Personal perceptions of risky drinking and alcohol guidelines – a qualitative analysis

Introduction
Risky drinking is prevalent in European countries despite health authorities issuing guidelines created to support individuals to make informed choices about their alcohol intake. The current study explored personal perceptions of risky drinking, perceptions of the personal relevance of guidelines, and the processes used to form perceptions.

Method
Three hundred and eight participants from Sweden and the UK completed an online survey containing open-ended questions about perceptions of risky drinking and personal relevance of drinking guidelines. Data was analysed using Thematic analysis embedded within a Framework analysis comparing answers from Sweden and UK.

Results
Personal perceptions of risky drinking were formed primarily using experiential and affective judgments, and related to concerns over developing problems with alcohol, losing control, drinking as a coping mechanism, and causing harm to oneself or others. Guidelines were interpreted using experiential judgements, resulting in affective responses, expressed as negative attitudes towards the guidelines in terms of scepticism and denial. Those acknowledging the risk expressed ambivalence, in terms of a struggle for change.

Conclusions
Perceptions of risky drinking extend beyond the physical act of consuming alcohol and encompass various contextual factors, affective states, effects of alcohol on the individual, and its impact on social roles and relationships. Risk guidance may not be interpreted as intended, with many who exceed the recommendations do not perceive their behaviour as risky. Understanding perceptions of risk can help support changes in behaviour,