Abstract
Increasing alcohol consumption among older individuals is a public health concern. Lay understandings of health risks and
stigma around alcohol problems may explain why public health messages have not reduced rates of heavy drinking in this
sector. A qualitative study aimed to elucidate older people’s reasoning about drinking in later life and how this interacted
with health concerns, in order to inform future, targeted, prevention in this group. In 2010 a diverse sample of older adults
in North East England (ages 50–95) participated in interviews (n = 24, 12 male, 12 female) and three focus groups
(participants n = 27, 6 male, 21 female). Data were analysed using grounded theory and discursive psychology methods.
When talking about alcohol use older people oriented strongly towards opposed identities of normal or problematic
drinker, defined by propriety rather than health considerations. Each of these identities could be applied in older people’s
accounts of either moderate or heavy drinking. Older adults portrayed drinking less alcohol as an appropriate response if
one experienced impaired health. However continued heavy drinking was also presented as normal behaviour for someone
experiencing relative wellbeing in later life, or if ill health was construed as unrelated to alcohol consumption. Older people
displayed scepticism about health advice on alcohol when avoiding stigmatised identity as a drinker. Drinking patterns did
not appear to be strongly defined by gender, although some gendered expectations of drinking were described. Identities
offer a useful theoretical concept to explain the rises in heavy drinking among older populations, and can inform preventive
approaches to tackle this. Interventions should engage and foster positive identities to sustain healthier drinking and
encourage at the community level the identification of heavy drinking as neither healthy nor synonymous with
dependence. Future research should test and assess such approaches.