These data demonstrate concerning alcohol behaviours amongst elite athletes of both genders. The results of our study demonstrate high levels of alcohol-related harms and binge drinking. Our findings replicate and expand on the results of prior studies of both elite and non-elite male GAA players [18, 20, 31, 33]. Similar to other elite sportspeople, alcohol harm levels in elite GAA players were above the reported populational baseline [12, 31, 32]. 96% of players currently drink alcohol. This is far higher than the national Irish rate of 76% . In our study, 73% of current drinkers displayed adverse alcohol use. Of concern, 35% drank more with teammates, with only 12% drinking less; 65% of current drinkers had alcohol-related harm in the past year, and 2% required Emergency Department attendance. Alcohol consumption was seasonal with more binge drinking and higher quantities and frequencies of alcohol consumption in the off-season, a pattern seen in elite Australian rules football players . Most players would turn to family (36%) or friends (21%) for help with addiction issues. In multivariate analysis, monthly binge drinking, smoking, generally drinking in public, current gambling, male gender, past-year alcohol harm and not cohabiting with a partner were associated with adverse alcohol use. This is important and useful information. In an era of limited resources, this enables targeted interventions for those most likely to benefit.
The seasonal pattern of alcohol consumption was captured in the players’ comments. Many players feel unable to drink alcohol for long periods for numerous reasons (drinking bans, peer pressure, inability to perform in their chosen sport) and then drink heavily when the opportunity arises, as was outlined in respondent comments: there seems to be a culture of full duck or no dinner and 'players tend to abstain from alcohol for long periods of time and then when they do drink they binge heavily. I am definitely guilty of this. The culture in elite GAA appears of drinking to excess as opposed to in moderation. Some respondents suggested that they feel unable to drink in moderation throughout the year and over-indulge in the off-season: ‘The extremes are the issue – going from drinking nothing to binge drinking. A culture whereby it was acceptable to have one drink infrequently eg. with dinner, rather than complete enforced abstinence may reduce the extremes’. During the season, players spend long periods together and often have limited social outlets. At the conclusion of competitions, alcohol seems to be an integral part of a celebration of victory or commiseration of defeat. ‘Post League or Championship, players on all panels I’d say would do a bender in a pub somewhere due to the fact they haven’t drunk in so long and justify it in their own minds that it’s ok due to the sacrifice they made of staying off it for months or weeks – whereas if the culture was changed, few drinks after games is fine and players could relax then this wouldn’t happen.’ Some respondents feel that underage GAA members grow up associating sports with alcohol: ‘… underage members of our club growing up in the same drinking culture and heavily associating it with GAA. There are also many occurrences of underage drinking as a result. I have seen children as young as 11 or 12 drinking after county final celebrations’.
However, there were also encouraging findings. Annual alcohol consumption amongst players was below national levels. Forced binge drinking as a form of initiation for new teammates was much less prevalent than in North American collegiate sports. Some respondents believe the alcohol culture is changing for the better: ‘I do not know if there is a wider problem but within my own camp there does not appear to be the same level of consumption or frequency of consumption as there was 10 years ago’.
This study provides a detailed insight into alcohol culture in elite athletes. It describes a large cohort (n = 717), including females who are often neglected in studies examining addiction in athletes. All registered active adult players were contacted, ensuring no bias. This study used validated tools, allowing comparison with national data and prior studies. It also offers a detailed examination of alcohol culture. Seasonality of drinking, hazing, attitudes to alcohol sponsorship and sources of support were explored. Understanding these details is key in designing effective interventions to target this high-risk group [18, 31, 33].
The use of self-reported outcome measures is a limitation. Recollection of unpleasant situations can be influenced by denial and repression . However, self-report surveys are often used to assess alcohol use and have been validated [35, 36].
Reversing the harmful drinking culture discussed likely requires a multifaceted approach involving the players, representative bodies, backroom staff, government and GAA policy and wider society.
