SOCIAL CLIMATE ON ALCOHOL IN ROTTERDAM, THE NETHERLANDS: PUBLIC OPINION ON DRINKING BEHAVIOUR AND...

Alcohol & Alcoholism Vol. 32, No. 2. pp. 141-150. 1998

SOCIAL CLIMATE ON ALCOHOL IN ROTTERDAM, THENETHERLANDS: PUBLIC OPINION ON DRINKING BEHAVIOUR AND

ALCOHOL CONTROL MEASURESINGE M. B. BONGERS*, IEN A. M. VAN DE GOOR and HENK F. L. GARRETSEN

Addiction Research Institute, Erasmus University, Heemraadssingel 194, 3021 DM Rotterdam, The Netherlands

(Received 7 April 1997; in revised form 28 July 1997; accepted 5 August 1997)

Abstract — Research was undertaken regarding the Dutch climate on alcohol in 1994 and results werecompared with earlier findings. It was found that the social climate on alcohol in The Netherlands can becharacterized by 'moderation'. Over the years, drinking without problems has become more acceptable(and is even encouraged at times) whereas excessive dnnking and consequent problems still meet strongdisapproval. Opinions concerning alcohol control measures mirror this attitude. Measures such as therestriction of drinking in public places and raising the age limits are endorsed by the public. However,more people are now against restrictions on the general availability of alcohol. Although drink-drivinghas decreased over the years, its prevalence is still high, especially among those who are most at risk.

INTRODUCTION

Alcohol is known and used throughout the world.However, the way in which, and to what extentalcohol is integrated into society differs acrosscountries: every society has its own social climateon alcohol. Social climate on alcohol can bedescribed as the blend of different views ondrinking, conceptions of alcohol-related problems,and the defining of appropriate measures fordealing with them. All such aspects exist inevery society and may change over time (Partanenand Montonen, 1988).

In The Netherlands, alcohol consumption isdeeply integrated into society. This integration ismarked by a steep, threefold increase of alcoholconsumption per capita from 1960 to 1980. In the1980s, the consumption per capita stabilized at ahigh level of ~ 9 1 . Since the late 1980s and early1990s, consumption per capita has decreasedslightly to ~81 (de Zwart and Mensink, 1996).The marked increase in alcohol consumption,leading to the highest level of alcohol use everin The Netherlands, provoked a political memor-andum Alcohol and Society (Alcohol en Samenlev-ing, 1986). A more comprehensive alcohol control

*Author to whom correspondence should be addressed.

policy was advocated: more prevention andeducational activities, a more efficient alcoholtreatment system, and modernization of the law onalcohol. Consequently, over the past decade, morepreventative activities have been developed andimplemented such as national mass media cam-paigns and alcohol education in schools (Garretsenand van de Goor, 1995; NIGZ, 1996). Greateremphasis is put on early recognition of problemdrinkers (Hoeksema and Holten, 1990). Also, abill for a revised law on alcohol is planned to bepresented in Parliament by the end of 1997.

The present law on alcohol regulates thedistribution of alcoholic beverages and the condi-tions of distribution. Some of the crucial articlesare: a legal drinking age of 16 years for beer andwine and 18 years for spirits, and sale licences forpublic houses and restaurants issued by themunicipal authority. The sale of beer and wine isallowed in every grocery store, but the sale ofspirits requires a licence. Alcohol advertising issubject to a voluntary code: all audiovisualadvertisements (except television) and 40% ofthe television advertisements will be accompaniedby an educational slogan. Furthermore, advertise-ments should not be aimed at under-aged children,relate drinking with work or sports or promoteheavy drinking. The bill for the revised law onalcohol proposes the prohibition of the sale of

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142 I. M. B. BONGERS et al.

alcohol in petrol stations and work places and toban alcohol from health care facilities, educationalinstitutes, and specific youth associations.

