Indmedica Home | About Indmedica | Medical Jobs | Advertise On Indmedica
Search Indmedica Web
Indmedica - India's premier medical portal

Indian Journal of Community Medicine

Epidemiology of Alcohol Use among Residents of Remote Hills of Arunachal Pradesh

Author(s): B.S. Deswal1, A.K. Jindal1, K.K.Gupta2

Vol. 31, No. 2 (2006-04 - 2006-06)

Introduction

Alcohol addiction is a worldwide problem as its self-induced intoxication is socially acceptable. Alcohol as a disease agent causes acute and chronic intoxication, cirrhosis of liver, toxic psychosis, gastritis, pancreatitis, cardiac myopathy and peripheral neuropathy. Also evidence is mounting that it is related to cancers of mouth, pharynx, larynx and oesophagus. Alcohol is an important aetiological factor in suicide, accidents, social family disorganisation, crime and loss of productivity. Increasing percentage of young people have started drinking alcohol in increased frequency and quantity thus constituting serious hazards to health, welfare and life1. Problems of alcohol use in India have widely attracted the attention of public, policy makers and research workers. However, data on prevalence of this problem in remote hilly areas of Arunachal Pradesh is not available. Hence, the present study was conducted to get such data.

Material and Methods

The present study was undertaken in a remote hilly population of West Kameng district of Arunachal Pradesh from July 2002 to June 2003 which consists of 3 sub divisions with a total population of 74,595 with a female to male ratio of 749 per 1000 residing in one town and 223 villages spread over an area of 7,422 km2. For the study purposes, 4,652 houses were numbered representing each of 3 sub divisions by probability proportion to size (PPS) sampling, of which 658 households (every seventh house) were selected as primary sample unit. People above 10 years of age residing in these sampled households formed the subjects of study. Houses found locked or individuals not found in homes were revisited twice to reduce the dropouts. The data were collected on pre-tested interview schedule.

Those individuals who were in the habit of drinking at the time of survey were taken as alcohol consumers. The individual who consumed alcohol at least three times a week (more than 3 drinks per week) considered as regular drinkers2. Alcohol users with CAGE scores of 2 and above were classified as alcohol dependents3. Standard drink was calculated in term of 40-50% alcohol of 30 ml (10 gm of ethanol alcohol) each.

Results

Out of a total of 658 houses listed, 636 were covered having the study population of 1,660 subjects of which 871 were males and 789 were females. Remaining 22 houses could not be covered as they were found locked in spite of two repeat visits.

Prevalence rate of alcohol consumption was found to be 64.2% among males and 34.7% among females, overall prevalence being 50.2%, of which 12.1% were regular users and 38.1% were occasional alcohol users. Among the regular users 26 (14.4%) individuals (24 males and 2 females) were found to be alcohol dependents and prevalence as per CAGE scores 2 or more found to be 1.6% (2.5% among males and 0.2% among females).

Table-I: Drinking status as per age and sex

Age
Group
Yrs.
Males Females
Occasional Regular Non-Drinkers Occasional Regular Non-Drinkers
10-19 20 (5.09) 8 (4.82) 189 (60.58) 3 (1.26) 1 (2.85) 193 (37.48)
20-29 115 (29.26) 32 (19.28) 45 (14.42) 81 (33.89) 11 (31.45) 81 (15.73)
30-39 99 (25.19) 53 (31.93) 13 (4.17) 85 (35.56) 13 (37.14) 46 (8.93)
40-49 78 (19.85) 43 (25.90) 19 (6.09) 51 (21.34) 7 (20.00) 60 (11.65)
50-59 61 (15.52) 22 (13.25) 20 (6.41) 15 (6.28) 2 (5.71) 69 (13.39)
60+ 20 (5.09) 8 (4.82) 26 (8.33) 4 (1.67) 1 (2.85) 6 (12.82)
Total 393 (100.0) 166 (100.0) 312 (100.0) 239 (100.0) 35 (100.0) 515 (100.0)
X2 for male alcohol users in age groups= 123.96, d f=10, p<0.001, X2 for female alcohol users in age groups= 183.79, d f-10, p<0.001, Figures in parenthesis indicate percentage

Drinking was significantly more among males as compared to females. Among male regular alcohol users, the maximum numbers of regular alcohol users (31.9%) were in 30-39 years age group followed by 25.9% in 40-49 years age group. Among female regular alcohol users, 37.1% regular users were in 30-39 years followed by 31.4% in 20-29 years age groups (Table I).

