ARCHIVED - Awareness of the Effects of Alcohol Use During Pregnancy and Fetal Alcohol Syndrome Results of a National Survey

Prepared for: Health Canada
Prepared by: Environics Research Group Limited

January, 2000

Final Report

PDF Version (73 pages 321 KB) PN4568

Table of contents

1. Introduction

2. Summary of Findings

3. Behaviours to Increase Likelihood Of Having Healthy Baby

A. Top-of-Mind Awareness of Behaviours

B. Assessing the Importance of Specific Actions

4. Effects of Alcohol Use During Pregnancy

A. Beliefs about the Effects of Alcohol Use

B. Beliefs about the Effects of Specific Amounts of Alcohol

5. Recall of Information About the Effects of Alcohol Use

6. Awareness of Fetal Alcohol Syndrome and Fetal Alcohol Effects

A. Awareness of Fetal Alcohol Syndrome

B. Awareness of Fetal Alcohol Effects

7. Information Sources

8. Support for Initiatives to Provide Information About the Risks of Alcohol Use

9. Women and Their Partners

A. Alcohol Use During Pregnancy

B. Influence of Partner on Alcohol Use During Pregnancy

10. Men and their Partners

11. Communications Implications

Appendices
Survey Methods
Questionnaire

1. Introduction

In November 1999, Environics Research Group Limited was retained by Health Canada to conduct a benchmark survey of key population segments, to measure knowledge of the effects of alcohol use during pregnancy and awareness of Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE). The population segments included women, aged 18 to 40, and partners of women, aged 18 to 40. This age group represents women in their child-bearing years, and partners of women in this age group, who would be the key target groups of a campaign to raise awareness and knowledge of Fetal Alcohol Syndrome.

Environics conducted a nation-wide survey of 1,205 respondents, including 902 women and 303 men. The margin of error for the sample of women is ±3.3 percentage points, 19 times in 20; the margin of error for the sample of men is ±5.8 percentage points. The survey was conducted between November 26 and December 9, 1999.

The survey examined knowledge and beliefs about alcohol use during pregnancy, awareness of FAS and FAE, recall of information and preference for information sources about the impact of alcohol, support for public information initiatives, and the expected behaviours of women and partners of women, during pregnancy.

This report presents the findings of the survey and recommendations regarding directions for communications initiatives. The survey methods and the English questionnaireused in the survey is appended to this report. Statistical tables are presented under separate cover.

2. Summary of Findings

The major findings of the survey are:

• There is a high level of knowledge that alcohol use during pregnancy is harmful to the child, and the more consumption the more harmful and likely the effects, but there is confusion about the safety of "small amounts" of alcohol.
• There is high awareness of FAS and FAE - most respondents have heard of the terms - but there is little knowledge of what these are.
• Most women say they would stop or cut back alcohol use if they were to become pregnant. The effect of male partners is apparent on "positive" side - women are most receptive to support and encouragement from their spouses to stop or cut back.
• Almost three-quarters of respondents recall seeing information about the effects of alcohol use on a child during pregnancy; almost half say a doctor's office would be their best source of information about the topic.
• There is substantial public support for initiatives to inform about the risks of alcohol use, including government-sponsored advertising, warning messages on alcohol advertising, warning labels on alcohol products, and others.
• Men in general are somewhat more likely than women to think that alcohol use during pregnancy is safe.
• Women with lower levels of education are somewhat less knowledgeable about the risks of alcohol use during pregnancy than those with higher levels of education.
• Quebec women are significantly more likely than women outside Quebec to think that alcohol use during pregnancy is safe.
• Women who have greater alcohol consumption (as measured by number of drinks per week) are more likely than those who drink less to think that alcohol consumption during pregnancy is safe.

A detailed summary of findings is as follows:

