Prevalence of alcohol consumption, abuse and dependence in a country with high per capita consumption: findings from the German TACOS study

Background The aim of the Transitions in Alcohol Consumption and Smoking (T ACOS) project is to investigate substance use and use disorders in the adul t general population in a region of the under-researched north of Germany, focussing on smoking and alcohol consumption. In this study, the design and quality assurance provisions of the baseline cross-section of the longitud inal project are described. Prevalence rates of alcohol use disorders, cons umption pattern, and the nature of their association are also analysed with regard to preventive strategies. Method: A random sample of 4075 participa nts, aged 18 to 64 and drawn from residents registration office files, was interviewed with a DSM-IV adapted version of WHO CIDI. Fieldwork resulted i n a response rate of 70.2% and an unbiased database with regard to demograp hic characteristics. Results: Low lifetime prevalence of alcohol use disord ers (4.5% abuse, 3.8% dependence) and hazardous consumption (13.2% lifetime ; 6.0% 12-month) was found compared to southern regions of Germany and US A merican data. In contrast, we found a comparatively high percentage of mode rate alcohol uses. Male subjects are more affected by lifetime alcohol use disorders (abuse OR 8.3, 95% CI 5.3-13.2; dependence OR 4.3, 95% CI 2.8-6.4 ). The association between alcohol use disorders and alcohol consumption pa ttern revealed a weaker relation for alcohol abuse compared to dependence. Conclusion: National and regional drinking habits and norms have to be cons idered as a significant source of variance, supporting the need for Europea n epidemiological research on substance use in addition to US American acti vities, and emphasising the advantages of community-based preventive measur es. An evaluation of public recommendations for safe limits of alcohol cons umption and prevention targets referring to average consumption is indicate d. There is also a need for a clear distinction between alcohol abuse and d ependence.