Fatal attraction: Scottish women and alcohol

SHE is trying to dab her numbers but her hand won't keep still. "It's the shakes," says Kathleen as she struggles with her bingo card. "It's the Charlie Drakes; because of the drinking."

The 46-year-old is sitting in a huge Mecca, just south of the Clyde. She, like the best part of another thousand women packed into the huge tin shed, is deathly silent as the numbers are called. But she is also itching to tell her story about alcohol, about Scottish women and how much they drink.

"It nearly did for me," says Kathleen as she takes a cigarette break outside the building, clutching a plastic tumbler of Coke. "I have done it all, rehab and everything. I have vomited my own blood. I have lost my business. I am better now, more or less. But I still have peripheral nerve damage; my hands, my fingers still shake. That is what it does to you."

Kathleen – not her real name because she is frightened "the social" will discover she has taken a rare night out – is just one of thousands of Scottish women now suffering from serious alcohol-related illnesses. She is more than aware she could be one of the horrifying statistics from her own Glasgow neighbourhood, Ibrox, where the female death toll for alcohol-related diseases, at 59 per 100,000 people every year, is the highest in Scotland.

So why do Scots – and especially Scotswomen – drink so much? "For me it was confidence," says Carole-Anne, another fortysomething Bingo player who doesn't want her full name in the paper. "I couldn't do anything without a drink. I got engaged on Babycham. I got married on Tia Maria. I got separated too. But I don't remember what I was drinking when that happened."

The national 'alcohol death tables' published by Scotland on Sunday today provide yet more compelling evidence of the effects of booze on men and women. Astonishingly, the average death rate among females from alcohol-related disease – chronic liver disease and cirrhosis – is now greater than that of English men.

Glasgow University researchers found that in the top-ranked areas such as Glasgow Ibrox, the death rate was almost four times the average.

And although most of the worst 25 locations are working-class areas, some, like Glasgow West End, Glasgow Robroyston and Edinburgh Holyrood, have a high number of middle-class homes in the mix. Nor are the worst areas restricted to the central belt, with areas of Inverness and parts of the Western Isles among the leaders.

Just a generation ago, the image of a hard-drinking Scot was predominantly male but the new map suggests that the hard-drinking Scotswoman is now not very far behind.

Next month, the Scottish Government's new Criminal Justice Bill is expected to place the war against excessive alcohol consumption centre stage with a new range of measures aimed at curbing the destructive Scottish booze culture.

But with no evidence that anti-alcohol public health campaigns have had any effect so far on even holding back, let alone reducing, the new tidal wave of female drinking, is there now a need for a different set of messages to promote a more sensible drinking culture among women north of the border? Dr Laurence Gruer, director of public health science at NHS Health Scotland, says: "It is very disappointing that health education campaigns have had so little impact but we now know that the main thing that influences consumption of alcohol is price and availability.

"The evidence is if price goes up, consumption goes down and the opposite is also the case, as we have found out over the last 30 years of falling prices. The Scottish Government is well aware of this and has suggested a number of measures – such as minimum pricing, banning sales to under-21s and separate check-outs in supermarkets, which make alcohol more expensive and more difficult to get. It remains to be seen whether they will implement them."

The statistics on alcohol-related deaths in Scotland, fuelled by the eighth-highest alcohol consumption rate in the world, are alarming. According to a report by Dr Richard Mitchell from Glasgow University's Public Health Department and Dr Carol Emslie, from the university's Medical Research Council Social and Public Health Sciences Unit, alcohol-related fatalities have doubled over the past 10 years.

Every year in Scotland, 448 women die directly from alcohol-related causes. Dr Emslie says that might be an underestimate.

"Heavy drinking used to be much more of a masculine trait but the cultural norms are changing. Although women have not yet caught up with the male death rate, the consumption rate is narrowing.

"Drinking alcohol is now just as much a part of life for many young women as it is for young men. That the death rate among women is now more than the rate among men in England is something we should all worry about and take responsibility for."

According to Dr Gruer, one third of Scots women now drink more than the Government recommended limit of 14 units of alcohol per week. "There used to be a cultural taboo about women drinking in Scotland – at one time they were not allowed in pubs, but that has gradually changed," he says. "It started to open up in the 1960s and 1970s with the advent of feminism and more women going out to work. And since the 1970s, Scotland has had a more liberal licensing regime with longer opening hours for both pubs and off-licences. The drinking culture has become more and more permissive."

There have been other, more recent, changes too, such as the higher demand for wine. Gruer says women's alcohol consumption can be underestimated because they are more likely to drink wine, which now comes in larger glasses than before.

"Also more people are drinking at home and, at home, the measures are even more generous. Wine is also getting stronger with an increased alcohol content."

Gillian Bell, spokeswoman for campaign group Alcohol Focus Scotland, says increasing wine consumption is prevalent among all levels of society. "Many women are developing the drinking habits that were once the preserve of men," she says. "They may not be drinking as much but it is affecting everyone from every background. Women are using alcohol to deal with stresses in the workplace; as a release. They open up a bottle of wine when they get home from their job. But we know that awareness among women about units is low. They do not know how to keep track of the wine they drink."

Campaigners point to the smoking ban in Scotland as an example of how attitudes can be changed by legislation rather than the gentle persuasion of health education programmes. Bell is convinced similar tough measures are needed to curb Scotland's excessive drinking. "The only way is to increase price and decrease availability," she says.

Back in Ibrox, Maggie Ahmad, 59, is on her way to the pictures at Glasgow's Springfield Quay with friends Catherine Higgins, 64, and Mirijam Kraemer, 44. They haven't had a drink, but worry about those who have and agree that the problem is low cost and availability.

Kraemer, who is Swiss, says: "On the continent, it is still frowned upon. I was shocked when I came to Scotland four years ago and found everybody talking about how much they had been drinking. Even at work, in the office, where people are trying to appear professional. Even junior managers were boasting about their drinking. Is that just something about Scottish culture? Or is that new?"