This examination of individual negative consequences as well as groupings of consequences across a diverse sample of countries also provides insight generally into the measurement of negative consequences from drinking. First, the most highly endorsed consequences, headache or nausea from drinking and feeling the effects, likely reflect both occasional experiences of usually light drinkers as well as problems from chronic drinking. That is, even people consuming as little as one or two drinks might report feeling the effects. Thus, it is questionable whether these should be considered indicators of problem drinking in the same way as items in the personal and social groupings. Differential results for high endorsement consequences than for personal and social consequences on the country rankings and country comparisons using HLM also suggest that the high endorsement consequences may not belong with the other negative consequences as indicators of drinking problems.
