Alcohol Use In India Research Articles

Assessing the societal value of health lost to alcohol use in India compared to excise taxes on alcohol sales.

We retrospectively studied the societal value of lost health due to alcohol use and compared it with excise taxes on alcohol sales for India in 2019. We estimated the overall alcohol-attributable disease burden using disability-adjusted life-years (DALY) for India and its 30 states for all causes with alcohol use as a risk factor from the GBD 2019 Study. The societal value of lost health was calculated using value of life-year (VLY) approach by multiplying region-specific factors from 'Global Health 2035', 2019-2020 GDP per capita and DALYs. We acquired the national and state-level (top 10 states) alcohol sales excise taxes from the Reserve Bank of India. Net losses were assessed by subtracting the revenue collected from excise taxes from VLY. All values are in Indian rupees (INR). The societal value of health lost due to alcohol use in India was 6.2 (95% uncertainty interval 4.8, 7.8) trillion INR in 2019. The absolute state-level values varied from 7.3 (4.7, 10.4) billion INR in Mizoram to 1.1 (0.8, 1.4) trillion INR in Maharashtra. The per capita values ranged from 950.2 (642.9, 1285.3) INR for Bihar to 61,332 (39,273.7, 87,288.5) INR for Mizoram. Nationally, excise tax collection from alcohol sales was 1.8 trillion INR depicting a net loss of 4.4 (3.1, 6.0) trillion. Maharashtra had the largest absolute and per capita net loss. These are novel estimates depicting the net losses due to alcohol use in India with direct policy implications to disincentivise sales and adequately raise taxes.

How and What are Indians Drinking? Findings from the National Family Health Survey.

To assess recent changes in the extent and pattern of alcohol use in India using the National Family Health Survey (NFHS) data. We used unit-level data from both rounds of NFHS. The pattern of alcohol use was categorized as: 'almost every day', 'almost once a week' and 'less than once a week'. The information was segregated for the urban and rural settings. Information was also available on the type of alcoholic beverage used by the respondents. The z test for differences in proportions was carried out for the study variables. Findings suggest a 22.37 and 39.02% reduction in the proportion of men and women who reported alcohol use, respectively. The proportion of men reporting 'almost every day' and 'about once a week' consumption of alcohol increased by 24.19 and 7.14%, respectively. With the caveats of expected limitations of surveys, the findings suggest an overall decrease in alcohol use in India, though the proportion of men with more frequent alcohol has increased. There is a need to strengthen the investment in the initiatives targeted at the harms due to alcohol use.

Gender and regional pattern of alcohol use and projection of problematic drinking in India, 1998-2016.

Alcohol use is the third leading risk factor for premature mortality. India is one of the largest markets for alcoholic beverages. Existing research in India is localized to specific settings lacking national generalizability. The present study aims to estimate the trends in alcohol use in India by gender and regions and to estimate the current projected number of the population involved in problematic drinking. The National Family Health Survey (NFHS) is used to estimate the age-standardized alcohol prevalence by gender and region. World Bank, 2019 population estimates are used to estimate the total population currently involved in problematic drinking, using the recent alcohol prevalence estimates. Nationally, the age-standardized prevalence of alcohol use increased between 1998-1999 and 2005-2006 and declined thereafter, being higher among men than women. Exceptions to the declines after 2005 are seen in some regions where alcohol use still increased. A 43.6% increase and 8.5% decrease in the age-standardized prevalence of problematic drinking is observed among men and women, respectively, between 2005-2006 and 2015-2016. However, problematic drinking increased in some regions for both men and women. 103.62 million men and 3.34 million women in India were involved in problematic drinking during 2019, with the highest incidences being among men aged 40-44 years and among women aged 45-49 years. Despite the overall progress India has made in reducing its alcohol prevalence, lowering it further remains a public health priority. There was a substantial rise in the prevalence of problematic drinking among the population, which warrants immediate action. Spreading knowledge and awareness about the negative health effects of problematic drinking among the adult population seems necessary. Strict implementation of policies would therefore not only aid in reducing the prevalence of alcohol use and problematic drinking, but, in turn, would also help to reduce the burden of alcohol-related morbidity and associated mortality in India.

The "Hidden Story" about Change in Alcohol Use in India over the Past Two Decades: Insights from a Secondary Analysis of Data from the National Family Health Survey.

