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Indian Journal of Community Medicine

A Comparative Study of Prevalence of Regular Alcohol Users Among The Male Individuals in An Urban and Rural Area of Distt. Amritsar, Punjab

Author(s): Jagjeet Singh, Gurmit Singh, V. Mohan, A.S. Padda

Vol. 25, No. 2 (2000-04 - 2000-06)

Department of S.P.M., Govt. Medical College, Amritsar.

Abstract:

Research question: What is the magnitude of the problem of regular alcohol users in urban and rural community of district Amritsar (Punjab)?

Objectives: 1. To find out the prevalence of alcohol users among the male individuals of more than 10 years of age, in an urban and rural area of Distt. Amritsar. 2. To determine the age wise distribution, marital status, educational status, and pattern of drinking in regular alcohol users.

Study design: Cross-sectional study.

Setting: Village Gumtala (Rural) and area under urban training health centre, Govt. Medical College, Amritsar (Urban).

Participants: Male population of more than 10 years of age in both these area.

Sample size: 851 subjects.

Study variables: Prevalence, age, marital status, educational status and pattern of drinking in Regular alcohol users.

Statistical analysis: Simple proportions.

Results: The prevalence rate of alcohol consumption was 25.11% in urban and 60% in rural area, of district Amritsar. Regular users of alcohol were of the order of 10.77% and 17.03% in urban and rural area respectively. Majority of the regular users were in age bracket 40-49 (26.3%) and 50-59 (71.4%) in urban and rural area respectively. 30.9% of these regular users in urban and 52.1% in rural area had their first drink in 20-29 years of age. 93.75% and 79.71% of the persons were married. Majority of the regular users consumed or preferred to consume alcohol with some company. More than three fourth of these in Urban (87.5%) as well as in rural (82.9%) area, were consuming alcohol daily.

Keywords: Regular alcohol user, Occasional user, Marital status, Educational status, Pattern of drinking.

Introduction:

Alcohol addiction or alcoholism is a worldwide problem in the developed, developing and the under developed countries. The economic cost, which is associated with the problem is being counted as massive. To these relatively tangible costs, must be added, the heavy toll of human unhappiness represented by broken marriages, ruined careers and neglected children. For the reasons set forth above, in 1979, the 32nd World Health Assembly declared in resolution, WHAS - 32.40, that "problems related to alcohol and particularly to its excessive consumption rank among the world's major public health problems and constitute serious hazards for human health, welfare and life1".

The state of Punjab is one of the most progressive and affluent in the federal union of India. Those who are moving upwards socially tend to adopt new lifestyles, which include new patterns of alcohol and drug use. Also many people who have emigrated from this state to other countries return from time to time to visit their relatives and bring with them the values and life styles of their adopted countries.

In rural society of Punjab, income from green revolution tends to get diverted into excessive recreational or regular use of alcohol. Lack of reliable date makes it difficult to provide detailed description of consumption trends. The prevalence of alcohol use may be estimated not only from the existing statistics and case registration but mainly by community survey. The problem of alcohol use in India has widely attracted the attention of the public, policy makers, research officials and workers. However, very few studies have been carried out, especially in this part of the region. To highlight the problem the present study was carried out.

Material and Methods:

The study was conducted from March to November 1996, in village Gumtala and in the area of Urban Training Health Centre, Amritsar, which are rural and urban field practice areas attached with the Department of Community Medicine, Govt. Medical College Amritsar. A total of 1200 houses (having 5000 population approximately), each in urban and rural area were numbered. By systematic random sampling technique, 200 houses each of the urban and rural area were selected by including every 6th house. The date was collected by home visits through interview questionnaire method on the pretested proforma and the results statistically analyzed.

Regular alcohol users: The persons consuming 200 ml or more of 40-60% alcohol daily for 4 days or more in a week for the last 5 years or more.

Occasional users: The persons consuming alcohol once a month or less than once a month.

Results:

In urban area 200 houses were covered. Out of these 18 were found locked and so 182 houses, having a under SHC Gumtala, out of 200 houses, 12 were found locked and so 188 houses having a population of 985 were surveyed. A total 1998 population was covered for study. In the total of 1998 population, 1584 (851 males and 733 females - 79.27%) ; were above 10 years of age, out of which 847 (446 males and 401 females) were in urban and 737 (405 males and 332 females) in rural areas.

Table I: Regular and occasional alcohol users among the male individuals of more than 10 years of age, in urban and rural area.