In the context of the alcohol control policy,knowledge of the social climate on alcohol is ofmajor importance. First, social climate on alcoholdirectly influences drinking behaviour and hencealcohol-related problems. Furthermore, socialclimate on alcohol is the framework withinwhich alcohol control policy and its measuresare placed (Edwards et al, 1994). The efficacy ofan alcohol control policy depends to a large extenton public support for this policy. On the otherhand, preventative measures may influence thesocial climate on alcohol use, for instance towardsa greater awareness of alcohol-related harm. Thisgreater awareness may in turn change the accept-ability of public policies known to reduce alcohol-related harm. Despite its importance for alcoholpolicy, only limited empirical information isavailable on the Dutch social climate on alcohol.In 1958, just before the strong increase in alcoholconsumption, Gadourek (1963) assessed someaspects of social climate on alcohol. The nextand last survey in which comprehensive informa-tion was gathered on social climate on alcohol wasconducted in 1980-81, at a time when alcoholconsumption per capita stabilized at a high level(Garretsen, 1983). Since 1980, however, variousaspects concerning alcohol have changed in Dutchsociety. The consumption per capita remains at ahigh level, but recently a slight decline was noted.Furthermore, the memorandum Alcohol andSociety {Alcohol en Samenleving, 1986) inducedpolitical action. Therefore, it seems expedient torenew insight into the Dutch social climate onalcohol.

The aims of this study were to gain insight intovarious aspects of social climate on alcohol amongthe inhabitants of Rotterdam, The Netherlands, in1994, and the changes in social climate over theyears. Conforming to the definitions by Partanenand Montonen (1988), the following indicators ofsocial climate on alcohol were used: (1) attitudestowards drinking behaviour of close relatives; (2)attitudes towards drinking behaviour at a party; (3)the journey home after having drunk; (4) opinionson restrictive measures. The first three indicatorsgive insight into attitudes towards drinkingbehaviour and its consequences. The last indicatorsheds light on public opinion about measures of

alcohol policy. It could be argued that trends inalcohol consumption per capita will be mirroredby attitudes towards drinking behaviour: the moresociety drinks, the higher the tolerance withrespect to drinking behaviour in society and viceversa. Therefore, the stabilization of alcoholconsumption per capita at a high level over thelast 15 years should be expected to be mirrored bya stabilization of public tolerance with respect todrinking behaviour at a high level. However,prevention and information campaigns may haveincreased public awareness of alcohol-relatedharm. This increased awareness could have ledto stronger support for alcohol control measuresand a (slight) decrease in tolerance for alcohol use.Law enforcement on legal limits for drinking anddriving might have produced a decrease in drink-driving. Furthermore, from a political view-point,it is important to know whether the revision of thelaw on alcohol, stressing restrictions on theavailability of alcohol in public places andamong young people, is supported by the public.

METHODS

Data collection

Data on social climate on alcohol in 1994 werecollected within the framework of a large-scalegeneral population survey called Risky Lifestylesin Rotterdam. For this survey, a random sample of8000 persons was drawn from the municipalpopulation register of Rotterdam, The Nether-lands, in February 1994. The sample includedinhabitants between 16 and 69 years of ageand, to avoid language problems, persons withDutch nationality. Data collection by postalquestionnaire and oral interview (7500 and 500people respectively) took place in the spring of1994. No differences were found between the twodata collection methods with respect to self-reported drinking habits (Bongers and van Oers,1998).

The overall response rate was 44.2%(n = 3537). Considering the main data collectionmethod (postal questionnaires), the low saliencyof the research topic and the location of the study(a highly urbanized city), the response rate is notatypical (Hox and de Leeuw, 1994). Furthermore,a follow-up study among a sample of the non-responders to our study revealed that about half of



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SOCIAL CLIMATE ON ALCOHOL IN ROTTERDAM 143

them were unwilling to cooperate in any survey. Inthis follow-up study, it was concluded that it wasunlikely for non-responders to be selective withregard to the topic of the study (Jansen and Hak,1996). However, non-response analyses showedthat the response was selective in terms of sex andage (Bongers et at, 1997). The differentialresponse probability model was used to evaluateand correct for the consequences of this differ-ential non-response (Bethlehem and Kersten,1986). The 1994 results reported in this articleare based on the weighted data set.

To study changes in the social climate onalcohol the 1994 findings were compared withfindings of 1958 and 1980-81. In 1958, Gadourek(1963) conducted a survey on alcohol andsmoking among the Dutch general population. In1980-81, Garretsen (1983) examined an alcoholsurvey among Dutch inhabitants of Rotterdam,The Netherlands. The design and methods of thesestudies are extensively explained in the abovepublications.

