Table of Contents  
ORIGINAL ARTICLE
Year : 2015  |  Volume : 8  |  Issue : 2  |  Page : 165-168  

A cross-sectional study to determine the pattern, health-related problems and social aspects associated with alcohol use among adults of the rural population in Pune, Maharashtra


1 DADH, HQ 5 Mountain Division, C/O 99 APO, India
2 Department of Community Medicine, Armed Forces Medical College, Pune, Maharashtra, India
3 DADH, HQ 17 Mountain Division, C/O 99 APO, India
4 DMS (Health), Dte of Med Services (Air), Air HQ, RK Puram, West Block-6, New Delhi, India
5 DADH, HQ 25 Infantry Division, C/O 56 APO, India
6 DADH, HQ 71 Infantry Division, C/O 99 APO, India

Date of Web Publication13-Mar-2015

Correspondence Address:
Vijaykumar K More
DADH, HQ 5 Mountain Division. C/O 99 APO. PIN-908405
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.153148

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  Abstract 

Background: The increasing production, distribution, promotion and easy availability of alcohol have resulted in alcohol-related problems emerging as a major public health concern. It is a causal factor in more than 60 major types of diseases and injuries and results in approximately 2.5 million deaths each year. It is also a known risk factor for increasing crime, work absenteeism, loss of productivity, damage to property and physical and emotional abuse of women and children. Objectives: The aim was to find out the pattern, health related problems and social aspects associated with alcohol use among adults of a rural population of Pune, Maharashtra. Materials and Methods: A cross-sectional study was carried out in a rural field practice area of the Medical College in Pune among 300 respondents during January 12 and February 12. Pretested WHO designed alcohol survey questionnaire was used for collecting data by interview after obtaining informed consent. Results: Out of 300 respondents 45.7% (137) were found to be alcohol-user. Among these 35.77% were "daily drinkers.' The most common alcoholic drink consumed was desi (country) liquor (33.5%). Daily drinking was found to be related to adverse health related events. Poor health status, deprivation of family, increasing occurrence of unintentional and intentional injury, the greater extent of health problems were significantly higher among users. Conclusion: Alcohol consumption was high among adults in rural population. The study has also revealed negative impact of alcohol on both, user and their family.

Keywords: Alcohol use, health problems, India, rural, social aspects


How to cite this article:
More VK, Ray S, Kunte R, Pandya K, Katoch S, Patel BB. A cross-sectional study to determine the pattern, health-related problems and social aspects associated with alcohol use among adults of the rural population in Pune, Maharashtra. Med J DY Patil Univ 2015;8:165-8

How to cite this URL:
More VK, Ray S, Kunte R, Pandya K, Katoch S, Patel BB. A cross-sectional study to determine the pattern, health-related problems and social aspects associated with alcohol use among adults of the rural population in Pune, Maharashtra. Med J DY Patil Univ [serial online] 2015 [cited 2019 Dec 9];8:165-8. Available from: http://www.mjdrdypu.org/text.asp?2015/8/2/165/153148


  Introduction Top


The increasing production, distribution, promotion and easy availability of alcohol coupled with the changing values of society have resulted in alcohol-related problems emerging as a major public health concern. [1],[2] A broad range of alcohol consumption patterns, from occasional hazardous drinking to daily heavy drinking, creates significant public health problems. Harmful alcohol consumption is risky both for the drinker and for the family members as an intoxicated person can harm others by involving them in traffic accidents or violent behavior or by negatively affecting co-workers, relatives, friends or strangers.

Almost 4% of all deaths worldwide are attributed to alcohol, greater than deaths caused by HIV/AIDS, violence or tuberculosis. It mostly affects the young people between the age of 15 and 29 resulting in 9% of all deaths in this age group. The hazardous and harmful use of alcohol also impacts workers' productivity. This causes huge financial and psychological burden to families. Perhaps the biggest social impact is crime and violence related to alcohol consumption, which create significant costs for justice and law enforcement sectors. [3],[4] Alcohol-related problems account for more than a fifth of hospital admissions; 18% of psychiatric emergencies; more than 20% of all brain injuries and 60% of all injuries reporting to India's emergency rooms. The role of alcohol in domestic violence is substantial: A third of violent husbands drink, according to a WHO study. Most of the violence took place during intoxication. [5],[6],[7]

A recent Lancet study [5] found that sales of alcohol in India have seen a growth rate of 8% in the past 3 years. Officially though, Indians are still among the world's lowest consumers of alcohol - Government statistics shows only 21% of adult men and around 2% of women drink. But up to a fifth of this group - About 14 million people - Are dependent drinkers requiring "help".