On a national level, reducing alcohol affordability through taxation or price regulation is the most effective and cost-effective way to reduce alcohol-related harms . However, in elite GAA, the players themselves would likely need to be key drivers of change. Over half of respondents reported a player-led alcohol policy, and that players had the most influence on alcohol culture. Improving health behaviours in sportspeople is particularly important to society, as athletes can function as role models, particularly to young people [38,39,40,41]. Professional footballer Marcus Rashford’s successful campaign to extend means-tested free school meals in the UK over the summer of 2020 provided a clear example of the importance of sportspeople in our societies . Elite athletes have an extended reach. From a public health perspective, influencing those who influence others may prove an effective strategy. Rashford has over 14 million followers on social media (Twitter and Instagram).
There are numerous evidence-based solutions to reduce adverse alcohol use. Sponsorship of sportspeople by the alcohol industry, especially the provision of discounted or free alcoholic beverages, is associated with hazardous drinking . Almost half the respondents in this study have received some form of alcohol promotion in the past year. Previously, the alcohol industry was the main national sponsor of the senior GAA hurling national championship. In contrast to many other sporting organisations, the GAA is a community-based volunteer organisation that describes player welfare as one of its core values . Interestingly, in 2018, the GAA prohibited betting firms sponsoring any competition, team, playing gear or facility . This contrasts starkly with many other sporting organisations. In 2017, half of English Premier League teams had a gambling company as shirt sponsor . There is currently a campaign by Alcohol Action Ireland to ban alcohol sponsorship of sport in Ireland to ‘decelerate the relentless promotion of alcohol’ . The authors believe that the GAA, in the public interest, should continue to show leadership by extending its ban on gambling sponsorship to include the alcohol industry.
Recent years have seen strategies to curb problem alcohol use in Ireland. The GAA and the Health Service Executive launched The Alcohol & Substance Abuse Prevention (ASAP) Programme and the ‘Drink Less and Gain More’ campaign [47, 48]. The 2018 Public Health (Alcohol) Act legislated for minimum unit pricing in Ireland, an intervention proven to decrease alcohol consumption . The GPA launched a counselling service to deal with issues such as alcohol addiction. This current study highlights players at high risk of adverse alcohol use (including males, smokers, current gamblers and those not living with a partner).
Screening and brief interventions are beneficial for individuals with addiction issues [50,51,52,53]. These have demonstrated health and fiscal improvements for both harmful (damaging health) and hazardous (at risk of an alcohol-related problem) drinkers . Interventions have successfully reduced risky alcohol consumption amongst athletes [55, 56]. Perhaps elements of these could be successfully replicated in other sporting organisations. Over two-thirds of players in this study would turn to turn to family, friends or partners for help with addiction issues. This highlights the need to involve these stakeholders, as this is to whom the players are most likely to turn to for support rather than representative bodies, teammates, counsellors, doctors or management.
Limiting alcohol accessibility for underage drinkers is important. The age of the first alcoholic drink has been shown to predict future alcohol consumption . In a prior study of GAA players, age at first drink predicted regular binge drinking . In our study, the mean age of first drink was 16 years old which is below the legal age of alcohol consumption (18 years).
Another potential intervention is to increase taxation on alcohol. More expensive alcohol is particularly effective in decreasing intake in younger, regular and heavy drinkers . The introduction of hypothecated taxes on tobacco can decrease the tobacco industry’s funding of sport . This approach could potentially decrease alcohol sponsorship also . The Alcohol Harm Paradox alludes to the finding that lower socioeconomic status groups suffer more alcohol-related problems despite drinking less alcohol . The paradox is particularly significant for males and those in younger age groups .
Overall, these data suggest that, similar to other sportspeople, Gaelic athletes of both genders show high rates of binge drinking and adverse alcohol use with a seasonal drinking pattern occurring mainly outside of the playing season; 65% of current drinkers had alcohol-related harm in the past year. Worryingly, 35% of players drank more with teammates, with only 12% drinking less. Players who are male, smoke, binge drink, generally drink in public, gamble and do not live with a partner appear at particular risk and may benefit from targeted interventions.