Measurements

Social climate. Social climate was assessed bythe following indicators: (1) attitudes towardsdrinking behaviour of close relatives; (2) attitudestowards drinking behaviour at a party; (3) thejourney home after having drunk (drink-driving);(4) opinions on restrictive measures. In 1994 and1980-81 all four indicators were measured,whereas in 1958 only the first two indicatorswere measured. Attitudes towards drinking beha-viour of close relatives were measured by thequestions: 'Would you mind if a close relativewas: (a) tipsy every now and then; (b) drunk everyweek; (c) a teetotaller?' Attitudes towards drink-ing at a party were measured by the questions:'Suppose there is a party, how many alcoholicdrinks is a man of your age allowed to drinkaccording to you? He will not be driving a carhimself. Respondents were asked the samequestion about women. Drink-driving was mea-sured by asking respondents: 'How do you usuallyproceed home after having drunk three or moreglasses?'. The cut-off point of three or moreglasses was chosen, as it corresponds on averageto a blood-alcohol concentration (BAC) higherthan 0.5 promille, (50 mg/dl) which is the Dutchlegal limit. Opinions on restrictive measures wereascertained by asking respondents whether they

were in favour or against: (1) prohibition ofadvertising; (2) a price increase per glass of 50cents (equal to a price increase of ~ 20-25%); (3)restrictions on alcohol use in public places likeschools, trains, and swimming pools; (4) reductionin the number of public houses; (5) reduction inthe number of outlets in which alcoholic beveragesare sold.

Drinking behaviour. Drinking behaviour wasmeasured by the Quantity-Frequency-Variabilitymethod. Four questions were asked: 'Whichalcoholic drinks do you usually drink when youdrink?'; 'How many days a month do you drink onaverage?' (F); 'If you drink alcohol, how manyglasses do you drink on average?' (Q); 'Have youever drunk six or more glasses in one day in thepast 6 months?' (V). Based on these questions,respondents were categorized into abstainers,light, moderate, excessive, and very excessivedrinkers (for categorization, see Bongers et ai,1997).

Background variables. The background factorsof sex, age, daily activities, and educational levelwere measured. The variable of daily activitiescategorized respondents as employed or house-keeping; unemployed; declared unfit for work;retired; student or conscript. Educational level wasdefined as respondent's highest level of education.

Data analysis. To gain insight into the socialclimate on alcohol in 1994 and its changes overtime, proportions of respondents with restrictiveand less restrictive attitudes or opinions werecompared for each indicator of social climate. Onthe basis of the 1994 data, insight was gained intodifferences in social climate by backgroundvariables and by own drinking behaviour.

The relation between social climate and thebackground variables of sex, age, daily activities,and educational level was analysed bivariately.Differences in attitudes towards others, drinkingbehaviour and own drinking behaviour wereanalysed by logistic regression analyses. Oddsratios were calculated and adjusted for differencesin background variables. Differences in drink-driving and restrictive measures by own drinkingbehaviour were analysed bivariately. For alcoholpolicy, it is important to know how respondentsbehave and react, who are most likely to drink anddrive, or who are most affected by restrictivemeasures respectively. In these cases, adjusting forbackground variables is not informative.



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Table 1. Public opinion on drinking behaviour of close relatives (%)

Would you mind if a close relativeTipsy every now and then?Drunk every week?A teetotaller?

Yes

is:68.698.1

9.9

1958*

No

30.41.6

86.6

Don'tknow

1.00.33.0

n

129112891286

Yes

56.395.34.0

1980-8 If

No

39.93.4

93.4

Don'tknow

3.81.42.6

n

212821392111

Yes

44.892.9

5.4

1994

No

48.24.3

88.8

Don'tknow

7.02.95.7

n

337933733361

*Gadourek (1963); tGarretsen (1983).

RESULTS

Public opinion on drinking behaviour and itsconsequences

Attitude towards close relatives' drinking beha-viour. Table 1 shows respondents' attitudestowards drinking behaviour of close relativesover the years. The percentage of respondentswho would not mind their close relatives beingtipsy occasionally increased substantially over theyears. In 1958, 30% of the respondents would notmind whereas in 1980-81 and 1994, figures of40% and 45% were obtained. The percentage ofrespondents who would mind if their closerelatives were to be drunk every week decreasedslightly from 98% in 1958, to 95% in 1980-81,and 93% in 1994. In 1958, 87% of the respondentswould not care if a close relative was a teetotaller.This percentage increased to 93% in 1980-81, anddeclined to 89% in 1994.

