title: White cider consumption and heavy drinkers: a low-cost option but an unknown price.
abstract: OBJECTIVE
  To compare characteristics of heavy drinkers who do, or do not, drink white cider during their typical drinking week and to contrast white cider drinkers' behaviour with a similar group recruited in comparable settings 4 years previously. To consider if excessive white cider consumption poses a specific health risk.
  
  
  METHODS
  Cross-sectional survey of alcohol purchasing and consumption by heavy drinkers consuming white cider in Edinburgh and Glasgow during 2012; comparison of purchasing patterns within Edinburgh in 2008-2009 and 2012. Participants were 639 patients (in- and out-patient settings) with serious health problems linked to alcohol, 345 in Glasgow, 294 in Edinburgh in 2012, and 377 in Edinburgh in 2008-2009.
  
  
  RESULTS
  In 2012 white cider consumption was reported by 25% of participants (median consumption (all alcohol) was 249 UK units per week-1 UK unit being 8 g of ethanol). They were more likely to be male and younger. They drank more units of alcohol than non-white cider drinkers and reported more alcohol-related problems. The median price paid for white cider in 2012 was 17 ppu. The period 2008-2012 was associated with decreasing affordability of alcohol, but consumption levels amongst the heaviest drinkers were maintained, associated with an increased proportion of units purchased as white cider.
  
  
  CONCLUSIONS
  White cider makes an important contribution to the weekly intake of heavy drinkers in Scotland, likely facilitated by low price per unit of alcohol. We suggest these characteristics permit this drink to act as a buffer, supporting the continuation of a heavy drinking pattern when affordability of alcohol falls.
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Black
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK.
authors.forename: Lucie
authors.initials: L
authors.lastname: Michalova
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK jgill@qmu.ac.uk.
authors.forename: Jan
authors.initials: J
authors.lastname: Gill
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Rees
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Chick
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: O'May
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Rush
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: McPake
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000191:economics* / Q000453:epidemiology*; D000434:Alcoholic Beverages / Q000191:economics*; D000435:Alcoholic Intoxication / Q000191:economics / Q000453:epidemiology; D003132:Commerce / Q000191:economics*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012606:Scotland / Q000453:epidemiology