Alcohol-Tolerant Workplace Environments Are a Risk Factor for Young Adult Alcohol Misuse on and off the Job in Australia and the United States
Research paper
Background and significance
Introduction
Although alcohol use among adolescents in high-income countries has declined over the last decades, it still is a major contributor to the global burden of disease and mortality.
But evidence-based programs and policies now exist to prevent early initiation and use of alcohol in adolescence – both important risk factors for the development of alcohol use problems later in life.
Gap in effective alcohol prevention services for young adults outside university
Nevertheless, there are few efficacious approaches for the prevention of alcohol use disorder in young adulthood, despite the fact that alcohol use and use disorder peak during this time, making it a critical period for intervention and prevention. The few existing effective approaches for young adults almost exclusively focus on college students. But more than half of 18- to 24-year-olds do not attend college and may therefore miss out on alcohol and other drug use prevention and treatment services. To address this gap, the present research examined factors in the workplace to explore its potential as an intervention setting for the prevention of alcohol use problems among young adults.
Workplace remains important social context and is promising context for alcohol prevention
The workplace is a promising but mostly overlooked intervention context for young adults. Most young adults are employed, including college students who tend to work at least part-time. Although remote work arrangements have become more widespread, they are most often part-time and concentrated in certain industries (e.g., computer, business, finance, engineering, sciences, arts, design, and media).
The workplace remains an important social context, especially for young adults, as most employees still spend two or three days per week at the office or the work site and young workers are overrepresented in food preparation, service, hospitality, and construction, i.e., industries that are the least likely to offer remote work options.
Unique workplace risks for alcohol use problems
The workplace is not only a context that most young adults encounter, but it is also a setting that presents unique risks for alcohol use problems.
According to data from the 2002–2003 U.S. National Survey of Workplace Health and Safety (NSWHS), 10.2% of young adult women and 22.0% of young adult men (ages 18–30) were alcohol-impaired at work in the past year due to working under the influence of alcohol or coming to work with a hangover compared to 2.8% of older (ages 31–65) female and 7.4% of older male employees.
This is especially true in industries with alcohol-tolerant work cultures, including food preparation and serving; hospitality; arts and entertainment; and construction industries, which are more likely to employ young adults.
The alcohol norm at work
Alcohol-tolerant work environments are concerning not only because they increase the risk for alcohol use and alcohol-induced impairment at work but also for alcohol use problems and alcohol use disorder in general, including outside of work.
A permissive workplace alcohol environment – a strong alcohol norm – could contribute to
- the initiation of alcohol use in young adulthood,
- encourage alcohol use problems among those who did not yet consume alcohol heavily, or
- perpetuate and escalate alcohol problems for those who already had them.
Workplace as site for alcohol prevention and intervention
To utilize the workplace as a site for alcohol prevention and intervention, identifying malleable factors that function as risk mechanisms for alcohol use and linked problems at work and possibly also off the job is crucial.
Risk factors for workplace alcohol use
Several comprehensive reviews have summarized the state of evidence regarding risk factors for workplace alcohol use.
In addition to demographic (e.g., male sex, younger age) and individual characteristics (e.g., rebelliousness, impulsivity), four key aspects of the workplace environment have been shown to increase the risk for alcohol use and alcohol-induced impairment at work:
- alcohol availability,
- alcohol policies (and their enforcement by supervisors),
- work stressors (such as physical hazards and job insecurity), and
- alcohol norms generated by coworkers’ alcohol use at work (descriptive norms) and their approval of workplace alcohol use (injunctive norms).
The present study aimed to fill several gaps in the existing understanding of the link between the workplace alcohol environment and young adult workers’ alcohol use problems off and on the job by comparing survey data from state-representative samples of 25-year-olds in Washington, U.S. and Victoria, Australia.
The researchers examined the link between three key aspects of the workplace alcohol environment (alcohol availability, policy, and norms) and young adults’ alcohol use or impairment at work as well as their high-risk alcohol use in general.
Main results
As hypothesized, young adults in Victoria were almost twice as likely as those in Washington to engage in high-risk alcohol use.
Young adults in Victoria were also about one and half times as likely to have used alcohol in adolescence and had used it more frequently. Young adults in Victoria were almost twice as likely than those in Washington to use alcohol at work during work hours, almost three times as likely to consume alcohol at work after work hours, and 25% more likely to have come to work with a hangover.