Attitudes towards drinking behaviour of closerelatives differed by sociodemographic character-istics. More than half of the women (52.2%)would mind if close relatives were to be tipsyoccasionally, against 37.1% of the men. Age wasalso an important influential factor: the higher the

age, the more respondents cared if their closerelatives were tipsy. It was found that 28.9% of theyoung people between 16 and 24 years of agewould mind this against 68.7% of the respondentsbetween 55 to 69 years of age. Consistent with thefindings by age, 28.9% of the subgroup of studentsand conscripts would mind if close relatives weresometimes tipsy against 66.8% of the retiredrespondents. Furthermore, the higher the educa-tional level the less respondents would mind ifclose relatives were tipsy. Although the findingswith regard to being drunk every week were lesspronounced, they pointed in the same direction.Finally, no clear differences in opinion towardsteetotallers were found by background factors.

Respondents' drinking behaviour was found tobe strongly related to their attitude towardsdrinking behaviour of close relatives after con-trolling for differences in sex, age, educationallevel, and daily activities (Table 2). The level oftolerance with respect to close relatives beingtipsy every now and then increased significantly inparallel to their own drinking behaviour: veryexcessive drinkers were almost nine times aslikely as abstainers to tolerate this kind ofdrinking. Although most respondents agree on

Table 2. Odds of tolerance with respect to drinking behaviour of close relatives by own drinking behaviour controlled forsex, age, educational level, and daily activities (based on 1994 data)

Very excessiveAbstainers Light drinkers Moderate drinkers Excessive drinkers drinkers

Odds of not minding if closerelatives would be:

Tipsy every now and then 1 2.38 11.88-3.02] 5.78 [4.28-7.80] 6.56 [4.28-10.06] 8.89 [5.04-15.68]Drunk every week 1 0.74 [0.42-1.31] 1.99 [1.08-3.66] 2.11 [1.00-4.45] 3.17 [1.33-7.57]A teetotaller 1 1.40 [0.90-2.18] 0.94 [0.55-1.61] 0.82 [0.39-1.76] 0.39 [0.18-0.88]



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Table 3. Public opinion on male and female drinking behaviour of respondents' contemporaries at a party when they do nothave to drive home themselves (%)

1958* 1980-8 ItMales Females Males Females

1994

Males Females

Men or women are allowed to drink at a party:as much as they like % X>5 glasses 33.7 11.83 or 4 glasses 31.2 32.21 or 2 glasses 9.4 26.80 glasses 1.7 8.2don't know 24.1 21.0n 1251 1256

36.224.319.75.91.2

12.72150

34.117.422.410.42.3

13.32150

38.220.920.3

8.62.39.6

3368

37.215.720.912.73.3

10.23412

*Gadourek (1963); tGarretsen (1983); J'no answer' category in this study.

their negative attitude towards frequent drunken-ness, moderate and (very) excessive drinkers weresignificantly more likely than abstainers to betolerant if close relatives were to be drunk everyweek. No significant differences were found intolerance with respect to teetotallers by owndrinking behaviour, except that very excessivedrinkers were significantly less likely to betolerant.

Drinking at a party. Table 3 shows tolerancetowards drinking behaviour at a party over theyears. A considerable number of respondentsanswered 'don't know' to these questions, espe-cially in 1958. In 1994, almost 40% of therespondents allowed men to drink as much asthey like at a party provided they did not have todrive home themselves. Another 21% of therespondents answered they would allow five ormore glasses. Only 2% of the respondents thoughtmen should not drink at all at a party. Similarfigures were found with respect to female drinkingat parties. These findings resemble the findings of1980-81. In 1958, however, people were muchstricter with respect to drinking at a party: onlyone-third of the respondents allowed men to drinkfive or more glasses. Also notable is that, in 1994,as in 1980-81, the norms towards male and femaledrinking behaviour at a party were similar,whereas in 1958, people (men as well aswomen) were stricter towards female than towardsmale drinking.

Attitudes towards drinking behaviour at a partydiffered by subgroup of the population. Womenwere less tolerant than men with respect to levelsof drinking at a party: 43.3% of the men against

33.1% of the women answered that men of thesame age may drink as much as they want. Agewas also related to attitude: drinking as much asyou want was tolerated by almost half of theyoung people (47.2%) against only one-fifth(19.9%) of people in the oldest age category.Furthermore, the higher the educational level, themore tolerant respondents were towards maledrinking behaviour at a party. Comparable resultswere found for female drinking behaviour at aparty.

