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A Reframe NEW YORK TIMES BESTSELLER “An unflinching examination of how our drinking culture hurts women and a gorgeous memoir of how one woman healed herself.” Glennon Doyle, #1 New York Times bestselling author of Untamed “You don’t know how much you need this book, or maybe you do. Either way, it will save your life.” Melissa Hartwig Urban, Whole30 co-founder and CEO The founder of the first female-focused recovery program offers a groundbreaking look at alcohol and a radical new path to sobriety. "We live in a world obsessed with drinking. We drink at baby showers and work events, brunch and book club, graduations and funerals. Yet no one ever questions alcohol’s ubiquity—in fact, the only thing ever questioned is why someone doesn’t drink. It is a qualifier for belonging and if you don’t imbibe, you are considered an anomaly. As a society, we are obsessed with health and wellness, yet we uphold alcohol as some kind of magic elixir, though it is anything but. When Holly Whitaker decided to seek help after one too many benders, she embarked on a journey that led not only to her own sobriety, but revealed the insidious role alcohol plays in our society and in the lives of women in particular. What’s more, she could not ignore the ways that alcohol companies were targeting women, just as the tobacco industry had successfully done generations before. Fueled by her own emerging feminism, she also realized that the predominant systems of recovery are archaic, patriarchal, and ineffective for the unique needs of women and other historically oppressed people—who don’t need to lose their egos and surrender to a male concept of God, as the tenets of Alcoholics Anonymous state, but who need to cultivate a deeper understanding of their own identities and take control of their lives. When Holly found an alternate way out of her own addiction, she felt a calling to create a sober community with resources for anyone questioning their relationship with drinking, so that they might find their way as well. Her resultant feminine-centric recovery program focuses on getting at the root causes that lead people to overindulge and provides the tools necessary to break the cycle of addiction, showing us what is possible when we remove alcohol and destroy our belief system around it. Written in a relatable voice that is honest and witty, Quit Like a Woman is at once a groundbreaking look at drinking culture and a road map to cutting out alcohol in order to live our best lives without the crutch of intoxication. You will never look at drinking the same way again. |
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| Heightened Awareness & Empowered Personal Choices, In All Facets of Choosing a More Mindful Life. |
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| Deeper Listening @TheMarginalian |
The Less Alcohol Shift In Australia
Recent Research Evidence
In recent decades, population-level alcohol consumption in Australia has changed in significant ways. Since the early part of the 2000 s, per-capita consumption has declined by around 10% (Australian Bureau of Statistics, 2019), likely driven by major declines in drinking among teenagers and young adults (Livingston et al., 2018a).
In contrast, drinking among older adults has been stable or increasing (Livingston et al., 2018a, Livingston and Dietze, 2016a, Australian Institute of Health and Welfare, 2019). These patterns have been repeated in many high-income countries, with youth drinking falling markedly in Western and Northern Europe and most English-speaking countries (Vashishtha et al., 2021, de Looze et al., 2015), while consumption among other age groups does not.
Given the unique recent divergence in patterns between age groups and generations, researchers examining changes in alcohol consumption at the population level are increasingly taking an age-period-cohort approach, which aims to tease apart trends due to population age structures (age effects), overall time trends (period effects) and trends due to generational shifts in drinking (cohort effects).
These approaches to analysing trend data provide an important framework for understanding how behaviours change in a population.
Earlier Australian work on consumption identified relatively limited period effects, but substantial cohort differences with drinking highest for those born in the 1960 s and 1970 s and markedly lower for recent cohorts (Livingston et al., 2016a). These patterns have been broadly replicated in studies from Russia and Sweden (8{Kraus, 2015 #2203)}, while US work has highlighted cohorts of women born in the late 1950 s as drinking at higher levels than earlier or later cohorts (Kerr et al., 2009).
Research that has focussed on recent trends for young people specifically has found some initial evidence has shown that these cohort differences continue as young people age into adulthood (though do shrink with age), implying potentially lifelong lower levels of drinking for these cohorts (Callinan et al., 2020, Livingston et al., 2022), although in the U.S. cohort differences have dissipated entirely by early adulthood (Age, 2022).
Multiple reasons have been proposed to explain these relatively sudden declines in drinking for young people (Kraus et al., 2020, Pape et al., 2018, Pennay et al., 2015), but empirical research has thus far been largely inconclusive.
In a systematic review of the literature on declining adolescent drinking trends, Vashishtha et al. found growing evidence that parental factors (including alcohol specific parenting like willingness to supply and broader factors like warmth and relationship quality) have been important, but noted general weaknesses in the literature across a range of other potential explanatory factors (Vashishtha et al., 2020).