Similar proportions of employed young adults in both states worked while under the influence of alcohol.
As hypothesized, workplace alcohol environments of young adults in Victoria were significantly more alcohol tolerant compared to those in Washington.
Young adults in Victoria were about twice as likely to report that alcohol was available at their workplace.
In both states, alcohol at work was most common at special work functions and occasions, but with significantly higher prevalence in Victoria than Washington.
Young adults in Victoria also were less likely than those in Washington to say that their workplace had a written alcohol policy, including one that completely banned alcohol, but were more likely to say that they did not know if there was a policy.
Young adults in Victoria also were more likely than those in Washington to report that their coworkers used alcohol at work or came to work alcohol-impaired and they perceived attitudes toward alcohol use in their workplaces to be more tolerant than in Washington.
All dimensions of the workplace alcohol environment were strongly associated with each other.
Regression analyses indicated that each dimension of the workplace alcohol environment on its own was associated with increased odds of alcohol use and impairment at work, even after controlling for concurrent high-risk alcohol use in general, and most had also an independent influence when all workplace factors were considered together. For the most part, relationships were similar in strength in Victoria and Washington.
| Victoria | Washington | Difference | ||
|---|---|---|---|---|
| n = 777 a | n = 750 a | Chi-Square | p | |
| Alcohol is available at work, % | 46.6 | 21.8 | 106.04 | 0.000 |
| Through staff club or cafeteria, % | 4.5 | 1.6 | 10.79 | 0.001 |
| At special work functions and occasions, % | 33.5 | 12.7 | 92.49 | 0.000 |
| During regular end of the day drinks, % | 12.6 | 6.4 | 17.03 | 0.000 |
| For use by management, % | 1.8 | 1.1 | 1.45 | 0.228 |
| Another way, % | 4.0 | 4.1 | 0.02 | 0.887 |
| Workplace has a written alcohol policy, % | 55.7 | 69.4 | 31.06 | 0.000 |
| Alcohol is completely banned, % | 30.8 | 54.8 | 91.06 | 0.000 |
| Alcohol is not completely banned, % | 24.9 | 14.6 | ||
| No policy, % | 15.1 | 11.6 | ||
| Do not know, % | 29.2 | 19.0 | ||
| Workplace attitude toward drinking or being under the influence of alcohol at work | ||||
| Not acceptable, % | 71.7 | 81.3 | 23.68 | 0.000 |
| Discouraged, % | 14.5 | 11.5 | ||
| Tolerated if not frequent, % | 10.7 | 5.9 | ||
| Tolerated even if frequent, % | 1.8 | 0.9 | ||
| Encouraged, % | 1.3 | 0.4 | ||
| Coworkers drank at work or came to work drunk or under the influence of alcohol, % | 31.9 | 26.0 | 6.41 | 0.011 |
Alcohol availability matters
The availability of alcohol at work was a strong risk factor for alcohol use or impairment at work.
The statistical interaction test suggested that this association was about two and a half times stronger in Victoria than Washington.
Young adults who said alcohol was available at work were five times as likely to use alcohol or be impaired at work as those who said it was not available if they lived in Victoria and two times as likely if they lived in Washington.
A workplace that did not have a written alcohol policy, especially one that did not completely ban alcohol, increased the odds of young adults’ alcohol use or impairment at work three-fold.
Alcohol norm (availability, acceptability) drives alcohol harm at work
Workplace alcohol norms increased the odds of workplace alcohol use and impairment in both states.
Young adults who thought their workplace tolerated or even encouraged alcohol use were almost five times as likely to use alcohol at work as those who thought that alcohol was not acceptable in their workplace.
Even perceiving the workplace to be only discouraging of alcohol use increased the odds of alcohol use and alcohol impairment at work almost three-fold.
Young adults who said their coworkers used alcohol at work were about four times as likely to consume alcohol at work as those who reported that their coworkers did not use alcohol.
As expected, the workplace alcohol environment was less consistently associated with general high-risk alcohol use after adjusting for concurrent workplace alcohol use or impairment. There was little evidence that the availability of alcohol at work, the absence of at least some workplace alcohol policy, or the absence of a policy that completely banned alcohol were associated with general high-risk alcohol use.
In Washington, however, not knowing if the workplace had a written alcohol policy or whether an existing policy banned alcohol doubled the odds of general high-risk alcohol use, even after adjusting for workplace alcohol use or impairment and the other workplace dimensions. This association was significantly weaker in Victoria.