Background:Studies and published reports have not commented on the change in the proportion of the Indian population that consumed alcohol over the years.Methods:We report the findings on changes in alcohol use in India over the past two decades, based on a secondary analysis of the data gathered over the successive National Family Health Surveys (NFHS-3 to 5).Results:There was a significant decline (P < 0.001) of around 8% and 45% for the current use of alcohol among men and women from NFHS-3 to NFHS-4. There was a decline in the proportion of men reporting alcohol use across all but one state in NFHS-5 compared to NFHS-3. The decline was statistically significant (P < 0.001) for all but one state. There was a decline in the proportion of women reporting alcohol use in 12 states and an increase in three states. Also, there was a significant (P < 0.001) decline in the proportion of men reporting alcohol use in all the states in NFHS-5 compared to NFHS-4. There was an increase in the proportion of women reporting alcohol use in nine states (statistically significant in six states) in NFHS-5 compared to NFHS-4. However, the proportions were more than NFHS-3 values in two states.Conclusions:These observations on changes in alcohol use in the country over the past two decades will help better understand the trends in alcohol consumption and help better plan the future strategy to address alcohol use and alcohol use disorders.

Screening for Alcohol Abuse among Indian Adolescents

The negative impact of alcohol is well documented and alcohol use disorders (AUDs) have become a significant public health burden. However, the epidemiological analysis of AUDs in the Indian setting is missing in the literature. The present review explored the prevalence of alcohol abuse among Indian adolescents based on available school or college based studies conducted in the Indian setting. The prevalence of AUDs in college students ranged from 6.9% to 19.2%. The current review provides a systematic summary of the alarming magnitude of alcohol consumption in India. Considering the changing trends of alcohol use in India, epidemiological data regarding the patterns of alcohol use forms the mainstay for proper health planning and to formulate further intervention strategies in this setting. Keywords: Screening, Alcohol abuse, Adolescents.

Patterns and Correlates of Alcohol Use- A Retrospective Study in a Secondary Care Hospital Setting

Introduction: Alcohol use in India has been increasing over the years, and it results in myriad medical and psychosocial problems. Primary and secondary care physicians can play a unique role in the early recognition and treatment of patients with alcohol problems. Aim: To determine the prevalence of different patterns of use of alcohol and factors associated with it among patients presenting to the psychiatry clinic in a secondary hospital. Materials and Methods: A retrospective review of the medical records of patients attending the Psychiatry Department in a secondary care hospital in a semi-urban area of southern India who attended the clinic between 1st January 2016 to 31st December 2016 was made. Data regarding alcohol use and other clinical and socio-demographic details were analysed. Bivariate and multivariate statistics was used to identify factors associated with dependence pattern of alcohol use. Results: A total of 103 charts, which documented substance use were analysed of which 78 documented alcohol use in the subjects. The mean age of the sample was 44.09±13.18 years and majority (97.43%) were males. The prevalence of a dependence pattern of alcohol use was 83.4%. Factors associated with alcohol dependence were being married, greater daily expenditure on alcohol, greater number of days of alcohol use in a month, presence of a co-morbid medical diagnosis, problems with employment and marital discord. Depression was present in 33 (42.3%) individuals and it was the most commonly associated psychiatric morbidity. Conclusion: There is a high prevalence of Alcohol Use Disorders (AUD) in secondary care settings. Tackling this problem requires a combination of strategies including early and effective medical and psychosocial intervention in addition to public health strategies and legislation to regulate the availability and consumption of the substance.

Alcohol consumption in India: A rising burden and a fractured response.

To review the burden of alcohol use in India, examine current policy initiatives and programs specific to India and provide a roadmap for future actions. A literature search was undertaken to review available published research papers, unpublished reports and anecdotal media information in the period 2000-2020 to assess the burden and pattern of alcohol use and appraise alcohol control policies in India. The per-capita alcohol consumption among individuals aged 15+ years was 5.7 L, which increased over time. Prevalence of alcohol use varied across states with considerable impact on the nation. Regulatory policies and alcohol control programs vary across Indian states, with poor enforcement and implementation. Taxation and pricing policies are revenue oriented. Policies are needed to address the aggressive and innovative marketing strategies of the alcohol industry. The system for regular monitoring of alcohol burden and conducting alcohol policy analysis needs strengthening. Alcohol use and its public health impact would continue to increase in India in the absence of effective policy and programs; the country may not achieve its stated goal of relative reduction of alcohol use prevalence by 10% by 2025. The prevailing alcohol control policies and programs in India have been less than fully effective in controlling the burden of alcohol use and its associated impact. There is a need for comprehensive, evidence-based and consensus-driven national alcohol control policy to appropriately guide and support the Indian states in regulating alcohol and reducing the associated burden. Effective implementations of such policies are central to its success.