• When asked, in an open-ended question, to name important things that women can do to increase the likelihood of having a healthy baby, majorities of respondents mention good nutrition (75%), cutting down on or stopping smoking (63%) and cutting down on or stopping alcohol use (52%). One-quarter (25%) mention increasing or maintaining physical activity. About one in ten each mention cutting down on or stopping drug use (14%) and visiting a doctor or health professional (11%). Much smaller proportions mention other behaviours.
• When asked specifically about the importance of a number of behaviours, majorities say cutting down on or stopping smoking (63%), cutting down on or stopping using alcohol (60%) and eating nutritious food (54%) are one of the most important things that pregnant women might do to increase the likelihood that their baby will be born healthy. Significant minorities also say the same of visiting a doctor or health professional regularly (42%) and avoiding second-hand smoke (36%). Much smaller proportions place the same degree of importance on avoiding environmental pollution (22%), avoiding stressful situations (19%) and reducing strenuous physical activity (12%).
• There is unanimous belief that the more alcohol a pregnant woman drinks, the more likely that the baby will be harmed (98%) and that the more alcohol a pregnant woman drinks, the more harm that may be done to the baby (98%). There is less belief, although still at a majority level, that any alcohol consumption during pregnancy can harm the baby (66%). A slight majority, however, believe that a small amount of alcohol use during pregnancy can usually be considered safe (51%). Much smaller proportions believe that alcohol use before a pregnancy begins can harm a baby, even if a woman stops alcohol use during the pregnancy (39%), that a small amount of alcohol consumption during pregnancy would never lead to serious harm to the baby (30%) and that a moderate amount of alcohol consumption during pregnancy can usually be considered safe (25%).
• There is almost unanimous belief that alcohol use during pregnancy can lead to life-long disabilities in a child (89%). Similarly, most (82%) do not believe that the effects of alcohol use on a child disappear as the child grows older.
• When asked about specific amounts of alcohol consumption in terms of its effect on a baby that is born, seven in ten each think that it is not at all safe for a pregnant woman to drink one alcoholic drink each day during the pregnancy (69%) or three or four alcoholic drinks each weekend during the pregnancy (68%). However, opinion is divided on the use of smaller amounts of alcohol, such as drinking two alcoholic drinks on two or three different occasions during the pregnancy (47% say this is safe; 52% say this is unsafe) or a total of one or two alcoholic drinks during the pregnancy (65% say this is safe; 34% say this is unsafe).
• Seven in ten respondents (72%) recall seeing information about the effects of alcohol use on a baby during pregnancy. Among those who recall information, the largest proportions say they saw this information in brochures/pamphlets (33%) and media programs/articles in newspapers/ magazines (33%). Smaller numbers mention television advertising (24%), a doctor or health care professional (20%), books (15%), a poster (12%), magazine advertising (11%), infant care groups/ classes (6%), school/special classes such as CPR (6%) and personal experience/word of mouth (5%).
• Seven in ten respondents (71%) report awareness of Fetal Alcohol Syndrome, but detailed knowledge of what FAS actually involves is much more limited. The largest proportion of these say Fetal Alcohol Syndrome refers to the effects of alcohol on a fetus (34%). Smaller numbers mention that the baby is addicted to alcohol/experiences withdrawal (22%), harmful/ill effects in general (13%), delayed development (11%), physical disorders (11%), learning disabilities (10%), birth defects/deformities (10%), brain damage (9%), mental disorders (8%), cranial/ facial deformities (8%), lower I.Q./retardation (7%), behavioural problems (7%) and low birth weight (5%).
• Fewer respondents (56%), express awareness of Fetal Alcohol Effects, but detailed knowledge is much more limited. Among those who express awareness, the most common descriptions are physical disorders (17%), baby addicted to alcohol/experiences withdrawal (14%), learning disabilities (14%), brain damage (10%) and delayed development (10%). Fewer mention lower I.Q./ retardation/Down's Syndrome (8%), effect of alcohol on fetus (8%), cranial/facial deformities (8%), mental disorders (7%), behavioural problems (7%), low birth weight (6%), Attention Deficit Disorder/hyperactivity (6%), psychological/emotional problems (6%), birth defects (6%), unhealthy child (5%), growth problems (5%) and fetal/infant organ/respiratory damage (5%).
• The largest number of respondents (47%) say a doctor or doctor's office would be the best source of information about Fetal Alcohol Syndrome and about the effects of alcohol use during pregnancy. Much smaller proportions would first look to books or magazines (10%), health clinics/hospitals (9%), TV programs or advertisements (8%), Internet sources (5%) and Health Canada/ flyers and pamphlets (4%).
• When asked an open-ended question about other good sources of information on this topic, the largest proportion mention books or magazines (28%), followed by a doctor or doctor's office (21%), health clinics/hospitals (18%), Internet sources (18%), TV programs (12%), Health Canada/flyers and pamphlets (7%), public health organizations/programs (7%), library (6%), newspapers (5%) and pre-natal class (5%).
• Overwhelming numbers of 78 percent or more are supportive overall of a number of initiatives to provide information about the risks of alcohol use during pregnancy.
• Large majorities of respondents strongly approve of government-sponsored advertising describing the effects and warning about the risks of alcohol use during pregnancy (78%), requiring messages on alcohol advertising warning about the risks of alcohol use during pregnancy (73%) and requiring labels on alcohol products warning about the risks of alcohol use during pregnancy (66%). A smaller number, but still a majority, strongly approve of requiring signs in bars and clubs warning about the risks of alcohol use during pregnancy (55%). Less than a majority (40%) strongly approve of requiring signs in restaurants warning about the risks of alcohol use during pregnancy.
• Six in ten women (62%) say they would stop alcohol use if they were to become pregnant. Another 11 percent say they would cut back on their alcohol use. Only four percent say they would not change their alcohol use. A total of 23 percent say they don't use alcohol now.
• Women are most likely to say they would lower their alcohol use during their pregnancy if their spouse or partner encouraged them to stop or cut back their alcohol use during their pregnancy (39%). The same number (39%) say this would not affect their alcohol use. Majorities of women say they would not be affected one way or the other by other actions on the part of their partners, including their partner continuing to drink during their pregnancy (69% say this would have no effect on their use of alcohol), offering them a drink during their pregnancy (61%), or stopping drinking during their pregnancy (57%). Almost no women say they would be more likely to drink alcohol, even if their spouse were to offer it to them or continue to drink themselves.
• Seven in ten men (71%) say they would be very likely to encourage their pregnant spouse or partner to stop or cut back on her alcohol use during the pregnancy. Men are much less likely to say they would stop drinking alcohol themselves during their partner's pregnancy.
• Quebec women differ from women outside Quebec in a number of areas; they are less likely to mention cutting down or stopping alcohol use as a behaviour to increase the likelihood of having a healthy baby and are less likely to think that smaller amounts of alcohol will be harmful. Quebecers are also less likely to recall information about the effects of alcohol use on a baby during pregnancy and to be aware of Fetal Alcohol Syndrome and Fetal Alcohol Effects. Quebec women are less likely to stop using alcohol if they become pregnant, and Quebec men are less willing to encourage their spouse or partner to stop alcohol use during pregnancy or to stop alcohol consumption themselves.
• Women who drink more alcohol are more likely to believe that small amounts of alcohol consumption during pregnancy would never lead to serious harm to the baby and are less likely to believe that any alcohol consumption during pregnancy can harm the baby.

