Alcohol Use During Pregnancy and Awareness of Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorder
Results of a National Survey

May, 2006

Final Report

PDF Version (73 pages 323 kb)

Table of contents

1. Introduction
2. Summary Of Findings
   Résumé des Résultats
3. Behaviours to Increase Likelihood of Having Healthy Baby
   
   • 3.1 Top-of-mind Awareness of Behaviours
   • 3.2 Assessing the Importance of Specific Actions
4. Effects of Alcohol Use During Pregnancy
   
   • 4.1 Beliefs About the Effects of Alcohol Use
   • 4.2 Beliefs About the Effects of Specific Amounts of Alcohol
5. Awareness of Fetal Alcohol Syndrome or Fetal Alcohol Spectrum Disorder
   
   • 5.1 Awareness of Fetal Alcohol Syndrome or Fetal Alcohol Spectrum Disorder
   • 5.2 Awareness of Alcohol-related Birth Defects
6. Recall of Information And Advertising About The Effects of Alcohol Use
   
   • 6.1 Top-of-mind Recall of Information
   • 6.2 Top-of-mind Recall of Advertising
7. Information Sources
   
   • 7.1 Best Source of Information
   • 7.2 Government of Canada Information Initiatives
8. Support for Initiatives to Provide Information About the Risks of Alcohol Use
9. Women and their Partners
   
   • 9.1 Alcohol Use During Pregnancy
   • 9.2 Effect of Partner On Alcohol Use During Pregnancy
10. Women and Advice from Doctors
11. Men and their Partners
12. Awareness of Levels of Alcohol Consumption
13. Conclusions and Recomendations
14. Appendices
    Survey Methods
    Questionnaires

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1. Introduction

Fetal Alcohol Syndrome (FAS) is the leading cause of developmental disability among Canadian children. The new term, Fetal Alcohol Spectrum Disorder (FASD), is an umbrella term used to describe a number of disabilities associated with prenatal exposure to alcohol. Progress has been made in understanding FASD in Canada and internationally in recent years. FASD has no cure, but it can be prevented. A major factor in this prevention is a well-informed and knowledgeable public, and, particularly, well-informed prospective parents.

In February 2006, Environics Research Group Limited was retained by Public Health Agency of Canada (PHAC) to conduct a survey of population segments, to measure knowledge of the effects of alcohol use during pregnancy, and awareness of Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorder. The population segments included women, aged 18 to 40, and male partners of women, aged 18 to 40, who would be key target groups of a campaign to raise awareness and knowledge of Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorder.

This survey follows a baseline survey conducted by Environics in November 1999 (n=1,205) and another in March 2002 (n=1,207), examining these issues with the same population segments, on behalf of Health Canada. This report makes reference to the findings of these previous studies, where applicable. Only changes that are statistically significant have been discussed in the report.

The survey was designed to include approximately equal numbers of respondents (360) in each of the ten provinces, and a ratio of 75 percent women and 25 percent male partners. Environics conducted the nation-wide survey of 3,633 respondents, including 2,724 women and 909 men, between March 1 and April 30, 2006.

The results for the total sample are weighted to reflect the actual populations of each of the provinces, as well as by age group for women, consistent with the weighting of the 2002 survey. The 2002 survey used 1996 census data and the 2006 survey used 2001 census data.

The margin of error for the full sample of women is ±1.9 percentage points, 19 times in 20; the margin of error for the sample of men is ±3.3 percentage points. The margin of error for each province (n= approximately 360) is ±5.2 percentage points.

The survey examined knowledge and beliefs about alcohol use during pregnancy, awareness of FAS and FASD, recall of information and advertising about the impact of alcohol, preferred information sources and effectiveness of information initiatives, support for initiatives to provide information about the risks of alcohol use, and the expected behaviours of women and partners of women, during pregnancy.

This report presents the findings of the survey. The survey methods and the English and French questionnaires used in the survey are appended to this report. Detailed statistical tables are presented under separate cover.

