Social gradients in binge drinking and abstaining: Trends in a cohort of British adults

Objective: To investigate (1) social gradients in non-drinking and binge drinking, and (2) changes in social gradients in drinking with increasing age. Methods: British men and women born during the same week in March 1958 were prospectively followed up to adulthood. The frequency and amount of alcohol use were recorded at age 23, 33 and 42 years. Abstainers "never" drank, binge drinkers consumed ≥10 units (men) and ≥7 units (women) per occasion. Educational qualifications and occupation were reported at age 23 and 33 years. Logistic and repeated-measures models were used to investigate associations between social position and drinking status at single and multiple ages in adulthood. Results: Less educated men and women had greater odds of being non-drinkers at each age in adulthood, with similar gradients at ages 23-42 years. At 23 years of age, men without qualifications had 2.94 times greater odds of non-drinking than men with higher qualifications. Less educated men had greater odds of binge drinking, and gradients did not change at ages 23-42 years. At age 23 years, less educated women had lower odds of binge drinking (odds ratio (OR) 0.67 for women with no qualifications) than women with higher qualifications. By age 42 years, the gradient reversed, and less educated women had higher odds of binge drinking (OR 2.68). Conclusions: Stable gradients in non-drinking and trends in gradients in binge drinking may reinforce alcohol-related health inequalities over time.