The detailed findings on each topic are discussed in the following sections.

 

3.0 BEHAVIOURS TO INCREASE LIKELIHOOD OF HAVING HEALTHY BABY

A.  Top-of-Mind Awareness of Behaviours

Top-of-mind, majorities of respondents think good nutrition, cutting down on or stopping smoking and cutting down on or stopping alcohol use are the most important things pregnant women can do to increase their likelihood of having a healthy baby.

Good nutrition, cutting down on or stopping smoking and cutting down on or stopping alcohol use are seen as the most important behaviours that pregnant women can do to increase their likelihood of having a healthy baby.

In this open-ended question, respondents were asked to name, without any prompting or anything suggested to them, the behaviours that they think are important for pregnant women to increase infant health.

Top-of-mind, majorities of respondents mention good nutrition (75%), cutting down on or stopping smoking (63%) and cutting down on or stopping alcohol use (52%) as the most important things that pregnant women can do to increase the likelihood that their baby will be born healthy. One-quarter (25%) mention increasing or maintaining physical activity. About one in ten each mention cutting down on or stopping drug use (14%) and visiting a doctor or health professional (11%). Much smaller proportions mention other behaviours.

Men are more likely than women to say cutting down on or stopping using alcohol is an important thing that pregnant women can do to increase the likelihood that their baby will be born healthy. Among women, those aged 25 to 29 and those with the lowest levels of education and income are less likely to mention this.

Quebec women are less likely to mention cutting down on or stopping using alcohol; Alberta women are more likely to mention this.

Q.1 Thinking about healthy infants and children, what, in your opinion, are the most important things that pregnant women can do to increase the likelihood that their baby will be born healthy?

B. Assessing the Importance of Specific Actions

Majorities say cutting down on or stopping smoking, cutting down on or stopping using alcohol and eating nutritious food are one of the most important things that pregnant women might do to increase the likelihood that they will have a healthy baby.

When asked about the importance of specific actions, once again, respondents say that cutting down on or stopping smoking, cutting down on or stopping alcohol use and eating nutritious food are among the most important things that pregnant women might do to increase the likelihood that they will have a healthy baby.

Looking at strongly held opinions on this question, majorities say cutting down on or stopping smoking (63%), cutting down on or stopping using alcohol (60%) and eating nutritious food (54%) are one of the most important things that pregnant women can do to increase the likelihood that their baby will be born healthy. Significant minorities also say the same of visiting a doctor or health professional regularly (42%) and avoiding second-hand smoke (36%). Much smaller proportions place the same degree of importance on avoiding environmental pollution (22%), avoiding stressful situations (19%) and reducing strenuous physical activity (12%).

Quebec women are less likely to say that cutting down on or stopping alcohol use is one of the most important things that pregnant women might do to increase the likelihood that their baby will be born healthy; Alberta women are more likely to feel this way.

*Less than one percent

Q.2 Here are some things that pregnant women might do to increase the likelihood that their baby will be born healthy. In your opinion, is each of the following one of the most important things to do, a very important thing to do, a less important thing to do or not at all important to do?

 EFFECTS OF ALCOHOL USE DURING PREGNANCY

A.   Beliefs about the Effects of Alcohol Use

There is unanimous belief that the more alcohol a pregnant women drinks the more harm this may have on the baby and that alcohol use during pregnancy can lead to life-long disabilities in a child. However, opinion is divided as to the impact of small amounts of alcohol.

Respondents show a high awareness that more alcohol use is harmful, and that alcohol use can cause lifelong disabilities in a child. However, there is a division of opinion as to the impact of small amounts of alcohol use.

There is unanimous belief that the more alcohol a pregnant woman drinks, the more likely that the baby will be harmed (98%) and that the more alcohol a pregnant woman drinks, the more harm that may be done to the baby (98%). There is less belief, although still at a majority level, that any alcohol consumption during pregnancy can harm the baby (66%).

A slight majority, however, believe that a small amount of alcohol use during pregnancy can usually be considered safe (51%); 46 percent disagree.

Much smaller proportions believe that alcohol use before a pregnancy begins can harm a baby, even if a woman stops alcohol use during the pregnancy (39%), that a small amount of alcohol consumption during pregnancy would never lead to serious harm to the baby (30%) and that a moderate amount of alcohol consumption during pregnancy can usually be considered safe (25%).

Men are more likely than women to believe that small or moderate amounts of alcohol consumption during pregnancy can usually be considered safe and that a small amount of alcohol consumption would never lead to serious harm to the baby, and are less likely to believe that any alcohol consumption during pregnancy can harm the baby.

Looking specifically at women, we find that younger women and those who don't drink are less likely to think that small amounts of alcohol consumption during pregnancy can usually be considered safe. Those with a university education and those who don't drink are less likely to think that a moderate amount of alcohol consumption is safe. Those aged 18 to 24, those with higher levels of education and those who are not mothers are less likely to think that a small amount of alcohol consumption during pregnancy would never lead to serious harm to the baby. Those aged 18 to 29 and those who don't drink are more likely to believe that any alcohol consumption during pregnancy can harm the baby. Women who drink are less likely to believe that any consumption can be harmful.