2.0 Summary of Findings

The major findings of the survey are:

• A slight majority (52%) say, top-of-mind, that cutting down or stopping using alcohol is among the most important thing pregnant women can do to increase the likelihood of having a healthy baby.
• When asked specifically about specific actions, there has been a clear decline since 2002 in the proportions who believe that most of these actions are one of the most important things that pregnant women can do to increase the likelihood that their baby will be born healthy. A clear majority (58%, down 5 points) strongly believe that cutting down or stopping alcohol use is one of the most important things that pregnant women can do to increase the likelihood that their baby will be born healthy. This view is down among both men (52%, down 7) and women (60%, down 4) since 2002, and is lower among women in the lowest socio-economic groups and those living in rural areas.
• A large majority (76%) are aware that any alcohol use during pregnancy is harmful to the baby; this view has increased progressively since 1999 among both men (68%, up 4 points from 2002, and 9 from 1999) and women (79%, up 9 points from 2002 and up 11 from 1999).
• There continues to be unanimous belief that the more alcohol pregnant women consume, the more likely the baby will be harmed and the more serious the effects.
• Majorities are also aware of the impact of small amounts of alcohol use. There have been progressive declines since 1999 in the numbers of men (45%, down 8 points from 2002 and down 12 from 1999) and women (34%, down 12 points from 2002 and down 15 from 1999) who think that a small amount of alcohol use during pregnancy can usually be considered safe. Awareness of the impact of small amounts of alcohol use is lower in Quebec and Ontario.
• Majorities are aware of the impact of specific amounts of alcohol use, but respondents are divided about the harmful effects of extremely small amounts of alcohol consumption – one or two drinks during the course of the pregnancy. Awareness of the harm done by all amounts has increased.
• There is unanimous belief that alcohol use during pregnancy can lead to life-long effects and that effects will not disappear as the child grows older. However, a sizable minority of almost four in ten believe that the effect of alcohol on the development of the fetus is unclear, and this view is higher in Quebec. Since 2002, there have been increases in the proportions of both men and women who do not believe this statement; this indicates that knowledge about the effects of alcohol on the development of the fetus has increased over the past four years.
• Although there is a very high level of recognition of the terms Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Spectrum Disorder (FASD), there is far less detailed knowledge as to what FAS and FASD actually involves. Recognition of the terms and more detailed knowledge remain lower in Quebec, but there has been a huge increase in recognition among Quebec women (up 25 points since 2002, and up 41 since 1999).
• A large majority are also familiar with alcohol-related birth defects, but once again, detailed knowledge of what these defects are is more limited. Quebec women are less likely than those in the rest of the country to express awareness of alcohol-related birth defects and to have detailed knowledge of what these defects are.
• A large majority recall seeing information about the effects of alcohol use on a baby during pregnancy, and recall among both men and women has increased since 2002. Quebec women remain less likely to recall this information, but this proportion is up 16 points since 2002.
• One-half recall advertising about alcohol use during pregnancy, FAS, FASD, or alcohol-related birth defects. Among those who recall this advertising, the largest proportion saw the advertising on television. Most do not recall the sponsor of this advertising, but the largest proportion (just over one in ten) mention the federal government or Health Canada.
• Television or other media, and a doctor or doctor's office are seen as the best sources of information about the effects of alcohol during pregnancy.
• Large majorities think sending information to doctors and health care professionals (72%), television advertising (69%), and placing posters in waiting rooms and clinics (67%) are very effective ways to inform them about the risks of alcohol use during pregnancy. Smaller proportions think other initiatives tested would be very effective. Women are more likely than men to think all the initiatives tested would be very effective ways of reaching them on the subject of the risks of alcohol use.
• There is overwhelming approval, overall, of a number of initiatives to provide information about the risks of alcohol use during pregnancy. Strong approval continues to be higher for governmentsponsored advertising (78%) and warning messages on alcohol advertising (71%), especially compared to that for requiring warning signs in restaurants (45%). Women are more likely than men to strongly approve of all the initiatives tested.
• A large majority of women (72%) say they would stop alcohol use if they were to become pregnant. This proportion is lower among Quebec women, who are more likely than others to say they would just cut back on their alcohol use.
• Women are somewhat more likely to be motivated to lower their alcohol use during their pregnancy if they were encouraged by their spouse or partner to do so. However, majorities say their partner continuing to drink during their pregnancy, offering them a drink during their pregnancy or stopping drinking during their pregnancy, would have no effect on their use of alcohol.
• Fully one-half of women report not receiving advice from their doctor regarding alcohol consumption during pregnancy, including 38 percent of women who are currently pregnant. Among those who have received advice, the most common advice is that they should not drink alcohol at all.
• A large majority of men (87%) say they would be very likely to encourage their pregnant spouse to stop or cut back on her alcohol use during pregnancy; only about four in ten (43%) would be very likely to stop drinking alcohol themselves during their spouse or partner's pregnancy.

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