  Urban(n=446) Rural(n=405) Total(n=851)
No. % No % No %
Regular users 48 10.77 69 17.03 117 13.74
Occasional users 64 14.34 174 42.97 238 27.96
Total 112 25.11 243 60.00 355 41.71

The prevalence rate of alcohol consumption was 25.11% in urban males of more than 10 years of age and in rural area it was 60%. In this group, 10.77% were regular and 14.34% occasional alcohol users in urban area while these figures were 17.03% and 42.97% respectively in rural area. Similar observations regarding consumption of alcohol have been made by Mohan et al (52.4% in 15 years) and Lal and Singh (29.3% in 10 years and above). Verma et al (1980) observed that 19% of Chandigarh urban, 31.4% of Chandigarh rural and 45.9% of rural population of district Jalandhar in Punjab were current users3-5. The difference in the prevalence rate of the present study and other studies in Punjab and outside Punjab, observed by various authors may be due to various socio-cultural variations in those areas.

Table II: Age-wise distribution of regular alcohol users in urban and rural area.

Age group (yrs) Urban Rural Total
No. of persons No. of regular users % No. of persons No. of regular users % No. of persons No. of regular users %
10-19 100 - - 119 - - 219 - -
20-29 94 4 4.3 73 5 6.8 167 9 5.4
30-39 71 6 8.5 88 9 10.2 159 15 9.4
40-49 80 21 26.3 56 28 50.0 136 49 36.0
50-59 48 10 20.8 21 15 71.4 69 25 36.2
60 & above 53 7 13.2 48 12 25.0 101 19 18.8
Total 446 48 10.8 405 69 17.0 851 117 13.7

Maximum no. of regular users were in 50-59 years (36.2%) and 40-49 years (36.0%) age group in the total combined population. In the urban area, maximum number (26.3%) was in 40-49 years followed by 50-59 years (20.8%) age groups. It was minimum in 20-29 years (4.3%) age group and none in 10-19 years age group. While in rural area, the maximum number of alcohol users were in 50-59 years (71.4%) followed by 40-49 years (50.0%) age group. Here also minimum number was in 20-29 yrs *6.8%) age group and none in 10-19 yrs age group.

Table III: Age at which first drink taken in regular alcohol users.

Age group (yrs) Urban Rural Total
No. of persons No. of regular users % No. of persons No. of regular users % No. of persons No. of regular users %
10-19 100 11 11.0 119 21 17.6 219 32 14.6
20-29 94 29 30.9 73 38 52.1 167 67 40.1
30-39 71 6 8.5 88 07 8.0 159 13 8.2
40 & above 181 2 1.1 125 3 2.4 306 5 1.6
Total 446 48 10.8 405 69 17.0 851 117 13.7

In rural area more persons (17.6%) had their first drink in younger age (less than 20 yrs of age) as compared to urban area (11.0%). It was 20-29 yrs age group, in which maximum number of regular alcohol users had their first drink in urban (30.9%) as well as in rural area (52.1%). Reasons for more percentage of starting alcohol intake at younger age, in rural area may be due to cheap and easy availability of certain brands of alcohol, especially of country liquor and low literacy rate in the areas. About the age of starting of alcohol or tasting alcohol for the first time, Mohan et al3 observed that 41.9% of the users reported alcohol intake between 15-24 yrs of age while Verma et al5 found that 15% had started drinking before 14 yrs, 73% between 15-25 years and only 7.4% after 26 yrs of age.

The findings of the present study of initiation of alcohol at younger age in rural as well as in urban area is in close consistence with respect to a WHO study group on "young and drugs", which stated that most of the experimentation and initiation of the majority of dependence producing drugs takes place during adolescence6.

Table IV: Marital status of regular alcohol users in urban and rural area.

Marital status Urban Rural
Number % Number %
Married 45 93.75 55 79.71
Unmarried 1 2.08 12 17.39
Widower 2 4.17 1 1.45
Separated - - 1 1.45
Total 48 100.00 69 100.00

Percentage of married regular users was more (93.75%) in urban area as compared to rural area (79.71%). Unmarried regular users, were many times more in rural area (17.39%) than urban area (20.8%). Singh P et al found 92% married, 7% unmarried and 1% divorced as regular users. Percentage of alcohol users was more in married persons, both in urban and rural areas, may be party due to the age factor and partly due to the increased social responsibilities of married life7.

Table V: Distribution of regular alcohol users in relation to educational status.

Education Urban Rural
No. % No. %
Illiterate 2 4.16 15 21.74
Just literate 4 8.33 1 1.45
Primary 5 10.42 23 33.33
Middle 7 14.59 12 17.39
Matric 17 35.42 14 20.29
Sub total 35 72.92 65 94.20
10+2 & Graduates 10 20.83 4 5.80
Post Graduates 2 4.163 - -
Professional 1 2.09 - -
Sub total 13 27.08 4 5.80
Total 48 100.00 69 100.00

X2= 5.22, p<0.05

In rural area, just literate to matriculate constituted 72.46% of total regular users as compared to 68.76% in urban area. 21.74% were illiterates in rural as compared to 4.16% in urban area. While in urban area 10+2, graduates, post graduates and professionals constituted 27.08% of the total regular users and these were only 5.8% in rural area. The difference might be due to the prevalent literacy status of the area i.e. there are more illiterates and just literates to matriculates in rural area as compared to urban area, while 10+2 and above were more in urban area.