Quebec women are more likely to believe that small or moderate amounts of alcohol consumption during pregnancy can usually be considered safe; women in Atlantic Canada are less likely to believe either of these two statements. Quebec women are also more likely to think a small amount of alcohol consumption during pregnancy would never lead to serious harm to the baby; women from Atlantic Canada and Alberta are less likely to agree with this view. Quebec women are less likely to believe that any alcohol consumption during pregnancy can harm the baby; women from Atlantic Canada and Alberta are more likely to believe this statement.

There is almost unanimous belief that alcohol use during pregnancy can lead to life-long disabilities in a child (89%). Similarly, most (82%) do not believe that the effects of alcohol use on a child usually disappear as the child grows older.

Less educated women are less likely to disagree that most of the effects of alcohol use on a child usually disappear as the child grows older.

Quebec women are less likely than other Canadian women to believe that alcohol use during pregnancy can lead to life-long disabilities in a child; Western Canadian women are more likely to agree with this view. Quebec women are also less likely to disagree that most of the effects of alcohol use on a child usually disappear as the child grows older; Western Ca-nadian women are more inclined to disagree with this view.

*Less than one percent

Q.3 Please tell me if you think each of the following statements about alcohol use during pregnancy and its effect on a baby that is born is true or is not true?

Q.9 Is each of the following statements true or not true?

B.   Beliefs about the Effects of Specific Amounts of Alcohol

There is unanimous belief that one alcoholic drink each day or three or four alcoholic drinks each weekend during a pregnancy are unsafe for the baby. However, opinion is divided as to whether two alcoholic drinks on two or three different occasions or a total of one or two drinks during the pregnancy are safe.

When asked about specific amounts of alcohol consumption, respondents have a high awareness about the negative effect of large amounts of alcohol on the baby, but are again divided as to whether there are harmful effects of smaller amounts of alcohol use.

When asked about specific amounts of alcohol consumption in terms of its effect on a baby that is born, seven in ten respondents believe it is not at all safe for a pregnant woman to drink one alcoholic drink each day during the pregnancy (69%) or three or four alcoholic drinks each weekend during the pregnancy (68%).

However, opinion is divided as to the effect of smaller amounts of alcohol, such as drinking two alcoholic drinks on two or three different occasions during the pregnancy (47% say this is safe; 52% say this is unsafe) or a total of one or two alcoholic drinks during the pregnancy (65% say this is safe; 34% say this is unsafe).

Women are much more likely than men to think that one alcoholic drink each day during the pregnancy or three or four alcoholic drinks each weekend during the pregnancy are not safe. It should be noted that younger women are more likely to think all of the amounts of alcohol surveyed are not safe. Women who drink more are less likely to think any of these amounts of alcohol are not safe.

Quebec women are less likely to think any of these amounts of alcohol are not safe, with the exception of one alcoholic drink each day during the pregnancy. Alberta women are more likely to think all of the amounts are not safe.

*Less than one percent

Q.4 In terms of its effect on a baby that is born, do you think it would be very safe, somewhat safe, not very safe or not at all safe for a pregnant woman to drink each of the following amounts of alcohol?

5.0 RECALL OF INFORMATION ABOUT THE EFFECTS OF ALCOHOL USE

Seven in ten recall seeing information about the effects of alcohol use on a baby during pregnancy. The largest proportion of these have seen this information in brochures/pamphlets and media programs/articles in newspapers or magazines.

There is significant recall of information about the effects of alcohol use on a baby during pregnancy. Brochures/pamphlets and media programs/articles in newspapers or magazines are the most frequently cited sources of this information.

Seven in ten respondents (72%) recall seeing information about the effects of alcohol use on a baby during pregnancy. Three in ten (28%) do not recall seeing any information on this topic.

Women, especially those with higher levels of education and income and those who are mothers, are more likely than men to recall seeing information about the effects of alcohol use on a baby during pregnancy.

Quebec women are less likely to recall any such information - only 56 percent of Quebec women have seen any information.

Among those who recall information, the largest proportions say they saw this information in brochures/pamphlets (33%) and media programs/articles in newspapers/magazines (33%). Smaller numbers mention television advertising (24%), a doctor or health care professional (20%), books (15%), a poster (12%), magazine advertising (11%), infant care groups/classes (6%), school/special classes such as CPR (6%) and personal experience/word of mouth (5%). Fewer mention other information sources.

Women are more likely than men to mention brochures/pamphlets, a doctor/health care professional, books, a poster, magazine advertising and school/special classes. Men are more likely than women to mention media programs/articles in newspapers/magazines and television advertising.

*Less than one percent   Note: Multiple answers possible

Q.5a Do you recall seeing any information about the effects of alcohol use on a baby during pregnancy?

Q.5b What kind of information was it?

When we look specifically at women, we find that the most affluent women are more likely to mention books, and those aged 18 to 24 and those with university education are more likely to mention school/ special classes. Mothers are more likely to mention brochures/pamphlets and a doctor or health care professional.

Quebec women who have seen information are less likely to mention brochures/pamphlets, television advertising, posters and school/special classes, but are more likely to mention books and infant care groups/ classes. Women from Western and Atlantic Canada are more likely than others to mention television advertising. Alberta women are more likely to mention a doctor or a health care professional and Brit-ish Columbia women are more likely to mention a poster and alcohol bottles or vendors.

