Byline: Kinley. Wangdi, Tshering. Jamtsho
Background: Alcohol-related ailments are among the 10 leading causes of morbidity and mortality in Bhutan. The objectives of this article were to determine the prevalence and explore the correlates of current alcohol use among Bhutanese adults. Materials and Methods: This is a retrospective study of secondary data from the National Health Survey 2012 of Bhutan. The outcome variable of interest was current alcohol use. The questionnaire was developed following the World Health Organization (WHO) STEPwise approach to Surveillance (STEPS) of noncommunicable diseases. Univariate and multivariate logistic regression was performed to identify the correlates of current alcohol use. The prevalence of current alcohol use was 30.9%. The correlates of current alcohol use were male sex [adjusted odds ratio (AOR) = 1.85; 95% confidence interval (CI) 1.47-2.36], widowhood (AOR = 2.92, 95% CI, 1.22-6.99), and chewing betel quid >20 times per week (AOR = 2.07, 95% CI, 1.08-4.03). Primary (AOR = 0.67, 95% CI, 0.50-0.91), high (AOR = 0.52, 95% CI, 0.38-0.71), and university (AOR = 0.46, 95% CI, 0.29-0.73) educated participants were less likely to be current alcohol users when compared with those who had no education. Compared with unskilled workers, services and sales workers were less likely to use alcohol regularly (AOR = 0.64, 95% CI, 0.49-0.82). Homemade alcohol Ara was the most common drink. Conclusion: The national prevalence of current alcohol use in Bhutan is higher than the national average in the WHO South-East Asia Region. Prevention should target the correlates and limit the availability of locally home-brewed Ara.
Introduction
Alcohol is a psychoactive substance with dependence-producing properties. The consumption of alcohol and problems related to alcohol vary widely around the world, but the burden of alcohol-related disease and death remains significant in most countries.[1],[2] Harmful use of alcohol ranks among the top five risk factors for disease, disability, and death throughout the world.[3] In 2012, about 3.3 million deaths were attributed to the harmful use of alcohol. This accounts for 5.9% of all deaths worldwide, which surpasses the proportion of deaths from HIV/AIDS (2.8%), violence (0.9%), or tuberculosis (1.7%).[1] Alcohol was responsible for 2.8% of all deaths from cancer, liver cirrhosis, and injury: 1.3% for women and 4.1% for men globally.[4]
Harmful use of alcohol causes direct harm to the liver. It is also an important risk factor for many chronic diseases, notably high blood pressure and other cardiovascular diseases,[5],[6],[7] poor mental health,[8],[9] unsafe driving, and traffic accidents.[10],[11],[12],[13],[14] Around 4.9% of the world's adult population is believed to suffer from alcohol use disorder.[15] Harmful alcohol use stems from regular, heavier drinking, defined as drinking more than 40 g of pure alcohol per day for men and 20 g of pure alcohol per day for women.[16],[17] In addition to the average volume of alcohol consumption, patterns of drinking - especially, irregular heavy-drinking occasions or binge drinking (defined as drinking at least 60 g of pure alcohol or five standard drinks in one sitting) - also result in harmful health impacts.[18]
The negative impact of...