Longevity and Economic Growth in China and India Using a Newly Developed Bootstrap ARDL Model.

In this study, we use a recently developed Bootstrap ARDL model to examine the influence of longevity (life expectancy after giving birth) and alcohol consumption on economic progression (GDP) in both China and India during the years between 1992 and 2015. Empirical results have shown an extended link across economic development, longevity, and alcohol use in both China and India. The Granger causality test, derived from the Bootstrap ARDL model, demonstrates a unidirectional relationship between economic growth and longevity in China. However, a bidirectional causality exists between longevity and alcohol use in India. Results have important implications for Indian and Chinese governments' public health policies, focused on alcohol consumption reduction specifically, and population health generally.

A Reveille on the Prevalence of Alcohol Use in India: What Does the Epidemiological Literature Say?

There is a piece of classical and voluminous evidence in the literature regarding the use of alcohol from the Hebrew Bible, literary heritage of Greeks and Romans and the Vedas of India. However, the recent evidence suggests that excessive alcohol consumption is a risk factor for a wide range of health and social problems and a major cause of premature illness and death. The present paper explores the findings of the national and regional based epidemiological survey on alcohol use in the Indian setting. Although there is a difference in the technique and screening instrument, it can be assumed that the prevalence of alcohol use disorders in India can vary from 4.6 % to 5.2 %. The studies conducted in various parts of India using AUDIT as a research instrument found a varying prevalence of alcohol dependence ranging from 12.4 to 36.5 %. Furthermore, harmful alcohol use is found to vary from 33.2 to 52.6 %. The recent data suggest that fewer people in India consume alcohol, but a larger proportion is affected by harmful use or dependence on alcohol. Considering the changing trends of alcohol use in India, epidemiological data regarding the patterns of alcohol use forms the mainstay for proper health planning.

Alcohol use among allopathic doctors and their perceptions in relation to alcohol use in India: a cross-sectional study

Alcohol use among allopathic doctors and their perceptions in relation to alcohol use in India: a cross-sectional study

The socioeconomic correlates of substance use among male adults in Northeast India

BackgroundSubstance use – defined by the consumption of alcohol, smoking, and smokeless tobacco - has been identified as a serious health hazard in India. Understanding the socioeconomic correlates of substance use in Northeast India (NEI) will provide crucial input for public health policies in this region. ObjectivesTo examine the socioeconomic correlates of substance consumption among male adults of NEI. Data and methodsWe analyzed nationally representative data from the National Family Health Survey (NFHS-4) 2015–2016. We examined the prevalence and frequency of smoking, using smokeless tobacco products, alcohol consumption, and other substance use among 14,555 men in the 15 to 54-year age group. We carried out binary logistic regressions to investigate the socioeconomic correlates of substance use among male adults in NEI. ResultsSubstance use was significantly higher among the male adults of NEI than among those from elsewhere in the country (any substance i.e. smoking, smokeless tobacco and alcohol use in India: 50.03% vs. NEI: 70.83%). The frequency of smoking and alcohol consumption is also higher in NEI compared to the rest of the country. In total, there are about 10.2 million substance users, of which 6.7 million are from the state of Assam. About 44.38% of adolescents (aged between 15 and 19) use at least one type of substance. Substance use plateaus in the 25 to 49 age group before beginning to decline among users aged between 50 and 54 years. The likelihood of substance use goes down with increasing education and wealth in NEI. Among social groups, Scheduled Tribe adults have the highest likelihood of using any substance. ConclusionThe intensity of substance consumption in NEI is very high. These unhealthy behaviors are more prevalent among socioeconomically disadvantaged populations. This calls for intensive research to better understand the dynamics of substance availability and use in NEI. Furthermore, strong policy measures are needed to reduce substance use among vulnerable groups.