After controlling for sex, age, educational level,and daily activities, the likelihood of tolerancewith respect to drinking levels at a party wasstrongly related to respondents' own drinkingbehaviour (Table 4). Compared with abstainers,moderate drinkers were five times as likely andexcessive drinkers 10 times as likely to allow mento drink five or more glasses at a party. For femaledrinking behaviour, the same pattern was found,although the odds ratios were not as high as formale drinking behaviour.

The journey home after drinking three or moreglasses. In 1980-81 and 1994, respondents whodrank were asked how they usually returned homeafter having drunk three or more glasses. For theseyears, the percentage of respondents who reporteddriving home by car or motorcycle decreased from12% to 7% (Table 5).

Drink-driving was strongly related to drinkingbehaviour (Table 6). The more respondents drank,the more often they reported driving home afterthree or more drinks. Almost a quarter of the veryexcessive drinkers and 15% of the respondentswho drank six or more glasses once a week or



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Table 4. Odds of tolerance with respect to male and female drinking behaviour at a party by own drinking behaviourcontrolled for sex, age, educational level, and daily activities (based on 1994 data)

Abstainers Light drinkers Moderate drinkers Excessive drinkersVery excessive

drinkers

Odds of allowing males orfemales to drink >5 glasses ata party when they do nothave to drive home themselves:

Males 1Females 1

2.29 [1.81-2.90] 5.04 [3.71-6.86] 10.21 [5.94-17.35] 11.65 [5.83-23.25]2.00[1.58-2.52] 4.25 [3.17-5.69] 6.83 [4.28-10.90] 7.41 [4.14-13.25]

more drove home themselves. The more regularlyrespondents drank outside their own homes, themore often they drove home after three or moredrinks. Respondents who drank regularly in sportsclub canteens were particularly likely to drivethemselves home.

Drink-driving also differed by subgroups of thepopulation. In 1994, men drove home more oftenafter drinking than women (11.3% vs 2.5%). Ofthe young people (16-24 years of age) only 3.1%drove home after drinking, against 10.1% of therespondents between 44 and 54 years of age. Thepercentages among the other age categories variedbetween 6 and 9%. Consistent with the results byage, the percentage of students and conscripts whodrove home after drinking was very low (1.9%).The percentage of those who drove home afterdrinking was relatively high among working andretired respondents: 8.2 and 8.5%, respectively.

Public opinion on alcohol control measures

In 1994 as well as in 1980-81, the greatmajority of respondents was in favour of restrictedalcohol consumption in public places like schools

or trains (Table 7). In both years, more than 60%of respondents were in favour of raising the agelimit for buying alcoholic beverages. With respectto the remaining measures (price increase of 50cents, reduction of traditional outlets, and prohibi-tion of advertising), only a minority of therespondents reported in favour. The support forprohibition of advertising and price increase hasdropped by 10% from 1980-81 to 1994.

Attitudes towards restrictive measures differedby background characteristics (Table 8). Womenwere more often in favour of restrictive measuresthan men. Younger people (under 35 years of age)were more negative about restrictive measures.Educational level was also related to attitudestowards restrictive measures: the higher theeducational level of respondents, the less theywere in favour of restrictive measures. Finally,students and conscripts were mostly negativetowards restrictive measures.

Respondents' drinking behaviour was stronglyrelated to their opinion on restrictive measures.The more people drank, the less they favouredrestrictive measures. Half or more of the abstain-

Table 5. How respondents usually return home after having drunk three or more glasses

1980-8 If 1994

Usual way of going home after having drunk >3 glasses:By car/motorbikeBy bikeBy cab, by public transport, or driven home by friend/partnerOn footDoes not apply to me as I never drink >3 glassesOthern

12.13.3

57.89.6

26.31.5

1672

7.113.755.322.032.14.0

2878

•Respondents were allowed to give more answers. In 1980-81, however, the maximum was two answers whereas in1994 no maximum was given; tsecondary analyses on the dataset of Garretsen (1983).