Majority of alcohol users (81.9%) started drinking at 20-29 years age group while 10.7% started at 30-39 years age, 1.8% at the age of 40 years or above and 5.6% at very young age group of 10-19 years.

Alcohol drinking was significantly more among illiterates and individuals in low education group as compared to those in high education group. Majority of alcohol users were married (66.2%), followed by unmarried (30.1%) and remaining in widower/separated (3.8%) categories. The difference as per marital status was found to be significant (p<0.001). Among regular users 30.9% consumed 1-2 drinks, 27.4% consumed 3-4 drinks and 41.8% consumed 5 or more drinks per drinking session where as majority (82.3%) of occasional users consumed 1-2 drinks. Most of the alcohol users (53.3%) consumed local home beverages followed by Indian Desi (34.3%). Beverage making with local grains by families was found to be very popular and prevalent practice in the area. Majority of individuals (73.1%) consumed alcohol with friends, 12.1% all alone/with family members.

Discussion

A high prevalence of alcohol use in our study (50%) compares favorably with the results reported from Punjab by Singh et al4 (60.0% among rural and 25.1% among urban with an overall 41.7%). Prevalence among females was more in our study as compared to the study carried out at Pune by Hazra et al 5. This may be due to socio culture difference in North Eastern Indian states. Prevalence of alcohol dependence (2.57%) among males and 0.50% among females in the study was lower than that reported by Hazra et al5 which may be due to difference in age group studied.

In the present study, increased number of alcohol users in younger age group and drinking pattern among females in contravention to other study4 may be due to the different culture of the study area. Initiation of first drink at younger age are in consistence with the similar disturbing trends of declining abstention among teenagers observed by others. Our findings of maximum alcohol users being illiterate and of low education group one in conformity with field surveys conducted by others.6 Married group had higher prevalence of alcohol use as compared to unmarried and widowers/ separated in conformity with published literature6. This may probably due to stress and strains of married life. Most (82.3%) of occasional drinkers consumed 1-2 standard drinks in contrast to their counterpart regular users among those 30.8% consumed 1-2 drinks, 27.4% consumed 3-4 drinks and 41.8% consumed 5 or more drinks per drinking session. Most of the alcohol users (53.3%) consumed local home beverages, 34.3% consumed Indian Desi, 9.7% IMF Whisky/Rum/Brandy/Gin and 2.6% consumed Wine/ other liquors. Singh 6 also reported high rate (60.0%) of illicit consumption in rural area of Punjab. Majority of individuals (73.1%) consumed alcohol with friends, 12.1% all alone and with family members each and 2.6% with other groups (table 8). Similarly Singh et al4 also found that 71.8% consumed alcohol with some company and 28.2% individuals preferred to have drink all alone.

References

  1. WHO Problems related to alcohol consumption, Technical Report Series 1980; 650: 10-16.
  2. WHO. Measurements of levels of health. WHO Regional Publication European Sr. No.7, Copenhegan. 1979; 7:116.
  3. Mayfield D, McLeod G, Hall P. The CAGE questionnaire: validation of a new alcohol-screening test. American J Psychiatry, 1974; 131:1121-1123.
  4. Singh J, Singh G, Mohan V, Padda AS. A comparative study of prevalence of alcohol users among the male individuals in an urban and rural area of district Amritsar, Punjab. Indian J Community Med. 2000; 25:73-78.
  5. Hazra A, Jayaram J, Chaudhury S, Banerjee A, Vaz LS. Industrial Psychiatry J 2002; 2:123-127.
  6. Singh G. Epidemiology of alcohol use in India. In: Ray R, Pickens RW (Editorial), Proceedings of Indo - US Symposium on alcohol and drug abuse. NIMHNS Bangalore Publication; No. 20, 1989: pp 3-11.

1. Deptt. of PSM, Armed Forces Medical College, Pune-411040.
2. Headquarters, 5 Mountain Division (Medical Branch) C/O 99 APO.
E-mail: [email protected]
Received: 18.12.2003

Access free medical resources from Wiley-Blackwell now!

About Indmedica - Conditions of Usage - Advertise On Indmedica - Contact Us

Copyright © 2005 Indmedica