Personal experiences

The third domain within reflective motivation is that of personal experiences, where participants reported changing their alcohol consumption behaviour in response to an event or tangible consequence of drinking. For example, M4 who took regular morphine to relieve the pain caused by osteoarthritis and osteoporosis described an incident that led to a reduction in his usual drinking quantity from five pints per drinking occasion:

It was when I started on the morphine that I cut right down… I went all dizzy and fell over. So I’m limiting meself now. I sometimes have two and a half if I’m in a good conversation, but it’s never any more than two and a half. (M4)

He reflected on his knowledge of the potential interactions between morphine and health and balanced the negative experience that he attributed to morphine against the personal benefits of drinking, concluding on reflection that behaviour change was appropriate.

A group of older adults used medication to enable them to continue drinking alcohol when they suffered gastric pain. Their personal experience was that taking the medication reduced gastric pain and therefore they could continue drinking without pain rather than

changing drinking behaviour. For example, M3 was prescribed a proton pump inhibitor (medication that reduces gastric acid production) when he experienced stomach pain:

Well, I was put on the tablets because I was having some pain in my stomach, sometimes after eating and sometimes after a sherry, so I had the tablets and it was marvellous, you know, never had a problem. (M3)

His personal experience was that taking this medication prevented his gastric pain and he therefore believed that it was a good solution for his problem. Whilst taking such medication one participant still occasionally experienced some gastric pain so chose to drink alcohol with a lower alcohol by volume (ABV):

Perhaps after I’ve had me glass of wine on a Sunday but it’s not very often… I try to drink wine with lower alcohol content so that I’m not drinking so much. (F5)

Knowledge of the health consequences of alcohol consumption was reinforced by personal experience that transformed abstract risks into tangible effects. For example, F5 could describe in detail the effects of drinking alcohol on her body:

Now with me, with what I’ve got, alcohol, even just a little bit, sends my body in an uproar. I mean it can cause me to have diarrhoea, bleeding and just well, I’m just not with it. With what I’ve got, rheumatoid arthritis, the other one, osteoporosis, then there’s fibromyalgia, myasthenia gravis, well they’re all to do with muscles so I mean it affects the brain alcohol, which then will affect my muscles and I can’t control anything… (F5)

For F5 this reasoning had an impact on long-term alcohol consumption through restricting consumption to one glass of wine a week.

In addition to personal experiences of the interactions between alcohol consumption and health or medications, participants described their personal experience of the impact of alcohol on sleep and relaxation. There was a view that alcohol had a beneficial impact on relaxation and conflicting views on the effect of alcohol on sleep. Alcohol was used as a tool to facilitate relaxation in general, with a meal, and after work. Whilst some participants implied that they used alcohol to relax, others were explicit. For example, in describing reasons for drinking alcohol one woman acknowledged:

… One drinks because it is a wonderful anaesthetic and a relaxant and it would be wrong to say, to pretend otherwise. (F3)

This view developed from personal experience regarding the effects of alcohol.

Regarding alcohol and sleep, there was one view that alcohol facilitated sleep but a contrasting view that whilst it may be easier to get to sleep after an alcoholic drink, quality of

sleep is worse. There was a third view that alcohol does not affect sleep, which was often voiced by participants with a low-level of consumption. An example of a participant who found that drinking was beneficial described specific circumstances that he felt illustrated a positive relationship between his alcohol consumption and sleep:

I sleep better when I’ve been drinking. I’ve just done, last week and the week before I’ve just done four nights up in Barnsley… I’ve just done four days last week and four nights when I come home, I don’t get home ‘till 10 half past 10 and it’s take me tablets, straight to bed, and it’s been half past seven, eight o’clock next morning, which is very unusual because I’m usually up between five and six most mornings. (M1)

In his experience therefore, on the nights when he consumed alcohol he also had a better night’s sleep.

Participants who reported that drinking negatively affected their sleep described a number of different reasons for this belief including finding it harder to work the following day, waking up thirsty, and needing to visit the toilet during the night, for example:

I do get back off to sleep but I do feel tired when I go to bed and maybe sleep for an hour or two and then wake up. If I, the odd, very odd occasions when I’ve had more than one glass of, red wine especially, I do wake up feeling very thirsty. (F9)

The only way in which it might is as I’ve got older I find that if I’d had a lot to drink at the night then I’ll probably have to get up at some point during the night and visit the toilet… (M10)

Participants described how these personal experiences sometimes resulted in the modification of their drinking behaviour: for example F9 reported limiting her alcohol consumption to two glasses of wine to prevent repeatedly waking up thirsty during the night and F2 tried to avoid drinking alcohol on a week night because she believed that it affected her ability to concentrate at work the next day.

Within this group of older adults there was also a view that alcohol can aid the process of getting to sleep, with alcohol occasionally used for medicinal purposes:

My husband said why don’t you have a whisky and that might, I found I was coughing so much when I went to bed and he said that might just put you over to sleep. (F9)

Such medicinal benefits of alcohol consumption were reported for short-term illness rather than long-term conditions. Participants describing a medicinal benefit to drinking were among the older participants in the sample.