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Table 6. Driving home by car or motorbike after having had three or more drinks by drinking behaviour (among drinkers)

Drinking behaviourDriving home by car/motorbike

after drinking >3 glasses

Categories of drinkingLight drinkersModerate drinkersExcessive drinkersVery excessive drinkers

Drinking >6 glassesOnce or more a weekLess than once a weekNever

Drinking in a pub, restaurant ordisco

Once or more a weekLess than once a weekNever

Drinking in a sports club canteenOnce or more a weekLess than once a weekNever

Place where one drinks the mostper occasion

At home (own or that offriends/family)In public placesAt work or at school

1931616185100

4479611334

3761582543

1553981812

y2

r

y2

x2

3.911.915.324.3

= 115.01; df=3; P < 0.00

15.68.83.2

= 89.98; df = 2; P < 0.001

11.97.63.1

= 26.40; df = 2; P < 0.001

21.413.44.9

= 82.37; df = 2; P < 0.001

1705

80922

6.4

19.8X2 = 10.04; df = 2; P = 0.007

ers were in favour of restrictive measuresirrespective of the type of measure. Excessivedrinkers most often opposed these restrictivemeasures. However, a relatively high percentageof very excessive drinkers was in favour of therestrictive measures: their percentage lay betweenthat of light and moderate drinkers.

In general, those subgroups in the populationwhich would be particularly affected by themeasures were less in favour of restrictions.More than half of those between 16 and 19 yearsof age (57.6%) were against raising the age limitsfor buying alcoholic beverages. Among studentsand conscripts, as many as two-thirds (64.6%)were against raising the age limits. Of this samesubgroup, more than three-quarters (76.3%)opposed a price increase of 50 cents. Incomewas not related to opinion as regards the lattermeasure. Furthermore, among those who drink in

licensed premises once or more a week, only 10%were in favour of a reduction in the number ofpublic houses.

DISCUSSION

The present results indicate that the public hasbecome more tolerant with respect to alcohol use.Tolerance of 'being tipsy every now and then'increased remarkably between 1958 (Gadourek,1963) and 1980-81 (Garretsen, 1983) andincreased slightly from 1980-81 to 1994. Drinking(a lot) at a party was tolerated by the majority ofthe respondents in 1994 as well as in 1980-81. In1958, respondents were much stricter with respectto this behaviour. It is noteworthy that, since 1958,the norms towards male and female drinking at aparty have converged. Several factors were relatedto attitudes towards drinking behaviour. The most



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Table 7. Public opinion on alcohol control measures in 1980-81 and 1994 i

In favour or against:Prohibition of advertisingPrice increase of 50 cents a glassRestrictions on alcohol use in

public placesRaising age limitsReduction in number of public housesReduction of number of shops

selling alcoholic beverages

In favour

52.141.977.6

61.530.432.9

1980-81

Indifferent

26.524.211.3

18.630.629.4

Against

21.433.811.1

19.939.037.6

n

209420892107

208020382056

In favour

40.631.581.1

61.729.232.8

1994

Against

59.468.518.9

38.370.867.2

n

335833463440

338133013325

important factor was the respondent's own drink-ing behaviour: the more people drink, the moretolerant they were of other people's drinkingbehaviour.

As hypothesized, the changes in attitudetowards alcohol use over time are mirrored bychanges in consumption per capita: the increasedacceptability of alcohol use is in line with thesharp increase in consumption per capita from1960 to the 1980s. Stabilization of the consump-tion per capita at a high level in more recent yearsis mirrored by stabilization in tolerance withrespect to drinking (a lot) at a party.

Contrary to the recent slight decrease inconsumption per capita, tolerance with regard toclose relatives 'being tipsy every now and then'slightly increased between 1980-81 and 1994.Consequently, the question is whether this slightincrease in tolerance is real. It may, for instance,be explained by different interpretations of 'beingtipsy every now and then': in 1994, 'being tipsy'might be perceived as just 'drinking a little toomuch' and in 1980-81 as 'being nearly drunk'.Further research is needed, as no conclusiveanswer can be given on the basis of this study.

