Future Directions • Explore the idea of problem drinking more in-depth. This concept was very prominent throughout all of the interviews, yet was never fully defined. • Inclusion of women • Control for education • More blinding of subjects • Another observation in a local pub that was more covert and in a more • More strict inclusion criteria for Irish-Americans

23. The End