Health impact and economic burden of alcohol consumption in India

BackgroundThe health and economic consequences of alcohol consumption have been assessed mainly in developed countries. This study aims to estimate health impact and economic burden attributable to alcohol use in India. MethodsA combination of decision tree and mathematical markov model was parameterized to assess the health effects and economic cost attributable to alcohol consumption. Health effect of alcohol was modelled for a time period of 2011 to 2050 on three sets of conditions – liver disease, cancers and road traffic accidents. Estimates of illness, death, life years lost and quality adjusted life years (QALYs) gained were estimated as a result of alcohol consumption. Both direct and indirect costs were estimated to determine economic burden. Future costs and consequences were discounted at 3% for time preferences of cost and utility. Uncertainties in parameters were assessed using probabilistic sensitivity analysis. ResultsBetween 2011 and 2050, alcohol attributable deaths would lead to a loss of 258 million life years. In contrast, 552 million QALYs would be gained by eliminating alcohol consumption. Treatment of these conditions will impose an economic burden of INR 3127 billion (US$ 48.11 billion) on the health system. Societal burden of alcohol, inclusive of health system cost, out of pocket expenditure and productivity losses will be INR 121,364 billion (US$ 1867 billion). Even after adjusting for tax receipts from sale of alcohol, alcohol poses a net economic loss of INR 97,895 billion (US$ 1506 billion). This amounts to an average loss of 1.45% of the gross domestic product (GDP) per year to the Indian economy. ConclusionAlcohol causes significant negative health impact and economic burden on Indian society and evidence informed policy interventions are needed to control alcohol attributable harm.

Contextual predictors of AUDIT scores among adult men living in India

Madden, D., Rathi, L., Stewart, A., &amp; Clapp, J. (2017). Contextual predictors of AUDIT scores among adult men living in India. The International Journal Of Alcohol And Drug Research, 6(1), 53-58. doi:http://dx.doi.org/10.7895/ijadr.v6i1.241Introduction: Currently, little is known about the prevalence of alcohol use in India. In order to begin to address this knowledge gap, this exploratory study examined contextual aspects of drinking events and the relationship between these factors and high-risk drinking.Methods: A convenience sample of 198 adult men was recruited from rural areas adjacent to the city of Nagpur. Participants were sampled in two waves. Respondents in both waves completed a nine-item survey that addressed alcohol use, including motivation to drink, where one drinks, and with whom one drinks. Demographic characteristics (e.g., income) were also recorded. Respondents recruited in the second wave (n = 98) completed the Alcohol Use Disorders Identification Test (AUDIT). The data were analyzed using Poisson regression models.Results: Of those who completed the AUDIT, 37% were at high risk for developing an alcohol-use disorder (i.e., received a score of 20 or greater). Participants had higher AUDIT scores (i.e., alcohol-use problems) when they reported typically buying alcohol in a shop. Furthermore, respondents with greater weekly incomes and those who drink with the motivation to get very drunk have higher AUDIT scores.Conclusions: This study found an alarmingly high rate of alcohol use and alcohol-related issues among respondents. A better understanding of drinking patterns and contextual aspects of drinking events is warranted.

Awareness of Alcohol among Adolescents and Young Adults of Mangalore

Abstract Introduction: Alcohol consumption is a major public health problem in most parts of the world responsible for 3.2per cent of deaths (1.8 million). Prevalence of alcohol use in India is reported to be 21.4%. The concern, is that there has been a rapid change in patterns and trends of alcohol use in India, chief among them is people are beginning to drink at ever-younger ages. Alcohol consumption of the students under the age of 18 years is markedly high which needs to be addressed. Aims and Objectives: To assess the awareness of risk factors in alcohol consumption among adolescents and young adults. Materials and Method: Materials used are -Questionnaire pertaining to the awareness of alcohol consumption. Methodology: Assessment of awareness and knowledge of alcohol consumption was done by means of answering a pretested validated questionnaire with anonymity. Results: According to the study done, 67.18% of students knew who consumed alcohol under the age of 18. It was found, 28.03% of the subjects perceived that alcohol consumption started because of the urge to try something new. Conclusion: A high majority of the students are aware of the underage drinking and risk factors associated with it.

