Measuring lifetime alcohol exposure: A scoping review and implications for translational research and alcohol‐related harm

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BACKGROUND AND AIMS: Understanding lifetime alcohol exposure is fundamental to appreciating the risks of alcohol dependence and the multiplicity of alcohol-related harms, such as cirrhosis. However, most research relies on self-reported alcohol use measures that rarely extend beyond recent consumption. This represents a critical limitation in assessing the relationship between alcohol exposure and biological or psychological outcomes. Concerns about recall bias may be overstated and risk obstructing translational research into long-term effects of alcohol, including treatment engagement. This scoping review examined the evidence for the reliability and validity of self-reported measures of lifetime alcohol consumption. METHODS: We searched the MEDLINE, EMBASE and PsycINFO databases in June 2024 for English-language articles published since 1970. We included studies that performed at least one of the following psychometric assessments on a lifetime alcohol exposure measure: test-retest reliability, internal consistency, concurrent validity or construct validity. RESULTS: The search identified 1607 unique records. After title and abstract screening, 24 studies underwent full-text review, with nine meeting the inclusion criteria. Most studies were conducted in North America (78%). The most frequently used instrument was the Lifetime Drinking History (LDH) (67%). Across all studies, there were 6010 participants (3478 male, 2532 female), with sample sizes ranging from 49 to 3255. In 78% of studies, alcohol exposure data were collected via face-to-face interview. Eight studies assessed test-retest reliability, with retest intervals ranging from 14 days to 13 years; none assessed internal consistency. Three studies (33%) formally assessed validity. Where assessed, test-retest reliability and concurrent and construct validity were moderate to strong. Test-retest reliability ranged from 0.67 to 0.92, and concurrent and construct validity with external reference measures ranged from 0.40 to 0.80, indicating generally acceptable performance. CONCLUSIONS: Existing instruments for measuring lifetime alcohol exposure appear to be valid and reliable and can overcome concerns regarding biases; however, these instruments vary in structure, lack standardisation and may fail to capture binge or episodic drinking, highlighting important gaps for refinement.

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