Keeping this background in mind, this study was conducted with the aim to study the pattern, health related problems and social aspects associated with alcohol use among adults of a rural population in Maharashtra.


  Materials and Methods Top


A cross-sectional study was carried out at a rural area. Alcohol use was considered to be the outcome variable. Only one user from each household was taken, and if woman is user, she was taken in the study. Households were selected by systemic random sampling (k = 3). If any household was found locked, the neighboring household was taken. Some persons who were under influence of alcohol during survey refused to participate and were excluded from study. History of spouse abuse was not answered by some participants and in these cases; we took the history from the family members. WHO designed Alcohol Survey Questionnaire [1] pilot tested in the rural setting, was used after suitable modification, and after obtaining informed consent and interview technique was used. Part 1 was exclusively for alcohol-user and Part 2 for all respondents. Part 1 focused on obtaining information pertaining to the use of alcohol in the past 12 months (type, duration, frequency, amount spent), and context of drinking (with whom, when and what happened). Part 2 focused on eight components: Status and details of physical health, details about both unintentional and intentional injury (suicide, abuse of spouse), social aspects (staying away from home-may not return home after alcohol consumption etc.), occupation-related issues (absenteeism, working under the influence of alcohol, losing pay, borrowing money, etc.), economic aspects (difficulty in undertaking routine activities, bad practices such as gambling, etc.), emotional and psychological aspects (psychological distress, sexual relationships, etc.), legal aspects (police complaints, payment of penalties and fines, etc.), and help-seeking aspects. Alcohol-user was an individual who had consumed alcohol in the past 12 months. Standard definitions for the predictors, as used in the WHO document were used. [1]

The sample size, calculated by taking 30% prevalence [8] of alcohol consumption with 95% level of significance, in a population of 5000, was 302 and with population finite correction, was 285 (Epi Info 7, Epi Info is a trademark of the Centers for Disease Control and Prevention (CDC)).The data was compiled, tabulated and analyzed using SPSS 17.0 version. This product uses WinWrap Basic, Copyright 1993-2007 Polar Engineering and Consulting, http://www.winwrap.com/.


  Results Top


In this study, a total of 300 respondents were interviewed about alcohol use. The mean age of users was 44.60 years (95% confidence interval [CI] = 42.16-47.04) while that of nonusers was 40.90 years (95% CI = 38.58-43.23).133(56.8%) of males and 4 (6.1%) of females were alcohol-user (odds ratio [OR]: 20.4 {95% CI = 7.1-58}, [P < 0.0001]). 91.2% users were in lower socioeconomic status (SES) of Kuppuswamy socioeconomic class while remaining 8.7% were in lower middle SES class (OR: 1.3 [0.6-2.8]) [Table 1]. Majority of the study population were farmers (47.7%) or daily wage earners/daily laborers (22.7%).
Table 1: Association of alcohol use with demographical variables

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Regarding the pattern of drinking, we found that nearly two-third (70%) of the users have been consuming alcohol for more than 5 years. 3.7% were found to have recently started using alcohol (within last 12 months). Almost 35.8% (95% CI = 27.8-44.4) of the study population indulged in regular alcohol-use (every day or nearly every day).Binge drinking (defined as per WHO Bangalore study [1] as consumption of four or more large (60 ml) drinks at one sitting) was practiced by 36 (26.27%) individuals and mostly in the higher age group. Desi (Country) liquor and illicit brew were the first choice for 60.6% of the user population.

Out of 58 individuals who had health problems, significantly more individuals (58.6% vs. 41.4%) were alcohol-user (OR: 1.91 [1.03-3.56], P = 0.02) [Table 2]. Daily drinking was related with health problems like tremors (10.2%), palpitation (5.8%), vomiting/gastritis (5.1%) and headache (2.2%) etc., [Figure 1]. Alcohol was related with unintentional injuries in almost 13.1% users. Only five individuals reported suicidal thoughts and related it to alcohol.