At the time of the publication of the systematic review, no studies had been published exploring the decline in youth drinking with changes in young people’s alcohol-related attitudes or perceptions. A few subsequent papers have found potential links between attitudes and drinking trends, with Ball et al. in New Zealand reporting that declines in the acceptability of alcohol use for young people was the key contributor to declines in heavy episodic drinking (5 +) there (Ball et al., 2020), while increases in the perceived riskiness of alcohol among young people was linked to drinking declines in the Nordic countries (Raitasalo et al., 2021).
Similarly, qualitative work points to the importance of shifts in norms and attitudes among young people for a complex range of reasons, including perceptions of alcohol consumption as risky and unhealthy, and intoxication as uncool, unseemly or demonstrating weakness of character (Caluzzi et al., 2021a, Caluzzi et al., 2021b, Törrönen et al., 2019, Törrönen et al., 2021).
Similarly, while researchers have flagged concerns about the effects of drinking among for higher drinking generations, especially baby boomers (Trevisan, 2008, Babatunde et al., 2014, Roche and Kostadinov, 2019), there has been little research explicitly focussing on why these cohorts differ from preceding and subsequent generations. Their emergence into adulthood during heavy drinking periods (e.g. per capita consumption in Australia peaked in the late 1970 s (Anon, 2011) likely plays a role, with sociologists arguing that they reflect an upswing in the ‘long waves’ of population drinking (Kraus et al., 2020).
Few studies have assessed quantitatively whether attitudes or norms related to alcohol have changed across populations in recent decades. Policy researchers have systematically examined trends in attitudes to policy in a number of jurisdictions (Callinan et al., 2014, Rossow and Storvoll, 2014, Hope, 2014, Giesbrecht et al., 2001), but broader data on population perspectives about drinking are relatively scarce. In a significant paper, Keyes et al (Keyes et al., 2012). demonstrated that trends in adolescent drinking were influenced not just by changes in individual attitudes, but by shifts in broader norms regarding approval of weekend heavy drinking. In other words, young people who grew up in cohorts that disapproved of heavy drinking were less likely to drink than young people from other generations even adjusting for their individual attitudes towards alcohol. Using the same measure, the Monitoring the Future survey reports have shown a steady increase in adolescent disapproval since the late 1990 s, broadly consistent with shifts in adolescent consumption (Miech et al., 2021). However, using a measure of risk perception rather than disapproval, Waddell found relatively little change in US attitudes to alcohol between 2002 and 2019 and no difference in attitude trends across age groups (Waddell, 2022). Surveys of adolescents in Scotland and England provide mixed evidence that attitudes have changed among young people, with English teenagers becoming more disapproving of drinking and drunkenness between 2003 and 2014, while there was little change in Scottish attitudes. Adolescent drinking declined steadily in both countries over the period (NHS Digital, 2019, The Scottish Government, 2019). In Australia, analyses of data from 2001 to 2013 found increasing concern about alcohol across a range of measures, with only minor variation in trends by age group (Livingston and Callinan, 2017).
Overall, there remains relatively little robust research into recent trends into alcohol attitudes, despite the marked changes in drinking that have been observed. In part, this seems to be linked to a lack of standardised measures for attitudes to alcohol at the population level. Studies have used relatively simple measures of approval (Keyes et al., 2012), multi-choice items comparing the impacts of different substances (Livingston and Callinan, 2017) and items assessing the perceived level of risk associated with various levels of consumption (Waddell, 2022). Standardised scales on norms have focussed specifically on adolescent or college populations (e.g (McAlaney et al., 2015, Wood et al., 1992).) and there have been few studies assessing trends in these measures over time.
Despite these limitations, the literature provides some indication that changing attitudes or perceptions about alcohol may be an important driver of generational differences in drinking. However, the lack of any systematic attempt to examine how trends in attitudes vary by cohorts is a glaring gap, given Keyes et al.’s work identifying cohort factors as critical influences on youth drinking and the marked variation in drinking by cohort identified in recent age-period-cohort (APC) models in high income countries (Radaev and Roshchina, 2019, Livingston et al., 2016b, Kraus et al., 2015, Meng et al., 2014).
Earlier work has highlighted generational differences in drinking trends in Australia, including increases within some sub-groups (Livingston et al., 2018b), suggesting a need to explore how attitudes have varied within specific cohorts alongside broader population-level analyses. APC models decompose trends in attitudes into three component parts: an overall change in population attitudes over time (a ‘period’ effect), the impact of differing attitudes over the life course (e.g. more positive attitudes to drinking by young people) as the population age structure changes (an ‘age’ effect), or changes in attitudes between generations that continue across their life course (a ‘cohort’ effect).
In this study, we use four items on attitudes and beliefs about alcohol collected in seven waves of the National Drug Strategy Household Survey (NDSHS) conducted every three years between 2001 and 2019 to estimate age, period and cohort models of attitudes and beliefs about alcohol to improve our understanding of the potential drivers of recent drinking trends in Australia.
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| Is Sobriety The New Clean Eating? via Women's Health |