Epidemiological study of alcohol and tobacco consumption in people above 15 years of age in rural area of Nagpur, Maharashtra, India

Background: The World Health Organization predicts that tobacco deaths in India may exceed 1.5 million annually by 2020.Very few community-based studies have been conducted on the prevalence of alcohol use in India. Alcohol consumption has a U- shaped relation with ischemic heart disease and is as well a strong frisk factor for hepatic cirrhosis and many other type of injury. Methods: It was a cross-sectional study, carried out in three villages of a PHC. A total of 3771 study subjects aged 15 years and above were included in the study. It was conducted from July 2007 to December 2009. General information and socio-economic details of study subjects were obtained. Details were recorded about personal habits like smoking, consumption of smokeless tobacco, alcohol. General and systemic examination was carried out and findings were recorded. Results: In the present study, the prevalence of current smokers was 20.5% among males and none among females. In the present study the prevalence of smokeless tobacco use was 48.3% and the prevalence of current consumer of alcohol was 37.7% among males while there were none among the female. Conclusions: we found a low prevalence of smoking tobacco and non-consumption of alcohol among females which can be attributed to the less social acceptability of smoking in this rural part of Nagpur, Maharashtra, India.

Alcohol Use in India: The Road Ahead

Prohibition has been incorporated in the Constitution of India among the Directive Principles of State Policy. But, the liquor manufacturers in India are able to glorify alcohol consumption by promoting drinking in congenial social settings and through glamour and celebrity status. This study surveyed articles on alcohol consumption to note down its impact on various fronts of social life. It was found that the tendency to consume alcohol had percolated down to the youth of India. The media played a leading role in encouraging alcohol use among the youth. In Kerala, the age of alcohol consumption was 19 in 1986, by 1990 it dropped to 17, and by 1994 the age came down to 14. The positive finding was that 60 per cent effect of prohibition could be achieved only by increasing the legal age of drinking from 18 years to 21 years. This paper aims to study the negative implications of alcohol use from different angles so that policy makers would probably take a stand on prohibition. The paper also aims to dissuade individuals to use alcohol. It (the paper) calls upon the supporters of alcohol use to reduce their vigor of persuasion. The study tries to identify the research gaps so that the cost and impact of alcohol on national economies could be studied comprehensively in future.

A study on socio-demographic characteristics of alcoholics attending the de-addiction center at Burdwan medical college and hospital in West Bengal

Prevalence of alcohol use in India is reported to be 21.4% and there is increasing alcohol intake among the young people. The present study was undertaken to study the socio-demographic characteristics of patients having alcohol-related disorders attending the de-addiction center at Burdwan Medical College in West Bengal and to find out some factors responsible for that. A clinic-based descriptive cross-sectional study was conducted among 187 patients with the help of pre-tested pre-designed schedule after obtaining informed consent. Data analysis was carried out with the help of Epi info software version 6. Majority of the patients were male, in productive age group and married. Age of initiation and amount of alcohol intake were significantly associated with positive family history of alcoholism. Children having family history of alcoholism should be counseled to prevent development of alcoholism.

Patterns of alcohol use, their correlates, and impact in male drinkers: a population-based survey from Goa, India.

PurposeAssociations between low socio-economic class and alcohol use disorders are relatively well established in developed countries; however, there is comparably little research in India and other developing countries on the associations between socio-economic class, drinking patterns, and alcohol-related problems. We sought to assess drinking patterns and adverse outcomes among male drinkers and examine whether the association between drinking patterns and adverse outcomes differ by socioeconomic class.MethodsPopulation survey of 732 male drinkers screened from 1,899 men, aged 18 to 49 years, randomly selected from rural and urban communities in northern Goa, India.ResultsUsual quantity of alcohol consumed by 14.8 % (rural 16.8 %; urban 13.6 %) current drinkers is at high-risk level. About 28.6 % (rural 31 %; urban 27.2 %) and 33.7 % (rural 30.5 %; urban 35.5 %) of current drinkers reported monthly or more frequent heavy episodic drinking and drunkenness, respectively. Lower education and lower standard of living (SLI) were associated with higher usual quantity of alcohol consumption. More frequent heavy episodic drinking was associated with older age, being separated, lower education, and lower standard of living; weekly or more frequent drunkenness was associated only with rural residence. All three risky drinking patterns were associated with common mental disorders, sexual risk, intimate partner violence, acute alcohol-related consequences, and alcohol dependence. Significant interactions between SLI and risky alcohol use patterns suggested an increased risk of intimate partner violence among men with risky drinking and lower SLI.ConclusionsRisky drinking patterns are common among male drinkers in Goa and associated with lower socio-economic class. A range of adverse health and social outcomes were associated with risky drinking across all socio-economic classes. Alcohol policy should target risky drinking patterns, particularly among poorer men, to reduce the health and social burden of alcohol use in India.