It was also observed that out of 39 (13%) individuals with a history of spouse abuse, 29 (74%) were users, and 10 (26%) were non-users (OR: 4.11 [1.83-9.45], P < 0.001) and the difference was highly significant [Table 2]. 22 users refused to give a history of spouse abuse. Furthermore, high were social issues of running away from home (13.2%) and family members feeling bad (63.5%), which was assessed by history from family members.
Figure 1: Health problems among users

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Table 2: Association of alcohol use with health problems and spouse abuse

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  Discussion Top


The present study showed almost half the population in the village to be alcohol-user (46%) that was more than most of the other studies in India. [6],[8],[9],[10] The study also found that most of the users were more than 30 years old, married farmers and consumed 'Desi' (34.4%) alcohol, followed by illicit brew (26.3%). This was mainly because of the presence of local breweries inside and around the village. Among alcohol-user 36% were 'daily drinkers' and majority were farmers (47.7%) and daily wage laborers (22.7%). Overall, heavy drinking was found to be less in the lower age groups as found in other studies. [7],[10] Daily drinking is related with adverse health-related events. This study has revealed negative impact of alcohol on both the user and their family. More users gave history of health problems due to alcohol consumption when compared to nonusers [Table 2]. Poor health status, deprivation of family, increasing occurrence of unintentional and intentional injury, greater extent of health problems have been found to be higher among users.

The major limitation of the study was that it was conducted in a small village with a population of approximately 5000. However, the findings from our study are strikingly significant. Those users having alcohol problems were counseled and referred to nearest rural hospital for psychological counseling and treatment of the ailments.

We should create an environment in the community that help alcohol-user who want to quit. Awareness should be made of the ill-effects of alcohol use by individual and group discussions through health workers and through the media. Besides health professionals, religious leaders may be powerful agents for influencing change of drinking behaviors in rural areas. Proper legislation to tackle growth of illicit liquor industry is urgently required. Cessation services should be provided to people who are not able to gather sufficient support from outside or within themselves to quit the habit and sustain it.

 
  References Top

1.
Gururaj G, Girish N, Benegal V. Burden and Socio-Economic Impact of Alcohol - The Bangalore Study, WHO, 2006. Available from: http://www.nimhans.kar.nic.in/deaddiction/CAM/The_">http://www.nimhans.kar.nic.in/deaddiction/CAM/The_ Bangalore _Study.pdf. [Last accessed on 2012 Apr 04].  Back to cited text no. 1
    
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Clausen T, Rossow I, Naidoo N, Kowal P. Diverse alcohol drinking patterns in 20 African countries. Addiction 2009;104:1147-54.  Back to cited text no. 2
    
3.
World Health Organization (WHO). Global Status Report on Alcohol and Health, 2011. Available from: http://www.who.int/substance_abuse/publications/global_alcohol_ report/en/index.html. [Last accessed on 2012 Apr 04].  Back to cited text no. 3
    
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Rehm J, Gmel G, Sempos CT, Trevisan M. Alcohol-related morbidity and mortality. Alcohol Res Health 2003;27:39-51.  Back to cited text no. 4
    
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Prasad R. Alcohol use on the rise in India. Lancet 2009;373:17-8.  Back to cited text no. 5
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Henderson A, Langston V, Greenberg N. Alcohol misuse in the Royal Navy. Occup Med (Lond) 2009;59:25-31.   Back to cited text no. 6
    
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Benegal V, Gururaj G, Murthy P. Report on a WHO Collaborative project on unrecorded consumption of Alcohol in Karnataka, India. Available from: http://www.nimhans.kar. nic.indeaddictionCAMUNDOC_Cover___Index.pdf. [Last accessed on 2012 May 06].   Back to cited text no. 7
    
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National Health and Family Survey, NFHS 3: National final report. Available from: http://www.nfhs india.org/nfhs3.html. [Last accessed on 2013 Apr 04].   Back to cited text no. 8
    
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Ray R. The extent, pattern and trend of drug abuse in India: National survey. Ministry of social justice and empowerment, Government of India and United Nations Office on Drugs and Crime; 2004.   Back to cited text no. 9
    
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Girish N, Kavita R, Gururaj G, Benegal V. Alcohol use and implications for public health: patterns of use in four communities. Indian J Community Med 2010;35:238-44.  Back to cited text no. 10
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