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Questionnaire template

Workplace Alcohol Use Survey

Anonymous employee survey on drinking levels, alcohol's effects on work, workplace culture and awareness of policy and support.

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Healthcare · Alcohol assessment. All Healthcare templates

Questions in this template

Your Work

  1. Thank you for taking part. This anonymous survey asks about alcohol and work so we can shape a fair policy and the right support. No answer will be traced back to you.

  2. Which best describes your type of work?

    Choose one:

    • Office or administrative
    • Manual or production
    • Driving or transport
    • Healthcare or care
    • Sales or customer service
    • Management
    • Other

  3. Does your job involve safety-critical tasks, such as driving or operating machinery?

    Choose one:

    • Yes
    • No
    • Not sure

  4. What is your usual working pattern?

    Choose one:

    • Regular daytime hours
    • Shifts including nights
    • Irregular hours or on call
    • Mostly from home

Drinking Habits

  1. The next three questions are the AUDIT-C, the consumption items of the World Health Organization's Alcohol Use Disorders Identification Test (Babor and colleagues; short form by Bush and colleagues, 1998). They are free to use.

  2. Your answers are a screening aid, not a diagnosis. A 'drink' means one standard drink, such as a small glass of wine, a bottle of regular beer or a single measure of spirits.

  3. How often do you have a drink containing alcohol?

    Choose one:

    • Never
    • Monthly or less
    • 2-4 times a month
    • 2-3 times a week
    • 4 or more times a week

  4. How many drinks containing alcohol do you have on a typical day when you are drinking?

    Condition: Shown to people who drink

    Choose one:

    • 1 or 2
    • 3 or 4
    • 5 or 6
    • 7 to 9
    • 10 or more

  5. How often do you have six or more drinks on one occasion?

    Condition: Shown to people who drink

    Choose one:

    • Never
    • Less than monthly
    • Monthly
    • Weekly
    • Daily or almost daily

Alcohol and Work

  1. In the past 12 months, how often has each of these happened to you?

    Condition: Shown to people who drink

    • I worked while hungover
    • I drank alcohol during the working day, including breaks
    • I missed work, or arrived late, after drinking
    • Drinking affected how well I did my job

    For each row: choose one:

    • Never
    • Once or twice
    • Several times
    • Monthly or more

  2. How far do you agree with each statement about your workplace?

    • Drinking is expected at work social events
    • Colleagues would notice if someone had a drinking problem
    • It is safe to ask for help with alcohol here

    For each row: choose one:

    • Strongly disagree
    • Disagree
    • Neither agree nor disagree
    • Agree
    • Strongly agree

  3. In the past 12 months, have you noticed a colleague's drinking affecting their work?

    Choose one:

    • Yes
    • No
    • Prefer not to say

Policy and Support

  1. Do you know whether your organisation has an alcohol policy?

    Choose one:

    • Yes
    • No
    • Not sure

  2. Would you know where to find confidential help with alcohol through work?

    Choose one:

    • Yes
    • No

  3. Which kinds of support should the organisation offer? Select all that apply.

    Choose any that apply:

    • Confidential counselling
    • Information and awareness sessions
    • Alcohol-free work events
    • Clear guidance for managers
    • Other
    • None needed

  4. Is there anything else you would like to say about alcohol and the workplace?

    Open answer