The Evolution of Alcohol Use in India

This paper traces the role of alcohol production and use in the daily lives of people in India, from ancient times to the present day. Alcohol use has been an issue of great ambivalence throughout the rich and long history of the Indian subcontinent. The behaviors and attitudes about alcohol use in India are very complex, contradictory and convoluted because of the many different influences in that history. The evolution of alcohol use patterns in India can be divided into four broad historical periods (time of written records), beginning with the Vedic era (ca. 1500-700 BCE). From 700 BCE to 1100 CE, ("Reinterpretation and Synthesis") is the time of emergence of Buddhism and Jainism, with some new anti-alcohol doctrines, as well as post-Vedic developments in the Hindu traditions and scholarly writing. The writings of the renowned medical practitioners, Charaka and Susruta, added new lines of thought, including arguments for "moderate alcohol use." The Period of Islamic Influence (1100-1800 CE), including the Mughal era from the 1520s to 1800, exhibited a complex interplay of widespread alcohol use, competing with the clear Quranic opposition to alcohol consumption. The fourth period (1800 to the present) includes the deep influence of British colonial rule and the recent half century of Indian independence, beginning in 1947. The contradictions and ambiguities-with widespread alcohol use in some sectors of society, including the high status caste of warriors/rulers (Kshatriyas), versus prohibitions and condemnation of alcohol use, especially for the Brahmin (scholar-priest) caste, have produced alcohol use patterns that include frequent high-risk, heavy and hazardous drinking. The recent increases in alcohol consumption in many sectors of the general Indian population, coupled with the strong evidence of the role of alcohol in the spread of HIV/STI infections and other health risks, point to the need for detailed understanding of the complex cross-currents emerging from the past history of alcohol use and abuse in India.

Effect of tobacco chewing, tobacco smoking and alcohol on all-cause and cancer mortality: A cohort study from Trivandrum, India

Objective: To study the risk of all-cause, cancer and tobacco-related cancer mortality associated with tobacco chewing, tobacco smoking and alcohol use. Design: Prospective community-based cohort study initiated in 1996. Participants: 167 343 adult subjects, aged 34 and older, living in 13 panchayaths (rural municipal administrative units) in South India, were regularly followed-up for a mean duration of 6.5 years. Main outcome measures: Mortality from all-causes, all cancer and tobacco-related cancer. Results: The mortality risks associated with chewing (and 95% confidence intervals), after adjusting for age, sex, socio-economic and dietary variables, and for other habits, were 0.90 (0.86–0.94) for all-cause, 1.07 (0.94–1.22) for cancer and 1.22 (1.04–1.44) for tobacco-related cancer; with smoking the respective mortality risks were 1.31 (1.24–1.39), 1.63 (1.37–1.94) and 1.68 (1.36–2.08); and with alcohol use the risks were 1.13 (1.06–1.20), 1.32 (1.11–1.57) and 1.47 (1.19–1.80), respectively. Reduced risk of all-cause mortality by chewing was observed only in the 60–84 years old group (0.90 (0.85–0.94)), and detrimental effects of chewing on cancer mortality were shown in the young and middle-age groups: 34–39 years old (1.33 (0.67–2.65)), and 40–59 years old (1.26 (1.03–1.55)). Conclusion: Tobacco in any form and alcohol uses were harmful and a higher quality of life could be achieved by avoiding these habits. Given the demographic, epidemiological and economic transitions and changes in pattern of tobacco and alcohol use in India, the health loss from the tobacco and alcohol will grow even larger, unless effective interventions and policies to reduce these habits are implemented.