6.0 Awareness of Fetal Alcohol Syndrome and Fetal Alcohol Effects

A.   Awareness of Fetal Alcohol Syndrome

Seven in ten report awareness of Fetal Alcohol Syndrome. Of these, the largest proportion say Fetal Alcohol Syndrome refers to the effects of alcohol on the fetus.

Respondents report a high level of awareness of Fetal Alcohol Syndrome, but detailed knowledge of what FAS actually involves is much more limited.

Seven in ten respondents (71%) say they have heard of Fetal Alcohol Syndrome. Three in ten (29%) say they have not.

Among those who report some awareness, the largest proportion say Fetal Alcohol Syndrome refers generally to the effects of alcohol on a fetus (34%). Others mention that the baby is addicted to alcohol/ experiences withdrawal (22%), or harmful/ill effects in general (13%). Much smaller numbers say FAS involves delayed development (11%), physical disorders (11%), learning disabilities (10%), birth defects/ deformities (10%), brain damage (9%), mental disorders (8%), cranial/facial deformities (8%), lower I.Q./retardation (7%), behavioural problems (7%) and low birth weight (5%). Fewer mention other descriptions. Fourteen percent of those who say they are aware of FAS offer no description of it.

Women, especially the most educated and most affluent, are slightly more likely than men to be aware of Fetal Alcohol Syndrome. Less educated women are less likely to give detailed knowledge of what FAS actually involves while more highly educated women are more likely to mention physical disorders, delayed development, cranial/facial deformities and behavioural problems.

Only 32 percent of Quebec women are aware of Fetal Alcohol Syndrome. Atlantic Canadian women are less likely than others to have detailed knowledge of what FAS actually involves. Quebec women who are aware are more likely to mention that it involves a baby addicted to alcohol.

* Less than one percent  Note:   Multiple answers possible

Q.6a Have you ever heard of Fetal Alcohol Syndrome?

Q.6b Can you tell me what Fetal Alcohol Syndrome is?
Subsample: Have heard of Fetal Alcohol Syndrome

B. Awareness of Fetal Alcohol Effects

Just under six in ten respondents report awareness of Fetal Alcohol Effects. Of these, the most common descriptions are physical disorders, baby addicted to alcohol/experiences withdrawal, learning disabilities, brain damage and delayed development.

Fewer respondents, but still a majority, express awareness of Fetal Alcohol Effects. As with Fetal Alcohol Syndrome, detailed knowledge of what FAE is tends to be much more limited.

Just under six in ten respondents (56%) have heard of Fetal Alcohol Effects. More than four in ten (43%) say they have not.

Among those who report awareness, the most common descriptions are physical disorders (17%), baby addicted to alcohol/experiences withdrawal (14%), learning disabilities (14%), brain damage (10%) and delayed development (10%). Fewer mention lower I.Q./retardation/Down's Syndrome (8%), effect of alcohol on fetus (8%), cranial/facial deformities (8%), mental disorders (7%), behavioural problems (7%), low birth weight (6%), Attention Deficit Disorder/ hyperactivity (6%), psychological/emotional problems (6%), birth defects (6%), unhealthy child (5%), growth problems (5%) and fetal/infant organ/respiratory damage (5%). Seventeen percent of those who say they are aware offer no description.

Women, especially those who are older and better educated, are much more likely than men to express awareness of Fetal Alcohol Effects and to give more detailed knowledge of what Fetal Alcohol Effects involves.

Only 41 percent of Quebec women are aware of Fetal Alcohol Effects. Quebec women who are aware are more likely to think FAE involves a baby addicted to alcohol, birth defects and an unhealthy child, but are less likely to mention learning disabilities and cranial/facial deformities.

*Less than one percent   Note: Multiple answers possible

Q.7a Have you ever heard of fetal alcohol effects?

Q.7b Can you tell me what fetal alcohol effects are?
Subsample: Have heard of fetal alcohol effects

7.0 INFORMATION SOURCES

Almost half of respondents say a doctor or doctor's office would be the best source of information about Fetal Alcohol Syndrome and about the effects of alcohol use during pregnancy.

Respondents are most likely to mention that, for them, a doctor or doctor's office is the best source of information about Fetal Alcohol Syndrome and about the effects of alcohol use during pregnancy.

The largest number of respondents (47%) say a doctor or doctor's office would be the best source of information for them to learn about Fetal Alcohol Syndrome and about the effects of alcohol use during pregnancy. Much smaller proportions would first look to books or magazines (10%), health clinics/hospitals (9%), TV programs or advertisements (8%), Internet sources (5%) Health Canada/flyers and pamphlets (4%). Fewer mention other sources of information and five percent offer no opinion.

When asked about other good sources of information on this topic, the largest proportion mention books or magazines (28%), followed by a doctor or doctor's office (21%), health clinics/hospitals (18%), Internet sources (18%), TV programs or advertisements (16%), library/school (9%), Health Canada/flyers and pamphlets (7%), public health organizations/programs (7%), newspapers (5%) and pre-natal class (5%). Fewer mention other sources of information and nine percent offer no opinion.

Women, especially those aged 30 to 34 and those who are among the most affluent, are slightly more likely than men to mention a doctor or doctor's office as the best source of information about Fetal Alcohol Syndrome. Men are more likely than women to mention Internet sources.

Quebec women are slightly less likely than other women to mention a doctor or doctor's office, but are more likely to mention health clinics or hospitals as the best source of information.