Behavioral and attitudinal workplace alcohol norms, on the other hand, were independent risk factors for general high-risk alcohol use, even beyond alcohol use or impairment at work. They increased the odds of high-risk alcohol use between 42% and 75%.
What does it all mean?
This cross-national study set out to fill several of the gaps in the understanding of the link between a tolerant workplace alcohol environment and young adults’ alcohol use off and on the job.
All three dimensions of the workplace alcohol environment considered in this study – availability of alcohol in the workplace, absence of a written alcohol policy, and alcohol-tolerant norms and attitudes – are independently linked with greater risk for on-the-job alcohol use or impairment.
Alcohol-tolerant workplace norms, but not alcohol availability or policy, were associated with greater young adults’ risk for high-risk alcohol use in general, including outside of work, after adjusting for their on-the job alcohol use. This finding may reflect that young adults likely also socialize outside of work with coworkers who consume heavy and high-risk amounts of alcohol.
Young adults in Victoria were particularly more likely than those in Washington to report that alcohol was available at special work functions and occasions. This possibly indicates that alcohol use at work is part of job expectations more so in Australia than in the U.S.
Prior research is not yet sufficient to develop effective workplace alcohol interventions. The findings from this study add to prior research e.g., in four ways.
- First, by examining three key aspects of the workplace alcohol environment together, this study increased understanding of the total and unique associations of various workplace features that will help inform the development of workplace alcohol interventions.
- Second, by considering high-risk alcohol use in general as well as on-the-job alcohol use and impairment, this study examined the extent to which the workplace alcohol environment could have broader implications for alcohol prevention. A doubling of the odds of on-the-job alcohol use or impairment due to a tolerant workplace alcohol environment, as this study found, could be linked with a significantly higher risk for general high-risk alcohol use indirectly because of their strong association. The current study fills in knowledge gaps for young adults who reported using alcohol or being alcohol-impaired at work were almost nine times as likely to also report high-risk alcohol use in general compared to those who did not use alcohol at work.
- Third, by using prospectively measured adolescent risk for alcohol use problems and by accounting for demographic, individual, and employment differences, the analyses controlled for potential selection and confounding associations in a way often not possible in prior research. The study, thus, strengthened the case for causal interpretations.
- Fourth, by comparing the link between workplace alcohol environment and workplace alcohol use in the U.S. and Australia, findings from this study have generalizable implications for contexts with different policy settings and alcohol cultures. For the most part, a permissive alcohol environment at work was associated with greater risk of on-the-job alcohol use or impairment to a similar degree in Victoria and Washington
Conclusions
Given a general lack of existing evidence-based programs for young adults who are not in college, this study’s findings have important implications. Results suggest that the workplace promises to be an intervention setting with potentially high impact for the prevention and reduction of alcohol use problems in young adults even in the new post-COVID-19 pandemic context.
Workplace interventions that limit alcohol availability, or better still, completely ban alcohol at work, and also aim to reduce alcohol-tolerant norms among employees have the potential to significantly contribute to the prevention and reduction in young adult workers’ alcohol use on and even off the job.
Abstract
The workplace has been understudied as a setting for the prevention of young adult alcohol use disorder.
This study examined if alcohol-tolerant workplace environments are associated with greater risk for alcohol use and use disorder on and off the job among young adults.
Data were collected in 2014 from state-representative, sex-balanced samples (51% female) of 25-year-olds in Washington, U.S. (n = 751) and Victoria, Australia (n = 777).
Logistic regressions indicated that availability of alcohol at work, absence of a written alcohol policy, and alcohol-tolerant workplace norms and attitudes were independently associated with a 1.5 to 3 times greater odds of on-the-job alcohol use or impairment.
Alcohol-tolerant workplace norms were associated also with greater odds of high-risk alcohol use generally, independent of on-the-job alcohol use or impairment.
Associations were mostly similar in Washington and Victoria, although young adults in Victoria perceived their workplaces to be more alcohol-tolerant and were more likely to use alcohol or be impaired at work and to consume alcohol heavily generally compared to young adults in Washington.
Cross-nationally, workplace interventions that limit the availability of alcohol, ban alcohol at work, and reduce alcohol-tolerant norms have the potential to prevent and reduce young adults’ alcohol use and alcohol use problems on and off the job.