The results were statistically analyzed between just literate to matric and 10+2 to post graduates and professionals of urban and rural area and the difference was statistically significant.

Table VI: Distribution in relation to pattern of drinking.

Pattern of drinking Urban Rural Total
No. % No. % No. %
Always alone 18 37.50 15 21.74 33 28.20
With company 30 62.50 54 78.26 84 71.80
Total 48 100.00 69 100.00 117 100.00

X2= 3.5, p<0.05

Majority of the regular users i.e. 84(71.8%) consumed or preferred to consume alcohol with some company. It was only about one third (37.5%) persons in urban and still less (21.74%) in rural area which preferred to have the same alone. The results were statistically analyzed and the difference was statistically insignificant i.e. similar pattern of drinking existed between urban and rural areas.

Vashishth et al8 and Mohan D (1980) made similar observations3.

Table VII: Distribution of time/days of alcohol consumption.

Pattern of drinking Urban Rural Total
No. % No. % No. %
Once a month or less than once a month - - - - - -
2-3 time a month - - - - - -
Weekly 1 2.08 1 1.45 2 1.71
2-3 times a week 1 2.08 1 1.45 2 1.71
3-4 times a week 2 4.17 5 7.25 7 5.98
4-5 times a week 2 4.17 6 8.70 8 6.84
Sub total 6 12.50 14 20.29 20 17.10
Daily 42 87.50 55 79.71 97 82.90
Total 48 100.00 69 100.00 117 100.00

More than three fourth of the regular users, in urban (87.5%) as well as in rural (79.71%) area, were consuming alcohol daily. More consumption in urbanite population might be due to more stress and strains in urban life as compared to rural life. Singh P et al observed that 91% were taking alcohol daily and 9%, 3 to 4 times a week7.

Discussion:

In societies such as ours, alcohol is more accurately described as a social problem. Alcohol related problems with inappropriate ad excessive drinking, affect not just the individual drinkers concerned but in many cases, the person with the problem is someone, other than the person particularly family members. In real sense, the situation is that alcohol consumption and harm are at high levels, are rising and will, presumably, continue to rise unless preventive action is taken to tackle the problem. As observed in the findings that drinking is quite rampant; especially in the rural areas and also it is the younger age group which is more involved, more common in married persons, which may result in strained family relations and more regular users in lower educational status group, especially in rural areas calls for the need to take specific steps.

Measures - the level of excise duties in an obvious example - which affect the drinking population as a whole must necessarily play an important role in an overall strategy. But there is no denying the importance of the targetted approach, or that the main need is, to focus on harmful and dangerous patterns of consumption.

There is need to concentrate more on rural areas and adopt measures to regulate the supply of alcohol in urban as well as in rural area, besides raising the general educational standard of individuals, especially in rural area. There is a need that national alcohol education programme provide information not just about alcohol as a potential social problem but also about the ways in which alcohol can disrupt social and especially, marital and family relationships. School and other institutions and professionals having contact with children are provided with the education and training necessary for identifying and supporting children from problem drinking families. Measures targeting whole population, as well as specific at high risk group e.g. specific areas and specific settings should be aimed at.

The most important way of limiting total alcohol consumption is by reducing the availability of alcohol while at the same time trying to influence drinking habits through information, education, opinion formation and caring measures.

References:

  1. WHO: Problems related to alcohol consumption Technical Report Series, 1980; 7: 650, 10-16.
  2. Mohan D, Sharma AK, Darshan S, Surdram KR, Neki JS: Prevalence of drug abuse in young rural males in Punjab. Indian J. Med. Res., 1978; 68: 689.
  3. Mohan D: Drug problems in Socio-cultural context. W.H.O. Geneva, 1980; 42-47.
  4. Lal B, Singh G: Alcohol consumption in Punjab. Ind. J. of Psychiat. 1978; 20: 212-6.
  5. Verma VK, Dang R: A study of attitudes, perception and exposure to drug use and its relation to socio-demographic variables. Ind. Jour. Psychiat, 1978; 2: 318.
  6. WHO: Study group on youth and drugs, TRS 1973; 526.
  7. Singh P et al: Rate of Prevalence of Physical and Mental changes in alcoholism. A.M.D. (General Medicine) thesis GNDU ASR, 1919; 1219.
  8. Vashisth et al: An epidemiological study of drug abuse in rural field practice area attached to SPM Deptt., Medical College, Amritsar, 1981.
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