*Less than one percent   Note: Multiple answers possible

Q.8a What for you would be the best source of information about Fetal Alcohol Syndrome and about the effects of alcohol use during pregnancy?

Q.8b Are there any other good sources for you to find this information?

8.0 SUPPORT FOR INITATIVES TO PROVIDE INFORMATION ABOUT THE RISKS OF alcohol USE

Overwhelming numbers of respondents approve of a number of initiatives to provide information about the risks of alcohol use during pregnancy.

Overwhelming numbers of 78 percent or more of respondents are supportive overall of a number of initiatives to provide information about the risks of alcohol use during pregnancy.

In addition, large majorities strongly approve of government-sponsored advertising describing the effects and warning about the risks of alcohol use during pregnancy (78%), requiring messages on alcohol advertising warning about the risks of alcohol use during pregnancy (73%) and requiring labels on alcohol products warning about the risks of alcohol use during pregnancy (66%). A smaller number, but still a majority, strongly approve of requiring signs in bars and clubs warning about the risks of alcohol use during pregnancy (55%). Less than a majority (40%) strongly approve of requiring signs in restaurants warning about the risks of alcohol use during pregnancy.

Women, especially those who are older, mothers, and those who drink less, are more likely than men to strongly approve of all of the initiatives to provide information about the risks of alcohol use. Highly educated women are less likely to strongly approve of all of these initiatives, the only exception being the initiative involving government-sponsored advertising.

Atlantic Canadian women are more likely to strongly approve of most of these initiatives. British Colum-bia women are more likely to strongly approve of requiring signs in restaurants and in bars and clubs warning about the risks of alcohol use during pregnancy. Quebec women are less likely to strongly approve of requiring labels on alcohol products warning about the risks of alcohol use during pregnancy.

*Less than one percent

Q.10 Do you strongly approve, somewhat approve, somewhat disapprove or strongly disapprove of each of the following requiring labels on alcohol products warning about the risks of alcohol use during pregnancy ... requiring signs in restaurants warning about the risks of alcohol use during pregnancy ... requiring signs in bars and clubs warning about the risks of alcohol use during pregnancy government-sponsored advertising describing the effects and warning about the risks of alcohol use during pregnancy ... requiring messages on alcohol advertising warning about the risks of alcohol use during pregnancy?

9.0 WOMEN AND THEIR PARTNERS

A.   Alcohol Use During Pregnancy

A total of 85 percent of women say they would not drink alcohol during pregnancy.

Most women respondents say they would not consume alcohol if they were to become pregnant.

Six in ten women (62%) say they would stop alcohol use if they were to become pregnant and another 23 percent say they don't use alcohol now. Another 11 percent say they would cut back on their alcohol use. Only four percent say they would not change their alcohol use.

In the survey, a total of 48 percent of women say they are currently pregnant (6%) or might become pregnant in the future (42%). Fully 88 percent of women who anticipate pregnancy say they would stop consuming (70%) or currently don't use alcohol (18%). Seventy-eight percent of women who are now pregnant say they have stopped (46%) or do not consume alcohol (32%).

Better educated women and those aged 18 to 24 are more likely to say they would stop alcohol use if they were to become pregnant. However, less educated women are more likely to say they don't drink. More affluent women and those who drink more are more likely than others to say they would just cut back on their alcohol use.

Quebec women are much less likely than women in other provinces to say they would stop alcohol use, and are more likely than others to say they would just cut back on their alcohol use.

*Less than one percent

Q.13 If you were to become pregnant, would you ... not change your alcohol use ... cut back on your alcohol use, or ... stop alcohol use? Subsample: Women

B.   Influence of Partner on Alcohol Use During Pregnancy

Women are most likely to say they would lower their alcohol use during their pregnancy if their spouse or partner encouraged them to stop or cut back.

Women are more likely to say they would lower their alcohol use during their pregnancy if encouraged by their spouse to do so. Most say they would not be influenced one way or the other by their partners' continuing use of alcohol or by their partner offering them a drink during their pregnancy.

Women are most likely to say they would lower their alcohol use during their pregnancy if their spouse or partner encouraged them to stop or cut back their alcohol use during their pregnancy (39%). The same number (39%) say this would not affect their alcohol use.

Majorities of women say they would not be influenced one way or the other by other actions on the part of their partners, including their partner continuing to drink during their pregnancy (69% say this would have no effect on their use of alcohol), offering them a drink during their pregnancy (61%), or stopping drinking during their pregnancy (57%). Almost no women say they would be more likely to drink alcohol, even if their spouse were to offer it to them or continue to drink themselves.

Women aged 18 to 24, those who are better educated and those who drink more are more likely to be influenced by their spouse's encouragement and by their spouse's own efforts to stop consuming alcohol.

*Less than one percent

Q.14

Thinking about yourself, would you be more likely to drink alcohol, less likely to drink alcohol or would it make no difference to your alcohol use in each of the following situations ...? Subsample: Women

10.0 MEN AND THEIR PARTNERS

Seven in ten men say they would be very likely to encourage their pregnant spouse to stop or cut back on her alcohol use during the pregnancy. Only three in ten would be very likely to stop drinking alcohol themselves during their partner's pregnancy.

As we saw in the previous section, women are the most likely to be influenced by a spouse who encourages them to reduce alcohol consumption during pregnancy. Here we see that men themselves are quite willing to take on that role.