Another indicator of social climate on alcoholwas drink-driving. The prevalence of drivinghome after having drunk three or more glasseswas assessed. Three or more glasses was chosensince the legal limit in The Netherlands is set at aBAC of 50 mg/dl which corresponds to up to twoglasses for an average person. The percentage ofpeople who drive themselves home after havingdrunk three or more glasses decreased from 12 to7% from 1980-81 to 1994. This decrease is likelyto be due to the increased level of enforcement ofthe legal limit over those years (Mathijssen and

Wesemann, 1993). Deterrence is the primaryapproach to prevent drinking in conjunction witha risky situation. Drink-driving legislation whenenergetically enforced has been shown to be ahighly effective public policy in terms of injuriesaverted and lives saved (Edwards et al., 1994). Ofcourse it is alarming that among those who drink alot and/or often drink outside the home, drink-driving was most prevalent. Education pro-grammes on drink-driving should be aimed atthese specific target groups. Contrary to what isoften thought, young people are not the section ofthe population that should be approached in thisrespect. The percentage of young people whodrove home after having drunk too much wasrelatively low. This finding might be explained bythe fact that many young people do not possess avehicle but, as they live in the urban city ofRotterdam, they have access to public transport.The occurrence of drink-driving found among'normal' moderate drinkers raises the questionwhether mass media campaigns and alcoholeducation programmes reach all the risk groups.More attention should be paid to the fact thatmoderate drinking can also cause problems incertain situations.

In both 1980-81 and 1994, support was clearlygiven to a restriction on alcohol use in publicplaces. The next most favoured measure wasraising the age limits. Yet, in 1994 only a minorityof respondents supported measures whichrestricted the general availability of alcohol.When comparing our results with those of asurvey among Dutch Members of Parliament in1994 (Hendriks et al, 1997) it became clear thatboth the public and Members of Parliamentgenerally desire restrictions on alcohol in public



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Table 8. Public opinion on alcohol control measures by background variables in 1994 (%)

In favour of>4 measures

In favour of 2 or3 measures

In favour of zeroor 1 measure

Total population(n = 3159)Sex

MaleFemale

Age (yr)16-2425-3435-4445-5455-69

Educational levelPrimary schoolLower vocational/

generalIntermediate

vocational/general andhigher general

Higher vocationalUniversity

Daily activitiesEmployed/housekeeperUnemployedDeclared unfit to workRetiredStudent/conscript

32.3

25.838.6

X2 = 85.83;df=2;

23.122.933.540.149.0

•/;= 178.42; df= 8;

52.741.9

28.4

20.99.3

X2 = 281.78; df = 8;

31.734.449.344.218.8

72 = 140.86; d f = 8 ;

P < 0.001

P < 0.001

P < 0.001

P < 0.001

40.0

40.039.9

37.742.842.438.136.0

31.939.2

41.8

43.240.7

41.644.532.739.331.6

27.8

34.221.5

39.234.424.121.815.0

15.419.0

29.8

35.950.0

26.721.118.016.549.6

places. It is notable, however, that only one-fifthof the Members of Parliament wished to raise theage limits against almost two-thirds of the public.

The support for prohibition of alcohol advertis-ing and a price increase of 50 cents per glassdropped by 10% between 1980-81 and 1994.There are no definite explanations for this drop insupport. The lower level of support for a ban onalcohol advertising might be related to thevoluntary code on alcohol advertising that hasoperated since 1990. People may consider thecode as sufficient.

The 1994 and 1980-81 data were limited to thegeneral population of Rotterdam. Rotterdam is acity in the urban west of The Netherlands.Although The Netherlands is not a large country,differences in social climate on alcohol bygeographic region are possible. Garretsen andKnibbe (1985) showed that people in the south

eastern Netherlands are more tolerant with respectto drinking than people in Rotterdam. Therefore,caution should be exercised when extrapolating tothe whole Dutch population. The comparison ofthe 1958 figures with those of 1994 and 1980-81also require some caution, as the sample in 1958was representative of the total Dutch population,whereas in the later studies the general Rotterdampopulation was sampled.

In summary, the social climate on alcohol in1994 in Rotterdam, The Netherlands, can becharacterized by 'moderation': both positive andnegative aspects of alcohol are recognized.Drinking without problems is tolerated (andsometimes even stimulated), whereas excessivedrinking and its consequent problems are stronglydisapproved of. The opinions on alcohol controlmeasures are mirrored by attitudes towardsdrinking. Measures such as the restrictions on



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150 I. M. B. BONGERS el al.

drinking in public places and raising the age limitsare endorsed by the public. However, most peopleare against measures, including price increases,which would restrict the availability of alcoholicbeverages.

REFERENCES

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Partanen, J. and Montonen, M. (1988) Alcohol and theMass Media. Euro Reports and Studies 108. WorldHealth Organization, Regional Office for Europe,Copenhagen.

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