The Harms That Drinkers Cause: Regional Variations Within Countries.

Aims: Multinational studies of drinking and the harms it may cause typically treat countries as homogeneous. Neglecting variation within countries may lead to inaccurate conclusions about drinking behavior, and particularly about harms drinking causes for people other than the drinkers. This study is the first to examine whether drinkers' self-reported harms to others from drinking vary regionally within multiple countries.

Design setting and participants: Analyses draw on survey data from 12,356 drinkers in 46 regions (governmental subunits) within 10 countries, collected as part of the GENACIS project (Wilsnack et al., 2009).

Measures: Drinkers reported on eight harms they may have caused others in the past 12 months because of their drinking. The likelihood of reporting one or more of these eight harms was evaluated by multilevel modeling (respondents nested within regions nested within countries), estimating random effects of country and region and fixed effects of gender, age, and regional prevalence of drinking.

Findings: Reports of causing one or more drinking-related harms to others differed significantly by gender and age (but not by regional prevalence of drinking), but also differed significantly by regions within countries.

Conclusions: National and multinational evaluations of adverse effects of drinking on persons other than the drinkers should give more attention to how those effects may vary regionally within countries.