Seven in ten men (71%) say they would be very likely to encourage their pregnant spouse or partner to stop or cut back on her alcohol use during the pregnancy. Fewer men (30%) say they would be very likely to stop drinking alcohol themselves during their spouse's or partner's pregnancy; 37 percent say they would not likely stop.

Only eight percent of men say they would not be likely to encourage their spouse to stop or cut back on alcohol use.

Quebec men are less likely to encourage their spouse to stop or cut back on her alcohol use during pregnancy and to stop drinking themselves during their spouse's pregnancy.

*Less than one percent

Q.17 Thinking about yourself, if your spouse or partner were to become pregnant, would you be very likely, somewhat likely, not very likely or not at all likely to do each of the following ... ? Subsample: Men

11.0 COMMUNICATIONS IMPLICATIONS

The survey suggests a number of directions for communications initiatives, both in terms of content and in terms of vehicles or media to be used in a communications or public information campaign.

In terms of content issues, it is clear that there is a widespread awareness among the target groups examined here, that alcohol use during pregnancy is harmful to an infant and the more alcohol is consumed, the more likely and extensive the harm may be. The real information challenge relates to the effects of small amounts of alcohol. Canadian women and men in the target group are divided in their belief about the effect of small amounts, and communication initiatives about alcohol use should be aware of this confusion or division.

A second issue relating to content involves the generally low levels of knowledge about FAS and FAE. Although most people claim to be aware of these terms, it is clear from the survey that there is very little knowledge about what these disabilities actually are and how serious they can be. A communications campaign to inform target audiences should have higher public knowledge of this as one of its goals. Raising awareness of FAS will also contribute to a heightened awareness overall, of the harmful effects of alcohol use during pregnancy.

On the topic of sources of information and appropriate media for communications initiatives, the survey confirms the importance of health professionals and health settings, such as clinics and hospitals, as the place where information about the effects of alcohol use is sought. However, many media are also important as information sources including brochures, pamphlets, articles in magazines and newspapers, and television advertising. The survey suggests that efforts should be made to create written materials (brochures, pamphlets, posters) for distribution to health care providers and settings, as well as to create materials and strategies to increase awareness of the topic in the general media.

The importance of increasing public awareness of all aspects of this topic in Quebec cannot be over-emphasized. The survey suggests that Quebecers' lower levels of awareness and knowledge about the effects of alcohol use during pregnancy can be traced in part to the general media environment. There is a need to create and distribute much more information about this topic within Quebec - to health professionals and particularly to health clinics, as well as in the Quebec media in general. Governments, their partners and the industries involved (spirits, wine, beer) should also consider sponsoring advertising, including warnings on alcohol advertising, and other initiatives, as part of a strategy to increase overall awareness and knowledge of these topics in Quebec.

One other important target group is women who consume greater amounts of alcohol. The survey shows that women who consume more on a regular basis are less likely than other women to believe that alcohol consumption is harmful. From the survey, women who consume more (four or more alcoholic drinks per week) are more likely to be younger, single, or with higher household income levels. There are no significant regional differences in alcohol consumption. The special need for information and efforts directed toward women who consume alcohol should be part of any communications initiative.

The survey suggests that communications initiatives should be developed that will be appropriate for women across a range of socio-economic and education groups, but with a greater emphasis on women with middle-to-lower levels of education, where knowledge and awareness levels are lower.

The survey also shows that men (spouses) have lower levels of knowledge than women. Communications directed toward men should build knowledge and awareness of the effects of alcohol use and should emphasize the importance of providing support and encouragement to their spouses to stop consumption, since the survey has shown that women, especially women who consume larger amounts of alcohol, are most likely to be influenced by this.

The following table summarizes the target groups where the need for information about the effects of alcohol use and FAS/FAE is higher than average, along with appropriate settings and vehicles of communications for each.

SURVEY METHODS

The results of the survey are based on questions asked to 1,205 respondents within the ten provinces of Canada. The survey was conducted by telephone from November 26 to December 9, 1999.

The sample frame for this survey involved identifying households from the general population across the country, using previous Environics survey research, that included women who were between the ages of 18 to 40 years of age. Random sampling among the general population of households was used to supplement this procedure.

The sample was chosen to be slightly disproportionate to the sample sizes of each province in order to achieve a certain minimum number for analysis. The final results are weighted to reflect the actual proportions in the population.

Within households, respondents were eligible to respond to this survey if anyone in the responding household was a female between the ages of 18 and 40 or the husband or partner of a female between the ages of 18 and 40.

The survey of 1,205 included 902 women and 303 men. The margin of error for the sample of women is ±3.3 percentage points, 19 times in 20; the margin of error for the sample of men is ±5.8 percentage points.

The following table presents the detailed completion results for this survey of 1,205 interviews.

*Less than one percent

ENGLISH QUESTIONNAIRE with marginals

December 14, 1999

Hello, my name is _______________________ . I am calling from Environics Research Group. We are conducting a brief survey on behalf of Health Canada (registration number HC-005-435-9945) about some health issues facing the country today. Please be assured that this is strictly a research project and that I am not selling anything.

Is anyone in your household…

A) a female aged between 18 and 40?

1 - Yes 2 - No

B) a husband or partner of a female aged between 18 and 40?

1 - Yes 2 - No

IF NO TO BOTH, POLITELY TERMINATE

IF YES TO A OR B, ASK TO SPEAK TO THAT PERSON, AND CONTINUE. IF YES TO BOTH, RANDOMIZE.

REPEAT: We are conducting a survey about some important health issues. Please be assured that we are not selling anything. Individual answers to this survey will be kept confidential and the tabulated findings will be used to create informational materials to help all families.

1. Thinking about healthy infants and children, what, in your opinion are the most important things that pregnant women can do to increase the likelihood that their baby will be born healthy? What things come to mind as important?DO NOT READ. CODE ALL THAT APPLY. FIRST MENTION. SECOND MENTION, THIRD MENTION. Are there any others?

2. Here are some things that pregnant women might do to increase the likelihood that their baby will be born healthy. In your opinion, is each of the following one of the most important things to do, a very important thing to do, a less important thing to do or not at all important to do?
   READ AND ROTATE

3. Please tell me if you think each of the following statements about alcohol use during pregnancy and its effect on a baby that is born is true or is not true?
   READ AND ROTATE

4. In terms of its effect on a baby that is born, do you think it would be very safe, somewhat safe, not very safe or not at all safe for a pregnant woman to drink each of the following amounts of alcohol

a) One alcoholic drink each day during the pregnancy?

5. a) Do you recall seeing any information about the effects of alcohol use on a baby during pregnancy?

1 - Yes 2 - No 3 - DK/NA

b) What kind of information was it?
DO NOT READ. CODE ALL THAT APPLY

ROTATE Q.6 AND Q.7

6. a)  Have you ever heard of Fetal Alcohol Syndrome?

1 - Yes 2 - No 3 - DK/NA

b) Can you tell me what Fetal Alcohol Syndrome is? PROBE FOR COMPLETE RESPONSE. What happens with Fetal Alcohol Syndrome?

7. a) Have you ever heard of fetal alcohol effects?

1 - Yes 2 - No 3 - DK/NA

b) Can you tell me what fetal alcohol effects are? PROBE

8. What for you would be the best source of information about Fetal Alcohol Syndrome and about the effects of alcohol use during pregnancy? DO NOT READ Are there any other good sources for you to find this information? CODE ALL THAT APPLY

8 b. Are there any other good sources for you to find this information?

10.

Do you strongly approve, somewhat approve, somewhat disapprove or strongly disapprove of each of the following: READ AND ROTATE

a) Requiring labels on alcohol products warning about the risks of alcohol use during pregnancy.

b) Requiring signs in restaurants warning about the risks of alcohol use during pregnancy.

d) Government-sponsored advertising describing the effects and warning about the risks of alcohol use during pregnancy.

b) Did you give birth to a child within the past five years?

12. a)  Thinking about yourself, are you currently pregnant or think you might become pregnant within the next two years?

   b) Do you think you might become pregnant at some point in the future?

13. If you were to become pregnant, would you…

14.  Thinking about yourself, would you be more likely to drink alcohol, less likely to drink alcohol or would it make no difference to your alcohol use in each of the following situations:

READ AND ROTATE

a) If your spouse or partner continued to drink alcohol during your pregnancy?

d)  If your spouse or partner stopped drinking alcohol during your pregnancy?

MEN ONLY—OTHERS GO TO Q.18

15. a) Do you have any children?

1 - Yes 2 - No 3 - DK/NA

b)  Do you have any children aged 5 or younger?

16. a)  Do you currently have a spouse or partner who is pregnant, or whom you think might become pregnant within the next two years?

N=303

1. Yes —Go to Q.17—31%
2. No—Ask (b)—68%
3. DK/NA— 1%

b)  Do you think your spouse or partner might become pregnant at some point in the future?

N=214

1. - Yes —Go to Q.17—27%
2. - No —Ask (b)—72%
3. - DK/NA—2%

17.  Thinking about yourself, if your spouse or partner were to become pregnant, would you be very likely, somewhat likely, not very likely or not at all likely to do each of the following?

READ AND ROTATE

a)  Encourage her to stop or cut back on her alcohol use during the pregnancy

23. a) Are you currently:

b)  How long have you been married or living with your partner?

DO NOT READ

1. Less than one year
2. 1 to less than 2 years
3. 2 to less than 4 years
4. 4 to less than 5 years
5. 5 to less than 10 years
6. 10 to less than 15 year
7. over 15 years
8. DK/NA

Into which of the following categories would you put the total annual income in 1998 of all the members of your household, including yourself, before taxes and deductions?

1. Under $10,000
2. $10,001 to $20,000
3. $20,001 to $30,000
4. $30,001 to $40,000
5. $40,001 to $50,000
6. $50,001 to $60,000
7. $60,001 to $70,000
8. $70,001 to $80,000
9. $80,001 to $90,000
10. $90,001 to $100,000
11. $100,000 and over
12. DK/NA /Refused

24.

25. Finally, how many alcoholic drinks did you have during an average week in the last month (1RWH-WR LQWHUYLHZHU- a drink is a glass of wine, one wine cooler, one can or bottle of beer, one shot of liquor, one mixed cocktail)?

'2-127-5($'

1 - No drinks during an average week

2 - Less than one drink during an average week 3 - 1 to 3 drinks a week 4 - 4 to 6 drinks a week 5 - 7 to 10 drinks a week 6 - 11 to 14 drinks a week 7 - 15 to 17 drinks a week 8 - 18 or more drinks a week 9 - DK/NA

1RWH-WR-LQWHUYLHZHU- If respondent asks for more information on the topic, read:

If you would like to receive information about alcohol and pregnancy, please call the Canadian Centre on Substance Abuse at 1-800-559-4514.